Visits & medical services prices at Ascension St. John Sapulpa
Sapulpa, OK · every code in this section with a posted price and a Medicare benchmark.
201 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Airway Inhalation Treatment (94640) | $29.88 | $80.75 | 0.1× |
| Airway resistance by oscillometry (94728) | $269.36 | $728 | 2.2× |
| Analyze neurostim complex (95972) | $183.89 | $497 | 2.0× |
| Analyze neurostim no prog (95970) | $62.72 | $169.50 | 0.5× |
| Analyze Neurostim Simple (95971) | $142.54 | $385.25 | 1.6× |
| Anogenital Xm Magnify Child/Suspect Trauma W Img (99170) | $71.50 | $193.25 | 0.4× |
| Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) | $29.05 | $78.50 | 2.0× |
| Assessment of aphasia per hr (96105) | $119.60 | $323.25 | 1.2× |
| Behavral qualit analys voice (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× |
| C motor evoked uppr limbs (95928) | $347.80 | $940 | 0.4× |
| C motor evoked upr&lwr limbs (95939) | $200.36 | $541.50 | 0.2× |
| 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) range across 2 matching MRF lines |
$248.27–$481.09 | $671–$1,300.25 | varies |
| Cardioversion (92960) range across 4 matching MRF lines |
$163.17–$551.12 | $441–$1,489.50 | varies |
| Cbt 1st hour (94644) | $103.79 | $280.50 | 0.8× |
| Chemo Anti-Neopl Sq/Im (96401) range across 3 matching MRF lines |
$55.13–$65.86 | $149–$178 | varies |
| Chemo Hormon Antineopl Sq/Im (96402) | $56.89 | $153.75 | 0.8× |
| Chemo Ia Push (96420) | $110.35 | $298.25 | 0.3× |
| Chemo IV infusion addl hr (96415) | $71.78 | $194 | 1.0× |
| Chemo IV push addl drug (96411) range across 4 matching MRF lines |
$49.21–$76.87 | $133–$207.75 | varies |
| Chemother Prolong Infuse W/Pump (96416) | $187.13 | $505.75 | 0.6× |
| Chemotherapy Admin Intra-Arterial Infus </1 Hr (96422) | $161.88 | $437.50 | 0.5× |
| Chemotherapy Into Cns (96450) | $248.18 | $670.75 | 0.8× |
| Chemotherapy Intracavitary (96440) | $359.27 | $971 | 1.1× |
| Chemotx Admn Ia Nfs >8 Hr Prtble Impltbl Pmp (96425) | $156.60 | $423.25 | 0.5× |
| Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) | $77.70 | $210 | 1.1× |
| Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) | $246.51 | $666.25 | 0.8× |
| Chemotx admn IV push tq 1/1st sbst/drug (96409) range across 4 matching MRF lines |
$85.47–$123.95 | $231–$335 | varies |
| Chemotx Njx Subarachnd/Intraventr Rsvr 1/Mult (96542) | $132.65 | $358.50 | 0.4× |
| Chest Wall Manipulation (94668) | $27.47 | $74.25 | 0.2× |
| Color/duplex Doppler, complete (93975) | $444.65 | $1,201.75 | 1.9× |
| Color/duplex Doppler, limited (93976) | $348.91 | $943 | 3.5× |
| Community/Work Reintegration Trainj Ea 15 Min (97537) | $42.55 | $115 | 1.3× |
| Continuous Pulse Ox (94762) | $78.07 | $211 | 0.6× |
| Cpap Ventilation Cpap Initiation&Mgmt (94660) | $103.69 | $280.25 | 0.5× |
| Cpt initial (94667) | $78.81 | $213 | 0.6× |
| Critical care first hour (99291) range across 6 matching MRF lines |
$241.61–$1,211.94 | $653–$3,275.50 | varies |
| Ctr Motor Ep Std Transcrnl Motor Stimj Lwr Limbs (95929) | $127.28 | $344 | 0.4× |
| Debridement Open Wound 20 Sq Cm< (97597) range across 5 matching MRF lines |
$60.59–$125.71 | $163.75–$339.75 | varies |
| 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 Xtr Veins Complete Bilateral Study (93970) | $407.46 | $1,101.25 | 1.8× |
| Dup-scan xtr veins unilateral/limited study (93971) | $385.36 | $1,041.50 | 3.8× |
| 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 Hemodialysis Access (93990) | $256.04 | $692 | 2.5× |
| Duplex up extrem art bilat (93930) | $358.35 | $968.50 | 1.6× |
| Duplex up extrem art unilat/ltd (93931) | $280.83 | $759 | 2.8× |
| ECG/monitoring and analysis (93271) | $176.86 | $478 | 1.9× |
| Echo Congenital Complete (93303) | $890.41 | $2,406.50 | 1.7× |
| 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× |
| Eeg 41-60 Minutes (95812) | $461.85 | $1,248.25 | 2.2× |
| EEG awake and asleep (95819) | $245.31 | $663 | 1.2× |
| EEG awake drowsy (95816) | $245.31 | $663 | 1.2× |
| EEG extended monitoring 61-119 minutes (95813) | $660.27 | $1,784.50 | 3.2× |
| Eeg Sleep Only (95822) | $245.31 | $663 | 1.2× |
| Electrical Stimulation Ea 15 Min (97032) | $25.07 | $67.75 | 1.7× |
| Electrocardiogram Tracing (93005) | $68.82 | $186 | 1.2× |
| Emergency Dept Visit Level 2 (99282) | $314.96 | $851.25 | 2.1× |
| Emergency Dept Visit Level 3 (99283) | $529.47 | $1,431 | 2.0× |
| Emergency Dept Visit Level 4 (99284) | $757.95 | $2,048.50 | 1.9× |
| Emg 3 Extremities (95863) | $157.25 | $425 | 1.3× |
| Emg 4 Extremities (95864) | $310.52 | $839.25 | 2.5× |
| Er level 1 (99281) range across 7 matching MRF lines |
$22.57–$141.62 | $61–$382.75 | varies |
| Er level v (99285) range across 7 matching MRF lines |
$191.29–$1,152.46 | $517–$3,114.75 | varies |
| Evaluate pt use of inhaler (94664) | $85.56 | $231.25 | 0.4× |
| Evaluate Speech Production (92522) | $68.64 | $185.50 | 0.6× |
| Evaluate Swallowing Function (92610) | $88.43 | $239 | 1.0× |
| Evaluation of speech fluency (92521) | $76.41 | $206.50 | 0.6× |
| 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× |
| Extracranial Bilat Study (93880) | $347.52 | $939.25 | 1.5× |
| Extracranial Uni/Ltd Study (93882) | $251.05 | $678.50 | 2.5× |
| F-up/limited tthrc echo congenital car anomaly (93304) | $314.69 | $850.50 | 0.6× |
| Funcjal Cort&Subcort Mapg Phys/Qhp Attnd Init Hr (95961) | $398.77 | $1,077.75 | 0.5× |
| Group Therapeutic Procedures (97150) | $32.75 | $88.50 | 1.8× |
| Holter monitor recording (93225) | $121.18 | $327.50 | 0.9× |
| Immunization administration (90471) | $29.05 | $78.50 | 0.4× |
| Insert/Place Heart Catheter (93503) range across 2 matching MRF lines |
$144.30–$1,373.35 | $390–$3,711.75 | varies |
| Intracranial Complete Study (93886) | $336.61 | $909.75 | 1.5× |
| Iontophoresis 15 min (97033) | $32.38 | $87.50 | 1.7× |
| Irrig Drug Delivery Device (96523) range across 2 matching MRF lines |
$92.96–$100.36 | $251.25–$271.25 | varies |
| IV infusion hydration each additional hour (96361) range across 4 matching MRF lines |
$12.58–$67.06 | $34–$181.25 | varies |
| IV infusion hydration initial 31 min-1 hour (96360) range across 4 matching MRF lines |
$42.55–$144.67 | $115–$391 | varies |
| IV infusion ther proph addl sequential to 1 hr (96367) range across 4 matching MRF lines |
$23.68–$75.94 | $64–$205.25 | varies |
| IV infusion therapy prophylaxis/dx ea hour (96366) range across 5 matching MRF lines |
$17.02–$67.62 | $46–$182.75 | varies |
| IV push initial (96374) range across 4 matching MRF lines |
$41.81–$84.55 | $113–$228.50 | varies |
| Low frequency non-thermal us (97610) | $182.78 | $494 | 0.9× |
| Lung Function Test (Mbc/Mvv) (94200) | $69.75 | $188.50 | 1.2× |
| Lwr Xtr Vasc Stdy Bilat (93924) | $278.24 | $752 | 1.3× |
| Mechanical chest wall oscillation per session (94669) | $110.08 | $297.50 | 0.5× |
| 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× |
| Motion Fluoroscopy/Swallow (92611) | $134.59 | $363.75 | 1.5× |
| Muscle Test 2 Limbs (95861) | $280.92 | $759.25 | 2.2× |
| Muscle Test Nonparaspinal (95870) | $51.71 | $139.75 | 0.4× |
| Muscle Test One Limb (95860) | $148.65 | $401.75 | 1.2× |
| Nasopharyngoscopy (92511) range across 2 matching MRF lines |
$90.19–$116.18 | $243.75–$314 | varies |
| Needle Electromyography Cranial Nrv Muscle Bi (95868) | $164.74 | $445.25 | 0.8× |
| Needle Electromyography Cranial Nrv Muscle Uni (95867) | $149.11 | $403 | 0.7× |
| Needle Emg Thrc Paraspi Musc Excluding T1/T12 (95869) | $93.61 | $253 | 0.5× |
| 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 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 13 or more studies (95913) | $476.56 | $1,288 | 1.3× |
| Nerve Conduction Studies 3-4 Studies (95908) | $230.23 | $622.25 | 1.1× |
| Nerve conduction studies 5-6 studies (95909) | $453.53 | $1,225.75 | 2.2× |
| Nerve conduction studies 7-8 studies (95910) | $476.56 | $1,288 | 1.3× |
| Nerve Conduction Studies 9-10 Studies (95911) | $476.56 | $1,288 | 1.3× |
| Neuromuscular Junct Tstg Ea Nrv Any 1 Meth (95937) | $164.74 | $445.25 | 1.3× |
| Neuromuscular Reeducation (97112) | $31.17 | $84.25 | 1.0× |
| Oral Function Therapy (92526) | $87.32 | $236 | 1.0× |
| Oral Speech Device Eval (92597) | $106.01 | $286.50 | 1.5× |
| Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) | $34.50 | $93.25 | 0.7× |
| Osteopathic Manipulative Tx 1-2 Body Regions (98925) range across 2 matching MRF lines |
$24.88–$25.62 | $67.25–$69.25 | varies |
| Osteopathic manipulative tx 3-4 body regions (98926) range across 2 matching MRF lines |
$31.73–$36.54 | $85.75–$98.75 | varies |
| Osteopathic manipulative tx 5-6 body regions (98927) | $47.82 | $129.25 | 2.3× |
| Ot eval high complexity (97167) | $74.56 | $201.50 | 0.7× |
| Ot Eval Low Complex (97165) | $74.56 | $201.50 | 0.7× |
| Ot Eval Moderate Complexity (97166) | $74.56 | $201.50 | 0.7× |
| Ot manual therapy 15 min (97140) | $33.95 | $91.75 | 1.2× |
| Ot paraffin bath (97018) | $17.58 | $47.50 | 2.9× |
| 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× |
| Oxygen Uptake Rest Indirect (94690) | $50.41 | $136.25 | 0.9× |
| Peripheral arterial disease rehab per session (93668) | $53.65 | $145 | 0.9× |
| Phlebotomy therapeutic (99195) | $74.83 | $202.25 | 0.6× |
| Physical Performance Test (97750) | $44.49 | $120.25 | 1.3× |
| Plethysmography (94726) | $104.16 | $281.50 | 0.3× |
| Psychiatric diagnostic evaluation (90791) range across 2 matching MRF lines |
$118.77–$123.95 | $321–$335 | varies |
| Pt Eval High Complex (97163) | $74.56 | $201.50 | 0.8× |
| Pt eval low complex 20 min (97161) | $74.56 | $201.50 | 0.8× |
| Pt Eval Mod Complex (97162) | $74.56 | $201.50 | 0.8× |
| Pt gait training 15 min (97116) | $30.43 | $82.25 | 1.0× |
| Pt mechanical traction (97012) | $23.87 | $64.50 | 1.7× |
| Pt Re-Eval Est Plan Care (97164) | $40.89 | $110.50 | 0.6× |
| Pulm function test by gas (94727) | $89.45 | $241.75 | 0.4× |
| Pulmonary service/procedure (94799) range across 3 matching MRF lines |
$232.27 | $11–$627.75 | 1.9× |
| Pulmonary Stress Testing (94618) | $135.61 | $366.50 | 1.1× |
| Rapid Desensitization Procedure Each Hour (95180) | $412.09 | $1,113.75 | 1.0× |
| Refill&Maintenance Pump Drug Dlvr Spinal/Brain (95990) | $219.87 | $594.25 | 0.7× |
| Remote 30 Day Ecg Rev/Report (93270) | $120.81 | $326.50 | 3.4× |
| Respiratory flow volume loop (94375) | $269.36 | $728 | 1.3× |
| Rhythm Ecg 1-3 Leads Tracing Only W/O I&R (93041) | $29.14 | $78.75 | 0.5× |
| Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) | $112.85 | $305 | 0.6× |
| Rx sp-genratj augmnt&comunicaj dev 1st hr (92607) | $119.60 | $323.25 | 1.0× |
| Rx Sp-Genratj Augmnt&Comunicaj Dev Ea 30 Min (92608) | $59.85 | $161.75 | 1.3× |
| Self Care Mngment Training (97535) | $42.55 | $115 | 1.3× |
| Sensory Integration Ea 15 Min (97533) | $29.42 | $79.50 | 0.5× |
| 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× |
| Somatosensory Testing (95938) | $385.54 | $1,042 | 0.5× |
| Speech sound lang comprehen (92523) | $142.36 | $384.75 | 0.6× |
| Spirometry (94010) | $99.16 | $268 | 0.5× |
| Ssep lower limbs (95926) | $365.01 | $986.50 | 1.8× |
| Standardized Cognitive Performance Testing (96125) | $106.28 | $287.25 | 1.0× |
| Stress Tte Only (93350) | $640.10 | $1,730 | 1.2× |
| Subcutaneous Infusion Each Additional Hour (96370) | $66.51 | $179.75 | 1.5× |
| Subcutaneous infusion initial 1 hr w/pump set-up (96369) | $144.58 | $390.75 | 0.7× |
| Subq Infusion Additional Pump Infusion Site (96371) | $49.58 | $134 | 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 Ea Addl 15 Min (97130) | $27.38 | $74 | 1.3× |
| Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) | $40.33 | $109 | 1.1× |
| Ther Px 1/> Areas Each 15 Minutes Massage (97124) | $19.61 | $53 | 0.7× |
| Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) | $85.75 | $231.75 | 0.8× |
| Ther/Proph/Diag Inj Ia (96373) range across 2 matching MRF lines |
$15.17–$221.54 | $41–$598.75 | varies |
| Ther/Proph/Diag Inj Sc/Im (96372) range across 4 matching MRF lines |
$19.24–$61.14 | $52–$165.25 | varies |
| Ther/Proph/Diag Iv Inf Init (96365) range across 4 matching MRF lines |
$54.76–$229.40 | $148–$620 | varies |
| Therapeutic Activities (97530) | $34.50 | $93.25 | 1.0× |
| Tilt table test with heart rhythm and blood pressure monitoring (93660) | $487.29 | $1,317 | 1.4× |
| Tobacco Use Cessation Intensive >10 Minutes (99407) | $91.48 | $247.25 | 2.5× |
| Tobacco Use Cessation Intermediate 3-10 Minutes (99406) range across 2 matching MRF lines |
$11.10–$91.48 | $30–$247.25 | varies |
| Transcranial Doppler Stdy Intracranial Art Lmtd (93888) | $238.37 | $644.25 | 2.4× |
| Tte w/doppler, complete (93306) | $856.37 | $2,314.50 | 1.6× |
| Tte W/O Doppler Complete (93307) | $535.39 | $1,447 | 2.3× |
| Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) | $66.05 | $178.50 | 0.9× |
| Tx/Pro/Dx Inj New Drug Addon (96375) range across 4 matching MRF lines |
$17.02–$75.11 | $46–$203 | varies |
| Upr/L Xtremity Art 2 Levels (93922) | $194.71 | $526.25 | 1.5× |
| Upr/Lxtr Art Stdy 3+ Lvls (93923) | $280.46 | $758 | 1.4× |
| Vasopneumatic device (97016) | $21.55 | $58.25 | 1.8× |
| Vent Mgmt Inpat Init 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× |
| Whirlpool Therapy (97022) | $36.45 | $98.50 | 2.3× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.