Oncology tissue of origin cost in Oklahoma

ONCOLOGY TISSUE OF ORIGIN · CPT 81504

Hospital City Cash price Negotiated range Payers
SSM Health St. Anthony Hospital - Shawnee Shawnee not published $520.00 – $760.97 8
SSM Health St. Anthony Hospital - Midwest Midwest City not published $520.00 – $1,112.80 8
Ascension St. John Broken Arrow (St. John Broken Arrow, Inc.) Jenks not published $590.20 – $590.20 1
Ascension St. John Sapulpa (St. John Sapulpa, Inc.) Sapulpa not published $58.54 – $590.20 6
Ascension St. John Nowata (Jane Phillips Nowata Hospital, Inc.) Nowata not published $79.86 – $590.20 6
Ascension St. John Jane Phillips (Jane Phillips Memorial Medical Center, Inc.) Bartlesville not published $79.86 – $1,170.00 28
Ascension St. John Owasso (Owasso Medical Facility, Inc.) Owasso not published $62.01 – $1,170.00 28
Ascension St. John Medical Center (St. John Medical Center, Inc.) Tulsa not published $74.21 – $2,080.00 29
SSM Health St. Anthony Hospital - Oklahoma City Oklahoma City not published $468.00 – $1,112.80 10