St. John Medical Center, Inc.
St. John Medical Center, Inc. in Tulsa, OK publishes cash prices for 49 common procedures listed here, from its own machine-readable price file updated —. Click a procedure to compare it with other hospitals nearby.
1923 S Utica Ave Tulsa OK 74104 Collected Sep 23, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN PELVIS W CONTR 74177 | $1,187.61 | $3,209.75 | 63% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD PELVIS W 74177 | $1,187.61 | $3,209.75 | 63% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN PELVIS W CONTR 74177 | $1,187.61 | $3,209.75 | 63% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD PELVIS W 74177 | $1,187.61 | $3,209.75 | 63% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD PLAIN 70450 | $891.79 | $2,410.25 | 63% |
| CT scan of the head or brain, no contrast dye CPT 70450 MR/IAC/W/O 30035 | $891.79 | $2,410.25 | 63% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD RAPID 43267 | $891.79 | $2,410.25 | 63% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 MR/IAC/W/O 30035 | $891.79 | $2,410.25 | 63% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD PLAIN 70450 | $891.79 | $2,410.25 | 63% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD RAPID 43267 | $891.79 | $2,410.25 | 63% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS INFUSED 72193 | $971.25 | $2,625.00 | 63% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS INFUSED 72193 | $971.25 | $2,625.00 | 63% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MAM DIGTL DIAG BILAT 77066 | $208.87 | $564.50 | 63% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAM DIGTL DIAG BILAT 77066 | $208.87 | $564.50 | 63% |
| Diagnostic mammogram, one breast one side CPT 77065 MAM DIGTL DIAG LT 77065 | $161.69 | $437.00 | 63% |
| Diagnostic mammogram, one breast one side CPT 77065 MAM DIGTL DIAG RT 30111 | $161.69 | $437.00 | 63% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MAM DIGTL DIAG LT 77065 | $161.69 | $437.00 | 63% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MAM DIGTL DIAG RT 30111 | $161.69 | $437.00 | 63% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR JT L W/O R 71011 | $976.80 | $2,640.00 | 63% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR JT L W/O R 71011 | $976.80 | $2,640.00 | 63% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR JT L W/O L 61320 | $976.80 | $2,640.00 | 63% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR JT L W/O L 61320 | $976.80 | $2,640.00 | 63% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR JT L W/O BIL 73721 | $1,953.60 | $5,280.00 | 63% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR JT L W/O BIL 73721 | $1,953.60 | $5,280.00 | 63% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR JT U WO LIM RT 23798 | $976.80 | $2,640.00 | 63% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR JT U WO LIM LT 23797 | $976.80 | $2,640.00 | 63% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR JT U WO LIM LT 23797 | $976.80 | $2,640.00 | 63% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR JT U WO LIM RT 23798 | $976.80 | $2,640.00 | 63% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MR JT L W/O L 61320 | $976.80 | $2,640.00 | 63% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MR JT L W/O R 71011 | $976.80 | $2,640.00 | 63% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MR JT L W/O BIL 73721 | $1,953.60 | $5,280.00 | 63% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MR JT U WO LIM RT 23798 | $976.80 | $2,640.00 | 63% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MR JT U WO LIM LT 23797 | $976.80 | $2,640.00 | 63% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MR JT L W/O&W/ R 71033 | $1,070.87 | $2,894.25 | 63% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MR JT L W/O&W/ L 71032 | $1,070.87 | $2,894.25 | 63% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MR JT L W/O&W/ R 71033 | $1,070.87 | $2,894.25 | 63% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MR JT L W/O&W/ L 71032 | $1,070.87 | $2,894.25 | 63% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MR JT L W/O&W/ R 71033 | $1,070.87 | $2,894.25 | 63% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MR JT L W/O&W/ L 71032 | $1,070.87 | $2,894.25 | 63% |
| MRI of the brain, no contrast dye CPT 70551 MR BRAIN W/O CONTR 70551 | $870.98 | $2,354.00 | 63% |
| MRI of the brain, no contrast dye CPT 70551 MR BRAIN WO LIMITED 13282 | $870.98 | $2,354.00 | 63% |
| MRI of the brain, no contrast dye CPT 70551 MR BRAIN WO LIMITED 13282 | $870.98 | $2,354.00 | 63% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MR BRAIN W/O CONTR 70551 | $870.98 | $2,354.00 | 63% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MR BRAIN WO LIMITED 13282 | $870.98 | $2,354.00 | 63% |
| MRI of the brain, with and without contrast dye CPT 70553 MR BRAIN W/O&W/CONTR 70553 | $1,278.91 | $3,456.50 | 63% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MR BRAIN W/O&W/CONTR 70553 | $1,278.91 | $3,456.50 | 63% |
| MRI of the lower back, no contrast dye CPT 72148 MR L SPINE WO LIM 50449 | $924.82 | $2,499.50 | 63% |
| MRI of the lower back, no contrast dye CPT 72148 MR L SPINE WO LIM 50449 | $924.82 | $2,499.50 | 63% |
| MRI of the lower back, no contrast dye CPT 72148 MRI SPINE LUMBAR WO 50449 | $924.82 | $2,499.50 | 63% |
| MRI of the lower back, no contrast dye CPT 72148 MRI L SPINE W/O 72148 | $924.82 | $2,499.50 | 63% |
| MRI of the lower back, no contrast dye CPT 72148 MRI SPINE LUMBAR WO 50449 | $924.82 | $2,499.50 | 63% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI L SPINE W/O 72148 | $924.82 | $2,499.50 | 63% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI SPINE LUMBAR WO 50449 | $924.82 | $2,499.50 | 63% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MR L SPINE WO LIM 50449 | $924.82 | $2,499.50 | 63% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB US >14WK 76805 | $566.29 | $1,530.50 | 63% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 OB US >14WK 76805 | $566.29 | $1,530.50 | 63% |
| Screening mammogram, both breasts both sides CPT 77067 MAM DIGTL SCRN BILAT 77067 | $140.60 | $380.00 | 63% |
| Screening mammogram, both breasts CPT 77067 MAMMO DIG SCREEN BIL 77067 | $140.60 | $380.00 | 63% |
| Screening mammogram, both breasts one side CPT 77067 MAM DIGTL SCRN LT 30106 | $140.60 | $380.00 | 63% |
| Screening mammogram, both breasts one side CPT 77067 MAM DIG SCRN LT 30106 | $140.60 | $380.00 | 63% |
| Screening mammogram, both breasts one side CPT 77067 MAM DIG SCRN RT 30110 | $140.60 | $380.00 | 63% |
| Screening mammogram, both breasts one side CPT 77067 MAM DIGTL SCRN RT 30110 | $140.60 | $380.00 | 63% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 MAM DIGTL SCRN BILAT 77067 | $140.60 | $380.00 | 63% |
| Screening mammogram, both breasts inpatient CPT 77067 MAMMO DIG SCREEN BIL 77067 | $140.60 | $380.00 | 63% |
| Screening mammogram, both breasts inpatient one side CPT 77067 MAM DIG SCRN LT 30106 | $140.60 | $380.00 | 63% |
| Screening mammogram, both breasts inpatient one side CPT 77067 MAM DIGTL SCRN RT 30110 | $140.60 | $380.00 | 63% |
| Screening mammogram, both breasts inpatient one side CPT 77067 MAM DIGTL SCRN LT 30106 | $140.60 | $380.00 | 63% |
| Screening mammogram, both breasts inpatient one side CPT 77067 MAM DIG SCRN RT 30110 | $140.60 | $380.00 | 63% |
| Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNGRPH COMPLEX <6HR 62570 | $2,163.85 | $5,848.25 | 63% |
| Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNGRPH COMPLEX <6HR 62570 | $2,163.85 | $5,848.25 | 63% |
| Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNGRPH COMPLEX 95810 | $2,163.85 | $5,848.25 | 63% |
| Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNGRPH COMPLEX 95810 | $2,163.85 | $5,848.25 | 63% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMNGRPH COMPLEX 95810 | $2,163.85 | $5,848.25 | 63% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMNGRPH COMPLEX <6HR 62570 | $2,163.85 | $5,848.25 | 63% |
| Transvaginal pelvic ultrasound CPT 76830 TRANSVAGINAL SONOGRA 76830 | $378.88 | $1,024.00 | 63% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 TRANSVAGINAL SONOGRA 76830 | $378.88 | $1,024.00 | 63% |
| Ultrasound of the abdomen, complete CPT 76700 UPPER ABD GENERAL 76700 | $526.79 | $1,423.75 | 63% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 UPPER ABD GENERAL 76700 | $526.79 | $1,423.75 | 63% |
| X-ray of the lower back, 4 or more views CPT 72110 L SPINE 5V 72110 | $227.00 | $613.50 | 63% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 L SPINE 5V 72110 | $227.00 | $613.50 | 63% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 CHEM 8- 48337 | $31.73 | $85.75 | 63% |
| Basic metabolic panel (blood test) CPT 80048 CHEM 8- 48337 | $31.73 | $85.75 | 63% |
| Basic metabolic panel (blood test) inpatient CPT 80048 CHEM 8- 48337 | $31.73 | $85.75 | 63% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID GRP PHENOTYPING 44752 | $27.60 | $74.60 | 63% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID GRP PHENOTYPING 44752 | $27.60 | $74.60 | 63% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 GROUP LIPID- 48643 | $66.42 | $179.50 | 63% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 GROUP LIPID- 48643 | $66.42 | $179.50 | 63% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID GRP PHENOTYPING 44752 | $27.60 | $74.60 | 63% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 GROUP LIPID- 48643 | $66.42 | $179.50 | 63% |
| Complete blood count (CBC) with differential CPT 85025 CBC- 47048 | $45.33 | $122.50 | 63% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC- 47048 | $45.33 | $122.50 | 63% |
| Complete blood count (CBC), no differential CPT 85027 CBC NO DIFF- 46545 | $29.60 | $80.00 | 63% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC NO DIFF- 46545 | $29.60 | $80.00 | 63% |
| Comprehensive metabolic panel (blood test) CPT 80053 CHEM 14- 48338 | $40.79 | $110.25 | 63% |
| Comprehensive metabolic panel (blood test) CPT 80053 CHEM 14- 48338 | $40.79 | $110.25 | 63% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 CHEM 14- 48338 | $40.79 | $110.25 | 63% |
| Kidney function blood test panel CPT 80069 RENAL PR- 48340 | $26.55 | $71.75 | 63% |
| Kidney function blood test panel CPT 80069 RENAL PR- 48340 | $26.55 | $71.75 | 63% |
| Kidney function blood test panel inpatient CPT 80069 RENAL PR- 48340 | $26.55 | $71.75 | 63% |
| Liver function blood test panel CPT 80076 LIVER PNL- 48339 | $44.31 | $119.75 | 63% |
| Liver function blood test panel CPT 80076 LIVER PNL- 48339 | $44.31 | $119.75 | 63% |
| Liver function blood test panel inpatient CPT 80076 LIVER PNL- 48339 | $44.31 | $119.75 | 63% |
| Obstetric blood test panel CPT 80055 PREN80055- 45629 | $76.04 | $205.50 | 63% |
| Obstetric blood test panel CPT 80055 PREN80055- 45629 | $76.04 | $205.50 | 63% |
| Obstetric blood test panel inpatient CPT 80055 PREN80055- 45629 | $76.04 | $205.50 | 63% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 FREE PSA- 48625 | $100.64 | $272.00 | 63% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 FREE PSA- 48625 | $100.64 | $272.00 | 63% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 FREE PSA- 48625 | $100.64 | $272.00 | 63% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA- 48514 | $76.96 | $208.00 | 63% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA- 48514 | $76.96 | $208.00 | 63% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA- 48514 | $76.96 | $208.00 | 63% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 APTT- 46733 | $22.11 | $59.75 | 63% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 APTT 46733 | $22.11 | $59.75 | 63% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 APTT- 46733 | $22.11 | $59.75 | 63% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 APTT 46733 | $22.11 | $59.75 | 63% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PT WITH INR 41795 | $12.49 | $33.75 | 63% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME- 46742 | $29.60 | $80.00 | 63% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME 46742 | $29.60 | $80.00 | 63% |
| Prothrombin time (PT/INR) clotting test CPT 85610 ISTAT POC PT/INR- 46742 | $29.60 | $80.00 | 63% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT WITH INR 41795 | $12.49 | $33.75 | 63% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 ISTAT POC PT/INR- 46742 | $29.60 | $80.00 | 63% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME 46742 | $29.60 | $80.00 | 63% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME- 46742 | $29.60 | $80.00 | 63% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 NBS TSH SCREEN 41872 | $22.29 | $60.25 | 63% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 NBS TSH SCREEN 41872 | $22.29 | $60.25 | 63% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID ANALYZER 38819 | $40.89 | $110.50 | 63% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID ANALYZER 38819 | $40.89 | $110.50 | 63% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 ASSAY OF TSH STIM HORMONE 41736 | $41.26 | $111.50 | 63% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 ASSAY OF TSH STIM HORMONE 41736 | $41.26 | $111.50 | 63% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH SERUM RIA- 44544 | $83.07 | $224.50 | 63% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH SERUM RIA- 44544 | $83.07 | $224.50 | 63% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 NBS TSH SCREEN 41872 | $22.29 | $60.25 | 63% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID ANALYZER 38819 | $40.89 | $110.50 | 63% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 ASSAY OF TSH STIM HORMONE 41736 | $41.26 | $111.50 | 63% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH SERUM RIA- 44544 | $83.07 | $224.50 | 63% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS COMPLETE- 46480 | $33.02 | $89.25 | 63% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS COMPLETE- 46480 | $33.02 | $89.25 | 63% |
| Urinalysis without microscope exam, automated CPT 81003 UA DIPSTICK KID STONE SAT 44712 | $9.66 | $26.12 | 63% |
| Urinalysis without microscope exam, automated CPT 81003 UA DIPSTICK KID STONE SAT 44712 | $9.66 | $26.12 | 63% |
| Urinalysis without microscope exam, automated CPT 81003 UA W/O MICROSCOPIC- 46514 | $21.46 | $58.00 | 63% |
| Urinalysis without microscope exam, automated CPT 81003 SPECIFIC GRAVITY UR- 46471 | $21.46 | $58.00 | 63% |
| Urinalysis without microscope exam, automated CPT 81003 SPECIFIC GRAVITY UR- 46471 | $21.46 | $58.00 | 63% |
| Urinalysis without microscope exam, automated CPT 81003 UA W/O MICROSCOPIC- 46514 | $21.46 | $58.00 | 63% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA DIPSTICK KID STONE SAT 44712 | $9.66 | $26.12 | 63% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 SPECIFIC GRAVITY UR- 46471 | $21.46 | $58.00 | 63% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA W/O MICROSCOPIC- 46514 | $21.46 | $58.00 | 63% |
| Urinalysis without microscope exam, manual CPT 81002 REDUCING SUBSTANCES- 46465 | $18.59 | $50.25 | 63% |
| Urinalysis without microscope exam, manual CPT 81002 URINE DIP 81002 | $18.59 | $50.25 | 63% |
| Urinalysis without microscope exam, manual CPT 81002 BILIRUBIN ICTOTEST- 46517 | $18.59 | $50.25 | 63% |
| Urinalysis without microscope exam, manual CPT 81002 REDUCING SUBSTANCES- 46465 | $18.59 | $50.25 | 63% |
| Urinalysis without microscope exam, manual CPT 81002 URINE DIP 81002 | $18.59 | $50.25 | 63% |
| Urinalysis without microscope exam, manual CPT 81002 BILIRUBIN ICTOTEST- 46517 | $18.59 | $50.25 | 63% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 BILIRUBIN ICTOTEST- 46517 | $18.59 | $50.25 | 63% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 URINE DIP 81002 | $18.59 | $50.25 | 63% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 REDUCING SUBSTANCES- 46465 | $18.59 | $50.25 | 63% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Left heart catheterization, diagnostic CPT 93452 LT HEART CATH W ANGIO 93452 | $3,830.24 | $10,352.00 | 63% |
| Left heart catheterization, diagnostic inpatient CPT 93452 LT HEART CATH W ANGIO 93452 | $3,830.24 | $10,352.00 | 63% |
| Lower-back epidural injection, with imaging guidance CPT 62323 SC EPIDURL STEROID INJ LUMB 62323 | $660.73 | $1,785.75 | 63% |
| Lower-back epidural injection, with imaging guidance CPT 62323 SC EPIDURL STEROID INJ LUMB62323 | $660.73 | $1,785.75 | 63% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 SC EPIDURL STEROID INJ LUMB 62323 | $660.73 | $1,785.75 | 63% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 SC EPIDURL STEROID INJ LUMB62323 | $660.73 | $1,785.75 | 63% |
| Lower-back epidural injection, without imaging guidance CPT 62322 EPID LUMB/CAUDAL 62322 | $520.31 | $1,406.25 | 63% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 EPID LUMB/CAUDAL 62322 | $520.31 | $1,406.25 | 63% |
| Lower-back nerve root steroid injection, with imaging guidance both sides CPT 64483 INJ LUMB/SAC EPID SGL LEV BILAT | $1,285.20 | $3,473.50 | 63% |
| Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 L/S TRANS EPI UNILAT RT 45133 | $642.60 | $1,736.75 | 63% |
| Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 L/S TRANS EPI UNILAT LT 6545 | $642.60 | $1,736.75 | 63% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient both sides CPT 64483 INJ LUMB/SAC EPID SGL LEV BILAT | $1,285.20 | $3,473.50 | 63% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 L/S TRANS EPI UNILAT RT 45133 | $642.60 | $1,736.75 | 63% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 L/S TRANS EPI UNILAT LT 6545 | $642.60 | $1,736.75 | 63% |
| Prostate biopsy CPT 55700 BX PROSTATE PERCU 55700 | $2,412.22 | $6,519.50 | 63% |
| Prostate biopsy inpatient CPT 55700 BX PROSTATE PERCU 55700 | $2,412.22 | $6,519.50 | 63% |
| Upper endoscopy (EGD) with biopsy CPT 43239 EGD W/BIOPSY 43239 | $948.77 | $2,564.25 | 63% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD W/BIOPSY 43239 | $948.77 | $2,564.25 | 63% |
| Upper endoscopy (EGD), diagnostic CPT 43235 EGD COMPLEX 43235 | $948.77 | $2,564.25 | 63% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD COMPLEX 43235 | $948.77 | $2,564.25 | 63% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Family therapy with the patient, 50 minutes CPT 90847 FAMILY THERAPY W/PT 50 MIN 54342 | $210.44 | $568.75 | 63% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY THERAPY W/PT 50 MIN 54342 | $210.44 | $568.75 | 63% |
| Family therapy without the patient, 50 minutes CPT 90846 FAMILY THERPY W/O PT 50MIN 57449 | $210.44 | $568.75 | 63% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY THERPY W/O PT 50MIN 57449 | $210.44 | $568.75 | 63% |
| Group psychotherapy session CPT 90853 GROUP THERAPY 54514 | $210.44 | $568.75 | 63% |
| Group psychotherapy session inpatient CPT 90853 GROUP THERAPY 54514 | $210.44 | $568.75 | 63% |
| New patient office visit, about 30 minutes CPT 99203 NEW PT 30 MIN MOD 25 12626 | $165.39 | $447.00 | 63% |
| New patient office visit, about 30 minutes CPT 99203 NEW VISIT 30 MIN 99203 | $165.39 | $447.00 | 63% |
| New patient office visit, about 30 minutes CPT 99203 NEW PT/INIT LACT 30 MIN 34268 | $165.39 | $447.00 | 63% |
| New patient office visit, about 30 minutes CPT 99203 NEW VISIT<10HRS MOBS 99203 | $165.39 | $447.00 | 63% |
| New patient office visit, about 30 minutes inpatient CPT 99203 NEW VISIT 30 MIN 99203 | $165.39 | $447.00 | 63% |
| New patient office visit, about 30 minutes inpatient CPT 99203 NEW PT 30 MIN MOD 25 12626 | $165.39 | $447.00 | 63% |
| New patient office visit, about 30 minutes inpatient CPT 99203 NEW VISIT<10HRS MOBS 99203 | $165.39 | $447.00 | 63% |
| New patient office visit, about 30 minutes inpatient CPT 99203 NEW PT/INIT LACT 30 MIN 34268 | $165.39 | $447.00 | 63% |
| New patient office visit, about 45 minutes CPT 99204 NEWVISIT 11 24HR MOB 99204 | $126.54 | $342.00 | 63% |
| New patient office visit, about 45 minutes CPT 99204 NEW VISIT 45 MIN 99204 | $228.20 | $616.75 | 63% |
| New patient office visit, about 45 minutes CPT 99204 NEW PT 45 MIN MOD 25 12625 | $228.20 | $616.75 | 63% |
| New patient office visit, about 45 minutes CPT 99204 NEW PT/INIT LACT 45 MIN 34278 | $228.20 | $616.75 | 63% |
| New patient office visit, about 45 minutes CPT 99204 NEW VISIT 45-59 MIN 99204 | $228.20 | $616.75 | 63% |
| New patient office visit, about 45 minutes inpatient CPT 99204 NEWVISIT 11 24HR MOB 99204 | $126.54 | $342.00 | 63% |
| New patient office visit, about 45 minutes inpatient CPT 99204 NEW PT/INIT LACT 45 MIN 34278 | $228.20 | $616.75 | 63% |
| New patient office visit, about 45 minutes inpatient CPT 99204 NEW VISIT 45-59 MIN 99204 | $228.20 | $616.75 | 63% |
| New patient office visit, about 45 minutes inpatient CPT 99204 NEW VISIT 45 MIN 99204 | $228.20 | $616.75 | 63% |
| New patient office visit, about 45 minutes inpatient CPT 99204 NEW PT 45 MIN MOD 25 12625 | $228.20 | $616.75 | 63% |
| New patient office visit, about 60 minutes CPT 99205 NEW VISIT>24HRS MOBS 99205 | $157.25 | $425.00 | 63% |
| New patient office visit, about 60 minutes CPT 99205 NEW VISIT 60 MIN 99205 | $277.69 | $750.50 | 63% |
| New patient office visit, about 60 minutes CPT 99205 NEW PT 60 MIN MOD 25 12624 | $277.69 | $750.50 | 63% |
| New patient office visit, about 60 minutes CPT 99205 NEW PT INIT LACT 60 MIN 34296 | $277.69 | $750.50 | 63% |
| New patient office visit, about 60 minutes inpatient CPT 99205 NEW VISIT>24HRS MOBS 99205 | $157.25 | $425.00 | 63% |
| New patient office visit, about 60 minutes inpatient CPT 99205 NEW PT 60 MIN MOD 25 12624 | $277.69 | $750.50 | 63% |
| New patient office visit, about 60 minutes inpatient CPT 99205 NEW PT INIT LACT 60 MIN 34296 | $277.69 | $750.50 | 63% |
| New patient office visit, about 60 minutes inpatient CPT 99205 NEW VISIT 60 MIN 99205 | $277.69 | $750.50 | 63% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXER 15M 62962 | $33.02 | $89.25 | 63% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THER PROCEDURE 15M 39789 | $33.02 | $89.25 | 63% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THER PROCEDURE 15M 38113 | $33.02 | $89.25 | 63% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXER 15M 62962 | $33.02 | $89.25 | 63% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 TELEH THERAPEUTIC EXER 15M 40932 | $33.02 | $89.25 | 63% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 TELEH THER PROCEDURE 15M 40927 | $33.02 | $89.25 | 63% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXER 15M 39790 | $33.02 | $89.25 | 63% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THER PROCEDURE 15M 39789 | $33.02 | $89.25 | 63% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THER PROCEDURE 15M 38113 | $33.02 | $89.25 | 63% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 TELEH THERAPEUTIC EXER 15M 40932 | $33.02 | $89.25 | 63% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 TELEH THER PROCEDURE 15M 40927 | $33.02 | $89.25 | 63% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXER 15M 39790 | $33.02 | $89.25 | 63% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEH THERAPEUTIC EXER 15M 40932 | $33.02 | $89.25 | 63% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THER PROCEDURE 15M 38113 | $33.02 | $89.25 | 63% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXER 15M 39790 | $33.02 | $89.25 | 63% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THER PROCEDURE 15M 39789 | $33.02 | $89.25 | 63% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXER 15M 62962 | $33.02 | $89.25 | 63% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEH THER PROCEDURE 15M 40927 | $33.02 | $89.25 | 63% |
| Psychotherapy session, 30 minutes CPT 90832 THERAPY W PT 30 MINUTES 51260 | $210.44 | $568.75 | 63% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 THERAPY W PT 30 MINUTES 51260 | $210.44 | $568.75 | 63% |
| Psychotherapy session, 45 minutes CPT 90834 THERAPY W PT 45 MINUTES 90834 | $210.44 | $568.75 | 63% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 THERAPY W PT 45 MINUTES 90834 | $210.44 | $568.75 | 63% |
| Psychotherapy session, 60 minutes CPT 90837 THERAPY W PT 60 MINUTES 51261 | $210.44 | $568.75 | 63% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 THERAPY W PT 60 MINUTES 51261 | $210.44 | $568.75 | 63% |