Ascension St. John Medical Center (St. John Medical Center, Inc.)
1923 S Utica Ave, Tulsa, OK · Ascension · · NPI 1154417368
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 |
|---|---|---|---|---|
| Trmt of fracture (femoral shaft) 27500 CPT 27500 | $754.80 | $2,040.00 | $228.18 – $912.72 | 30 |
| Trnscath plc stent crv crtd without prtct CPT 37216 | $2,405.46 | $6,501.25 | $1,238.00 – $1,919.67 | 6 |
| Trnscath plc stent crv crtd w/prtct CPT 37215 | $3,122.06 | $8,438.00 | $1,133.45 – $2,038.04 | 7 |
| Trnscath plc stnt ante carotid art CPT 37218 | $1,337.64 | $3,615.25 | $928.36 – $1,506.75 | 6 |
| Trnscath plc vas stent w/s&i ea addl artery CPT 37237 | $12,816.80 | $34,640.00 | $245.60 – $392.51 | 6 |
| Trnscath plc vas stent w/s&i ea addl vein CPT 37239 | $12,816.80 | $34,640.00 | $173.52 – $274.14 | 6 |
| Trnscath plc vas stent w/s&i ini vein CPT 37238 | $27,826.41 | $75,206.50 | $344.42 – $588.42 | 6 |
| Trnscath retrv pq vasc fb w/guide CPT 37197 | $3,279.96 | $8,864.75 | $346.62 – $582.30 | 6 |
| Trnscath tx thromblytc artery non-intracrn ini day CPT 37211 | $1,601.64 | $4,328.75 | $442.76 – $762.56 | 6 |
| Trnscath tx thromblytc art/ven sbsq day CPT 37213 | $3,242.03 | $8,762.25 | $268.70 – $470.73 | 6 |
| Trnscath tx thromblytc cath rmv sbsq day CPT 37214 | $3,242.03 | $8,762.25 | $141.22 – $274.82 | 6 |
| Trnscath tx thromblytc vein ini day CPT 37212 | $1,380.01 | $3,729.75 | $386.33 – $673.46 | 6 |
| Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm CPT 14301 | not published | not published | $976.30 – $1,645.53 | 6 |
| Trnsfr/rearrngmnt adjcnt tiss defec ea addl 30sqcm/< CPT 14302 | not published | not published | $248.35 – $408.83 | 6 |
| Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/< CPT 14060 | $1,456.14 | $3,935.50 | $740.17 – $1,256.42 | 7 |
| Trnsfr/rearrngmnt adjcnt tiss eye/nose/ear/lip 10.1-30sqcm CPT 14061 | not published | not published | $919.78 – $1,548.26 | 7 |
| Trnsfr/rearrngmnt adjcnt tiss sclp/arm/lg 10.1-30sqcm CPT 14021 | not published | not published | $791.89 – $1,338.74 | 7 |
| Trnsfr/rearrngmnt adjcnt tiss trnk 10.1-30sqcm CPT 14001 | not published | not published | $714.14 – $1,216.29 | 7 |
| Trnsfr/rearrngmnt adjcnt tiss trnk 10sqcm/< CPT 14000 | not published | not published | $536.33 – $935.34 | 7 |
| Troponin quantitative CPT 84484 | $119.05 | $321.75 | $10.42 – $49.88 | 30 |
| Tr retinal les preterm inf CPT 67229 | not published | not published | $521.84 – $2,148.92 | 30 |
| Tte w or without fol w/con,stres HCPCS C8928 | $458.06 | $1,238.00 | $332.68 – $356.45 | 5 |
| Tte w or without fol w/cont, f/u HCPCS C8922 | $941.56 | $2,544.75 | $1,383.82 – $1,383.82 | 5 |
| Tubal Ligation (Laparoscopic) CPT 58670 | not published | not published | $400.77 – $688.41 | 7 |
| Tube trach disp innr can 5 xlt HCPCS A7521 | $128.39 | $347.00 | $91.37 – $91.37 | 1 |
| Tube trach fen sz 6 uncuffed HCPCS A7520 | $1,120.18 | $3,027.50 | $92.23 – $92.23 | 1 |
| Tumor cell deplete of harvst CPT 38211 | not published | not published | $84.57 – $1,663.40 | 30 |
| Tvh >250 gms 58290 CPT 58290 | not published | not published | $1,273.33 – $2,165.91 | 7 |
| Tvh w/mmk 58267 CPT 58267 | not published | not published | $1,160.06 – $1,991.78 | 7 |
| Tx atrial fib pulm vein isol CPT 93656 | $17,899.12 | $48,376.00 | $1,273.90 – $11,094.00 | 7 |
| Tx closed distal humerus fx CPT 24999 | $135.14 | $365.25 | $182.63 – $2,088.18 | 29 |
| Tx closed hip disl traumatic without anes CPT 27250 | $526.79 | $1,423.75 | $205.25 – $912.72 | 30 |
| Tx closed tib fx proximal w/w/o manip w/skel trac CPT 27532 | not published | not published | $622.14 – $1,061.87 | 7 |
| Tx closed tib shaft fx without manip CPT 27750 | $417.27 | $1,127.75 | $228.18 – $912.72 | 30 |
| Tx contour defects >10.0 cc CPT 11954 | not published | not published | $128.04 – $2,329.08 | 30 |
| Tx contour defects 1.1-5.0cc 11951 CPT 11951 | not published | not published | $79.75 – $2,329.08 | 30 |
| Tx ectopic pregnancy abdl pregnancy 59130 CPT 59130 | not published | not published | $1,041.03 – $1,579.55 | 7 |
| Tx ectopic pregnancy ntrstl prtl rescj uter 59136 CPT 59136 | not published | not published | $985.51 – $1,710.15 | 7 |
| Tx l/r atrial fib addl CPT 93657 | $16,109.25 | $43,538.50 | $482.10 – $11,094.00 | 7 |
| Tx open art fx mcp/iphlngl jnt incl int fixtn ea CPT 26746 | $1,679.52 | $4,539.25 | $752.58 – $1,359.14 | 7 |
| Tx open dstl phlngl fx f/t internal fixation ea CPT 26765 | $2,930.49 | $7,920.25 | $495.49 – $919.02 | 7 |
| Tx open iphlngl jt disl internal fixation sngl CPT 26785 | $3,238.80 | $8,753.50 | $541.93 – $1,002.02 | 7 |
| Tx open nsl fx uncomp CPT 21325 | not published | not published | $490.47 – $865.97 | 7 |
| Tx open nsl sptl fx CPT 21336 | not published | not published | $678.04 – $1,199.96 | 7 |
| Tx phalangeal shaft fx open prox/middle ea CPT 26735 | $1,391.29 | $3,760.25 | $611.43 – $1,094.52 | 7 |
| Tx septic abortion surgical 59830 CPT 59830 | not published | not published | $486.31 – $816.30 | 7 |
| Tx tarsal bone fx without manip 28450 CPT 28450 | $376.11 | $1,016.50 | $195.31 – $912.72 | 30 |
| Tympanic membrane repair CPT 69610 | not published | not published | $321.59 – $546.92 | 7 |
| Tympanolysis transcanal 69450 CPT 69450 | not published | not published | $574.77 – $1,023.78 | 7 |
| Tympanometry & reflex thresh CPT 92550 | not published | not published | $23.26 – $595.32 | 29 |
| Tympanostomy/ven tube/loc/top anes 69433 CPT 69433 | not published | not published | $140.19 – $1,937.64 | 30 |
| Tympp antrt/mastoidotomy prosthesis torp 69637 CPT 69637 | not published | not published | $1,484.50 – $2,584.28 | 7 |
| Tympp antrt/mastoid without ossic chain recnst 69635 CPT 69635 | not published | not published | $1,315.55 – $2,297.21 | 7 |
| Ua w/micro/comp poc CPT 81000 | not published | not published | $3.39 – $16.08 | 30 |
| Ugt1a1 gene analy common variants CPT 81350 | not published | not published | $225.39 – $936.00 | 29 |
| Ultrasound abdomen aorta screening study aaa CPT 76706 | not published | not published | $67.19 – $404.60 | 29 |
| Ultrasound bone density measure CPT 76977 | not published | not published | $3.44 – $404.60 | 30 |
| Ultrasound breast complete CPT 76641 | $695.23 | $1,879.00 | $72.22 – $404.60 | 29 |
| Ultrasound breast unilateral limited (both sides) CPT 76642 | $695.23 | $1,879.00 | $55.33 – $335.00 | 29 |
| Ultrasound chest CPT 76604 | $263.90 | $713.25 | $34.35 – $404.60 | 30 |
| Ultrasound doppler velocimetry fetal umbilical artery CPT 76820 | $340.03 | $919.00 | $23.00 – $404.60 | 30 |
| Ultrasound dx ophth b-scan CPT 76512 | $256.50 | $693.25 | $40.25 – $404.60 | 30 |
| Ultrasound elastography ea l target les CPT 76983 | $114.33 | $309.00 | $38.73 – $38.73 | 1 |
| Ultrasound elastography parenchyma CPT 76981 | $114.33 | $309.00 | $80.21 – $404.60 | 24 |
| Ultrasound encephalogram CPT 76506 | $226.26 | $611.50 | $40.47 – $404.60 | 30 |
| Ultrasound exam k transpl w/doppler CPT 76776 | $398.49 | $1,077.00 | $47.67 – $404.60 | 30 |
| Ultrasound fetal biophysical profile without non-stress testing CPT 76819 | $294.06 | $794.75 | $47.35 – $404.60 | 30 |
| Ultrasound guidance for vascular access CPT 76937 | $155.49 | $420.25 | $17.24 – $74.10 | 7 |
| Ultrasound guided needle placement supervision & interpretation CPT 76942 | $289.99 | $783.75 | $28.39 – $416.53 | 7 |
| Ultrasound guide intraoperative CPT 76998 | $193.42 | $522.75 | $75.63 – $136.50 | 6 |
| Ultrasound guide tissue ablation CPT 76940 | not published | not published | $72.39 – $221.52 | 6 |
| Ultrasound hips infant dynamic CPT 76885 | $175.75 | $475.00 | $46.34 – $335.00 | 30 |
| Ultrasound infant hips ltd without stress CPT 76886 | $93.80 | $253.50 | $38.32 – $335.00 | 30 |
| Ultrasound joint complete left CPT 76881 | $205.63 | $555.75 | $88.38 – $404.60 | 29 |
| Ultrasound joint/nonvascular extremity limited left CPT 76882 | $154.75 | $418.25 | $11.51 – $404.60 | 29 |
| Ultrasound nrv&acc strux 1xtr compre CPT 76883 | not published | not published | $101.15 – $404.60 | 23 |
| Ultrasound ob >=14wks ea addl gest CPT 76810 | $192.22 | $519.50 | $44.19 – $203.58 | 7 |
| Ultrasound pregnant uterus < 14 weeks each additional gestation CPT 76802 | $125.34 | $338.75 | $22.63 – $140.40 | 7 |
| Ultrasound pregnant uterus detailed fetal exam single/1st gestation CPT 76811 | $479.89 | $1,297.00 | $87.32 – $919.72 | 30 |
| Ultrasound pregnant uterus follow up per fetus CPT 76816 | $446.22 | $1,206.00 | $52.19 – $404.60 | 30 |
| Ultrasound pregnant uterus limited >= 1 fetuses CPT 76815 | $350.02 | $946.00 | $40.13 – $404.60 | 30 |
| Ultrasound pregnant uterus transvaginal CPT 76817 | $272.04 | $735.25 | $46.01 – $404.60 | 30 |
| Ultrasound prostate/transrectal CPT 76872 | $295.45 | $798.50 | $44.69 – $404.60 | 30 |
| Ultrasound retroperitoneal limited CPT 76775 | $277.13 | $749.00 | $30.19 – $404.60 | 30 |
| Ultrasound scrotum and contents CPT 76870 | $299.15 | $808.50 | $36.65 – $404.60 | 30 |
| Ultrasound spinal canal and contents CPT 76800 | $175.01 | $473.00 | $60.01 – $404.60 | 30 |
| Ultrasound transabd ea addl gest CPT 76812 | $137.55 | $371.75 | $108.53 – $443.83 | 7 |
| Ultrasound transvaginal non obstetric CPT 76830 | $378.88 | $1,024.00 | $42.80 – $404.60 | 30 |
| Ultrasound trgt dyn mbubb 1st les CPT 76978 | not published | not published | $169.34 – $677.36 | 28 |
| Ultraviolet therapy CPT 97028 | not published | not published | $7.23 – $29.84 | 30 |
| Umbilical artery cath newborn 36660 CPT 36660 | $293.78 | $794.00 | $82.11 – $138.09 | 7 |
| Umbilical cord occlud w/us CPT 59072 | not published | not published | $289.35 – $1,157.40 | 30 |
| Umbilicoplasty 15847 CPT 15847 | not published | not published | $518.35 – $1,557.00 | 6 |
| Unlistd noninvas vasc dx std CPT 93998 | not published | not published | $23.30 – $296.90 | 28 |
| Unlisted all/immlg svc/px CPT 95199 | not published | not published | $23.30 – $450.75 | 28 |
| Unlisted chemotherapy px CPT 96549 | not published | not published | $43.89 – $175.56 | 28 |
| Unlisted cranfcl&maxlfcl px CPT 21299 | not published | not published | $220.89 – $3,867.85 | 29 |
| Unlisted CT procedure CPT 76497 | not published | not published | $83.75 – $335.00 | 28 |
| Unlisted cv px dx nuc med CPT 78499 | not published | not published | $40.00 – $1,528.92 | 28 |
| Unlisted cytogenetic study CPT 88299 | not published | not published | $50.82 – $203.28 | 28 |
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.