Supplies, drugs & other prices at Hillcrest Hospital South
Tulsa, OK · every code in this section with a posted price and a Medicare benchmark.
58 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| 2d tee w or w/o fol w/con,in (C8925) | $1,121.70 | $3,739 | 1.5× |
| 2d tte w or w/o fol w/con,fu (C8924) | $361.80 | $1,206 | 1.1× |
| Adm tocilizu covid-19 1st (M0249) | $468.60 | $1,562 | 1.1× |
| Adm tocilizu covid-19 2nd (M0250) | $468.60 | $1,562 | 1.1× |
| Admin influenza virus vac (G0008) | $28.20 | $94 | 0.6× |
| Admin pneumococcal vaccine (G0009) | $28.20 | $94 | 0.6× |
| Autolog prp not diab ulcer (G0460) | $2,022.90 | $6,743 | 1.0× |
| Ca screen;flexi sigmoidscope (G0104) | $1,271.40 | $4,238 | 1.4× |
| Catheterize for urine spec (P9612) | $34.50 | $115 | 3.7× |
| Colon ca scrn not hi rsk ind (G0121) | $1,256.10 | $4,187 | 1.4× |
| Colorectal scrn; hi risk ind (G0105) | $1,444.80 | $4,816 | 1.6× |
| Covid-19 lab test non-cdc (U0002) | $45.30 | $151 | 0.9× |
| Direct refer hospital observ (G0379) | $582.30 | $1,941 | 1.0× |
| Drug test def 1-7 classes (G0480) | $111 | $370 | 1.0× |
| Elec stim other than wound (G0283) | $86.40 | $288 | 6.8× |
| Group mnt 2 or more 30 mins (G0271) | $23.10 | $77 | 1.4× |
| Hbot, full body chamber, 30m (G0277) | $309.90 | $1,033 | 2.3× |
| Home sleep test/type 3 porta (G0399) | $857.10 | $2,857 | 4.1× |
| Home sleep test/type 4 porta (G0400) | $745.20 | $2,484 | 3.6× |
| Hospital outpt clinic visit (G0463) | $247.80 | $826 | 1.9× |
| Inj for sacroiliac jt anesth (G0260) | $1,311.75 | $4,372.50 | 1.9× |
| Mnt subs tx for change dx (G0270) | $41.40 | $138 | 1.3× |
| Mra w/cont, abd (C8900) | $993.60 | $3,312 | 3.0× |
| Mra w/cont, chest (C8909) | $399.90 | $1,333 | 1.2× |
| Mra w/cont, lwr ext (C8912) | $1,951.80 | $6,506 | 5.8× |
| Mra w/o cont, abd (C8901) | $239.40 | $798 | 1.0× |
| Mra w/o cont, chest (C8910) | $239.40 | $798 | 1.0× |
| Mra w/o cont, lwr ext (C8913) | $1,774.20 | $5,914 | 7.7× |
| Mra w/o cont, pelvis (C8919) | $239.40 | $798 | 1.0× |
| Mra w/o fol w/cont, abd (C8902) | $1,093.50 | $3,645 | 3.3× |
| Mra w/o fol w/cont, chest (C8911) | $885.90 | $2,953 | 2.6× |
| Mra w/o fol w/cont, lwr ext (C8914) | $2,147.10 | $7,157 | 6.4× |
| Mra w/o fol w/cont, pelvis (C8920) | $399.90 | $1,333 | 1.2× |
| Mri w/o fol w/cont, breast, (C8908) | $694.20 | $2,314 | 2.1× |
| Mri w/o fol w/cont, brst, un (C8905) | $463.20 | $1,544 | 1.4× |
| Oth resp proc, group (G0239) | $89.70 | $299 | 2.5× |
| Oth resp proc, indiv (G0238) | $60.30 | $201 | 2.2× |
| Pathogen test for platelets (P9100) | $93.90 | $313 | 1.7× |
| Perc d-e cor revasc chro sin (C9607) unusually low: confirm this is the full procedure |
$8,052 | $26,840 | 0.5× |
| Perc d-e cor revasc t cabg s (C9604) | $6,039 | $20,130 | 0.5× |
| Perc d-e cor stent ather s (C9602) unusually low: confirm this is the full procedure |
$8,052 | $26,840 | 0.5× |
| Perc drug-el cor stent sing (C9600) | $8,052 | $26,840 | 0.7× |
| Prostate biopsy, any mthd (G0416) | $708 | $2,360 | 2.1× |
| Psa screening (G0103) | $28.20 | $94 | 1.5× |
| Revasc intra lithotrip-ather (C9766) | $10,422.60 | $34,742 | 0.6× |
| Revasc intra lithotrip-stent (C9765) | $10,422.60 | $34,742 | 0.6× |
| Revasc intravasc lithotripsy (C9764) | $6,226.50 | $20,755 | 0.6× |
| Revasc lithotr-ather tib/per (C9774) | $16,671.30 | $55,571 | 0.9× |
| Revasc lithotrip tibi/perone (C9772) | $10,422.60 | $34,742 | 0.9× |
| Revasc lithotrip-stent-ather (C9767) | $16,671.30 | $55,571 | 0.9× |
| Tcat insj perm 1chmbr ldls pacemaker r atrial (0823T) | $18,194.10 | $60,647 | 1.0× |
| Therapeutic procd strg endur (G0237) | $46.50 | $155 | 1.7× |
| Trgt gen seq alys sld orgn neo DNA 324 genes (0037U) | $3,942.30 | $13,141 | 1.1× |
| Trluml Perip Athrc Renal Art (0234T) | $21,943.80 | $73,146 | 2.0× |
| Trluml periph athrc w/rs&i brchiocphl ea vsl (0237T) | $14,910 | $49,700 | 1.3× |
| Trluml peripheral atherectomy iliac artery ea (0238T) | $21,908.70 | $73,029 | 1.2× |
| Tte w or wo fol wcon,doppler (C8929) | $1,210.50 | $4,035 | 1.6× |
| Unsched dialysis esrd pt hos (G0257) | $870 | $2,900 | 1.3× |