SelfPayRates
Hospital Tulsa, OK

PAM Rehabilitation Hospital of Tulsa

Listed in its price file as “Post Acute Medical Rehabilitation Hospital of Tulsa LLC”.

PAM Rehabilitation Hospital of Tulsa in Tulsa, OK publishes cash prices for 159 common procedures listed here, from its own machine-readable price file updated Aug 6, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Oklahoma median for 148 of 157 procedures and below it for 9. By typical cash price it ranks #56 of 56 Oklahoma hospitals and #16 of 16 hospitals in the Tulsa, OK area, cheapest first. Click a procedure to compare it with other hospitals nearby.

10020 E. 91st St., Tulsa, OK 74133 Collected Sep 29, 2026 Source price file

The price file shows no self-pay discount

For 386 of the 386 prices listed here, the cash price in PAM Rehabilitation Hospital of Tulsa's file equals its full list price (chargemaster), so the file publishes no self-pay discount. That is why it compares as expensive. Many hospitals still reduce bills for uninsured patients or offer financial assistance based on income: before a planned visit, ask the billing office for its self-pay rate and discount policy in writing.

Scans and imaging

ProcedureCash price List priceInsurers payvs OklahomaOff list
Ankle X-ray, complete, 3 or more views both sides CPT 73610 RAD Ankle 3 Views Bilat $456.05 $456.05 $25.46–$387.64 — —
Ankle X-ray, complete, 3 or more views one side CPT 73610 RAD Ankle 3 Views Lt $162.80 $162.80 $25.46–$176.04 7% below —
Ankle X-ray, complete, 3 or more views one side CPT 73610 RAD Ankle 3 Views Rt $162.80 $162.80 $25.46–$176.04 7% below —
Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 RAD Ankle 3 Views Bilat $456.05 $456.05 $319.24–$387.64 — —
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 RAD Ankle 3 Views Lt $162.80 $162.80 $113.96–$138.38 — —
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 RAD Ankle 3 Views Rt $162.80 $162.80 $113.96–$138.38 — —
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US Tcpo2 Multi Modfr 52 $443.95 $443.95 $73.37–$377.36 95% above —
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US Tcpo2 Multi Modfr 52 $443.95 $443.95 $310.77–$377.36 — —
Barium swallow (esophagus X-ray with contrast) CPT 74220 RAD Contrast Exam of Esophagus $491.10 $491.10 $64.76–$417.44 71% above —
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 RAD Contrast Exam of Esophagus $491.10 $491.10 $343.77–$417.44 — —
Bone scan, whole body (nuclear medicine) CPT 78306 NM Bone Scan Whole B $1,612.45 $1,612.45 $216.17–$1,370.58 75% above —
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM Bone Scan Whole B $1,612.45 $1,612.45 $1,128.72–$1,370.58 — —
Breast ultrasound, complete, one breast CPT 76641 US Ultrasound Breast Complete $1,479.08 $1,479.08 $62.06–$1,257.22 325% above —
Breast ultrasound, complete, one breast inpatient CPT 76641 US Ultrasound Breast Complete $1,479.08 $1,479.08 $1,035.36–$1,257.22 — —
Breast ultrasound, limited (one breast or one area) CPT 76642 US Breast Limited $1,733.94 $1,733.94 $47.36–$1,473.85 416% above —
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US Breast Limited $1,733.94 $1,733.94 $1,213.76–$1,473.85 — —
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angiography Chest w/Contras $4,970.70 $4,970.70 $170.24–$4,225.10 232% above —
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angiography Chest w/Contras $4,970.70 $4,970.70 $3,479.49–$4,225.10 — —
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT Angio Hrt W/3d Image $5,551.20 $5,551.20 $256.27–$4,718.52 352% above —
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT Angio Hrt W/3d Image $5,551.20 $5,551.20 $3,885.84–$4,718.52 — —
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abd & Pelvis W/O Contrast $4,278.95 $4,278.95 $156.14–$3,637.11 217% above —
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abd & Pelvis W/O Contrast $4,278.95 $4,278.95 $2,995.27–$3,637.11 — —
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen & Pelvis w/Contrast $6,611.20 $6,611.20 $338.61–$5,619.52 283% above —
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen & Pelvis w/Contrast $6,611.20 $6,611.20 $4,627.84–$5,619.52 — —
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abd & Pelv 1/> Regns w/wo c $7,364.15 $7,364.15 $338.61–$6,259.53 256% above —
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abd & Pelv 1/> Regns w/wo c $7,364.15 $7,364.15 $5,154.91–$6,259.53 — —
CT scan of the abdomen with contrast CPT 74160 CT Abdomen W/Contrast $4,407.50 $4,407.50 $158.53–$3,746.38 317% above —
CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen W/Contrast $4,407.50 $4,407.50 $3,085.25–$3,746.38 — —
CT scan of the abdomen without contrast CPT 74150 CT Abdomen W/O Contrast $2,852.65 $2,852.65 $101.47–$2,424.75 191% above —
CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen W/O Contrast $2,852.65 $2,852.65 $1,996.86–$2,424.75 — —
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial w/o contrast $2,852.65 $2,852.65 $101.47–$2,424.75 199% above —
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxillofacial w/o contrast $2,852.65 $2,852.65 $1,996.86–$2,424.75 — —
CT scan of the head or brain, no contrast dye CPT 70450 CT Head/Brain W/O Dye $2,852.65 $2,852.65 $101.16–$2,424.75 185% above —
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head/Brain W/O Dye $2,852.65 $2,852.65 $1,996.86–$2,424.75 — —
CT scan of the head with contrast CPT 70460 CT Head/Brain W/Contrast $4,407.50 $4,407.50 $146.41–$3,746.38 266% above —
CT scan of the head with contrast inpatient CPT 70460 CT Head/Brain W/Contrast $4,407.50 $4,407.50 $3,085.25–$3,746.38 — —
CT scan of the head without and with contrast CPT 70470 CT Head/Brain W/O & W/Dye $4,909.45 $4,909.45 $170.24–$4,173.03 281% above —
CT scan of the head without and with contrast inpatient CPT 70470 CT Head/Brain W/O & W/Dye $4,909.45 $4,909.45 $3,436.62–$4,173.03 — —
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Lumbar Spine W/O Dye $2,852.65 $2,852.65 $94.70–$2,424.75 174% above —
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Lumbar Spine W/O Dye $2,852.65 $2,852.65 $1,996.86–$2,424.75 — —
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT C-Spine W/O Dye $2,852.65 $2,852.65 $101.47–$2,424.75 162% above —
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT C-Spine W/O Dye $2,852.65 $2,852.65 $1,996.86–$2,424.75 — —
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis W/Dye $4,407.50 $4,407.50 $158.53–$3,746.38 307% above —
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis W/Dye $4,407.50 $4,407.50 $3,085.25–$3,746.38 — —
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 Duplex Scan/Carotid $538.00 $538.00 $118.07–$482.66 9% above —
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 Duplex Scan/Carotid $538.00 $538.00 $376.60–$457.30 — —
Chest X-ray, 2 views CPT 71046 RAD Chest 2 Views $439.80 $439.80 $20.66–$373.83 161% above —
Chest X-ray, 2 views inpatient CPT 71046 RAD Chest 2 Views $439.80 $439.80 $307.86–$373.83 — —
Chest X-ray, single view CPT 71045 RAD Chest 1 View $246.80 $246.80 $15.26–$209.78 39% above —
Chest X-ray, single view inpatient CPT 71045 RAD Chest 1 View $246.80 $246.80 $172.76–$209.78 — —
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Exam Abdo Back Wall Comp $816.70 $816.70 $66.86–$694.20 79% above —
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Renal Ultrasound Complete $1,415.51 $1,415.51 $66.86–$1,203.18 211% above —
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Exam Abdo Back Wall Comp $816.70 $816.70 $571.69–$694.20 — —
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 Renal Ultrasound Complete $1,415.51 $1,415.51 $990.86–$1,203.18 — —
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA Bone Density Axial $501.26 $501.26 $24.56–$426.07 152% above —
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA Bone Density Axial $501.26 $501.26 $350.88–$426.07 — —
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest w/o Dye $2,852.65 $2,852.65 $101.47–$2,424.75 199% above —
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest w/o Dye $2,852.65 $2,852.65 $1,996.86–$2,424.75 — —
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest W/ Dye $4,407.50 $4,407.50 $158.53–$3,746.38 274% above —
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest W/ Dye $4,407.50 $4,407.50 $3,085.25–$3,746.38 — —
Duplex ultrasound of the leg arteries, both legs CPT 93925 Noninv Extreme Art L $1,370.55 $1,370.55 $216.55–$1,164.97 185% above —
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 Noninv Extreme Art L $1,370.55 $1,370.55 $959.39–$1,164.97 — —
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Doppler Upper Extrem bilat $714.65 $714.65 $163.94–$607.45 — —
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Doppler Upper Extrem bilat $714.65 $714.65 $500.26–$607.45 — —
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echo Transthoracic 2d $850.95 $850.95 $119.48–$1,105.34 22% below —
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Echo Transthoracic 2d $850.95 $850.95 $595.67–$723.31 — —
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM Hepatobiliary $1,491.60 $1,491.60 $245.23–$1,267.86 29% above —
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM Hepatobiliary $1,491.60 $1,491.60 $1,044.12–$1,267.86 — —
Knee X-ray, 3 views both sides CPT 73562 RAD Knee 3 Views Bilat $679.70 $679.70 $28.46–$577.75 — —
Knee X-ray, 3 views one side CPT 73562 RAD Knee 3 Views Lt $322.30 $322.30 $28.46–$273.96 66% above —
Knee X-ray, 3 views one side CPT 73562 RAD Knee 3 Views Rt $322.30 $322.30 $28.46–$273.96 66% above —
Knee X-ray, 3 views inpatient both sides CPT 73562 RAD Knee 3 Views Bilat $679.70 $679.70 $475.79–$577.75 — —
Knee X-ray, 3 views inpatient one side CPT 73562 RAD Knee 3 Views Rt $322.30 $322.30 $225.61–$273.96 — —
Knee X-ray, 3 views inpatient one side CPT 73562 RAD Knee 3 Views Lt $322.30 $322.30 $225.61–$273.96 — —
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Exam Abdomen Limited $783.10 $783.10 $53.96–$665.64 102% above —
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Exam Abdomen Limited $783.10 $783.10 $548.17–$665.64 — —
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI Jnt of Lwr Extre W/O Dye $5,044.10 $5,044.10 $231.58–$4,287.49 257% above —
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI Jnt of Lwr Extre W/O Dye $5,044.10 $5,044.10 $3,530.87–$4,287.49 — —
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI Joint Lwr Extr W/O&w/Dye R $5,044.10 $5,044.10 $338.61–$4,287.49 197% above —
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI Joint Lwr Extr W/O&w/Dye R $5,044.10 $5,044.10 $3,530.87–$4,287.49 — —
MRI of the abdomen without contrast CPT 74181 MRI Abdomen W/O Dye $5,044.10 $5,044.10 $231.58–$4,287.49 367% above —
MRI of the abdomen without contrast inpatient CPT 74181 MRI Abdomen W/O Dye $5,044.10 $5,044.10 $3,530.87–$4,287.49 — —
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Angio Abdom W Orw/O Dye $5,044.10 $5,044.10 $338.61–$4,287.49 170% above —
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Angio Abdom W Orw/O Dye $5,044.10 $5,044.10 $3,530.87–$4,287.49 — —
MRI of the brain, no contrast dye CPT 70551 MRI Brain Stem W/O Dye $5,044.10 $5,044.10 $231.58–$4,287.49 378% above —
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain Stem W/O Dye $5,044.10 $5,044.10 $3,530.87–$4,287.49 — —
MRI of the brain, with and without contrast dye CPT 70553 MRI Brain Stem W/O & W/Dye $7,835.50 $7,835.50 $338.61–$6,660.18 443% above —
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain Stem W/O & W/Dye $7,835.50 $7,835.50 $5,484.85–$6,660.18 — —
MRI of the lower back, no contrast dye CPT 72148 MRI Lumbar Spine W/O Dye $5,044.10 $5,044.10 $231.58–$4,287.49 323% above —
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Lumbar Spine W/O Dye $5,044.10 $5,044.10 $3,530.87–$4,287.49 — —
MRI of the lower back, without and then with contrast dye CPT 72158 MRI Lumbar Spine W/O & W/Dye $7,835.50 $7,835.50 $338.61–$6,660.18 389% above —
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI Lumbar Spine W/O & W/Dye $7,835.50 $7,835.50 $5,484.85–$6,660.18 — —
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Thoracic Spine W/O Dye $5,044.10 $5,044.10 $231.58–$4,287.49 362% above —
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI Thoracic Spine W/O Dye $5,044.10 $5,044.10 $3,530.87–$4,287.49 — —
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Neck Spine W/O & W/Dye $7,835.50 $7,835.50 $338.61–$6,660.18 381% above —
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI Neck Spine W/O & W/Dye $7,835.50 $7,835.50 $5,484.85–$6,660.18 — —
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Neck Spine W/O Dye $5,044.10 $5,044.10 $231.58–$4,287.49 325% above —
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI Neck Spine W/O Dye $5,044.10 $5,044.10 $3,530.87–$4,287.49 — —
MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis W/O & W/Dye $7,835.50 $7,835.50 $338.61–$6,660.18 409% above —
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis W/O & W/Dye $7,835.50 $7,835.50 $5,484.85–$6,660.18 — —
MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis W/O Dye $5,262.62 $5,262.62 $231.58–$4,473.23 414% above —
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis W/O Dye $5,262.62 $5,262.62 $3,683.83–$4,473.23 — —
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI Uppr Ext Jnt W/O Dye $5,044.10 $5,044.10 $231.58–$4,287.49 241% above —
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI Upper Ext Jnt $5,044.10 $5,044.10 $231.58–$4,287.49 241% above —
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI Uppr Ext Jnt W/O Dye $5,044.10 $5,044.10 $3,530.87–$4,287.49 — —
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI Upper Ext Jnt $5,044.10 $5,044.10 $3,530.87–$4,287.49 — —
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Hrt Muscle Image Spect $12,632.76 $12,632.76 $334.84–$10,737.85 374% above —
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM Hrt Muscle Image Spect $12,632.76 $12,632.76 $8,842.93–$10,737.85 — —
PET/CT scan from the base of the skull to mid-thigh CPT 78815 NM Tumor Image Pet/CT Skul-T $28,516.32 $28,516.32 $1,050.00–$24,238.87 616% above —
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 NM Tumor Image Pet/CT Skul-T $28,516.32 $28,516.32 $19,961.42–$24,238.87 — —
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Exam Pelvic Limited $907.30 $907.30 $21.86–$771.21 201% above —
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Exam Pelvic Limited $907.30 $907.30 $635.11–$771.21 — —
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Exam Pelvic Complete $904.60 $904.60 $66.26–$768.91 86% above —
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Exam Pelvic Complete $904.60 $904.60 $633.22–$768.91 — —
Screening mammogram, both breasts both sides CPT 77067 Screening Mammo Bilat $1,628.79 $1,628.79 $82.76–$1,384.47 — —
Screening mammogram, both breasts inpatient both sides CPT 77067 Screening Mammo Bilat $1,628.79 $1,628.79 $1,140.15–$1,384.47 — —
Shoulder X-ray, complete, 2 or more views both sides CPT 73030 RAD Shoulder bilat comp 2vw $1,434.24 $1,434.24 $22.76–$1,219.10 — —
Shoulder X-ray, complete, 2 or more views CPT 73030 RAD Shoulder Complete $586.75 $586.75 $22.76–$498.74 150% above —
Shoulder X-ray, complete, 2 or more views one side CPT 73030 RAD Shoulder 2 Views Rt $325.60 $325.60 $22.76–$276.76 39% above —
Shoulder X-ray, complete, 2 or more views one side CPT 73030 RAD Shoulder 2 Views Lt $325.60 $325.60 $22.76–$276.76 39% above —
Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 RAD Shoulder bilat comp 2vw $1,434.24 $1,434.24 $1,003.97–$1,219.10 — —
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 RAD Shoulder Complete $586.75 $586.75 $410.73–$498.74 — —
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 RAD Shoulder 2 Views Rt $325.60 $325.60 $227.92–$276.76 — —
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 RAD Shoulder 2 Views Lt $325.60 $325.60 $227.92–$276.76 — —
Swallow study (modified barium swallow, video X-ray) CPT 74230 RAD Cine/Vid Throat/Esoph MBSS $854.45 $854.45 $94.16–$726.28 161% above —
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 RAD Cine/Vid Throat/Esoph MBSS $854.45 $854.45 $598.12–$726.28 — —
Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non-Ob $529.75 $529.75 $78.86–$450.29 27% above —
Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal Non-Ob $529.75 $529.75 $370.83–$450.29 — —
Ultrasound of the abdomen, complete CPT 76700 US Exam Abdom Complete $904.60 $904.60 $71.66–$768.91 72% above —
Ultrasound of the abdomen, complete inpatient CPT 76700 US Exam Abdom Complete $904.60 $904.60 $633.22–$768.91 — —
Ultrasound of the scrotum and testicles CPT 76870 US Exam Scrotum $357.45 $357.45 $63.86–$303.83 1% above —
Ultrasound of the scrotum and testicles inpatient CPT 76870 US Exam Scrotum $357.45 $357.45 $250.22–$303.83 — —
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Exam of Head and Neck $774.85 $774.85 $76.76–$658.62 90% above —
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Exam of Head and Neck $774.85 $774.85 $542.40–$658.62 — —
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 RAD Upper Gi Delay W/O Kub $567.40 $567.40 $79.16–$482.29 49% above —
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 RAD Upper Gi Delay Single Cont $2,136.45 $2,136.45 $79.16–$1,815.98 462% above —
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 RAD Upper Gi Delay W/O Kub $567.40 $567.40 $397.18–$482.29 — —
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 RAD Upper Gi Delay Single Cont $2,136.45 $2,136.45 $1,495.52–$1,815.98 — —
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 Duplx Scan Ext Veins Unil $845.50 $845.50 $94.70–$718.68 70% above —
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Doppler Extremity Vein Ltd Lt $933.90 $933.90 $94.70–$793.82 87% above —
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Doppler Extremity Vein Ltd RT $933.90 $933.90 $94.70–$793.82 87% above —
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 Duplx Scan Ext Veins Unil $845.50 $845.50 $591.85–$718.68 — —
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Doppler Extremity Vein Ltd RT $933.90 $933.90 $653.73–$793.82 — —
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Doppler Extremity Vein Ltd Lt $933.90 $933.90 $653.73–$793.82 — —
Wrist X-ray, complete, 3 or more views both sides CPT 73110 RAD Wrist Comp 3>vw Bilat $1,434.24 $1,434.24 $29.06–$1,219.10 — —
Wrist X-ray, complete, 3 or more views one side CPT 73110 RAD Wrist 3+ Views Lt $326.70 $326.70 $29.06–$277.70 62% above —
Wrist X-ray, complete, 3 or more views one side CPT 73110 RAD Wrist 3+ Views Rt $326.70 $326.70 $29.06–$277.70 62% above —
Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 RAD Wrist Comp 3>vw Bilat $1,434.24 $1,434.24 $1,003.97–$1,219.10 — —
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 RAD Wrist 3+ Views Rt $326.70 $326.70 $228.69–$277.70 — —
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 RAD Wrist 3+ Views Lt $326.70 $326.70 $228.69–$277.70 — —
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 RAD Hip 2-3 Views Unil Rt $374.00 $374.00 $32.36–$317.90 95% above —
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 RAD Hip 2-3 Views Unil Lt $374.00 $374.00 $32.36–$317.90 95% above —
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 RAD Hip 2-3 Views Unil Rt $374.00 $374.00 $261.80–$317.90 — —
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 RAD Hip 2-3 Views Unil Lt $374.00 $374.00 $261.80–$317.90 — —
X-ray of the abdomen, 1 view CPT 74018 RAD Abdomen 1 Vw $296.45 $296.45 $19.16–$251.98 77% above —
X-ray of the abdomen, 1 view CPT 74018 MRI Joint Lwr Extr W/O&w/Dye $296.45 $296.45 $19.16–$251.98 77% above —
X-ray of the abdomen, 1 view CPT 74018 RAD Exam Abdomen 1 View $296.45 $296.45 $19.16–$251.98 77% above —
X-ray of the abdomen, 1 view inpatient CPT 74018 MRI Joint Lwr Extr W/O&w/Dye $296.45 $296.45 $207.52–$251.98 — —
X-ray of the abdomen, 1 view inpatient CPT 74018 RAD Exam Abdomen 1 View $296.45 $296.45 $207.52–$251.98 — —
X-ray of the abdomen, 1 view inpatient CPT 74018 RAD Abdomen 1 Vw $296.45 $296.45 $207.52–$251.98 — —
X-ray of the ankle, 2 views both sides CPT 73600 RAD Ankle 2 Views Bilat $303.60 $303.60 $21.86–$258.06 — —
X-ray of the ankle, 2 views one side CPT 73600 RAD Ankle 2 Views Lt $161.70 $161.70 $21.86–$176.04 10% below —
X-ray of the ankle, 2 views one side CPT 73600 RAD Ankle 2 Views Rt $161.70 $161.70 $21.86–$176.04 10% below —
X-ray of the ankle, 2 views inpatient both sides CPT 73600 RAD Ankle 2 Views Bilat $303.60 $303.60 $212.52–$258.06 — —
X-ray of the ankle, 2 views inpatient one side CPT 73600 RAD Ankle 2 Views Rt $161.70 $161.70 $113.19–$137.45 — —
X-ray of the ankle, 2 views inpatient one side CPT 73600 RAD Ankle 2 Views Lt $161.70 $161.70 $113.19–$137.45 — —
X-ray of the finger(s), 2 or more views one side CPT 73140 RAD Finger(S) 2+ View Rt $266.20 $266.20 $27.56–$226.27 66% above —
X-ray of the finger(s), 2 or more views one side CPT 73140 RAD Finger(S) 2+ View Lt $266.20 $266.20 $27.56–$226.27 66% above —
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 RAD Finger(S) 2+ View Lt $266.20 $266.20 $186.34–$226.27 — —
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 RAD Finger(S) 2+ View Rt $266.20 $266.20 $186.34–$226.27 — —
X-ray of the foot, 2 views CPT 73620 RAD Foot 2 Views Bilater $479.60 $479.60 $18.56–$407.66 182% above —
X-ray of the foot, 2 views one side CPT 73620 RAD Foot 2 Views Rt $162.80 $162.80 $18.56–$176.04 4% below —
X-ray of the foot, 2 views one side CPT 73620 RAD Foot 2 Views Lt $162.80 $162.80 $18.56–$176.04 4% below —
X-ray of the foot, 2 views inpatient CPT 73620 RAD Foot 2 Views Bilater $479.60 $479.60 $335.72–$407.66 — —
X-ray of the foot, 2 views inpatient one side CPT 73620 RAD Foot 2 Views Lt $162.80 $162.80 $113.96–$138.38 — —
X-ray of the foot, 2 views inpatient one side CPT 73620 RAD Foot 2 Views Rt $162.80 $162.80 $113.96–$138.38 — —
X-ray of the foot, complete, 3 or more views CPT 73630 RAD Foot 3 Views Bilater $245.30 $245.30 $23.66–$208.51 18% above —
X-ray of the foot, complete, 3 or more views one side CPT 73630 RAD Foot 3 Views Rt $317.90 $317.90 $23.66–$270.22 52% above —
X-ray of the foot, complete, 3 or more views one side CPT 73630 RAD Foot 3 Views Lt $317.90 $317.90 $23.66–$270.22 52% above —
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 RAD Foot 3 Views Bilater $245.30 $245.30 $171.71–$208.51 — —
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 RAD Foot 3 Views Rt $317.90 $317.90 $222.53–$270.22 — —
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 RAD Foot 3 Views Lt $317.90 $317.90 $222.53–$270.22 — —
X-ray of the hand, 3 or more views both sides CPT 73130 RAD Hand 3>vw Bilat $434.50 $434.50 $25.16–$369.33 — —
X-ray of the hand, 3 or more views one side CPT 73130 RAD Hand 3 Views Rt $278.30 $278.30 $25.16–$236.56 20% above —
X-ray of the hand, 3 or more views one side CPT 73130 RAD Hand 3 Views Lt $278.30 $278.30 $25.16–$236.56 20% above —
X-ray of the hand, 3 or more views inpatient both sides CPT 73130 RAD Hand 3>vw Bilat $434.50 $434.50 $304.15–$369.33 — —
X-ray of the hand, 3 or more views inpatient one side CPT 73130 RAD Hand 3 Views Lt $278.30 $278.30 $194.81–$236.56 — —
X-ray of the hand, 3 or more views inpatient one side CPT 73130 RAD Hand 3 Views Rt $278.30 $278.30 $194.81–$236.56 — —
X-ray of the knee, 1 or 2 views both sides CPT 73560 RAD Knee 1-2 Views Bilat $342.10 $342.10 $23.36–$290.79 — —
X-ray of the knee, 1 or 2 views CPT 73560 RAD Knee/Patella 2 View $253.25 $253.25 $23.36–$215.26 41% above —
X-ray of the knee, 1 or 2 views one side CPT 73560 RAD Knee 1-2 Views Lt $292.60 $292.60 $23.36–$248.71 63% above —
X-ray of the knee, 1 or 2 views one side CPT 73560 RAD Knee 1-2 Views Rt $292.60 $292.60 $23.36–$248.71 63% above —
X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 RAD Knee 1-2 Views Bilat $342.10 $342.10 $239.47–$290.79 — —
X-ray of the knee, 1 or 2 views inpatient CPT 73560 RAD Knee/Patella 2 View $253.25 $253.25 $177.28–$215.26 — —
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 RAD Knee 1-2 Views Rt $292.60 $292.60 $204.82–$248.71 — —
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 RAD Knee 1-2 Views Lt $292.60 $292.60 $204.82–$248.71 — —
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 RAD Exam L-S Spine 2/3 Vws $398.05 $398.05 $26.06–$338.34 88% above —
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 RAD Exam L-S Spine 2/3 Vws $398.05 $398.05 $278.64–$338.34 — —
X-ray of the lower back, 4 or more views CPT 72110 RAD Exam L-2 Spine 4/>vws $208.30 $208.30 $34.76–$211.48 34% below —
X-ray of the lower back, 4 or more views inpatient CPT 72110 RAD Exam L-2 Spine 4/>vws $208.30 $208.30 $145.81–$177.06 — —
X-ray of the mid back (thoracic spine), 2 views CPT 72070 RAD Exam Thorac Spine 2vws $169.40 $169.40 $20.66–$211.48 20% below —
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 RAD Exam Thorac Spine 2vws $169.40 $169.40 $118.58–$143.99 — —
X-ray of the nasal bones, 3 or more views CPT 70160 RAD Nasal Bones 3 Views $334.85 $334.85 $26.66–$284.62 105% above —
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 RAD Nasal Bones 3 Views $334.85 $334.85 $234.40–$284.62 — —
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 RAD Exam Neck Spine 2-3 Vw $1,616.00 $1,616.00 $25.76–$1,373.60 690% above —
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 RAD Exam Neck Spine 2-3 Vw $1,616.00 $1,616.00 $1,131.20–$1,373.60 — —
X-ray of the pelvis, 1 or 2 views CPT 72170 RAD Exam of Pelvis $446.65 $446.65 $17.36–$379.65 132% above —
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 RAD Exam of Pelvis $446.65 $446.65 $312.66–$379.65 — —
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 RAD Exam Sacrum Tailbone $267.40 $267.40 $21.56–$227.29 50% above —
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 RAD Exam Sacrum Tailbone $267.40 $267.40 $187.18–$227.29 — —

Lab tests

ProcedureCash price List priceInsurers payvs OklahomaOff list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine Amino (ALT) (SGPT) $88.65 $88.65 $4.78–$75.35 168% above —
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Alanine Amino (ALT) (SGPT) $88.65 $88.65 $62.06–$75.35 — —
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute Hepatitis Panel $538.55 $538.55 $42.86–$457.77 190% above —
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Acute Hepatitis Panel $538.55 $538.55 $376.99–$457.77 — —
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP Antibody $86.55 $86.55 $11.65–$73.57 32% above —
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP Antibody $86.55 $86.55 $60.59–$73.57 — —
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA Antinuclear Antibodies $157.15 $157.15 $10.88–$133.58 172% above —
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA Antinuclear Antibodies $157.15 $157.15 $110.01–$133.58 — —
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B type BNP $200.90 $200.90 $35.34–$170.77 78% above —
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT PROBNP $265.20 $265.20 $35.34–$225.42 134% above —
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B type BNP $200.90 $200.90 $140.63–$170.77 — —
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NT PROBNP $265.20 $265.20 $185.64–$225.42 — —
Basic metabolic panel (blood test) CPT 80048 BMP with Total Calcium $359.40 $359.40 $7.62–$305.49 732% above —
Basic metabolic panel (blood test) inpatient CPT 80048 BMP with Total Calcium $359.40 $359.40 $251.58–$305.49 — —
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Level IV Tissue Exam By Path $241.85 $241.85 $27.41–$205.57 68% above —
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Level IV Tissue Exam By Path $241.85 $241.85 $169.30–$205.57 — —
Blood culture for bacteria CPT 87040 Blood Culture For Bacteria $267.00 $267.00 $9.29–$226.95 266% above —
Blood culture for bacteria inpatient CPT 87040 Blood Culture For Bacteria $267.00 $267.00 $186.90–$226.95 — —
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture $21.95 $21.95 $2.70–$18.66 111% above —
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venipuncture $21.95 $21.95 $15.37–$18.66 — —
Blood glucose (sugar) test CPT 82947 Glucose Blood Quant $334.85 $334.85 $3.54–$284.62 1221% above —
Blood glucose (sugar) test inpatient CPT 82947 Glucose Blood Quant $334.85 $334.85 $234.40–$284.62 — —
Blood lead test CPT 83655 Lead $126.65 $126.65 $10.90–$107.65 160% above —
Blood lead test inpatient CPT 83655 Lead $126.65 $126.65 $88.66–$107.65 — —
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Chorionic Gonadotropin BHCG $109.95 $109.95 $6.77–$93.46 142% above —
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Chorionic Gonadotropin BHCG $109.95 $109.95 $76.97–$93.46 — —
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Blood Typing Serologic ABO $167.00 $167.00 $2.69–$269.14 175% above —
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Blood Typing Serologic ABO $167.00 $167.00 $116.90–$141.95 — —
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP C-Reactive Protein $131.90 $131.90 $4.67–$112.12 247% above —
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP C-Reactive Protein $131.90 $131.90 $92.33–$112.12 — —
C. difficile toxin gene test (stool PCR) CPT 87493 Clostridium AmpProbe Cdiff $348.01 $348.01 $33.54–$295.81 313% above —
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Clostridium AmpProbe Cdiff $348.01 $348.01 $243.61–$295.81 — —
CA 19-9 blood test (tumor marker) CPT 86301 ImmunoTumor CA 19-9 $302.70 $302.70 $18.73–$257.30 232% above —
CA 19-9 blood test (tumor marker) inpatient CPT 86301 ImmunoTumor CA 19-9 $302.70 $302.70 $211.89–$257.30 — —
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-Cov-2 Cov10-19 $188.80 $188.80 $48.74–$160.48 158% above —
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-Cov-2 Cov10-19 $188.80 $188.80 $132.16–$160.48 — —
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel $187.50 $187.50 $12.05–$159.38 174% above —
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel $187.50 $187.50 $131.25–$159.38 — —
Complete blood count (CBC) with differential CPT 85025 Complete CBC W/Auto Diff $108.55 $108.55 $7.00–$92.27 139% above —
Complete blood count (CBC) with differential inpatient CPT 85025 Complete CBC W/Auto Diff $108.55 $108.55 $75.99–$92.27 — —
Complete blood count (CBC), no differential CPT 85027 CBC w/o differential $111.75 $111.75 $5.82–$94.99 164% above —
Complete blood count (CBC), no differential inpatient CPT 85027 CBC w/o differential $111.75 $111.75 $78.23–$94.99 — —
Comprehensive metabolic panel (blood test) CPT 80053 Comprehen Metabolic Panel CMP $468.75 $468.75 $9.50–$398.44 576% above —
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehen Metabolic Panel CMP $468.75 $468.75 $328.13–$398.44 — —
D-dimer blood test (blood clot marker) CPT 85379 FDP -D-dimer Quantitative $211.60 $211.60 $9.17–$179.86 112% above —
D-dimer blood test (blood clot marker) inpatient CPT 85379 FDP -D-dimer Quantitative $211.60 $211.60 $148.12–$179.86 — —
Ferritin blood test (iron stores) CPT 82728 Ferritin $169.60 $169.60 $12.26–$144.16 135% above —
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin $169.60 $169.60 $118.72–$144.16 — —
Folate (folic acid) blood test CPT 82746 Folate Folic Acid Serum $211.20 $211.20 $13.24–$179.52 235% above —
Folate (folic acid) blood test inpatient CPT 82746 Folate Folic Acid Serum $211.20 $211.20 $147.84–$179.52 — —
Free T3 thyroid hormone test CPT 84481 Free (FT-3) $322.10 $322.10 $15.25–$273.79 259% above —
Free T3 thyroid hormone test inpatient CPT 84481 Free (FT-3) $322.10 $322.10 $225.47–$273.79 — —
Free T4 (free thyroxine) thyroid blood test CPT 84439 Free Thyroxine (T4) $146.65 $146.65 $8.12–$124.65 120% above —
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Free Thyroxine (T4) $146.65 $146.65 $102.66–$124.65 — —
Free testosterone test CPT 84402 Free Testosterone $88.15 $88.15 $22.92–$74.93 2% above —
Free testosterone test inpatient CPT 84402 Free Testosterone $88.15 $88.15 $61.71–$74.93 — —
H. pylori stool antigen test CPT 87338 H. pylori Stool IA $246.80 $246.80 $12.95–$209.78 116% above —
H. pylori stool antigen test inpatient CPT 87338 H. pylori Stool IA $246.80 $246.80 $172.76–$209.78 — —
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 Quant&Revrse Trnscrpj $236.15 $236.15 $76.60–$200.73 19% above —
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 Quant&Revrse Trnscrpj $236.15 $236.15 $165.31–$200.73 — —
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin Glycosylated HGBA1C $117.75 $117.75 $8.74–$100.09 229% above —
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin Glycosylated HGBA1C $117.75 $117.75 $82.43–$100.09 — —
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hep B Surface Antibody $133.35 $133.35 $9.67–$113.35 200% above —
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hep B Surface Antibody $133.35 $133.35 $93.35–$113.35 — —
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface AG IA $98.90 $98.90 $9.30–$84.07 138% above —
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface AG IA $98.90 $98.90 $69.23–$84.07 — —
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C AB Test $164.35 $164.35 $12.84–$139.70 222% above —
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C AB Test $164.35 $164.35 $115.05–$139.70 — —
Homocysteine blood test CPT 83090 Homocysteine $584.50 $584.50 $16.13–$496.83 370% above —
Homocysteine blood test inpatient CPT 83090 Homocysteine $584.50 $584.50 $409.15–$496.83 — —
Iron blood test (serum iron) CPT 83540 Iron $75.90 $75.90 $5.82–$64.52 106% above —
Iron blood test (serum iron) inpatient CPT 83540 Iron $75.90 $75.90 $53.13–$64.52 — —
Iron-binding capacity (TIBC) test CPT 83550 TIBC Iron Binding Capacity $89.35 $89.35 $7.87–$75.95 91% above —
Iron-binding capacity (TIBC) test inpatient CPT 83550 TIBC Iron Binding Capacity $89.35 $89.35 $62.55–$75.95 — —
Kidney function blood test panel CPT 80069 Renal Function Panel $457.95 $457.95 $7.81–$389.26 605% above —
Kidney function blood test panel inpatient CPT 80069 Renal Function Panel $457.95 $457.95 $320.57–$389.26 — —
Lipase blood test (pancreas enzyme) CPT 83690 Lipase $153.00 $153.00 $6.20–$130.05 165% above —
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase $153.00 $153.00 $107.10–$130.05 — —
Liver function blood test panel CPT 80076 Hepatic Function Panel $300.20 $300.20 $7.36–$255.17 463% above —
Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel $300.20 $300.20 $210.14–$255.17 — —
Magnesium blood test CPT 83735 Magnesium $103.75 $103.75 $6.04–$88.19 179% above —
Magnesium blood test inpatient CPT 83735 Magnesium $103.75 $103.75 $72.63–$88.19 — —
Measles (rubeola) antibody test CPT 86765 Antibody Rubeola $128.80 $128.80 $11.59–$109.48 242% above —
Measles (rubeola) antibody test inpatient CPT 86765 Antibody Rubeola $128.80 $128.80 $90.16–$109.48 — —
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Total $203.30 $203.30 $16.55–$172.81 164% above —
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Total $203.30 $203.30 $142.31–$172.81 — —
Parathyroid hormone (PTH) blood test CPT 83970 Parathormone (PTH) $443.45 $443.45 $37.15–$376.93 218% above —
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathormone (PTH) $443.45 $443.45 $310.42–$376.93 — —
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT Thromboplastin Time Partia $125.60 $125.60 $5.41–$106.76 288% above —
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT Thromboplastin Time Partia $125.60 $125.60 $87.92–$106.76 — —
Prolactin blood test CPT 84146 Prolactin $219.90 $219.90 $17.45–$186.92 134% above —
Prolactin blood test inpatient CPT 84146 Prolactin $219.90 $219.90 $153.93–$186.92 — —
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time PT/INR $103.75 $103.75 $3.86–$88.19 217% above —
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time PT/INR $103.75 $103.75 $72.63–$88.19 — —
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Drug Test Prsmv Dir Opt Obs $189.00 $189.00 $11.34–$160.65 385% above —
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 Drug Test Prsmv Dir Opt Obs $189.00 $189.00 $132.30–$160.65 — —
Rapid flu test (influenza antigen) CPT 87804 Influenza Assay w/Optic Swab $165.50 $165.50 $14.89–$140.68 203% above —
Rapid flu test (influenza antigen) inpatient CPT 87804 Influenza Assay w/Optic Swab $165.50 $165.50 $115.85–$140.68 — —
Rubella antibody test (immunity check) CPT 86762 Antibody Rubella $143.90 $143.90 $12.95–$122.32 159% above —
Rubella antibody test (immunity check) inpatient CPT 86762 Antibody Rubella $143.90 $143.90 $100.73–$122.32 — —
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 RBC SED Rate Automated (ESR) $36.80 $36.80 $2.44–$31.28 77% above —
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 RBC SED Rate Automated (ESR) $36.80 $36.80 $25.76–$31.28 — —
Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood Feces $120.70 $120.70 $3.95–$102.60 430% above —
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Blood Feces $120.70 $120.70 $84.49–$102.60 — —
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Syphilis Test NonTrep Qual RPR $87.90 $87.90 $3.84–$74.72 214% above —
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Syphilis Test NonTrep Qual RPR $87.90 $87.90 $61.53–$74.72 — —
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB Test Cell - Quantiferon $127.05 $127.05 $55.79–$122.72 26% below —
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB Test Cell - Quantiferon $127.05 $127.05 $88.94–$107.99 — —
Testosterone blood test, total (not free testosterone) CPT 84403 Total Testosterone $36.70 $36.70 $20.19–$51.10 58% below —
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Total Testosterone $36.70 $36.70 $25.69–$31.20 — —
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stim Hormone $175.85 $175.85 $15.12–$149.47 235% above —
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stim Hormone $175.85 $175.85 $123.10–$149.47 — —
Uric acid blood test CPT 84550 Blood/Uric Acid $81.35 $81.35 $4.07–$69.15 208% above —
Uric acid blood test inpatient CPT 84550 Blood/Uric Acid $81.35 $81.35 $56.95–$69.15 — —
Urinalysis with microscope exam, automated CPT 81001 Urinalysis Auto W/Scope UA $83.30 $83.30 $2.86–$70.81 152% above —
Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis Auto W/Scope UA $83.30 $83.30 $58.31–$70.81 — —
Urinalysis with microscope exam, manual CPT 81000 Body Fluid/Urine Specific Grav $51.00 $51.00 $3.62–$43.35 188% above —
Urinalysis with microscope exam, manual inpatient CPT 81000 Body Fluid/Urine Specific Grav $51.00 $51.00 $35.70–$43.35 — —
Urinalysis without microscope exam, automated CPT 81003 Urinalysis Auto W/O Scope UA $62.75 $62.75 $2.03–$53.34 206% above —
Urinalysis without microscope exam, automated CPT 81003 UA Reflex to Microscopic $62.75 $62.75 $2.03–$53.34 206% above —
Urinalysis without microscope exam, automated inpatient CPT 81003 UA Reflex to Microscopic $62.75 $62.75 $43.93–$53.34 — —
Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis Auto W/O Scope UA $62.75 $62.75 $43.93–$53.34 — —
Urine culture for bacteria, with colony count CPT 87086 Urine Culture/Colony Count $184.85 $184.85 $7.26–$157.12 283% above —
Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Culture/Colony Count $184.85 $184.85 $129.40–$157.12 — —
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B-12 $172.70 $172.70 $13.57–$146.80 179% above —
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B-12 $172.70 $172.70 $120.89–$146.80 — —
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25 Hydroxy $594.75 $594.75 $26.64–$505.54 353% above —
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D 25 Hydroxy $594.75 $594.75 $416.33–$505.54 — —

Surgery and procedures

ProcedureCash price List priceInsurers payvs OklahomaOff list
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Arthro, Asp, and/or Inj w/o US $674.46 $674.46 $57.28–$620.93 151% above —
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Arthro, Asp, and/or Inj w/o US $674.46 $674.46 $472.12–$573.29 — —
Paracentesis with imaging guidance CPT 49083 Abd Paracentesis W/Img $1,716.53 $1,716.53 $137.22–$1,834.73 100% above —
Paracentesis with imaging guidance inpatient CPT 49083 Abd Paracentesis W/Img $1,716.53 $1,716.53 $1,201.57–$1,459.05 — —
Thoracentesis with imaging guidance CPT 32555 Thoracentesis asp w/Imaging $2,852.05 $2,852.05 $149.57–$2,424.24 323% above —
Thoracentesis with imaging guidance inpatient CPT 32555 Thoracentesis asp w/Imaging $2,852.05 $2,852.05 $1,996.44–$2,424.24 — —
Upper endoscopy (EGD) with biopsy CPT 43239 EGD Biopsy Single/Multi $2,503.44 $2,503.44 $177.53–$2,127.92 137% above —
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD Biopsy Single/Multi $2,503.44 $2,503.44 $1,752.41–$2,127.92 — —
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Deb Subq Tis <=20 Sq $1,623.80 $1,623.80 $73.02–$1,380.23 284% above —
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Deb Subq Tis <=20 Sq $1,623.80 $1,623.80 $1,136.66–$1,380.23 — —

Doctor visits and therapy

ProcedureCash price List priceInsurers payvs OklahomaOff list
Blood transfusion (giving blood or blood components) CPT 36430 Blood Admin Fee Surgery $887.50 $887.50 $53.22–$892.45 22% above —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Admin Fee Surgery $887.50 $887.50 $621.25–$754.38 — —
Critical care, first 30 to 74 minutes CPT 99291 Critical Care Init 30-74 Min $4,466.63 $4,466.63 $209.28–$3,796.64 371% above —
Critical care, first 30 to 74 minutes inpatient CPT 99291 Critical Care Init 30-74 Min $4,466.63 $4,466.63 $3,126.64–$3,796.64 — —
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG Photo Stimulatio $459.85 $459.85 $209.57–$436.79 7% above —
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG Photo Stimulatio $459.85 $459.85 $321.90–$390.87 — —
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG W/O Interpre and Repo-(RT) $279.25 $279.25 $5.50–$237.36 119% above —
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG W/O Interpre and Repo-(RT) $279.25 $279.25 $195.48–$237.36 — —
Neuromuscular re-education, 15 minutes CPT 97112 Neuromuscular re-ED 15 min $89.70 $89.70 $28.32–$125.00 29% above —
Neuromuscular re-education, 15 minutes inpatient CPT 97112 Neuromuscular re-ED 15 min $89.70 $89.70 $62.79–$76.25 — —
Occupational therapy evaluation, low complexity CPT 97165 OT Eval- Low Complexity $194.55 $194.55 $83.77–$188.58 80% above —
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT Eval- Low Complexity $194.55 $194.55 $136.19–$165.37 — —
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT Eval- High Complexity $388.85 $388.85 $83.24–$330.52 147% above —
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT Eval- High Complexity $388.85 $388.85 $272.20–$330.52 — —
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT Evaluation Low Complexity $120.35 $120.35 $66.19–$183.86 8% above —
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT Eval - Low Complexity $194.55 $194.55 $83.24–$183.86 74% above —
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT Evaluation Low Complexity $120.35 $120.35 $84.25–$102.30 — —
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT Eval - Low Complexity $194.55 $194.55 $136.19–$165.37 — —
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT Eval -Moderate Complexity $291.65 $291.65 $83.24–$247.90 124% above —
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT Eval -Moderate Complexity $291.65 $291.65 $204.16–$247.90 — —
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual therapy 15 min $103.75 $103.75 $22.55–$125.00 51% above —
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Manual therapy 15 min $103.75 $103.75 $72.63–$88.19 — —
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Ther procedure exercise 15 min $89.70 $89.70 $24.46–$125.00 29% above —
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Therapeutic proc/exer 15 min $89.70 $89.70 $24.46–$125.00 29% above —
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Ther procedure exercise 15 min $89.70 $89.70 $62.79–$76.25 — —
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Therapeutic proc/exer 15 min $89.70 $89.70 $62.79–$76.25 — —
Speech and language evaluation CPT 92523 Eval of speech/language comp $352.81 $352.81 $87.00–$427.51 97% above —
Speech and language evaluation inpatient CPT 92523 Eval of speech/language comp $248.60 $248.60 $174.02–$211.31 — —
Speech therapy session, individual CPT 92507 Speech/auditory tx individual $255.51 $255.51 $54.23–$217.18 123% above —
Speech therapy session, individual inpatient CPT 92507 Speech/auditory tx individual $255.51 $255.51 $178.86–$217.18 — —
Therapeutic activities (functional training), 15 minutes CPT 97530 Therapeutic activities 15 min $89.70 $89.70 $30.48–$125.00 50% above —
Therapeutic activities (functional training), 15 minutes CPT 97530 Therapeutic Activities 15 min $89.70 $89.70 $30.48–$125.00 50% above —
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Therapeutic activities 15 min $89.70 $89.70 $62.79–$76.25 — —
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Therapeutic Activities 15 min $89.70 $89.70 $62.79–$76.25 — —

Vaccines

ProcedureCash price List priceInsurers payvs OklahomaOff list
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VAC QUAD 2022-23 240MCG $136.29 $136.29 $74.96–$194.36 16% below —
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLU VAC QUAD 2022-23 240MCG $136.29 $136.29 $95.40–$115.85 — —
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumovax 23 25 mcg $236.05 $236.05 $126.80–$264.27 44% above —
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Pneumovax 23 25 mcg $236.05 $236.05 $165.24–$200.64 — —

Source file: https://sthpiprd.blob.core.windows.net/machine-readable-files/10979/473895137_post-acute-medical-rehabilitation-hospital-of-tulsa-llc_standardcharges.csv