Visits & medical services prices at Ascension St. John Medical Center

Tulsa, OK · every code in this section with a posted price and a Medicare benchmark.

268 codes. Prices are the hospital's own posted facility charges.

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ProcedureCash priceGross charge× Medicare
Ablation av node (93650) $3,877.79 $10,480.50 0.5×
Administration of prolonged chemotherapy into artery (96425) $156.60 $423.25 0.5×
Airway inhalation treatment (94640) $29.88 $80.75 0.1×
Analyze Neurostim Complex (95972) $183.89 $497 2.0×
Analyze neurostim no prog (95970) $62.72 $169.50 0.5×
Anogenital exam, child (99170) $71.50 $193.25 0.4×
Arrhythmia induction (93618) $1,382.88 $3,737.50 1.2×
Assessment of aphasia (96105) $119.60 $323.25 1.2×
Behavioral and qualitative analysis of voice and resonance (92524) $64.57 $174.50 0.6×
Blink reflex test (95933) $95.74 $258.75 1.7×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $159.01 $429.75 0.4×
Bundle of his recording (93600)
likely a partial charge, not the full procedure
$1,451.97 $3,924.25 0.2×
C motor evoked uppr limbs (95928) $347.80 $940 0.4×
C motor evoked upr&lwr limbs (95939) $200.36 $541.50 0.2×
Car seat/bed test 60 min (94780) $108.97 $294.50 3.0×
Cardiac Stress Tst,Tracing Only (93017) $365.84 $988.75 1.8×
Cardiopulmonary exercise testing (94621) $246.61 $666.50 0.7×
Cardiopulmonary resuscitation (92950) $445.48 $1,204 2.1×
Cardioversion (92960) $357.14 $965.25 0.6×
Cardioversion internal (92961) $678.86 $1,834.75 1.1×
Cath Cath Place/Coronary Angio, Img Super/Interp, Bypass Angio (93455) $4,643.96 $12,551.25 1.5×
Cath Cath Place/Coronary Angio, Img Super/Interp,W Right Heart Cath (93456) $4,001.55 $10,815 1.3×
Cath Perc Clos,Cong Interatrial Commun W/Impl (93580)
unusually low: confirm this is the full procedure
$6,954.34 $18,795.50 0.4×
Cath Place/Coron Angio, Img Super/Interp, Bypass Angio,W L Hrt Ventric (93459) $5,120.80 $13,840 1.6×
Cath Place/Coron Angio, Img Super/Interp,W Left Heart Ventriculography (93458) $5,032.46 $13,601.25 1.6×
Cbt 1st hour (94644) $103.79 $280.50 0.8×
Chemo Hormon Antineopl Sq/Im (96402) $56.89 $153.75 0.8×
Chemo inj subarach/intravent (96542) $132.65 $358.50 0.4×
Chemo IV push addl drug (96411) $76.87 $207.75 1.1×
Chemo Iv Push Sngl Drug (96409) $123.95 $335 0.4×
Chemo prolong 8+ hrs infuse w/pump (96416) $187.13 $505.75 0.6×
Chemother, IV infusion, 1 hr (96413) $246.51 $666.25 0.8×
Chemother, IV infusion, ea add hr (96415) $71.78 $194 1.0×
Chemother,ia infusn tech,<1 hr (96422) $161.88 $437.50 0.5×
Chemother,Ia Push Technique (96420) $110.35 $298.25 0.3×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $65.86 $178 1.0×
Chemotherapy admn intraarterial infusion ea hr (96423) $70.49 $190.50 1.6×
Chemotx Admn Cns Req Spinal Puncture (96450) $248.18 $670.75 0.8×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $77.70 $210 1.1×
Chemotx Admn Pleural Cavity Req&W/Thoracnts (96440) $359.27 $971 1.1×
Chronic care mgmt svcs staff 1st 20 min cal mo (99490) $68.54 $185.25 0.7×
Color/duplex Doppler, complete (93975) $444.65 $1,201.75 1.9×
Color/duplex Doppler, limited (93976) $348.91 $943 3.5×
Complx chron care coord w/o pt vst 1st hr per mo (99487) $86.03 $232.50 0.5×
Cont Gluc Monitoring Patient Provided Equipment (95249) $65.95 $178.25 1.2×
Continuous Glucose Monitoring (95250) $148.56 $401.50 1.2×
Coronary artery angio s&i (93454) $4,344.17 $11,741 1.4×
Cortical mapping 1st hr (95961) $398.77 $1,077.75 0.5×
Cpap initiation and management (94660) $103.69 $280.25 0.5×
Cpt initial (94667) $78.81 $213 0.6×
Critical care (99291) $253.73 $685.75 0.3×
Ctr motor ep std transcrnl motor stimj lwr limbs (95929) $127.28 $344 0.4×
Debridement Open Wound 20 Sq Cm< (97597) $125.71 $339.75 0.7×
Demo &/or eval,pt use,aerosol device (94664) $85.56 $231.25 0.4×
Dialysis other/than hemodialysis 1 phys/qhp eval (90945) $532.43 $1,439 1.3×
Dup-Scan Aorta Ivc Iliac Vascl/Bpgs Complete (93978) $188.52 $509.50 0.8×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $163.45 $441.75 1.6×
Dup-scan artl infl&ven o/f pen vsl compl (93980) $319.22 $862.75 3.2×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $395.99 $1,070.25 1.7×
Dup-scan lxtr art/artl bpgs uni/lmtd study (93926) $294.43 $795.75 2.9×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $358.35 $968.50 1.6×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $280.83 $759 2.8×
Dup-scan xtr veins unilateral/limited study (93971) $385.36 $1,041.50 3.8×
Duplex hemodialysis access (93990) $256.04 $692 2.5×
Duplex scan artl infl&ven o/f hemo compl bi std (93985) $734.64 $1,985.50 3.2×
Duplex scan artl infl&ven o/f hemo compl uni std (93986) $367.32 $992.75 3.7×
Duplex scan extracranial art compl bi study (93880) $347.52 $939.25 1.5×
Echo Heart Xthoracic,Limited (93308) $375.46 $1,014.75 1.6×
Echo transesophageal (93312) $847.95 $2,291.75 1.6×
Echo Transesophageal - Congenital Tee Complete (93315) $855.35 $2,311.75 1.6×
Echo Transthoracic - Congenital Tte Complete (93303) $890.41 $2,406.50 1.7×
Echo Transthoracic - Congenital Tte Limited (93304) $314.69 $850.50 0.6×
EEG awake asleep (95819) $245.31 $663 1.2×
EEG awake drowsy (95816) $245.31 $663 1.2×
EEG coma or sleep only (95822) $245.31 $663 1.2×
Eeg Extended Monitoring 61-119 Minutes (95813) $660.27 $1,784.50 3.2×
EKG (93005) $68.82 $186 1.2×
EKG rhythm strip (93041) $29.14 $78.75 0.5×
Elec alys nstim pls gen smpl sc/perph w/prgrmg (95971) $142.54 $385.25 1.6×
Electroencephalogram Extend Monitoring 41-60 Min (95812) $461.85 $1,248.25 2.2×
EMG cranial nerve bilat (95868) $164.74 $445.25 0.8×
EMG cranial nerve unilat (95867) $149.11 $403 0.7×
EMG four extremities (95864) $310.52 $839.25 2.5×
EMG one extremity (95860) $148.65 $401.75 1.2×
EMG thoracic paraspinal (95869) $93.61 $253 0.5×
EMG three extremities (95863) $157.25 $425 1.3×
EMG two extremities (95861) $280.92 $759.25 2.2×
Endomyocardial biopsy (93505) $3,595.66 $9,718 1.2×
Ep & ablate supravent arrhyt (93653) $17,899.12 $48,376 0.7×
Ep & ablate ventric tachy (93654) $17,004.28 $45,957.50 0.7×
Ep Compre Electrophysiologic Arrhythmia Induction (93620)
unusually low: confirm this is the full procedure
$2,677.04 $7,235.25 0.4×
Ep Compre Electrophysiologic W/O Arrhyt Induction (93619) $6,938.89 $18,753.75 0.9×
Ep Ephys Eval Pacg Cvdfb Prgrmg/Reprgrmg Parameters (93642) $1,251.43 $3,382.25 1.1×
Ep Right Ventricular Recording (93603) $1,382.88 $3,737.50 1.2×
Er level 1 (99281) $23.68 $64 0.3×
Er level ii (99282) $314.96 $851.25 2.1×
Er level iii (99283) $529.47 $1,431 2.0×
Er level IV (99284) $757.95 $2,048.50 1.9×
Er level v (99285) $200.82 $542.75 0.4×
Esophageal recording (93615) $624.56 $1,688 0.5×
Eval&/Fitg Voice Prostc Dev Suplmnt Oral Speec (92597) $106.01 $286.50 1.5×
Evaluation of speech fluency (92521) $76.41 $206.50 0.6×
Evaluation of speech sound production (92522) $68.64 $185.50 0.6×
Evaluation of swallowing function (92610) $88.43 $239 1.0×
Evaluation with prescription of speech-generating alternative (92607) $119.60 $323.25 1.0×
Exhaled Air Analysis (94690) $50.41 $136.25 0.9×
External ECG rec>48hr<7d recording (93242) $19.06 $51.50 0.5×
External ECG rec>7d<15d recording (93246) $31.36 $84.75 0.9×
External Ecg Scanning Analysis Report (93226) $196.10 $530 3.5×
Flow volume loop (94375) $269.36 $728 1.3×
Group Therapeutic Procedures (97150) $32.75 $88.50 1.8×
Hemodialysis (90935) $824.45 $2,228.25 1.2×
Holter Monitor Recording (93225) $121.18 $327.50 0.9×
Icd Device Interrogate (93289) $41.44 $112 1.2×
Immunization Admin (90471) $29.05 $78.50 0.4×
Injection intra arterial (96373) $221.54 $598.75 1.1×
Ins swan ganz bedside (93503) $758.82 $2,050.88 0.5×
Interrog dev eval scrms phys/qhp in person (93291) $16.28 $44 0.6×
Intra Atrial Recording (93602)
likely a partial charge, not the full procedure
$1,575.65 $4,258.50 0.2×
Intra-atrial pacing (93610)
likely a partial charge, not the full procedure
$1,575.65 $4,258.50 0.2×
Intraventricular pacing (93612) $6,938.89 $18,753.75 0.9×
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $100.36 $271.25 1.8×
IV infusion hydration each additional hour (96361) $67.06 $181.25 1.5×
IV infusion hydration initial 31 min-1 hour (96360) $144.67 $391 0.7×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $75.94 $205.25 1.1×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $229.40 $620 1.1×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $67.62 $182.75 1.5×
IV push initial (96374) $84.55 $228.50 0.4×
Low frequency non-thermal us (97610) $182.78 $494 0.9×
Maintenance of spinal canal or brain drug infusion pump (95990) $219.87 $594.25 0.7×
Manual therapy 15 min (97140) $33.95 $91.75 1.2×
Massage 15 min (97124) $19.61 $53 0.7×
Maximum voluntary ventilation (94200) $69.75 $188.50 1.2×
Mechanical chest wall oscillation (94669) $110.08 $297.50 0.5×
Mechanical traction (97012) $23.87 $64.50 1.7×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $26.64 $72 0.8×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $48.29 $130.50 1.3×
Methacholine challenge (94070) $156.51 $423 0.4×
Mnt Group Ea 30 Min (97804) $37 $100 2.2×
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $134.59 $363.75 1.5×
Multiple sleep latency test (95805) $1,166.89 $3,153.75 1.4×
Nasopharyngoscopy (92511) $103.18 $278.88 0.5×
Needle EMG lmtd std musc 1 xtr/non-limb uni/bi (95870) $51.71 $139.75 0.4×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $206.46 $558 1.1×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $249.66 $674.75 0.6×
Nerve conduction studies 13/> studies (95913) $476.56 $1,288 1.3×
Nerve Conduction Studies 3-4 Studies (95908) $230.23 $622.25 1.1×
Nerve Conduction Studies 9-10 Studies (95911) $386.46 $1,044.50 1.1×
Nerve conduction studies; 1-2 studies (95907) $163.26 $441.25 0.8×
Nerve conduction studies; 11-12 studies (95912) $476.56 $1,288 1.3×
Nerve conduction studies; 5-6 studies (95909) $361.12 $976 1.7×
Nerve conduction studies; 7-8 studies (95910) $476.56 $1,288 1.3×
Neuromuscular junction test (95937) $164.74 $445.25 1.3×
Newborn resuscitation (99465) $282.77 $764.25 0.4×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $194.71 $526.25 1.5×
Non-Invasive Physiologic Study Extremity 3 Levls (93923) $280.46 $758 1.4×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $78.07 $211 0.6×
Orthotics mgmt & traing initial enctr ea 15 mins (97760) $34.50 $93.25 0.7×
Osteopathic manipulative tx 1-2 body regions (98925) $25.25 $68.25 1.2×
Osteopathic manipulative tx 3-4 body regions (98926) $34.14 $92.25 1.6×
Osteopathic manipulative tx 5-6 body regions (98927) $47.82 $129.25 2.3×
Ot Community/Work Reintegration Trainj Ea 15 Min (97537) $42.55 $115 1.3×
Ot eval high complex 60 min (97167) $74.56 $201.50 0.7×
Ot eval low complex 30 min (97165) $74.56 $201.50 0.7×
Ot eval mod complex 45 min (97166) $74.56 $201.50 0.7×
Ot Prosthetic Training, Each 15 Min (97761) $28.77 $77.75 0.7×
Ot re-eval est plan care (97168) $38.30 $103.50 0.6×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $111.46 $301.25 0.9×
Outpatient cardiac rehab w/o cont ECG monitor (93797) $85.93 $232.25 0.7×
Paraffin bath (97018) $17.58 $47.50 2.9×
Peripheral arterial disease rehab per session (93668) $53.65 $145 0.9×
Perq transcath closure pda (93582) $43,742.23 $118,222.25 2.5×
Perq Transcath Cls Mitral (93590) $12,589.07 $34,024.50 0.7×
Plethysmography (94726) $104.16 $281.50 0.3×
Pm device eval in person (93288) $39.59 $107 1.1×
Pm device progr eval dual (93280) $39.59 $107 1.1×
Pm device progr eval multi (93281) $41.44 $112 1.2×
Pm device progr eval sngl (93279) $39.59 $107 1.1×
Pm/Icd Remote Tech Serv (93296) $29.42 $79.50 0.8×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $2,339.60 $6,323.25 2.8×
Prgrmg Eval Implantable Dfb - Cardiac Device Clinic Icd Biv Chamber (93284) $41.44 $112 1.2×
Programming of dual lead implantable defibrillator system (93283) $41.44 $112 1.2×
Programming of single lead implantable defibrillator system (93282) $41.44 $112 1.2×
Prq balloon valvuloplasty aortic valve (92986) $7,020.01 $18,973 1.3×
Prq Balloon Valvuloplasty Mitral Valve (92987) $6,699.13 $18,105.75 0.6×
Prq card revasc chronic 1vsl (92943) $8,878.24 $23,995.25 0.8×
Prq Card Stent W/Angio 1 Vsl (92928) $8,878.24 $23,995.25 0.8×
Prq Card Stent/Ath/Angio (92933) $8,878.24 $23,995.25 0.5×
Prq revasc byp graft 1 vsl (92937) $8,878.24 $23,995.25 0.8×
Prq Tcat Clsr Cgen Ventr Septal Dfct W/Implt (93581)
unusually low: confirm this is the full procedure
$6,954.34 $18,795.50 0.4×
Prq trluml coronary angio/atherect one art/brnch (92924) $12,319.24 $33,295.25 1.1×
Prq trluml coronary angioplasty one art/branch (92920) $5,845.45 $15,798.50 1.1×
Psychiatric diagnostic evaluation (90791) $121.36 $328 0.7×
Pt Aquatic Therapy/Exercises (97113) $40.33 $109 1.1×
Pt Electric Current Therapy (97033) $32.38 $87.50 1.7×
Pt Electrical Stimulation (97032) $25.07 $67.75 1.7×
Pt eval high complex 45 min (97163) $74.56 $201.50 0.8×
Pt eval low complex 20 min (97161) $74.56 $201.50 0.8×
Pt Gait Training Therapy (97116) $30.43 $82.25 1.0×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $31.17 $84.25 1.0×
Pt Physical Performance Test (97750) $44.49 $120.25 1.3×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $74.56 $201.50 0.8×
Pt re-evaluation (97164) $40.89 $110.50 0.6×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $42.55 $115 1.3×
Pt Ultrasound Therapy (97035) $29.05 $78.50 2.0×
Pt Whirlpool Therapy (97022) $36.45 $98.50 2.3×
Pulm Funct Test Oscillometry (94728) $269.36 $728 2.2×
Pulm function test by gas (94727) $89.45 $241.75 0.4×
Pulmonary stress testing (94618) $135.61 $366.50 1.1×
R & l hrt cath w/njx l ventriculog img s&i (93453) $3,531.28 $9,544 1.1×
R & L Hrt Cath Winjx Hrt Art& L Ventr Img (93460) $5,720.94 $15,462 1.8×
R hrt art/grft angio (93457) $4,457.58 $12,047.50 1.4×
R& L Hrt Cath W/Injec Hrt Art/Grft& L Vent I (93461) $5,177.04 $13,992 1.7×
Rapid Desensitization Procedure Each Hour (95180) $412.09 $1,113.75 1.0×
Refill/Maint Pump/Resvr Syst (96522) $111.93 $302.50 0.5×
Refill/maint, portable pump (96521) $122.75 $331.75 0.6×
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $120.81 $326.50 3.4×
Right heart cath (93451) $3,903.59 $10,550.25 1.3×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $112.85 $305 0.6×
Rt Chest Wall Manipulation,Subsequent (94668) $27.47 $74.25 0.2×
Rx Sp-Genratj Augmnt&Comunicaj Dev Ea 30 Min (92608) $59.85 $161.75 1.3×
Sc Ther Infusion Reset Pump (96371) $49.58 $134 0.7×
Sensory Integration Ea 15 Min (97533) $29.42 $79.50 0.5×
Short-latency somatosens ep std lwr limbs (95926) $365.01 $986.50 1.8×
Short-Latency Somatosens Ep Std Trnk/Head (95927) $358.35 $968.50 1.7×
Short-latency somatosens ep std upr limbs (95925) $188.70 $510 0.9×
Sleep study attended (95807) $697.17 $1,884.25 1.9×
Smoking cessation > 10 min (99407) $91.48 $247.25 2.5×
Somatosensory testing (95938) $385.54 $1,042 0.5×
Speech group therapy (92508) $46.62 $126 1.9×
Speech sound lang comprehen (92523) $142.36 $384.75 0.6×
Spirometry (94010) $99.16 $268 0.5×
Standardized Cognitive Performance Testing (96125) $106.28 $287.25 1.0×
Stress echo (93350) $640.10 $1,730 1.2×
Subcut infusion, therap/proph/diagnost,ea add hour (96370) $66.51 $179.75 1.5×
Subcut infusion, therap/proph/diagnost,initial,1st hour (96369) $144.58 $390.75 0.7×
Surfactant Admin Thru Tube (94610) $100.64 $272 0.5×
Temp transcutaneous pacing (92953) $479.43 $1,295.75 0.8×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $27.38 $74 1.2×
Ther Ivntj Cog Funcj Cntct Ea Addl 15 Minutes (97130) $27.38 $74 1.3×
Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) $85.75 $231.75 0.8×
Ther/Proph/Diag Inj Sc/Im (96372) $61.14 $165.25 0.9×
Therapeutic Activities (97530) $34.50 $93.25 1.0×
Therapeutic phlebotomy (99195) $74.83 $202.25 0.6×
Tilt Table Eval (93660) $487.29 $1,317 1.4×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $51.29 $138.62 1.4×
Trans Care Mgmt 14 Day Disch (99495) $149.11 $403 1.2×
Trans Care Mgmt 7 Day Disch (99496) $149.11 $403 1.2×
Transcran Doppler Intracran Art - Transcranial Doppler (93886) $336.61 $909.75 1.5×
Transcranial Doppler Limited (93888) $238.37 $644.25 2.4×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $856.37 $2,314.50 1.6×
Tte W/O Doppler Complete - Tte Complete No Doppler No Color (93307) $535.39 $1,447 2.3×
Tx atrial fib pulm vein isol (93656) $17,899.12 $48,376 0.7×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $66.05 $178.50 0.9×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $87.32 $236 1.0×
Tx/Pro/Dx Inj New Drug Addon (96375) $75.11 $203 1.7×
Unlisted Cardiovascular Service/Procedure (93799) $1,041.32 $2,814.38 8.4×
Unlisted pulmonary service/procedure (94799) $232.27 $11 1.9×
Vasc Duplex Extrem Venous,Bilat (93970) $407.46 $1,101.25 1.8×
Vasc Duplex Scan Extracranial,Limited (93882) $251.05 $678.50 2.5×
Vasc Non-Invasive Lower Extrem Art Stress/Rest, Complete,Bilateral (93924) $278.24 $752 1.3×
Vasopneumatic device (97016) $21.55 $58.25 1.8×
Ventilation assist & mgmt inpatient 1st day (94002) $354.55 $958.25 0.6×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $286.84 $775.25 0.5×
Visual Evoked Potential Test (95930) $452.97 $1,224.25 2.2×
Vital capacity total (94150) $84.92 $229.50 0.7×
Wheelchair Mgmt Ea 15 Min (97542) $29.60 $80 1.0×
Xtrnl Pt Activated Ecg Rec Dwnld 30 Days (93271) $176.86 $478 1.9×