SelfPayRates
Hospital

Jefferson County Hospital OK

Jefferson County Hospital OK in Waurika, OK publishes cash prices for 211 common procedures listed here, from its own machine-readable price file updated Mar 14, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Oklahoma median for 148 of 210 procedures and above it for 60. By typical cash price it ranks #11 of 43 Oklahoma hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

US-81 & US-70, Waurika, OK 73573 Collected Sep 27, 2026 Source price file (580) 228-2344

Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 371311 · CMS hospital register

Scans and imaging

ProcedureCash price List priceInsurers payvs OklahomaOff list
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE COMPLETE UNILATERAL XRAY $134.78 $384.00 $84.89–$360.96 23% below 65%
Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHAGUS - X-RAY $288.87 $823.00 $84.89–$773.62 1% above 65%
Breast ultrasound, complete, one breast CPT 76641 BREAST ULTRASOUND COMPLETE UNI $163.21 $465.00 $195.30–$649.93 51% below 65%
Breast ultrasound, limited (one breast or one area) CPT 76642 BREAST ULTRASOUND LIMITED UNI $158.65 $452.00 $189.84–$649.93 52% below 65%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST W/WO $1,712.17 $4,878.00 $1,245.37–$4,585.32 14% above 65%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CTA CORONARY ARTERIES $1,272.37 $3,625.00 $977.09–$3,407.50 9% above 65%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 ABD & PELVIS W/OUT CONTRAST $1,455.24 $4,146.00 $1,133.17–$3,897.24 9% above 65%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 RENAL STONE SCAN $1,652.85 $4,709.00 $1,133.17–$4,426.46 23% above 65%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 ABD & PELVIS WITH CONTRAST $1,652.85 $4,709.00 $1,133.17–$4,426.46 3% above 65%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 APPENDICITIS SCAN $1,787.64 $5,093.00 $1,133.17–$4,787.42 11% above 65%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT UROGRAPHY $1,455.24 $4,146.00 $1,133.17–$3,897.24 23% below 65%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 ABD & PELVIS W&W/OUT CONTRAST $1,787.64 $5,093.00 $1,133.17–$4,787.42 6% below 65%
CT scan of the abdomen with contrast CPT 74160 ABDOMEN WITH CONTRAST-CT $1,232.01 $3,510.00 $1,133.17–$3,299.40 10% above 65%
CT scan of the abdomen without contrast CPT 74150 ABDOMEN WITHOUT CONTRAST-CT $1,031.94 $2,940.00 $1,133.17–$2,763.60 3% above 65%
CT scan of the face and sinuses, no contrast dye CPT 70486 MAXILLOFACIAL WITHOUT-CT $848.01 $2,416.00 $922.67–$2,271.04 4% below 65%
CT scan of the head or brain, no contrast dye CPT 70450 HEAD WITHOUT CONTRAST-CT $1,119.69 $3,190.00 $437.58–$2,998.60 19% above 65%
CT scan of the head with contrast CPT 70460 HEAD WITH CONTRAST ONLY-CT. $1,203.93 $3,430.00 $437.58–$3,224.20 1% below 65%
CT scan of the head without and with contrast CPT 70470 HEAD W/WO CONTRAS-CT $1,289.92 $3,675.00 $437.58–$3,454.50 1% above 65%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 LUMBAR SPINE WITHOUT CONT-CT $1,040.01 $2,963.00 $767.01–$2,785.22 3% above 65%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CERVICAL SPINE WITHOUT C-CT $1,067.74 $3,042.00 $767.01–$2,859.48 8% above 65%
CT scan of the pelvis, with contrast dye CPT 72193 PELVIS WITH CONTRAST-CT $1,088.10 $3,100.00 $1,133.17–$2,914.00 at median 65%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 CAROTID SCAN/DOPPLER-US $508.95 $1,450.00 $413.95–$1,363.00 3% above 65%
Chest X-ray, 2 views CPT 71046 CHEST SPECIAL VIEWS - XRAY $129.51 $369.00 $84.89–$346.86 9% above 65%
Chest X-ray, 2 views CPT 71046 CHEST 2 VIEWS PA & LAT -XRAY $169.88 $484.00 $84.89–$454.96 43% above 65%
Chest X-ray, single view CPT 71045 CHEST SINGLE VIEW PA - XRAY $100.73 $287.00 $84.89–$269.78 43% below 65%
Chest X-ray, single view CPT 71045 COUNTY HEALTH CXR $131.27 $374.00 $84.89–$351.56 25% below 65%
Chest X-ray, single view CPT 71045 CHEST SINGLE VIEW PORTABLE $214.46 $611.00 $84.89–$574.34 22% above 65%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 RENAL ULTRASOUND-US $382.23 $1,089.00 $413.95–$1,023.66 4% below 65%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 THORAX WITHOUT CONTRAST-CT $1,004.56 $2,862.00 $922.67–$2,690.28 5% above 65%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 THORAX WITH CONTRAST-CT $1,251.66 $3,566.00 $922.67–$3,352.04 11% above 65%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT THORAX - PE PROTOCOL $1,251.66 $3,566.00 $922.67–$3,352.04 11% above 65%
Duplex ultrasound of the leg arteries, both legs CPT 93925 LOWER EXTREMITY ARTERIAL US $326.78 $931.00 $391.02–$1,080.49 17% below 65%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 BILATERAL EXTREMITY VENOUS US $413.82 $1,179.00 $495.18–$1,108.26 — 65%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHOCARDIOGRAM(2D)-COMPLETE $1,160.05 $3,305.00 $984.09–$3,106.70 7% above 65%
Knee X-ray, 3 views one side CPT 73562 KNEE UNILATERAL $151.98 $433.00 $84.89–$407.02 15% below 65%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 SINGLE QUADRANT US $457.70 $1,304.00 $413.95–$1,225.76 19% above 65%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 LIMITED PELVIC ULTRASOUND $198.66 $566.00 $237.72–$649.93 34% below 65%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 PELVIC ULTRASOUND-US $353.80 $1,008.00 $413.95–$947.52 27% below 65%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 ULT-PREGNANT UTERUS > 14 WKS $229.55 $654.00 $274.68–$614.76 46% below 65%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 ULT-PREGNANT UTERUS < 14 WKS $229.55 $654.00 $274.68–$614.76 46% below 65%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OB LIMITED-US $157.59 $449.00 $188.58–$422.06 55% below 65%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER UNILATERAL 2 VIEWS $151.98 $433.00 $84.89–$407.02 21% below 65%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 STRESS ECHOCARDIOGRAM $959.63 $2,734.00 $984.09–$2,569.96 18% below 65%
Swallow study (modified barium swallow, video X-ray) CPT 74230 SWALLOWING FUNCTION VIDEO $245.34 $699.00 $293.58–$893.34 22% below 65%
Transvaginal pelvic ultrasound CPT 76830 ULTRASOUND- TRANSVAGINAL NONOB $328.88 $937.00 $393.54–$880.78 13% below 65%
Transvaginal ultrasound during pregnancy CPT 76817 TRANS VAG W/TRANS ABDOM OB $124.95 $356.00 $149.52–$334.64 56% below 65%
Transvaginal ultrasound during pregnancy CPT 76817 PREGNANT UTERUS-TRANSVAGINAL $288.87 $823.00 $316.69–$773.62 2% above 65%
Ultrasound of the abdomen, complete CPT 76700 ABDOMEN STUDY-US $385.04 $1,097.00 $413.95–$1,031.18 27% below 65%
Ultrasound of the scrotum and testicles CPT 76870 SCROTUM ULTRASOUND $236.57 $674.00 $283.08–$649.93 31% below 65%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 THYROID ULTRASOUND-US $219.72 $626.00 $262.92–$649.93 46% below 65%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 GASTROGRAFIN UGI - XRAY $388.20 $1,106.00 $464.52–$1,039.64 2% above 65%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 UNILATERAL EXTREMITY VENOUS US $316.25 $901.00 $378.42–$1,080.49 36% below 65%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST UNILATERAL MIN 3 VIEWS $142.15 $405.00 $84.89–$380.70 19% below 65%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HIP DURING OPERATIVE PROCEDURE $156.19 $445.00 $84.89–$418.30 16% below 65%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP COMPLETE UNILATERAL MIN 2 $152.68 $435.00 $84.89–$408.90 18% below 65%
X-ray of the abdomen, 1 view CPT 74018 SCOUT (X-RAY) $129.51 $369.00 $84.89–$346.86 24% below 65%
X-ray of the abdomen, 1 view CPT 74018 ABDOMEN SUPINE - X-RAY $129.51 $369.00 $84.89–$346.86 24% below 65%
X-ray of the abdomen, 1 view CPT 74018 FETOGRAM - XRAY $129.51 $369.00 $84.89–$346.86 24% below 65%
X-ray of the abdomen, 1 view CPT 74018 KUB - XRAY $129.51 $369.00 $84.89–$346.86 24% below 65%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE UNILATERAL 2 VIEWS $98.63 $281.00 $84.89–$264.14 38% below 65%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGERS UNILATERAL - X-RAY $129.16 $368.00 $84.89–$345.92 20% below 65%
X-ray of the foot, 2 views one side CPT 73620 FOOT UNILATERAL 2 VIEWS $98.63 $281.00 $84.89–$264.14 39% below 65%
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT COMPLETE UNILATERAL MIN 3 $158.65 $452.00 $84.89–$424.88 15% below 65%
X-ray of the hand, 3 or more views one side CPT 73130 HAND UNILATERAL MIN 3 VIEWS $133.73 $381.00 $84.89–$358.14 25% below 65%
X-ray of the knee, 1 or 2 views CPT 73560 KNEE 1 OR 2 VIEWS $144.61 $412.00 $84.89–$387.28 14% below 65%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LUMBAR SPINE 2 OR 3 VIEWS XRAY $183.22 $522.00 $84.89–$490.68 13% below 65%
X-ray of the lower back, 4 or more views CPT 72110 LUMBAR SPINE W/ OBLIQUES-XRAY $244.99 $698.00 $84.89–$656.12 15% below 65%
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES COMPLETE 3 VIEWS $140.04 $399.00 $84.89–$375.06 14% below 65%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 CERVICAL SPINE AP & LAT -XRAY $144.96 $413.00 $84.89–$388.22 27% below 65%
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS 1 OR 2 VIEWS XRAY $143.20 $408.00 $84.89–$383.52 25% below 65%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM AND COCCYX MIN 2 VIEWS $142.15 $405.00 $84.89–$380.70 20% below 65%

Lab tests

ProcedureCash price List priceInsurers payvs OklahomaOff list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT $38.25 $109.00 $3.18–$102.46 18% above 65%
AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT $52.29 $149.00 $3.11–$140.06 38% above 65%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PANEL - ACUTE $199.68 $568.89 $28.58–$534.75 8% above 65%
Allergy blood test, specific IgE, per allergen CPT 86003 ASPERGILLUS FUMIGATUS IGE $11.23 $32.00 $3.13–$33.78 55% below 65%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN F2-COW MILK IGE $21.76 $62.00 $3.13–$58.28 12% below 65%
Allergy blood test, specific IgE, per allergen CPT 86003 CANDIDA ALB IGE M5 ALLRGN $22.81 $65.00 $3.13–$61.10 8% below 65%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PANEL - FOOD $54.40 $155.00 $3.13–$145.70 119% above 65%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLG SPEC IGE CRUDE XTRC EA $77.92 $222.00 $3.13–$208.68 214% above 65%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PEDIATRIC FOOD $85.29 $243.00 $3.13–$228.42 244% above 65%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PANEL - MOLDS $137.59 $392.00 $3.13–$368.48 455% above 65%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PANEL-RESP OK/TX $173.92 $495.50 $3.13–$465.77 602% above 65%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PANEL - CHILDHOOD $274.76 $782.80 $3.13–$735.83 1008% above 65%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ANTIBODY $18.13 $51.66 $7.77–$48.56 74% below 65%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLICCITRULLNTD PEPTIDE IgG $43.17 $123.00 $7.77–$115.62 39% below 65%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ANTIBODY (RHEUM EVALUATR) $64.93 $185.00 $7.77–$173.90 8% below 65%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES $15.44 $44.00 $7.25–$41.36 64% below 65%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODY $32.65 $93.03 $7.25–$87.44 24% below 65%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-TYPE NATRIURETIC PEPTIDE $43.52 $124.00 $23.56–$117.46 61% below 65%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 PRO-BNP $52.29 $149.00 $23.56–$140.06 53% below 65%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP (NON-PRO) $52.29 $149.00 $23.56–$140.06 53% below 65%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP-BRAIN NATRIURETIC PEPTIDE $55.79 $158.97 $23.56–$149.43 50% below 65%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL $31.62 $90.09 $5.08–$84.68 1% below 65%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURG PATH LEV 4 - GROSS & MICR $52.29 $149.00 $62.58–$140.06 59% below 65%
Blood culture for bacteria CPT 87040 BLOOD BAG CULTURE (TRANS RXN) $55.45 $158.00 $6.19–$148.52 10% below 65%
Blood culture for bacteria CPT 87040 BLOOD CULTURE $55.45 $158.00 $6.19–$148.52 10% below 65%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE JCH $9.12 $26.00 $5.45–$24.44 3% below 65%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE ER $9.12 $26.00 $5.45–$24.44 3% below 65%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE $9.84 $28.04 $5.45–$26.35 4% above 65%
Blood glucose (sugar) test CPT 82947 GLUCOSE LEVEL $33.31 $94.92 $2.36–$89.22 31% above 65%
Blood glucose (sugar) test CPT 82947 GLUCOSE 2 HR PP $33.31 $94.92 $2.36–$89.22 31% above 65%
Blood lead test CPT 83655 LEAD LEVEL $28.78 $82.00 $7.27–$77.08 32% below 65%
Blood lead test CPT 83655 LEAD URINE $29.48 $84.00 $7.27–$78.96 30% below 65%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 BHCG SERUM SCREEN $45.07 $128.42 $4.51–$120.71 12% above 65%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 GROUP (ABO) $35.10 $100.00 $1.79–$94.00 39% below 65%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN (INFLAM) $39.21 $111.72 $3.11–$105.01 44% above 65%
C. difficile toxin gene test (stool PCR) CPT 87493 CLOSTRIDIUM DIFF PCR - QUAL $55.42 $157.92 $22.36–$148.44 39% below 65%
C. difficile toxin gene test (stool PCR) CPT 87493 CDIFF/EPI PCR GENEXPERT $103.54 $295.00 $22.36–$277.30 15% above 65%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 TUMOR ANTIGEN $45.77 $130.41 $12.49–$122.58 50% below 65%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 TUMOR ANTIGEN $59.22 $168.74 $12.49–$158.61 3% below 65%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 CORONAVIRUS-COVID19 AMP PROBE $43.17 $123.00 $30.79–$115.62 41% below 65%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA T AMPLIF NA PROBE $21.59 $61.53 $21.05–$57.83 72% below 65%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS rRNA DET $55.45 $158.00 $21.05–$148.52 29% below 65%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA-AMPLIF NA PROBE $64.23 $183.00 $21.05–$172.02 18% below 65%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 UR-SURE CHLAMYDIA $81.00 $230.79 $21.05–$216.94 4% above 65%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL $26.09 $74.34 $8.03–$69.87 60% below 65%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL - BASIC $29.48 $84.00 $8.03–$78.96 55% below 65%
Complete blood count (CBC) with differential CPT 85025 CBC WITH AUTO DIFF $24.57 $70.00 $4.66–$65.80 46% below 65%
Complete blood count (CBC), no differential CPT 85027 CBC WITH NO DIFFERENTIAL $20.89 $59.54 $3.88–$55.96 30% below 65%
Comprehensive metabolic panel (blood test) CPT 80053 CMP W/ADJUSTED CALCIUM $15.79 $45.00 $6.34–$42.30 65% below 65%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL $42.30 $120.54 $6.34–$113.30 7% below 65%
D-dimer blood test (blood clot marker) CPT 85379 D DIMER (QUANTITATIVE) $94.12 $268.17 $6.11–$252.07 3% above 65%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-S $41.41 $118.00 $13.34–$110.92 45% below 65%
Estradiol blood test CPT 82670 ESTRADIOL $73.71 $210.00 $16.76–$197.40 1% below 65%
FSH (follicle-stimulating hormone) test CPT 83001 FSH PEDIATRIC 3RD GENERATION $11.93 $34.00 $11.15–$83.79 83% below 65%
FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE STIMULATING HORMONE $48.78 $139.00 $11.15–$130.66 29% below 65%
Fecal calprotectin (stool inflammation test) CPT 83993 STOOL CALPROTECTIN $86.16 $245.49 $11.78–$230.76 28% below 65%
Ferritin blood test (iron stores) CPT 82728 FERRITIN $54.72 $155.90 $8.18–$146.54 12% above 65%
Folate (folic acid) blood test CPT 82746 FOLATE (FOLIC ACID) $20.70 $59.00 $8.82–$55.46 64% below 65%
Folate (folic acid) blood test CPT 82746 FOLIC ACID $20.70 $59.00 $8.82–$55.46 64% below 65%
Free T3 thyroid hormone test CPT 84481 T3 FREE $64.75 $184.49 $10.16–$173.42 28% below 65%
Free T3 thyroid hormone test CPT 84481 T3 - FREE $64.75 $184.49 $10.16–$173.42 28% below 65%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE THYROXINE (T4) $43.71 $124.53 $5.41–$117.05 29% below 65%
Free testosterone test CPT 84402 TESTOSTERONE FREE-FEMALE&PEDI $62.12 $177.00 $15.28–$166.38 28% below 65%
Free testosterone test CPT 84402 TESTOSTERONE - FREE $86.53 $246.54 $15.28–$231.74 1% above 65%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE O'SULLIVAN $40.94 $116.66 $2.85–$109.66 40% above 65%
Glucose tolerance test, 3 samples CPT 82951 GTT - 3 SAMPLES $21.06 $60.00 $7.72–$56.40 68% below 65%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE-3 SPECIMENS $78.97 $225.00 $7.72–$211.50 21% above 65%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 2 HR $80.02 $228.00 $7.72–$214.32 23% above 65%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE--3 HRS $92.83 $264.50 $7.72–$248.63 43% above 65%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE--4 HRS $109.16 $311.00 $7.72–$292.34 68% above 65%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE--5 HRS $121.97 $347.50 $7.72–$326.65 87% above 65%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA AMPLIF NA PROBE $21.59 $61.53 $21.05–$109.63 72% below 65%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA-AMPLIF NA PROBE $64.23 $183.00 $21.05–$172.02 17% below 65%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 UR-SURE GC $81.00 $230.79 $21.05–$216.94 5% above 65%
H. pylori antibody blood test CPT 86677 H.PYLORI ANTIBODY IGM $67.39 $192.00 $10.11–$180.48 1% below 65%
H. pylori antibody blood test CPT 86677 H.PYLORI IGG ANTIBODY $75.81 $216.00 $10.11–$203.04 11% above 65%
H. pylori stool antigen test CPT 87338 H. PYLORI STOOL ANTIGEN $65.77 $187.40 $8.63–$176.15 42% below 65%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV RNA (PCR) $74.76 $213.00 $51.06–$200.22 62% below 65%
HIV-1 and HIV-2 antibody test CPT 86703 ST ANTHONY HIV 1 & 2 $20.70 $59.00 $8.23–$55.46 55% below 65%
HIV-1 and HIV-2 antibody test CPT 86703 HIV ANTIBODY 1 & 2 $45.98 $131.00 $8.23–$123.14 1% above 65%
HIV-1 and HIV-2 antibody test CPT 86703 NSTK HIV NON-DRH EMPLOYEE $48.08 $137.00 $8.23–$128.78 6% above 65%
HIV-1 and HIV-2 antibody test CPT 86703 NSTK HIV NON-DRH SOURCE $48.08 $137.00 $8.23–$128.78 6% above 65%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1 AND 2 ABS EIA W REFLEX $45.98 $131.00 $14.45–$123.14 4% below 65%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HIGH-RISK TYPES $40.01 $114.00 $21.05–$109.63 62% below 65%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCOSYLATED HEMOGLOBIN $57.56 $164.00 $5.83–$154.16 34% above 65%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE ANTIBODY TOTAL $36.45 $103.85 $6.44–$97.61 16% below 65%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SURFACE ANTIGEN $37.55 $107.00 $6.20–$100.58 4% below 65%
Hepatitis C antibody blood test (screening) CPT 86803 ST ANTHONY HEP C Ab IgG/EIA $34.39 $98.00 $8.56–$92.12 30% below 65%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY IGG $58.26 $166.00 $8.56–$156.04 19% above 65%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA (PCR)-QUANT $145.66 $415.00 $25.70–$390.10 34% below 65%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C RNA ULTRAQUANT $272.37 $776.00 $25.70–$729.44 23% above 65%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 TEST $18.60 $53.00 $7.91–$56.05 70% below 65%
Herpes blood test, HSV-1 antibody CPT 86695 AB HSV TYPE 1 (IGM) $25.39 $72.35 $7.91–$68.00 59% below 65%
Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 IGM TITER REFLEX $25.97 $74.00 $7.91–$69.56 58% below 65%
Herpes blood test, HSV-1 antibody CPT 86695 AB HSV TYPE 1 (IGG) $49.49 $141.00 $7.91–$132.54 19% below 65%
Herpes blood test, HSV-1 antibody CPT 86695 HSV TYPE 1 ANTIBODY $66.33 $189.00 $7.91–$177.66 8% above 65%
Herpes blood test, HSV-1 antibody CPT 86695 AB-HSV 1 $102.49 $292.00 $7.91–$274.48 67% above 65%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 TEST $16.84 $48.00 $11.61–$45.12 74% below 65%
Herpes blood test, HSV-2 antibody CPT 86696 AB HSV TYPE 2 (IGM) $25.39 $72.35 $11.61–$68.00 61% below 65%
Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 IGM TITER REFLEX $25.97 $74.00 $11.61–$69.56 60% below 65%
Herpes blood test, HSV-2 antibody CPT 86696 AB HSV TYPE 2 (IGG) $50.27 $143.22 $11.61–$134.62 23% below 65%
Herpes blood test, HSV-2 antibody CPT 86696 HSV TYPE 2 ANTIBODY $66.33 $189.00 $11.61–$177.66 2% above 65%
Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 INHIBITION $78.97 $225.00 $11.61–$211.50 21% above 65%
Herpes blood test, HSV-2 antibody CPT 86696 AB-HSV 2 $102.49 $292.00 $11.61–$274.48 57% above 65%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN ULTRAQUANT $97.92 $278.99 $7.77–$262.25 91% above 65%
Homocysteine blood test CPT 83090 HOMOCYSTEINE LEVEL $105.84 $301.56 $10.75–$283.46 15% below 65%
Insulin blood test CPT 83525 INSULIN LEVEL $59.22 $168.74 $6.86–$158.61 33% above 65%
Iron blood test (serum iron) CPT 83540 ASSAY OF IRON $7.37 $21.00 $3.88–$20.22 77% below 65%
Iron blood test (serum iron) CPT 83540 IRON LEVEL $28.08 $80.00 $3.88–$75.20 12% below 65%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING TEST $14.04 $40.00 $5.24–$38.68 64% below 65%
Iron-binding capacity (TIBC) test CPT 83550 TOT. IRON BINDING CAPACITY $32.65 $93.03 $5.24–$87.44 17% below 65%
Iron-binding capacity (TIBC) test CPT 83550 IRON AND IRON BINDING CAPACITY $61.60 $175.50 $5.24–$164.97 57% above 65%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL $102.49 $292.00 $5.21–$274.48 94% above 65%
LH (luteinizing hormone) test CPT 83002 LH PEDIATRICS 3RD GENERATION $44.05 $125.50 $11.11–$117.97 40% below 65%
LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE $48.78 $139.00 $11.11–$130.66 33% below 65%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE URINE $57.91 $165.00 $4.13–$155.10 35% above 65%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE $74.41 $212.00 $4.13–$199.28 73% above 65%
Liver function blood test panel CPT 80076 LIVER FUNCTION PANEL $61.42 $175.00 $4.90–$164.50 39% above 65%
Lyme disease antibody test CPT 86618 AB- LYME'S DISEASE $28.78 $82.00 $10.22–$77.08 60% below 65%
Lyme disease antibody test CPT 86618 LYME-BORRELIA BURG IgG $45.77 $130.41 $10.22–$122.58 36% below 65%
Lyme disease antibody test CPT 86618 LYME-BORRELIA BURG IgM $45.77 $130.41 $10.22–$122.58 36% below 65%
Lyme disease antibody test CPT 86618 LYME-BORRELIA BURG IgG/IgM $92.83 $264.50 $10.22–$248.63 30% above 65%
Magnesium blood test CPT 83735 MAGNESIUM (SERUM) LEVEL $28.08 $80.00 $4.02–$75.20 at median 65%
Magnesium blood test CPT 83735 MAGNESIUM URINE (RANDOM) $38.25 $109.00 $4.02–$102.46 37% above 65%
Measles (rubeola) antibody test CPT 86765 RUBEOLA ANTIBODY $12.28 $35.00 $7.73–$33.78 73% below 65%
Measles (rubeola) antibody test CPT 86765 MEASLES ANTIBODIES IGG IGM $16.28 $46.40 $7.73–$43.61 64% below 65%
Measles (rubeola) antibody test CPT 86765 MEASLES IgG (IMMUNE) $46.68 $133.00 $7.73–$125.02 2% above 65%
Measles (rubeola) antibody test CPT 86765 MEASLES IgM (ACUTE) $46.68 $133.00 $7.73–$125.02 2% above 65%
Mono test (heterophile antibody, Monospot) CPT 86308 MONO TEST $76.83 $218.90 $3.11–$205.76 133% above 65%
Obstetric blood test panel CPT 80055 OBSTETRIC PANEL $119.33 $339.99 $28.69–$319.59 9% below 65%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE $14.66 $41.79 $11.03–$39.28 85% below 65%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE (INCLUDES TOTAL) $56.68 $161.50 $11.03–$151.81 44% below 65%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA - TOTAL - DIAGNOSTIC $35.10 $100.00 $11.03–$94.00 54% below 65%
Pap test (liquid-based, automated screening with review) CPT 88175 SP AUTOMATED PAP & RVW $21.06 $60.00 $15.97–$59.74 71% below 65%
Pap test (liquid-based, automated screening with review) CPT 88175 TP CYTC PAP & RVW $21.06 $60.00 $15.97–$59.74 71% below 65%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 TP CYTC PAP $22.46 $64.00 $12.16–$60.16 68% below 65%
Parathyroid hormone (PTH) blood test CPT 83970 PTH (INTACT) $58.96 $168.00 $24.77–$157.92 58% below 65%
Parathyroid hormone (PTH) blood test CPT 83970 PTH - SEND OUT $58.96 $168.00 $24.77–$157.92 58% below 65%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE $58.96 $168.00 $24.77–$157.92 58% below 65%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL $5.61 $16.00 $3.61–$15.12 82% below 65%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT(PARTIAL THROMBOPLAST TIME) $44.22 $126.00 $3.61–$118.44 42% above 65%
Partial thromboplastin time (PTT) clotting test CPT 85730 VWP - APTT $49.56 $141.20 $3.61–$132.72 59% above 65%
Partial thromboplastin time (PTT) clotting test CPT 85730 PROTIME AND PTT $68.44 $195.00 $3.61–$183.30 119% above 65%
Progesterone blood test CPT 84144 PROGESTERONE $59.22 $168.74 $12.52–$158.61 22% below 65%
Prolactin blood test CPT 84146 PROLACTIN $59.22 $168.74 $11.63–$158.61 30% below 65%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME $23.16 $66.00 $2.57–$62.04 5% above 65%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCRN URINE-PRESUM OPTICAL $50.54 $144.00 $7.56–$135.36 30% above 65%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA ANTIGEN SCREEN $55.79 $158.97 $9.93–$149.43 at median 65%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP SCREEN $50.27 $143.22 $9.92–$134.62 4% above 65%
Rheumatoid factor (RF) test CPT 86431 RHEMATOID FACTOR W/TITER $11.23 $32.00 $3.40–$33.78 57% below 65%
Rheumatoid factor (RF) test CPT 86431 QUANT RHEUM FACTOR $15.44 $44.00 $3.40–$41.36 41% below 65%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR $24.21 $69.00 $3.40–$64.86 8% below 65%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID ARTHRITIS QUANT $52.29 $149.00 $3.40–$140.06 98% above 65%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR (EVALUATR) $194.63 $554.51 $3.40–$521.23 638% above 65%
Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY $13.33 $38.00 $8.63–$35.72 74% below 65%
Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY IgG (IMMUNE) $50.27 $143.22 $8.63–$134.62 2% below 65%
Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY IGM $50.27 $143.22 $8.63–$134.62 2% below 65%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGG $50.27 $143.22 $8.63–$134.62 2% below 65%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 ESR (SED RATE) $24.57 $70.00 $1.62–$65.80 18% above 65%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 SEMEN ANALYSIS $84.94 $242.00 $7.39–$227.48 29% below 65%
Stool ova and parasites exam CPT 87177 PARAD-O&P DIRECT SMEAR CONC/ID $38.84 $110.67 $5.34–$104.02 33% below 65%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR W/REFLEX TITER AND CONFIRM $12.28 $35.00 $2.56–$33.78 52% below 65%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 PREMARITAL RPR $20.56 $58.59 $2.56–$55.07 20% below 65%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL SERUM $21.76 $62.00 $2.56–$58.28 15% below 65%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL-SERUM $22.81 $65.00 $2.56–$61.10 11% below 65%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR (SYPHILIS SCREEN) SEND OUT $27.44 $78.20 $2.56–$73.50 7% above 65%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL CSF $30.18 $86.00 $2.56–$80.84 18% above 65%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON-TB GOLD PLUS $93.36 $266.00 $37.19–$250.04 44% below 65%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON-TB GOLD $134.78 $384.00 $37.19–$360.96 19% below 65%
Testosterone blood test, total (not free testosterone) CPT 84403 TES PNL-TESTOSTERONE- TOTAL $27.72 $79.00 $15.49–$83.79 66% below 65%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE FEMALE & PEDI $76.83 $218.90 $15.49–$205.76 6% below 65%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE - TOTAL $80.73 $230.00 $15.49–$216.20 1% below 65%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL $80.73 $230.00 $15.49–$216.20 1% below 65%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE AUTOABS $31.62 $90.09 $8.73–$84.68 43% below 65%
Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER KIDNEY MICROSOME AUTOABS $33.31 $94.92 $8.73–$89.22 40% below 65%
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI-THRYOID PEROXIDASE ANTI $37.55 $107.00 $8.73–$100.58 32% below 65%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH NEONATAL (CH) $14.39 $41.00 $10.08–$63.12 68% below 65%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE $46.47 $132.41 $10.08–$124.46 4% above 65%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS AMPLIF $21.59 $61.53 $21.05–$109.63 75% below 65%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS PCR GENEXPERT-M $35.80 $102.00 $21.05–$109.63 59% below 65%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS PCR GENEXPERT-F $35.80 $102.00 $21.05–$109.63 59% below 65%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS RNA QUAL MALE $40.57 $115.61 $21.05–$109.63 54% below 65%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS RNA QUAL FEMALE $40.57 $115.61 $21.05–$109.63 54% below 65%
Uric acid blood test CPT 84550 URIC ACID (SERUM) $17.90 $51.00 $2.71–$47.94 29% below 65%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS ROUTINE $20.56 $58.59 $1.90–$55.07 15% below 65%
Urinalysis without microscope exam, automated CPT 81003 DIPSTICK URINE $14.04 $40.00 $1.35–$37.60 23% above 65%
Urinalysis without microscope exam, automated CPT 81003 SPECIFIC GRAVITY $14.04 $40.00 $1.35–$37.60 23% above 65%
Urinalysis without microscope exam, automated CPT 81003 KETONE URINE $14.04 $40.00 $1.35–$37.60 23% above 65%
Urinalysis without microscope exam, automated CPT 81003 ALBUMIN URINE $14.04 $40.00 $1.35–$37.60 23% above 65%
Urinalysis without microscope exam, automated CPT 81003 PH URINE $15.79 $45.00 $1.35–$42.30 39% above 65%
Urinalysis without microscope exam, automated CPT 81003 NITRITE URINE $18.83 $53.66 $1.35–$50.44 65% above 65%
Urinalysis without microscope exam, automated CPT 81003 OCCULT BLOOD URINE $18.83 $53.66 $1.35–$50.44 65% above 65%
Urinalysis without microscope exam, automated CPT 81003 BILIRUBIN URINE $18.83 $53.66 $1.35–$50.44 65% above 65%
Urinalysis without microscope exam, automated CPT 81003 LEUKOCYTES URINE $18.83 $53.66 $1.35–$50.44 65% above 65%
Urinalysis without microscope exam, automated CPT 81003 BLOOD URINE $18.83 $53.66 $1.35–$50.44 65% above 65%
Urinalysis without microscope exam, automated CPT 81003 GLUCOSE-URINE QUAL $18.83 $53.66 $1.35–$50.44 65% above 65%
Urinalysis without microscope exam, manual CPT 81002 POC URINE ALB/PROT DIPSTICK $11.58 $33.00 $2.09–$31.02 34% below 65%
Urinalysis without microscope exam, manual CPT 81002 POC URINE BLOOD DIPSTICK $11.58 $33.00 $2.09–$31.02 34% below 65%
Urine culture for bacteria, with colony count CPT 87086 ENVIRONMENTAL CULTURE $35.80 $102.00 $4.84–$95.88 25% below 65%
Urine culture for bacteria, with colony count CPT 87086 CULTURE- URINE $37.20 $106.00 $4.84–$99.64 22% below 65%
Urine pregnancy test, read by color change CPT 81025 URINE HCG PREGNANCY TEST $45.07 $128.42 $5.17–$120.71 67% above 65%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 LEVEL $28.15 $80.22 $9.05–$75.40 52% below 65%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 $28.15 $80.22 $9.05–$75.40 52% below 65%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25-HYD TOTL-SEND OUT $117.93 $336.00 $17.76–$315.84 10% below 65%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D TOTAL (25 OH) $117.93 $336.00 $17.76–$315.84 10% below 65%
Zinc blood test CPT 84630 ZINC 24 HR URINE $24.21 $69.00 $6.83–$64.86 58% below 65%
Zinc blood test CPT 84630 ZINC LEVEL (SERUM OR URINE) $34.01 $96.92 $6.83–$91.10 41% below 65%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN CHORION HCG QUANT $21.59 $61.53 $9.03–$63.12 60% below 65%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BHCG-NON-PREGNANT TUMOR MARKER $30.18 $86.00 $9.03–$80.84 44% below 65%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 AFP TR/QD - HCG $55.80 $159.00 $9.03–$149.46 3% above 65%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA HCG - QUANTITATIVE $58.26 $166.00 $9.03–$156.04 8% above 65%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG-QUAN $64.42 $183.54 $9.03–$172.52 19% above 65%

Surgery and procedures

ProcedureCash price List priceInsurers payvs OklahomaOff list
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLSD TX DSTL FIB FX WO MANIP $610.74 $1,740.00 $730.80–$3,412.41 124% above 65%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 TRTMT OF METATARSAL FX WO MAN $610.74 $1,740.00 $730.80–$3,412.41 115% above 65%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION $541.94 $1,544.00 $648.48–$4,192.81 2% below 65%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CL TX RAD FX/ EPIP SEP WO MNP $610.74 $1,740.00 $730.80–$3,412.41 74% above 65%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REM IMPACT CERUMEN IRRIGATE $37.90 $108.00 $45.36–$181.75 39% below 65%
Earwax removal with instruments, one ear CPT 69210 CERUMEN REMOVAL W/INTR $39.31 $112.00 $47.04–$181.75 47% below 65%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS CYST SIMPLE $298.70 $851.00 $357.42–$1,752.39 39% above 65%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS $303.96 $866.00 $363.72–$2,200.14 28% above 65%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 MAJOR JOINT INJECTION $319.05 $909.00 $381.78–$2,200.14 34% above 65%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJ INTERM JOINT/BURSA $217.62 $620.00 $260.40–$2,200.14 4% below 65%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER CLOSURE 2.5CM OR LESS $199.71 $569.00 $238.98–$1,617.71 36% below 65%
Nail removal (partial or complete), one nail CPT 11730 AVULSION OF NAIL $219.72 $626.00 $262.92–$1,617.71 41% above 65%
Occipital nerve block (injection for headaches) CPT 64405 INJ ANESTH GRTR OCCIP NERVE $655.66 $1,868.00 $784.56–$3,240.88 72% above 65%
Paracentesis with imaging guidance CPT 49083 ABDOMINAL PARACENTESIS W/IMAG $637.76 $1,817.00 $763.14–$4,617.42 31% below 65%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION OF NAIL MATRIX $964.19 $2,747.00 $1,153.74–$5,460.69 167% above 65%
Removal of a foreign object under the skin, simple CPT 10120 INCISION/REMOVAL FOREIGN BODY $582.66 $1,660.00 $697.20–$1,752.39 137% above 65%
Short arm splint (forearm and hand) CPT 29125 APPL OF SHORT ARM SPLINT $283.25 $807.00 $338.94–$1,485.27 120% above 65%
Short leg splint (calf to foot) CPT 29515 APPL SHORT LEG SPLINT $283.25 $807.00 $338.94–$1,485.27 102% above 65%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR 2.5CM OR LESS $181.11 $516.00 $216.72–$1,617.71 8% below 65%
Skin tag removal, up to 15 tags CPT 11200 REMOVE SKIN TAGS <= 15 LESIONS $778.16 $2,217.00 $931.14–$2,083.98 400% above 65%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS<= 15 LESIONS $778.16 $2,217.00 $931.14–$2,083.98 400% above 65%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE $538.08 $1,533.00 $643.86–$3,536.27 10% below 65%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE REPAIR 2.6 - 7.5CM $181.46 $517.00 $217.14–$1,617.71 12% below 65%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR 2.5CM OR LESS $165.32 $471.00 $197.82–$1,617.71 22% below 65%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1-2 MUSCLES $303.96 $866.00 $363.72–$2,200.14 34% above 65%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD W/BIOPSY $698.13 $1,989.00 $835.38–$3,949.64 22% below 65%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD DIAGNOSTIC BRUSH WASH $808.00 $2,302.00 $966.84–$3,949.64 29% below 65%
Wart removal, up to 14 warts CPT 17110 DESTRUCTION BENIGN LES 1-14 $566.51 $1,614.00 $677.88–$1,556.32 247% above 65%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBQ 1ST 20 CM $194.45 $554.00 $232.68–$1,556.32 52% below 65%

Doctor visits and therapy

ProcedureCash price List priceInsurers payvs OklahomaOff list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION - JCH $666.19 $1,898.00 $797.16–$5,499.69 at median 65%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION - ER $924.18 $2,633.00 $1,105.86–$5,499.69 39% above 65%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SPUTUM COLLECTION $82.83 $236.00 $99.12–$1,671.17 33% below 65%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SMALL VOLUME NEB INITIAL $82.83 $236.00 $99.12–$1,671.17 33% below 65%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 METER DOSE INHALER TRMT INITIA $82.83 $236.00 $99.12–$1,671.17 33% below 65%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 IPPB TREATMENT INITIAL $82.83 $236.00 $99.12–$1,671.17 33% below 65%
Chemotherapy IV infusion, first hour CPT 96413 INFUSION CHEMO INIT TO 1 HR $122.14 $348.00 $146.16–$502.44 65% below 65%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE 30-74 MINUTES $726.92 $2,071.00 $869.82–$1,946.74 10% below 65%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG - AWAKE & DROWSEY $399.43 $1,137.99 $477.95–$3,296.99 7% below 65%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG - ER $108.10 $308.00 $36.97–$289.52 7% below 65%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG $175.50 $500.00 $36.97–$470.00 50% above 65%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 E.R. CARE UNIT LEVEL I $81.78 $233.00 $97.86–$219.02 28% below 65%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 E.R. CARE UNIT LEVEL II $160.05 $456.00 $191.52–$428.64 6% below 65%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 E.R. CARE UNIT LEVEL III $296.94 $846.00 $355.32–$795.24 1% above 65%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 E.R. CARE UNIT LEVEL IV $411.37 $1,172.00 $492.24–$1,101.68 7% below 65%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 E.R. CARE UNIT LEVEL V $554.58 $1,580.00 $663.60–$1,485.20 13% below 65%
Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIAC STRESS TEST $239.38 $682.00 $236.44–$641.08 36% below 65%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INFUSION HYDRATE INIT TO 1 HR $111.96 $319.00 $133.98–$502.44 31% below 65%
IV infusion of a medicine, first hour CPT 96365 INFUSN NON-CHEMO INIT TO 1 HR $126.36 $360.00 $151.20–$502.44 45% below 65%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION NON-CHEMO IM/SUBQ $36.85 $105.00 $44.10–$98.70 45% below 65%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 WOUND CARE LEVEL V $122.14 $348.00 $146.16–$327.12 44% below 65%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 CONTINENCE LEVEL V $122.14 $348.00 $146.16–$327.12 44% below 65%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OUTPATIENT CARE LEVEL 5 $128.11 $365.00 $153.30–$343.10 42% below 65%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OSTOMY CARE LEVEL V $128.11 $365.00 $153.30–$343.10 42% below 65%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 CONTINENCE LEVEL III $73.00 $208.00 $87.36–$195.52 45% below 65%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 WOUND CARE LEVEL III $73.00 $208.00 $87.36–$195.52 45% below 65%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OSTOMY CARE LEVEL III $76.51 $218.00 $91.56–$204.92 43% below 65%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OUTPATIENT CARE LEVEL 3 $76.51 $218.00 $91.56–$204.92 43% below 65%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 CONTINENCE LEVEL IV $97.22 $277.00 $116.34–$260.38 43% below 65%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 WOUND CARE LEVEL IV $97.22 $277.00 $116.34–$260.38 43% below 65%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OUTPATIENT CARE LEVEL 4 $102.14 $291.00 $122.22–$273.54 40% below 65%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OSTOMY CARE LEVEL IV $102.14 $291.00 $122.22–$273.54 40% below 65%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 CONTINENCE LEVEL II $48.78 $139.00 $58.38–$130.66 42% below 65%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 WOUND CARE LEVEL II $48.78 $139.00 $58.38–$130.66 42% below 65%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OSTOMY CARE LEVEL II $51.24 $146.00 $61.32–$137.24 39% below 65%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OUTPATIENT CARE LEVEL 2 $51.24 $146.00 $61.32–$137.24 39% below 65%
Spirometry before and after a bronchodilator CPT 94060 PEAK FLOW $95.15 $271.11 $113.86–$254.84 76% below 65%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY (THERAPEUTIC) $73.71 $210.00 $88.20–$463.11 41% below 65%

Vaccines

ProcedureCash price List priceInsurers payvs OklahomaOff list
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLULAVAL 2024-2025 $55.57 $158.33 $66.49–$148.83 29% above 65%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE 1440 UNITS $164.74 $469.35 $197.12–$441.18 11% above 65%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE $613.67 $1,748.35 $71.25–$1,643.44 11% below 65%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 DIP-TET ADSORBED 0.5ML $89.32 $254.48 $106.88–$239.21 1% above 65%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION $21.06 $60.00 $25.20–$56.40 65% below 65%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADM EACH ADDL $11.93 $34.00 $14.28–$31.96 59% below 65%

Source file: https://mrfs.hyvehealthcare.com/DuncanRegionalHealth/731008550_jefferson-county-hospital-ok_standardcharges.json