Supplies, drugs & other prices at Tulsa Spine & Specialty Hospital
Tulsa, OK · every code in this section with a posted price and a Medicare benchmark.
16 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| Adm tocilizu covid-19 1st (M0249) | $305.50 | $1,222 | 0.7× |
| Adm tocilizu covid-19 2nd (M0250) | $305.50 | $1,222 | 0.7× |
| Admin influenza virus vac (G0008) | $25 | $100 | 0.6× |
| Admin pneumococcal vaccine (G0009) | $25 | $100 | 0.6× |
| Ca screen;flexi sigmoidscope (G0104) | $479.25 | $1,917 | 0.5× |
| Colon ca scrn not hi rsk ind (G0121) | $765.63 | $3,062.53 | 0.9× |
| Colorectal scrn; hi risk ind (G0105) | $765.63 | $3,062.53 | 0.9× |
| Covid-19 lab test non-cdc (U0002) | $30 | $120 | 0.6× |
| Drug test def 1-7 classes (G0480) | $137.72 | $550.87 | 1.2× |
| Home sleep test/type 2 porta (G0398) | $93.75 | $375 | 0.5× |
| Home sleep test/type 3 porta (G0399) | $275 | $1,100 | 1.3× |
| Home sleep test/type 4 porta (G0400) | $93.75 | $375 | 0.5× |
| Inj for sacroiliac jt anesth (G0260) | $647.62 | $2,590.50 | 1.0× |
| Mra w/o cont, lwr ext (C8913) | $159 | $636 | 0.7× |
| Perq Sacral Augmt Bilat Inj (0201T) | $4,071.25 | $16,285 | 0.6× |
| Perq Sacral Augmt Unilat Inj (0200T) | $3,783.50 | $15,134 | 0.5× |