Saint Francis Hospital South
Saint Francis Hospital South in Tulsa, OK publishes cash prices for 44 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Click a procedure to compare it with other hospitals nearby.
10501 East 91St Street South, Tulsa, OK 74133,140 West 151st Street South, Glenpool, OK 74033 Collected Sep 23, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 Hc Ct Abdomen & Pelvis W/Contrast Material | $1,610.82 | $4,027.05 | 60% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 Hc Ct Abdomen & Pelvis W/Contrast Material | $1,610.82 | $4,027.05 | 60% |
| CT scan of the head or brain, no contrast dye CPT 70450 Hc Ct Head/Brain W/O Contrast Material | $924.16 | $2,310.40 | 60% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 Hc Ct Head/Brain W/O Contrast Material | $924.16 | $2,310.40 | 60% |
| CT scan of the pelvis, with contrast dye CPT 72193 Hc Ct Pelvis W/Contrast Material | $1,083.38 | $2,708.45 | 60% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 Hc Ct Pelvis W/Contrast Material | $1,083.38 | $2,708.45 | 60% |
| Diagnostic mammogram, both breasts both sides CPT 77066 Hc Diagnostic Mammo Digital Bilateral, Includes Cad When Performed | $260.64 | $651.60 | 60% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 Hc Diagnostic Mammo Digital Bilateral, Includes Cad When Performed | $260.64 | $651.60 | 60% |
| Diagnostic mammogram, one breast one side CPT 77065 Hc Diagnostic Mammo Digital Unilateral, Includes Cad When Performed | $202.08 | $505.20 | 60% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 Hc Diagnostic Mammo Digital Unilateral, Includes Cad When Performed | $202.08 | $505.20 | 60% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 Hc Mri Any Jt Lower Extrem W/O Contrast Matrl | $2,009.44 | $5,023.60 | 60% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 Hc Mri Any Jt Lower Extrem W/O Contrast Matrl | $2,009.44 | $5,023.60 | 60% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 Hc Mri Any Jt Lower Extrem W/O & W/Contrast Matrl | $2,825.30 | $7,063.25 | 60% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 Hc Mri Any Jt Lower Extrem W/O & W/Contrast Matrl | $2,825.30 | $7,063.25 | 60% |
| MRI of the brain, no contrast dye CPT 70551 Hc Mri Brain Brain Stem W/O Contrast Material | $919.98 | $2,299.95 | 60% |
| MRI of the brain, no contrast dye inpatient CPT 70551 Hc Mri Brain Brain Stem W/O Contrast Material | $919.98 | $2,299.95 | 60% |
| MRI of the brain, with and without contrast dye CPT 70553 Hc Mri Brain Brain Stem W/O W/Contrast Material | $1,327.34 | $3,318.35 | 60% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 Hc Mri Brain Brain Stem W/O W/Contrast Material | $1,327.34 | $3,318.35 | 60% |
| MRI of the lower back, no contrast dye CPT 72148 Hc Mri Spinal Canal Lumbar W/O Contrast Material | $1,030.18 | $2,575.45 | 60% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 Hc Mri Spinal Canal Lumbar W/O Contrast Material | $1,030.18 | $2,575.45 | 60% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Noncdm Charge Record | $129.60 | $324.00 | 60% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Hc Us Preg Uterus After 1St Trimest 1/1St Gestation | $520.22 | $1,300.55 | 60% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Noncdm Charge Record | $129.60 | $324.00 | 60% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Hc Us Preg Uterus After 1St Trimest 1/1St Gestation | $520.22 | $1,300.55 | 60% |
| Screening mammogram, both breasts CPT 77067 Hc Screeningmammographydigital, Includes Cad When Performed | $211.20 | $528.00 | 60% |
| Screening mammogram, both breasts inpatient CPT 77067 Hc Screeningmammographydigital, Includes Cad When Performed | $211.20 | $528.00 | 60% |
| Sleep study in a lab (polysomnography) CPT 95810 Hc Polysom 6/>Yrs Sleep 4/> Addl Param Attnd | $2,763.36 | $6,908.40 | 60% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 Hc Polysom 6/>Yrs Sleep 4/> Addl Param Attnd | $2,763.36 | $6,908.40 | 60% |
| Transvaginal pelvic ultrasound CPT 76830 Hc Ultrasound Transvaginal | $416.86 | $1,042.15 | 60% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 Hc Ultrasound Transvaginal | $416.86 | $1,042.15 | 60% |
| Ultrasound of the abdomen, complete CPT 76700 Hc Us Abdominal Real Time W/Image Documentation | $581.78 | $1,454.45 | 60% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 Hc Us Abdominal Real Time W/Image Documentation | $581.78 | $1,454.45 | 60% |
| X-ray of the lower back, 4 or more views CPT 72110 Hc X-Ray Spine Lumbosacral Minimum 4 Views | $313.88 | $784.70 | 60% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 Hc X-Ray Spine Lumbosacral Minimum 4 Views | $313.88 | $784.70 | 60% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 Hc Basic Metabolic Panel Calcium Total | $31.92 | $79.80 | 60% |
| Basic metabolic panel (blood test) inpatient CPT 80048 Hc Basic Metabolic Panel Calcium Total | $31.92 | $79.80 | 60% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Hc Lipid Panel | $65.36 | $163.40 | 60% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Hc Lipid Panel | $65.36 | $163.40 | 60% |
| Complete blood count (CBC) with differential CPT 85025 Hc Blood Count Complete Auto&Auto Difrntl Wbc | $45.60 | $114.00 | 60% |
| Complete blood count (CBC) with differential inpatient CPT 85025 Hc Blood Count Complete Auto&Auto Difrntl Wbc | $45.60 | $114.00 | 60% |
| Complete blood count (CBC), no differential CPT 85027 Hc Blood Count Complete Automated | $46.56 | $116.40 | 60% |
| Complete blood count (CBC), no differential inpatient CPT 85027 Hc Blood Count Complete Automated | $46.56 | $116.40 | 60% |
| Comprehensive metabolic panel (blood test) CPT 80053 Hc Comprehensive Metabolic Panel | $41.04 | $102.60 | 60% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Hc Comprehensive Metabolic Panel | $41.04 | $102.60 | 60% |
| Kidney function blood test panel CPT 80069 Hc Renal Function Panel | $33.06 | $82.65 | 60% |
| Kidney function blood test panel inpatient CPT 80069 Hc Renal Function Panel | $33.06 | $82.65 | 60% |
| Liver function blood test panel CPT 80076 Hc Hepatic Function Panel | $44.08 | $110.20 | 60% |
| Liver function blood test panel inpatient CPT 80076 Hc Hepatic Function Panel | $44.08 | $110.20 | 60% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 Hc Assay Of Prostate Specific Antigen Free | $111.72 | $279.30 | 60% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Hc Assay Of Prostate Specific Antigen Free | $111.72 | $279.30 | 60% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Hc Psa Total | $75.24 | $188.10 | 60% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Hc Assay Of Prostate Specific Antigen Total | $75.24 | $188.10 | 60% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Hc Assay Of Prostate Specific Antigen Total | $75.24 | $188.10 | 60% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Hc Psa Total | $75.24 | $188.10 | 60% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Hc Thromboplastin Time Partial Plasma/Whole Blood | $31.20 | $78.00 | 60% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Hc Thromboplastin Time Partial Plasma/Whole Blood | $31.20 | $78.00 | 60% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Hc Prothrombin Time | $41.76 | $104.40 | 60% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Hc Prothrombin Time | $41.76 | $104.40 | 60% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Hc Assay Of Thyroid Stimulating Hormone Tsh | $81.70 | $204.25 | 60% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Hc Tsh (State Health Dept) | $139.20 | $348.00 | 60% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Hc Assay Of Thyroid Stimulating Hormone Tsh | $81.70 | $204.25 | 60% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Hc Tsh (State Health Dept) | $139.20 | $348.00 | 60% |
| Urinalysis with microscope exam, automated CPT 81001 Noncdm Charge Record | $12.80 | $32.00 | 60% |
| Urinalysis with microscope exam, automated CPT 81001 Hc Urnls Dip Stick/Tablet Reagent Auto Microscopy | $63.36 | $158.40 | 60% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Noncdm Charge Record | $12.80 | $32.00 | 60% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Hc Urnls Dip Stick/Tablet Reagent Auto Microscopy | $63.36 | $158.40 | 60% |
| Urinalysis without microscope exam, automated CPT 81003 Hc Urnls Dip Stick/Tablet Rgnt Auto W/O Microscopy | $49.44 | $123.60 | 60% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Hc Urnls Dip Stick/Tablet Rgnt Auto W/O Microscopy | $49.44 | $123.60 | 60% |
| Urinalysis without microscope exam, manual CPT 81002 Noncdm Charge Record | $3.60 | $9.00 | 60% |
| Urinalysis without microscope exam, manual CPT 81002 Hc Urnls Dip Stick/Tablet Rgnt Non-Auto W/O Micrscp | $63.84 | $159.60 | 60% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Noncdm Charge Record | $3.60 | $9.00 | 60% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Hc Urnls Dip Stick/Tablet Rgnt Non-Auto W/O Micrscp | $63.84 | $159.60 | 60% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Left heart catheterization, diagnostic CPT 93452 Hc L Hrt Cath W/Njx L Ventriculography Img S&I | $4,675.14 | $11,687.85 | 60% |
| Left heart catheterization, diagnostic inpatient CPT 93452 Hc L Hrt Cath W/Njx L Ventriculography Img S&I | $4,675.14 | $11,687.85 | 60% |
| Lower-back epidural injection, with imaging guidance CPT 62323 Hc Injection Epidural (Not Neurolytic) - Lumbar Or Sacral All Inclusive | $443.08 | $1,107.70 | 60% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Hc Injection Epidural (Not Neurolytic) - Lumbar Or Sacral All Inclusive | $443.08 | $1,107.70 | 60% |
| Lower-back epidural injection, without imaging guidance CPT 62322 Hc Njx Interlaminar Lmbr/Sac W/O Imaging Guidance | $625.48 | $1,563.70 | 60% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Hc Njx Interlaminar Lmbr/Sac W/O Imaging Guidance | $625.48 | $1,563.70 | 60% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Hc Njx Anes&/Strd W/Img Tfrml Edrl Lmbr/Sac 1 Lvl | $953.42 | $2,383.55 | 60% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Hc Njx Anes&/Strd W/Img Tfrml Edrl Lmbr/Sac 1 Lvl | $953.42 | $2,383.55 | 60% |
| Upper endoscopy (EGD) with biopsy CPT 43239 Hc Edg Transoral Biopsy Single/Multiple | $320.34 | $800.85 | 60% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 Hc Edg Transoral Biopsy Single/Multiple | $320.34 | $800.85 | 60% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 Noncdm Charge Record | $20.80 | $52.00 | 60% |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 Noncdm Charge Record | $20.80 | $52.00 | 60% |
| Group psychotherapy session CPT 90853 Hc Group Psychotherapy | $126.92 | $317.30 | 60% |
| Group psychotherapy session CPT 90853 Hc Iop Chemical Dependancy | $159.22 | $398.05 | 60% |
| Group psychotherapy session CPT 90853 Hc Iop Psychiatric | $159.22 | $398.05 | 60% |
| Group psychotherapy session inpatient CPT 90853 Hc Group Psychotherapy | $126.92 | $317.30 | 60% |
| Group psychotherapy session inpatient CPT 90853 Hc Iop Psychiatric | $159.22 | $398.05 | 60% |
| Group psychotherapy session inpatient CPT 90853 Hc Iop Chemical Dependancy | $159.22 | $398.05 | 60% |
| New patient office visit, about 30 minutes CPT 99203 Noncdm Charge Record | $83.20 | $208.00 | 60% |
| New patient office visit, about 30 minutes inpatient CPT 99203 Noncdm Charge Record | $83.20 | $208.00 | 60% |
| New patient office visit, about 45 minutes CPT 99204 Noncdm Charge Record | $126.80 | $317.00 | 60% |
| New patient office visit, about 45 minutes inpatient CPT 99204 Noncdm Charge Record | $126.80 | $317.00 | 60% |
| New patient office visit, about 60 minutes CPT 99205 Noncdm Charge Record | $160.61 | $401.53 | 60% |
| New patient office visit, about 60 minutes inpatient CPT 99205 Noncdm Charge Record | $160.61 | $401.53 | 60% |
| Preventive checkup, new patient aged 18–39 CPT 99385 Hc Initial Preventive Medicine New Pt Age 18-39Yrs | $32.30 | $80.75 | 60% |
| Preventive checkup, new patient aged 18–39 CPT 99385 Noncdm Charge Record | $100.40 | $251.00 | 60% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Hc Initial Preventive Medicine New Pt Age 18-39Yrs | $32.30 | $80.75 | 60% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Noncdm Charge Record | $100.40 | $251.00 | 60% |
| Preventive checkup, new patient aged 40–64 CPT 99386 Hc Initial Preventive Medicine New Patient 40-64Yrs | $32.30 | $80.75 | 60% |
| Preventive checkup, new patient aged 40–64 CPT 99386 Noncdm Charge Record | $116.40 | $291.00 | 60% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 Hc Initial Preventive Medicine New Patient 40-64Yrs | $32.30 | $80.75 | 60% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 Noncdm Charge Record | $116.40 | $291.00 | 60% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 Hc Office/Op Consltj New/Est Pt Mod Mdm 40 Minutes | $45.60 | $114.00 | 60% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 Hc Office/Op Consltj New/Est Pt Mod Mdm 40 Minutes | $45.60 | $114.00 | 60% |
Source file: https://saintfrancis.com/finance/sfhs-cms-hpt