Supplies, drugs & other prices at OU Health University of Oklahoma Medical Center
Oklahoma City, OK · every code in this section with a posted price and a Medicare benchmark.
121 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) | $95.36 | $953.60 | 0.1× |
| 2d tte w or w/o fol w/con,co (C8923) | $95.36 | $953.60 | 0.1× |
| 2d tte w or w/o fol w/con,fu (C8924) | $45.80 | $458.02 | 0.1× |
| Admin hepatitis b vaccine (G0010) | $13.90 | $139 | 0.3× |
| Admin influenza virus vac (G0008) | $13.50 | $135 | 0.3× |
| Admin pneumococcal vaccine (G0009) | $15.02 | $150.25 | 0.3× |
| Alternating electric fields dosimetry and delivery-simulation modeling, creation and selection of patient-specific… (1025T) | $561.10 | $5,611 | 4.3× |
| Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype… (0877T) | $81.40 | $814 | 0.1× |
| Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype… (0878T) | $81.40 | $814 | 0.1× |
| Bdy surf activation mapg pm/cvdfb leads tm f/up (0696T) | $4.49 | $44.91 | 0.1× |
| Ca screen;flexi sigmoidscope (G0104) | $241.42 | $2,414.26 | 0.3× |
| Ca screen;pelvic/breast exam (G0101) | $46.20 | $462 | 0.5× |
| Catheterize for urine spec (P9612) | $3.85 | $11.04 | 0.4× |
| Chemo extend iv infus w/pump (G0498) | $40.34 | $403.35 | 0.1× |
| Colon ca scrn not hi rsk ind (G0121) | $374 | $3,740 | 0.4× |
| Colorectal scrn; hi risk ind (G0105) | $241.42 | $2,414.26 | 0.3× |
| Covid-19 lab test non-cdc (U0002) | $23 | $230 | 0.4× |
| Cyp2d6 3' gene dup/mlt (0076U) | $27.30 | $273 | 0.1× |
| Cyp2d6 full gene sequence (0071U) | $36.20 | $362 | 0.1× |
| Cyp2d6 gen com&slct rar vrnt (0070U) | $40.80 | $408 | 0.1× |
| Depression screen annual (G0444) | $3.42 | $34.18 | 0.1× |
| Diab manage trn per indiv (G0108) | $37.78 | $377.75 | 0.7× |
| Diab manage trn ind/group (G0109) | $37.80 | $378 | 2.4× |
| Direct refer hospital observ (G0379) | $117.25 | $1,172.50 | 0.2× |
| Drug test def 1-7 classes (G0480) | $18.30 | $183 | 0.2× |
| Drug test def simple all cl (G0659) | $28.80 | $288 | 0.5× |
| Egd flexible transnasal dx w/collj spec br/wa (0652T) | $400.71 | $2,266.24 | 0.2× |
| Egd flexible transnasal w/biopsy single/multiple (0653T) | $226.62 | $2,266.24 | 0.1× |
| Egd flexible transnasal w/insj intral tube/cath (0654T) | $806.46 | $8,064.60 | 0.2× |
| Ekg tracing for initial prev (G0404) | $3.55 | $35.46 | 0.1× |
| Elec stim other than wound (G0283) | $33.60 | $336 | 2.6× |
| Elec stim unattend for press (G0281) | $36.30 | $363 | 3.1× |
| Esd endoscopy or colonoscopy (C9779) | $456.12 | $4,561.20 | 0.1× |
| Extraction erupted tooth/exr (D7140) | $1,157.90 | $11,579 | 1.9× |
| Facility svs dental rehab (G0330) | $635.48 | $6,354.83 | 0.2× |
| Fecal microbiota prep instil (G0455) | $108.85 | $1,088.51 | 0.1× |
| Heart symp image plnr spect (0332T) | $169.12 | $1,691.16 | 0.1× |
| Home sleep test/type 3 porta (G0399) | $54.95 | $549.52 | 0.3× |
| Hospital outpt clinic visit (G0463) | $31 | $310 | 0.2× |
| Ig paraprotein qual bld/ur (0077U) | $25.30 | $253 | 0.6× |
| Initial preventive exam (G0402) | $15.74 | $157.44 | 0.1× |
| Inj for sacroiliac jt anesth (G0260) | $276 | $2,760 | 0.4× |
| Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that… (0216T) | $108.56 | $1,085.56 | 0.1× |
| Insertion of sinus tarsi implant (0335T) unusually low: confirm this is the full procedure |
$2,275.46 | $22,754.67 | 0.3× |
| Insertion perm ccm-d system pulse generator only (0916T) unusually low: confirm this is the full procedure |
$7,744 | $77,440 | 0.4× |
| Insj Perm Ccm-D Sys 1 Transvns Lead Only (0917T) unusually low: confirm this is the full procedure |
$2,855.20 | $28,552 | 0.4× |
| Insj Perm Ccm-D Sys Dual Transvns Leads Only (0918T) unusually low: confirm this is the full procedure |
$2,855.20 | $28,552 | 0.4× |
| Insj perm ccm-d sys pg&dual transvns eltrds/lds (0915T) unusually low: confirm this is the full procedure |
$11,061.30 | $110,613 | 0.4× |
| Interrog dev eval impl ccm-d system in person (0927T) | $12.90 | $129 | 0.4× |
| Jak2 Gene Analysis Trgt Seq Alys Exons 12-15 (0027U) | $59 | $590 | 0.5× |
| Liver dis 10 assays w/nash (0003M) | $82.90 | $829 | 0.2× |
| Mra w/cont, abd (C8900) | $513.35 | $5,133.50 | 1.5× |
| Mra w/cont, chest (C8909) | $116.20 | $1,162 | 0.3× |
| Mra w/cont, pelvis (C8918) | $125.10 | $1,251 | 0.4× |
| Mra w/o cont, abd (C8901) | $537.10 | $5,371 | 2.3× |
| Mra w/o fol w/cont, abd (C8902) | $778.60 | $7,786 | 2.3× |
| Mri w/o fol w/cont, breast, (C8908) | $492.10 | $4,921 | 1.5× |
| Mri w/o fol w/cont, brst, un (C8905) | $282.90 | $2,829.02 | 0.8× |
| Neuro csf detcj prion prtn quakg conf conv qual (0035U) | $144.95 | $1,449.50 | 0.3× |
| Njx dx/ther paraver fct jt w/us cer/thor 1 lvl (0213T) | $108.56 | $1,085.56 | 0.1× |
| Njx pltlt plasma w/img harvest/preparation (0232T) | $2,808.73 | $28,087.34 | 6.5× |
| No pt prsnt train initial 30 (G0541) | $5.20 | $52 | 0.2× |
| Non-ophthalmic fva (C9733) | $272.71 | $2,727.07 | 0.8× |
| Noninvasive prostate cancer estimation map, derived from augmentative analysis of image-guided fusion biopsy and… (0898T) | $239.15 | $2,391.50 | 0.3× |
| Obtaining screen pap smear (Q0091) | $3.55 | $35.46 | 0.1× |
| Ortho impl mvmt alys pair CT (0946T) | $13.30 | $133 | 0.1× |
| Pathogen test for platelets (P9100) | $20.55 | $205.50 | 0.4× |
| Pelvic ring fracture uni/bil (G0413) likely a partial charge, not the full procedure |
$2,070.37 | $20,703.66 | 0.3× |
| Perc d-e cor revasc chro sin (C9607) likely a partial charge, not the full procedure |
$2,088.41 | $20,884.14 | 0.1× |
| Perc d-e cor revasc t cabg s (C9604) likely a partial charge, not the full procedure |
$1,310.23 | $13,102.26 | 0.1× |
| Perc d-e cor stent ather s (C9602) likely a partial charge, not the full procedure |
$2,088.41 | $20,884.14 | 0.1× |
| Perc drug-el cor stent sing (C9600) likely a partial charge, not the full procedure |
$1,310.23 | $13,102.26 | 0.1× |
| Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral… (0627T) likely a partial charge, not the full procedure |
$3,671.80 | $36,718 | 0.3× |
| Perq Sacral Augmt Unilat Inj (0200T) likely a partial charge, not the full procedure |
$852.04 | $8,520.41 | 0.1× |
| Perq Tcat Ther Rx Dlvr Ntrac Rx Balo 1 Maj C Art (0913T) likely a partial charge, not the full procedure |
$712.70 | $7,127 | 0.1× |
| Ppps, initial visit (G0438) | $48.44 | $484.38 | 0.3× |
| Ppps, subseq visit (G0439) | $45.75 | $457.50 | 0.3× |
| Programming device eval impl ccm-d sys in person (0926T) | $12.90 | $129 | 0.4× |
| Prolonged iv inf, req pump (C8957) | $105.20 | $1,052 | 0.5× |
| Psa screening (G0103) | $2.41 | $24.14 | 0.1× |
| Quan mr alys tis compj wo MRI same sess mlt orgn (0697T) | $95.05 | $950.50 | 0.1× |
| Quan mr alys tiss compj w/o MRI same sess 1orgn (0648T) | $95.05 | $950.50 | 0.1× |
| Quan mr alys tiss composition w/MRI 1orgn (0649T) | $95.05 | $950.50 | 0.1× |
| Quan mr alys tiss composition w/MRI mlt organs (0698T) | $95.05 | $950.50 | 0.1× |
| Quan us tiss charac i&r w/o dx us same anat (0689T) | $10.82 | $108.23 | 0.1× |
| Rectal tumor excision, transanal endoscopic microsurgical, full thick (0184T) unusually low: confirm this is the full procedure |
$2,446.50 | $24,465 | 0.4× |
| Relocation skin pocket implanted ccm-d pg (0925T) | $631.10 | $6,311 | 0.3× |
| Removal perm ccm-d system pulse generator only (0919T) | $1,255.60 | $12,556 | 0.3× |
| Repositioning prev impl ccm-d transvns eltrd/ld (0924T) | $213.30 | $2,133 | 0.4× |
| Revasc intra lithotrip-ather (C9766) likely a partial charge, not the full procedure |
$2,088.41 | $20,884.14 | 0.1× |
| Revasc intra lithotrip-stent (C9765) likely a partial charge, not the full procedure |
$2,088.41 | $20,884.14 | 0.1× |
| Revasc intravasc lithotripsy (C9764) likely a partial charge, not the full procedure |
$1,481.06 | $14,810.63 | 0.1× |
| Revasc lith-sten-ath tib/per (C9775) unusually low: confirm this is the full procedure |
$5,296.80 | $52,968 | 0.3× |
| Revasc lithotr-ather tib/per (C9774) unusually low: confirm this is the full procedure |
$5,296.80 | $52,968 | 0.3× |
| Revasc lithotr-stent tib/per (C9773) unusually low: confirm this is the full procedure |
$5,527.30 | $55,273 | 0.3× |
| Revasc lithotrip tibi/perone (C9772) likely a partial charge, not the full procedure |
$2,889.60 | $28,896 | 0.3× |
| Revasc lithotrip-stent-ather (C9767) likely a partial charge, not the full procedure |
$2,088.41 | $20,884.14 | 0.1× |
| Rmvl Perm Ccm-D Sys 1 Transvns Dfb Lead Only (0921T) | $1,255.60 | $12,556 | 0.3× |
| Rmvl perm ccm-d sys 1 transvns pacing lead only (0920T) | $1,255.60 | $12,556 | 0.3× |
| Rmvl Perm Ccm-D Sys Dual Transvns Leads Only (0922T) | $1,255.60 | $12,556 | 0.3× |
| Rmvl&Rplcmt Permanent Ccm-D Pulse Generator Only (0923T) unusually low: confirm this is the full procedure |
$7,744 | $77,440 | 0.4× |
| Sim ang w/prs cath rad emb (C8004) likely a partial charge, not the full procedure |
$1,348.40 | $13,484 | 0.1× |
| Tcat insj perm 2chmbr ldls pm r atr pm compnt (0796T) likely a partial charge, not the full procedure |
$2,631.78 | $26,317.84 | 0.1× |
| Tcat insj perm 2chmbr ldls pm r ventr pm compnt (0797T) likely a partial charge, not the full procedure |
$4,103.24 | $41,032.34 | 0.2× |
| Tcat Insj Perm Dual Chamber Ldls Pm Compl Sys (0795T) likely a partial charge, not the full procedure |
$2,320.67 | $23,206.69 | 0.1× |
| Tcat Rmvl/Debulk Icar Mass Suction Device Perq (0644T) likely a partial charge, not the full procedure |
$680.73 | $6,807.30 | 0.1× |
| Tee w or w/o fol w/cont,cong (C8926) | $95.36 | $953.60 | 0.1× |
| Therapeutic procd strg endur (G0237) | $3.55 | $35.46 | 0.1× |
| Tomosynthesis, mammo (G0279) | $9.50 | $95 | 0.7× |
| Tpmt Nudt15 Gene Analysis Common Variants (0034U) | $84 | $840 | 0.2× |
| Transcatheter Renal Sympath Denervation Bilat (0339T) likely a partial charge, not the full procedure |
$680.73 | $6,807.30 | 0.1× |
| Trauma respons w/hosp criti (G0390) | $3,754.55 | $37,545.50 | 2.9× |
| Trluml peripheral atherectomy iliac artery ea (0238T) likely a partial charge, not the full procedure |
$2,074.60 | $20,746 | 0.1× |
| Tte w or w/o fol w/con,stres (C8928) | $95.36 | $953.60 | 0.1× |
| Tte w or w/o fol w/cont, com (C8921) | $391.98 | $3,919.80 | 0.5× |
| Tte w or w/o fol w/cont, f/u (C8922) | $95.36 | $953.60 | 0.1× |
| Tte w or wo fol wcon,doppler (C8929) | $95.36 | $953.60 | 0.1× |
| Unsched dialysis esrd pt hos (G0257) | $153.16 | $1,531.63 | 0.2× |
| Vasc emb/occ w/prs cath (C9797) likely a partial charge, not the full procedure |
$2,088.41 | $20,884.14 | 0.1× |
| Visit to determ ldct elig (G0296) | $26.40 | $264 | 0.3× |
| Wet mounts/ w preparations (Q0111) | $2.22 | $22.20 | 0.1× |