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 |
|---|---|---|---|---|
| Biopsy of testis CPT 54505 | not published | not published | $234.83 – $386.39 | 7 |
| Biopsy of toe joint lining CPT 28054 | not published | not published | $265.98 – $440.81 | 7 |
| Biopsy of upper nose/throat CPT 42804 | not published | not published | $123.47 – $214.28 | 7 |
| Biopsy of urethra CPT 53200 | $2,396.58 | $6,477.25 | $160.69 – $262.58 | 7 |
| Biopsy of wrist joint CPT 25100 | not published | not published | $366.57 – $633.99 | 7 |
| Biopsy oocyte polar body CPT 89291 | not published | not published | $163.00 – $2,979.04 | 28 |
| Biopsy oocyte polar body <=5 CPT 89290 | not published | not published | $163.00 – $2,497.44 | 28 |
| Biopsy/removal lymph nodes CPT 38525 | not published | not published | $459.94 – $808.14 | 7 |
| Biopsy/removal lymph nodes 38520 CPT 38520 | not published | not published | $507.18 – $865.28 | 7 |
| Biopsy renal percutaneous trocar/needle (both sides) CPT 50200 | $1,141.82 | $3,086.00 | $146.35 – $268.70 | 7 |
| Biopsy roof of mouth CPT 42100 | not published | not published | $117.99 – $206.79 | 7 |
| Biopsy skin incisional single lesion CPT 11106 | not published | not published | $582.27 – $2,329.08 | 23 |
| Biopsy/soft tissue/neck or thorax 21550 CPT 21550 | $916.68 | $2,477.50 | $172.77 – $292.52 | 7 |
| Biopsy thigh soft tissues CPT 27324 | not published | not published | $412.36 – $725.82 | 7 |
| Biopsy tongue anterior two-thirds CPT 41100 | not published | not published | $119.40 – $1,937.64 | 30 |
| Biopsy vaginal mucosa xtnsv CPT 57105 | not published | not published | $138.25 – $234.00 | 7 |
| Biopsy vestibule of mouth 40808 CPT 40808 | not published | not published | $112.26 – $1,937.64 | 30 |
| Biopsy vrt bdy open lmbr/crv CPT 20251 | not published | not published | $459.61 – $770.73 | 7 |
| Biopsy vrt bdy open thoracic CPT 20250 | not published | not published | $414.60 – $713.58 | 7 |
| Biospy of bladder CPT 53899 | not published | not published | $231.35 – $4,283.31 | 29 |
| Biotinidase - quest CPT 82261 | $78.26 | $211.50 | $16.87 – $67.48 | 30 |
| Bis xtracell fluid analysis CPT 93702 | not published | not published | $125.39 – $595.32 | 29 |
| Bivalirudin HCPCS J0583 | $634.79 | $1,715.65 | $8.63 – $8.63 | 5 |
| Bladder irrigate/lavage/instill 51700 CPT 51700 | $188.15 | $508.50 | $40.29 – $925.40 | 30 |
| Bld exchange truj oth thn nb CPT 36455 | not published | not published | $145.33 – $1,663.40 | 30 |
| Bld prd mix CPT 86965 | $61.98 | $167.50 | $13.55 – $652.00 | 29 |
| Bld push tfuj 2 yr/< CPT 36440 | not published | not published | $61.46 – $1,663.40 | 30 |
| Bleomycin 15 unit solution for injection HCPCS J9040 | $176.86 | $478.00 | $46.95 – $46.95 | 5 |
| Blepharoplasty lower 15820 CPT 15820 | not published | not published | $513.70 – $976.16 | 7 |
| Blepharoplasty upper 15822 CPT 15822 | not published | not published | $392.51 – $736.71 | 7 |
| Blepharoplasty upper eyelid 15823 CPT 15823 | not published | not published | $588.21 – $1,038.06 | 7 |
| Blepharp lwr eyelid fat pad CPT 15821 | not published | not published | $545.88 – $1,030.58 | 7 |
| Blinatumomab 35 mcg intravenous solution HCPCS J9039 | $211.38 | $571.30 | $136.07 – $145.79 | 5 |
| Blink reflex test CPT 95933 | $95.74 | $258.75 | $36.44 – $226.00 | 30 |
| Blm gene CPT 81209 | not published | not published | $39.31 – $164.47 | 29 |
| Block brachial plexus w/cath plmt w/img CPT 64416 | $1,644.28 | $4,444.00 | $89.99 – $3,387.44 | 30 |
| Block femoral nerve cont infusion cath w/img CPT 64448 | not published | not published | $81.22 – $3,387.44 | 30 |
| Block paracervical nrv CPT 64435 | not published | not published | $92.60 – $2,634.96 | 30 |
| Block plantar digital nerve CPT 64455 | not published | not published | $39.58 – $1,123.16 | 30 |
| Block tap inj(s) w/wo img bi CPT 64488 | not published | not published | $83.97 – $268.02 | 6 |
| Block tap inj(s) w/wo img uni CPT 64486 | not published | not published | $70.52 – $217.68 | 6 |
| Blood Clotting (PT/INR) Test CPT 85610 | $29.60 | $80.00 | $4.17 – $17.16 | 30 |
| Blood Clotting (PTT) Test CPT 85730 | $22.11 | $59.75 | $6.01 – $24.04 | 30 |
| Blood Count (CBC) Test CPT 85025 | $45.33 | $122.50 | $7.77 – $31.08 | 30 |
| Blood Count (CBC) Test (without differential) CPT 85027 | $29.60 | $80.00 | $6.47 – $25.88 | 30 |
| Blood count spun microhematocrit CPT 85013 | not published | not published | $2.61 – $28.00 | 30 |
| Blood Culture Test CPT 87040 | $61.70 | $166.75 | $10.32 – $41.28 | 30 |
| Blood draw capillary 36416 CPT 36416 | $7.68 | $20.75 | $5.17 – $6.97 | 6 |
| Blood gases o2 saturation direct measurement CPT 82805 | not published | not published | $29.97 – $315.08 | 30 |
| Blood gases ph venous CPT 82800 | $32.93 | $89.00 | $8.86 – $44.00 | 30 |
| Blood occult fecal hemoglobin immunoassay qualitative 1-3 simultaneous determinations diagnostic CPT 82274 | $58.28 | $157.50 | $15.92 – $63.68 | 30 |
| Blood occult feces 1-3 determinations other than neoplasm screening qualitative CPT 82272 | $20.17 | $54.50 | $3.39 – $16.92 | 30 |
| Blood occult feces colorectal neoplasm screening qualitative CPT 82270 | not published | not published | $3.39 – $17.52 | 30 |
| Blood occult peroxidase activity qualitative gastric CPT 82271 | $24.98 | $67.50 | $3.39 – $21.28 | 30 |
| Blood smear interpretation CPT 85060 | not published | not published | $18.09 – $52.25 | 7 |
| Blood smear microscopic w manual differential wbc count CPT 85007 | $32.47 | $87.75 | $3.65 – $15.20 | 30 |
| Blood typing abo CPT 86900 | $37.56 | $101.50 | $3.13 – $490.44 | 30 |
| Blood typing ag donor ea ag CPT 86902 | $64.29 | $173.75 | $5.96 – $1,368.68 | 29 |
| Blood typing patient serum CPT 86904 | not published | not published | $9.90 – $226.00 | 30 |
| Blood typing rbc ag non abo/rh ea CPT 86905 | $37.56 | $101.50 | $3.91 – $1,368.68 | 30 |
| Blood typing rh (d) CPT 86901 | $35.98 | $97.25 | $3.13 – $149.36 | 30 |
| Blood typing rh phenotype complete reference CPT 86906 | $42.09 | $113.75 | $8.08 – $149.36 | 30 |
| Blood volume CPT 78122 | not published | not published | $28.46 – $2,048.04 | 30 |
| Bone biopsy open superficial CPT 20240 | $1,491.19 | $4,030.25 | $171.26 – $412.23 | 7 |
| Bone Density Scan (DEXA) CPT 77080 | $109.34 | $295.50 | $12.46 – $404.60 | 30 |
| Bone imaging multiple areas CPT 78305 | $295.17 | $797.75 | $52.05 – $1,528.92 | 30 |
| Bone/joint imaging ltd area CPT 78300 | $378.88 | $1,024.00 | $39.12 – $1,528.92 | 30 |
| Bone marrow;aspiration only 38220 CPT 38220 | $817.05 | $2,208.25 | $69.25 – $112.25 | 7 |
| Bone marrow biopsyneedle/trocar 38221 CPT 38221 | $593.30 | $1,603.50 | $83.90 – $139.46 | 7 |
| Bone marrow harvest allogen CPT 38230 | not published | not published | $222.98 – $384.35 | 7 |
| Bone marrow harvest autolog CPT 38232 | not published | not published | $220.14 – $384.35 | 6 |
| Bone marrow imaging body CPT 78104 | not published | not published | $50.75 – $1,528.92 | 30 |
| Bone marrow imaging ltd CPT 78102 | $350.95 | $948.50 | $34.74 – $1,528.92 | 30 |
| Bone marrow imaging mult CPT 78103 | $395.44 | $1,068.75 | $47.21 – $1,528.92 | 30 |
| Bone marrow interpretation CPT 85097 | not published | not published | $37.66 – $3,108.20 | 30 |
| Bone/skin graft great toe CPT 20973 | not published | not published | $2,794.49 – $5,279.42 | 7 |
| Bone/skin graft metatarsal CPT 20972 | not published | not published | $2,717.81 – $4,146.12 | 7 |
| Bone survey-lead poisoning CPT 77074 | $240.22 | $649.25 | $28.46 – $404.60 | 30 |
| Boot mlti podous univ xlg HCPCS L4396 | $129.59 | $350.25 | $282.66 – $282.66 | 1 |
| Borrelia antibody CPT 86619 | not published | not published | $13.38 – $53.52 | 30 |
| Borrelia burgdorferi (lyme disease) antibody nonspecific CPT 86618 | $64.75 | $175.00 | $17.03 – $68.12 | 30 |
| Borrelia miyamotoi amp prb CPT 87478 | not published | not published | $35.09 – $140.36 | 23 |
| Bortezomib 3.5 mg (2.5 mg/ml) solution for subcutaneous injection HCPCS J9041 | $103.66 | $280.15 | $37.24 – $185.43 | 6 |
| (both sides) smear without diff wbc count CPT 85008 | not published | not published | $3.43 – $13.72 | 30 |
| Bowel imaging CPT 78290 | $314.22 | $849.25 | $43.13 – $1,528.92 | 30 |
| Brace afo lg left 6607 HCPCS L1930 | $596.40 | $1,611.90 | $494.01 – $494.01 | 1 |
| Brace afo spiral prefab HCPCS L1951 | $1,639.32 | $4,430.60 | $1,414.23 – $1,414.23 | 1 |
| Brace ank air stirrup univ HCPCS L4350 | $56.65 | $153.10 | $143.99 – $143.99 | 1 |
| Brace back t-lso custom HCPCS L0486 | $4,753.43 | $12,847.10 | $3,003.44 – $3,003.44 | 1 |
| Brace halo bremer l2830 HCPCS L2830 | $254.62 | $688.15 | $147.14 – $147.14 | 1 |
| Brace knee support neoprene padded open patella med HCPCS L1810 | $169.94 | $459.30 | $167.51 – $167.51 | 1 |
| Brace ortho exos 28-50in sm HCPCS L0637 | $2,413.45 | $6,522.85 | $2,045.84 – $2,045.84 | 1 |
| Brace ortho tlso 2xl 19in strnl y bar wst belt pd shldr HCPCS L0456 | $1,975.62 | $5,339.50 | $1,674.82 – $1,674.82 | 1 |
| Brachioplasty 15836 CPT 15836 | not published | not published | $803.67 – $1,469.34 | 7 |
| Brach/thor cath 1st CPT 36215 | $762.94 | $2,062.00 | $267.61 – $457.82 | 7 |
| Brach/thor cath 2nd CPT 36216 | $749.07 | $2,024.50 | $309.88 – $520.40 | 7 |
| Brach/thor cath 3rd CPT 36217 | $700.32 | $1,892.75 | $368.82 – $623.12 | 7 |
| Brach/thor cath addl CPT 36218 | $369.54 | $998.75 | $59.24 – $99.32 | 7 |
| Brachy source yttrium-90 HCPCS C2616 | $30,277.75 | $81,831.75 | $645.69 – $691.82 | 5 |
| Brachytx isodose complex CPT 77318 | not published | not published | $208.78 – $1,392.84 | 29 |
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.