healthcosts.net

Ascension St. John Medical Center (St. John Medical Center, Inc.)

1923 S Utica Ave, Tulsa, OK · Ascension · · NPI 1154417368

Source: hospital's published price file ↗ · Published Jan 1, 2026 · Ingested Sep 8, 2026

Published prices by procedure

Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.

Procedure Cash price Gross charge Negotiated range Payers
Separate eyelid adhesions CPT 68340 not published not published $393.71 – $766.64 7
Sept9 promoter methylation analysis CPT 81327 not published not published $94.97 – $768.00 29
Sequestrectomy olecrn proces CPT 24138 not published not published $714.11 – $1,238.73 7
Sequestrectomy radial h/n CPT 24136 not published not published $651.64 – $1,158.47 7
Sequestrectomy shft/dstl hum CPT 24134 not published not published $821.47 – $1,373.43 7
Serial casting application 97139app CPT 97139 not published not published $29.26 – $31.35 5
Serpina1 gene CPT 81332 $216.27 $584.50 $43.65 – $174.60 29
Set radiation therapy field CPT 77280 $350.76 $948.00 $43.56 – $505.16 30
Set radiation therapy field CPT 77285 $474.62 $1,282.75 $65.05 – $1,392.84 30
Set radiation therapy field CPT 77290 $647.59 $1,750.25 $96.62 – $1,392.84 30
Set-up cardiovert-defibrill CPT 93745 not published not published $285.28 – $1,141.12 28
Sever cranial nerve CPT 64771 not published not published $644.14 – $1,070.04 7
Sex transformation f to m CPT 55980 not published not published $7,210.66 – $7,210.66 5
Sex transformation m to f CPT 55970 not published not published $7,491.83 – $7,491.83 5
Sgmdsc w/band ligation CPT 45350 not published not published $114.59 – $114.59 1
Shave sgl skin lsn f/e/e/n/l/m 0.5cm/< CPT 11310 not published not published $48.55 – $756.04 30
Shave sgl skin lsn f/e/e/n/l/m 0.6-1.0cm CPT 11311 not published not published $71.03 – $756.04 30
Shave sgl skin lsn f/e/e/n/l/m 1.1-2cm CPT 11312 not published not published $81.54 – $1,520.16 30
Shave sgl skin lsn f/e/e/n/l/m >2cm CPT 11313 not published not published $109.18 – $1,520.16 30
Shave sgl skin lsn s/n/h/f/g 0.5cm/< CPT 11305 not published not published $42.64 – $756.04 30
Shave sgl skin lsn s/n/h/f/g 0.6-1.0 cm CPT 11306 not published not published $58.59 – $756.04 30
Shave sgl skin lsn s/n/h/f/g 1.1-2cm CPT 11307 not published not published $75.22 – $756.04 30
Shave sgl skin lsn s/n/h/f/g >2cm CPT 11308 not published not published $83.29 – $1,520.16 30
Shave sgl skin lsn t/a/l 0.5cm/< CPT 11300 not published not published $33.56 – $1,520.16 30
Shave sgl skin lsn t/a/l 0.6-1.0cm CPT 11301 not published not published $56.97 – $756.04 30
Shave sgl skin lsn t/a/l 1.1-2.0cm CPT 11302 not published not published $70.54 – $756.04 30
Shigella antibody CPT 86771 not published not published $13.81 – $97.92 30
Sho arthrs dx +- synovial bx CPT 29805 not published not published $509.35 – $870.05 7
Sho arthrs srg bicp tenodsis CPT 29828 not published not published $1,006.18 – $1,707.44 7
Sho arthrs srg capsulorraphy CPT 29806 not published not published $1,173.66 – $1,959.80 7
Sho arthrs srg compl synvct CPT 29821 not published not published $641.41 – $1,087.04 7
Sho arthrs srg lmtd dbrdmt CPT 29822 not published not published $622.72 – $1,061.19 7
Sho arthrs srg lss&rescj ads CPT 29825 not published not published $634.08 – $1,080.92 7
Sho arthrs srg prtl synvct CPT 29820 not published not published $587.06 – $996.57 7
Sho arthrs srg rmvl loose/fb CPT 29819 not published not published $640.41 – $1,081.61 7
Sho arthrs srg rpr slap les CPT 29807 not published not published $1,144.02 – $1,910.15 7
Sho arthrs srg xtnsv dbrdmt CPT 29823 not published not published $679.63 – $1,158.47 7
Shortening of hand tendon CPT 26479 not published not published $648.11 – $1,113.57 7
Shorten radius or ulna CPT 25390 not published not published $847.20 – $1,412.21 7
Shorten radius & ulna CPT 25392 not published not published $1,126.07 – $1,865.93 7
Shoulder Arthroscopy (Rotator Cuff Repair) CPT 29827 not published not published $1,167.55 – $1,986.33 7
Shoulder MRI (with and without contrast) CPT 73223 $1,070.87 $2,894.25 $134.83 – $1,358.84 30
Shoulder MRI (with contrast) CPT 73222 $1,025.64 $2,772.00 $101.53 – $3,006.08 30
Shoulder MRI (without contrast) CPT 73221 $2,051.28 $5,544.00 $84.59 – $919.72 30
Shoulder prosthesis removal CPT 23334 not published not published $1,190.52 – $1,888.38 6
Shoulder prosthesis removal CPT 23335 not published not published $1,419.81 – $2,254.35 6
Shoulder X-ray CPT 73030 $263.81 $713.00 $11.52 – $335.00 30
Shrinker prosth above knee HCPCS L8460 $157.49 $425.65 $128.24 – $128.24 1
Shrinker prosth below knee HCPCS L8440 $90.54 $244.70 $73.73 – $73.73 1
Shuntogram nonvascular supervision & interpretation CPT 75809 $99.25 $268.25 $29.40 – $404.60 30
Sialidase enzyme assay CPT 87905 not published not published $12.22 – $48.88 30
Sialography s&i CPT 70390 $168.72 $456.00 $23.98 – $919.72 30
Sialolithotomy 42330 CPT 42330 $1,805.60 $4,880.00 $181.48 – $312.24 7
Sickling rbc CPT 85660 $25.81 $69.75 $5.51 – $22.04 30
Sigmoidoscopy and biopsy CPT 45331 not published not published $81.39 – $3,468.96 30
Sigmoidoscopy flex decompression 45337 CPT 45337 not published not published $132.11 – $3,468.96 30
Sigmoidoscopy for bleeding CPT 45334 not published not published $134.11 – $308.16 7
Sigmoidoscopy/submucosal injection 45335 CPT 45335 not published not published $75.17 – $3,468.96 30
Sigmoidoscopy w/ablation CPT 45346 not published not published $183.36 – $351.02 6
Sigmoidoscopy w/fb removal 45332 CPT 45332 not published not published $119.66 – $209.52 7
Sigmoidoscopy w/plcmt stent CPT 45347 not published not published $176.45 – $329.24 6
Sigmoidoscopy w/resection CPT 45349 not published not published $226.72 – $226.72 1
Sigmoidoscopy w/tumr remove CPT 45338 not published not published $137.24 – $265.98 7
Sigmoidoscopy w/ultrasound CPT 45341 not published not published $141.16 – $3,468.96 30
Sigmoidoscopy w/us guide bx CPT 45342 not published not published $193.88 – $449.64 7
Sigmoid/rmv tumor/polyp/hot bx for 45333 CPT 45333 not published not published $106.78 – $3,468.96 30
Signal avg ecg w or without ecg 93278 CPT 93278 not published not published $16.00 – $226.00 30
Sig w/tndsc balloon dilation CPT 45340 not published not published $88.05 – $219.05 7
Simple cystometrogram 51725 CPT 51725 not published not published $97.04 – $925.40 30
Sincalide 5 mcg solution for injection HCPCS J2805 $204.98 $554.00 $92.63 – $92.63 5
Sinus CT scan (with and without contrast) CPT 70488 $786.90 $2,126.75 $89.07 – $677.36 30
Sinus CT scan (with contrast) CPT 70487 $741.48 $2,004.00 $82.24 – $677.36 30
Sinus CT scan (without contrast) CPT 70486 $756.00 $2,043.25 $71.66 – $406.79 30
Sinus/juglr venogram s&i CPT 75860 $2,517.48 $6,804.00 $73.36 – $320.59 7
Sinusotomy maxillary sinus 31020 CPT 31020 not published not published $365.52 – $665.28 7
Sinusotomy sinus remove polyps 31032 CPT 31032 not published not published $610.62 – $1,061.87 7
Sinusotomy sphenoid w/wo bx 31050 CPT 31050 not published not published $518.93 – $898.61 7
Sirolimus, oral HCPCS J7520 $22.20 $60.00 $19.78 – $19.78 5
Skin and muscle repair face CPT 15845 not published not published $1,037.99 – $1,897.22 7
Skin Biopsy CPT 11102 not published not published $189.01 – $756.04 23
Skin full graft 20sq cm less 15200 CPT 15200 not published not published $710.42 – $1,248.95 7
Skin full graft add-on 15241 CPT 15241 not published not published $124.85 – $208.16 7
Skin pedicle flap arms/legs CPT 15572 not published not published $785.88 – $1,372.07 7
Skin pedicle flap trunk CPT 15570 not published not published $777.67 – $1,371.39 7
Skin split graft addl 100sq cm 15101 CPT 15101 not published not published $123.86 – $205.44 7
Skin test unlisted antigen ea CPT 86486 $26.09 $70.50 $3.51 – $93.20 30
Sleep study attended CPT 95807 $697.17 $1,884.25 $99.31 – $2,018.88 30
Sleep Study (Polysomnography) CPT 95810 $2,163.85 $5,848.25 $209.89 – $3,871.04 30
Sleep study unattended CPT 95806 not published not published $100.11 – $595.32 30
Sling arm deluxe w/pad xs HCPCS A4565 $103.58 $279.95 $14.95 – $14.95 1
Slitting of prepuce CPT 54000 not published not published $119.87 – $197.28 7
Slitting of prepuce CPT 54001 not published not published $154.66 – $255.09 7
Slp eval for nonspeech dev ea addl 30 mins CPT 92618 not published not published $36.92 – $60.54 6
Slp eval non-spch gen comm dev CPT 92605 not published not published $99.02 – $164.63 6
Slp pure tone screening CPT 92551 not published not published $11.45 – $21.77 7
Slp stdy unatnd w/anal CPT 95801 not published not published $42.04 – $226.00 29
Slp ther svc non-spch gen CPT 92606 not published not published $79.36 – $131.97 6
Sm-153 lexidron ther HCPCS A9604 $15,695.96 $42,421.50 $6,421.31 – $6,421.31 5
Small bowel endoscopy CPT 44360 not published not published $164.18 – $295.23 7
Small bowel endoscopy CPT 44364 not published not published $233.71 – $414.27 7

A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.