Supplies, drugs & other prices at Oklahoma Surgical Hospital, LLC

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

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

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ProcedureCash priceGross charge× Medicare
2d tee w or w/o fol w/con,in (C8925) $1,444
2d tte w or w/o fol w/con,co (C8923) $1,444
2d tte w or w/o fol w/con,fu (C8924) $849
Admin influenza virus vac (G0008) $104
Admin pneumococcal vaccine (G0009) $104
Arthro/shoul surg; w/spacer (C9781) $14,459
Ca screen;pelvic/breast exam (G0101) $264
Colon ca scrn not hi rsk ind (G0121) $2,146.50
Colorectal scrn; hi risk ind (G0105) $2,166.50
Cysto impl 4 or more (C9740) $23,417.50
Cysto, litho, vacuum kidney (C9761) $21,990
Cystoscopy prostatic imp 1-3 (C9739) $12,516.50
Direct refer hospital observ (G0379) $1,206
Drug test def 1-7 classes (G0480) $529
Drug test def 8-14 classes (G0481) $359
Hospital outpt clinic visit (G0463) $343
Inj for sacroiliac jt anesth (G0260) $1,243.75
Injection(s), bone substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion,… (0707T) $6,983
Insertion of sinus tarsi implant (0335T) $17,765
Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging… (0784T) $29,389
Intens cardiac rehab w/exerc (G0422) $343
Mra w/cont, chest (C8909) $830
Mra w/o cont, abd (C8901) $682
Mra w/o fol w/cont, abd (C8902) $1,025
Njx pltlt plasma w/img harvest/preparation (0232T) $1,031.50
Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg,… (0817T) $47,195
Perc d-e cor revasc t cabg s (C9604) $28,479
Perc drug-el cor stent sing (C9600) $28,478.75
Posterior vertebral joint(s) arthroplasty (e.g., facet joint(s) replacement) including facetectomy, laminectomy,… (0202T) $43,732
Rectal tumor excision, transanal endoscopic microsurgical, full thick (0184T) $11,407
Revasc intra lithotrip-stent (C9765) $37,074
Revasc intravasc lithotripsy (C9764) $14,056.50
Revasc lithotrip tibi/perone (C9772) $23,187
Spine device implant surgery (C9757) $29,097
Tee w or w/o fol w/cont, mon (C8927) $1,805
Tee w or w/o fol w/cont,cong (C8926) $1,805
Transcatheter Renal Sympath Denervation Bilat (0339T) $13,558
Tte w or w/o contr, cont ecg (C8930) $2,029
Tte w or w/o fol w/con,stres (C8928) $1,805
Tte w or w/o fol w/cont, com (C8921) $1,805
Tte w or w/o fol w/cont, f/u (C8922) $1,805
Tte w or wo fol wcon,doppler (C8929) $1,805
Xenograft implantation into the articular surface (0737T) $30,598