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
Ureter endoscopy & biopsy CPT 50955 not published not published $399.76 – $674.81 7
Ureter endoscopy & biopsy CPT 50974 not published not published $536.97 – $876.17 7
Ureter endoscopy & catheter CPT 50972 not published not published $406.18 – $663.93 7
Ureter endoscopy & treatment CPT 50957 not published not published $402.47 – $656.45 7
Ureter endoscopy & treatment CPT 50961 not published not published $359.70 – $587.73 7
Ureter endoscopy & treatment CPT 50976 not published not published $529.50 – $863.93 7
Ureter endoscopy & treatment CPT 50980 not published not published $403.83 – $659.16 7
Ureteroneocystostomy 50780 CPT 50780 not published not published $1,247.82 – $2,044.83 7
Ureteroureterostomy 50760 CPT 50760 not published not published $1,266.90 – $2,088.38 7
Urethrcystgrphy rtrgrde s&i CPT 74450 $257.15 $695.00 $21.24 – $919.72 29
Urethrlys transvag with scope CPT 53500 not published not published $839.60 – $1,388.39 7
Urethrocystography void s&i CPT 74455 $269.36 $728.00 $21.24 – $919.72 30
Uric acid blood CPT 84550 $25.25 $68.25 $4.52 – $18.08 30
Uric acid urine CPT 84560 $23.59 $63.75 $4.95 – $20.32 30
Urinalysis microscopic only CPT 81015 $22.57 $61.00 $3.05 – $12.20 30
Urinalysis qual/semiquant excpt ia CPT 81005 not published not published $2.17 – $8.68 30
Urinalysis (with microscopy) CPT 81001 $33.02 $89.25 $3.17 – $12.68 30
Urinalysis (without microscopy) CPT 81003 $21.46 $58.00 $2.25 – $9.00 30
Urinary bldr retent nuc study CPT 78730 not published not published $10.81 – $117.69 7
Urinary reflex study CPT 51792 not published not published $56.50 – $226.00 30
Urine Culture Test CPT 87086 $47.82 $129.25 $8.07 – $32.28 30
Urine flow measurement 51736 CPT 51736 not published not published $7.20 – $490.44 30
Urine pregnancy test CPT 81025 $27.01 $73.00 $6.78 – $34.44 30
Urography, antegrade CPT 74425 $297.67 $804.50 $23.05 – $1,358.84 30
Urography inf drip &/or bolus CPT 74410 $292.12 $789.50 $31.13 – $677.36 30
Use 1st target lesion CPT 76982 $114.33 $309.00 $72.19 – $404.60 24
Ustekinumab 130 mg/26 ml intravenous solution HCPCS J3358 $133.50 $360.80 $17.57 – $18.83 5
Vaccine dtap < 7 years im CPT 90700 $51.45 $139.05 $22.15 – $28.63 6
Vaccine dtap-hep b-ipv im CPT 90723 $128.52 $347.35 $75.19 – $97.49 6
Vaccine dtap-ipv 4-6 years im CPT 90696 not published not published $66.06 – $66.06 5
Vaccine dtap-ipv/hib im CPT 90698 not published not published $72.91 – $110.98 6
Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im CPT 90647 not published not published $23.34 – $31.49 6
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im CPT 90648 $50.17 $135.60 $22.83 – $36.28 6
Vaccine hepatitis a (hepa) adult im CPT 90632 not published not published $45.55 – $79.14 6
Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im CPT 90636 $166.00 $448.65 $86.54 – $128.31 6
Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im CPT 90633 not published not published $23.94 – $39.80 6
Vaccine hepatitis a (hepa) pediatric/adolescent 3 dose im CPT 90634 not published not published $132.44 – $132.44 5
Vaccine hepatitis b (hepb) adolescent 2 dose im CPT 90743 not published not published $50.44 – $73.38 6
Vaccine hepatitis b (hepb) adult 3 dose im CPT 90746 $88.52 $239.25 $51.79 – $65.17 6
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 $35.61 $96.25 $26.64 – $29.55 6
Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im CPT 90649 not published not published $143.59 – $195.59 6
Vaccine influenza (iiv) preservative free antigen content im CPT 90662 not published not published $34.75 – $34.75 5
Vaccine influenza nos 0.5ml dose im CPT 90658 not published not published $12.51 – $14.70 6
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im CPT 90656 not published not published $12.54 – $13.03 6
Vaccine influenza quadrivalent (iiv4) 0.5ml dose im CPT 90688 not published not published $18.39 – $18.39 5
Vaccine influenza quadrivalent (iiv4) preservative free 0.25ml dose im CPT 90685 not published not published $25.35 – $25.35 5
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im CPT 90686 $37.06 $100.15 $19.63 – $19.63 5
Vaccine influenza quadrivalent live (laiv4) intranasal CPT 90672 not published not published $26.85 – $26.85 5
Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im CPT 90661 not published not published $22.56 – $22.56 5
Vaccine influenza trivalent (iiv3) 0.25ml dose im CPT 90657 not published not published $5.68 – $7.34 6
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im CPT 90734 $160.73 $434.40 $114.68 – $156.89 6
Vaccine mmr live subcutaneous CPT 90707 $115.29 $311.60 $51.74 – $77.56 6
Vaccine mmrv live subcutaneous CPT 90710 not published not published $141.78 – $215.07 6
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im CPT 90732 $150.79 $407.55 $41.37 – $94.96 6
Vaccine pneumococcal conjugate 13 valent (pcv13) im CPT 90670 $270.03 $729.80 $187.84 – $364.90 6
Vaccine polio (ipv) subcutaneous/im CPT 90713 $54.70 $147.85 $30.48 – $37.99 6
Vaccine rabies im CPT 90675 $595.40 $1,609.20 $154.89 – $1,270.68 29
Vaccine rotavirus attenuated (rv1) live 2 dose oral CPT 90681 not published not published $148.03 – $148.03 5
Vaccine rotavirus pentavalent (rv5) live 3 dose oral CPT 90680 not published not published $76.54 – $104.42 6
Vaccine tdap >=7 years im CPT 90715 $61.66 $166.65 $37.03 – $51.70 6
Vaccine td preservative free >= 7 years im CPT 90714 $53.22 $143.85 $20.04 – $25.89 6
Vaccine typhoid vicps im CPT 90691 not published not published $43.61 – $65.60 6
Vaccine varicella live subcutaneous CPT 90716 not published not published $89.79 – $130.76 6
Vaccine yellow fever live subcutaneous CPT 90717 not published not published $59.49 – $253.36 6
Vaccinia vrs vac 0.3 ml perq CPT 90622 not published not published $0.01 – $0.04 23
Vag hys/<250g/rmv tube/rpr entero 58263 CPT 58263 not published not published $1,093.52 – $1,870.01 7
Vag hyst incl t/o complex CPT 58291 not published not published $1,374.34 – $2,356.38 7
Vag hyst including t/o CPT 58262 not published not published $1,018.61 – $1,740.77 7
Vag hyst t/o & repair compl CPT 58292 not published not published $1,449.61 – $2,484.96 7
Vag hyst w/enterocele compl 58294 CPT 58294 not published not published $1,344.54 – $2,304.69 7
Vag hyst w/enterocele repair CPT 58270 not published not published $974.87 – $1,663.22 7
Vag hyst w/uro repair compl 58293 CPT 58293 not published not published $1,509.04 – $2,584.95 7
Vaginal bx CPT 58999 not published not published $191.36 – $5,962.15 28
Vaginal delivery after cesarean delivery 59612 CPT 59612 not published not published $1,005.20 – $1,725.80 7
Vaginal Delivery (full care) CPT 59400 not published not published $2,004.50 – $4,496.82 7
Vaginal hysterectomy CPT 58260 not published not published $912.10 – $1,560.50 7
Vaginectomy partial w/nodes CPT 57109 not published not published $1,849.63 – $3,110.10 7
Vagotomy pfrmd w/prtl dstl gstrct 43635 CPT 43635 not published not published $128.04 – $208.16 7
Vagotomy & pylorus repair 43640 CPT 43640 not published not published $1,277.94 – $2,186.33 7
Valproic acid total therapeutic drug level CPT 80164 $53.00 $143.25 $13.54 – $54.16 30
Valvuloplasty aortic CPT 92986 $7,020.01 $18,973.00 $1,491.31 – $2,472.71 7
Valvuloplasty mitral CPT 92987 $6,699.13 $18,105.75 $1,539.36 – $2,558.42 7
Valvuloplasty pulmonary CPT 92990 not published not published $1,225.87 – $2,004.69 7
Valvuloplasty/tv without ring insert 33463 CPT 33463 not published not published $3,506.73 – $5,852.87 7
Valvuloplasty/tv w/ring insertion 33464 CPT 33464 not published not published $2,768.26 – $4,637.27 7
Vancomycin peak therapeutic drug level CPT 80202 $90.84 $245.50 $13.54 – $54.16 30
Vanomycin dna amp probe CPT 87500 not published not published $35.09 – $140.36 30
Varicella zoster antibody igg CPT 86787 $128.11 $346.25 $12.88 – $51.52 30
Varicella-zoster immue globin im CPT 90396 not published not published $808.86 – $808.86 5
Vasc graft into carpal bone CPT 25430 not published not published $773.78 – $1,308.80 7
Vasectomy CPT 55250 not published not published $252.89 – $416.31 7
Vbac delivery 59610 CPT 59610 not published not published $2,110.97 – $4,108.71 7
Vbac/include postpartum care 59614 CPT 59614 not published not published $1,124.15 – $2,145.51 7
Vedolizumab 300 mg intravenous solution HCPCS J3380 $50.88 $137.50 $22.95 – $24.59 5
Veeg cont 2-12 hrs CPT 95713 not published not published $504.72 – $2,018.88 23
Veeg ea 12-26hr cont mntr CPT 95716 not published not published $967.76 – $3,871.04 23
Veeg intrmnt 2-12 hrs CPT 95712 not published not published $296.21 – $1,184.84 23
Veeg unmon 12-26 hrs CPT 95714 not published not published $504.72 – $2,018.88 23
Veeg unmon 2-12 hrs CPT 95711 not published not published $296.21 – $1,184.84 23
Vein bypass grft fem-popliteal 35583 CPT 35583 not published not published $1,664.57 – $2,804.00 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.