Ascension St John Sapulpa

1004 East Bryan, Sapulpa, OK 74066 · (918) 224-4280

Critical Access HospitalsVoluntary non-profit - PrivateTulsa, OK metro Website ↗Website taken from the domain of its price file

Price file

Prices published

File dated 2026-01-01

2,276 price rows for 68 procedures

Published prices

cash · negotiated range · list

Basic metabolic panel (blood test)

CPT 80048 · lowest of 2 lines · metro median $32

$32

cash

$11 to $86

19 negotiated rates

$86

list

CT scan of the abdomen and pelvis, with contrast

CPT 74177 · metro median $1,188

$1,188

cash

$222 to $616

12 negotiated rates

$3,210

list

CT scan of the head, no contrast

CPT 70450 · lowest of 3 lines · metro median $892

$892

cash

$74 to $295

33 negotiated rates

$2,410

list

CT scan of the pelvis, with contrast

CPT 72193 · metro median $971

$971

cash

$170 to $486

13 negotiated rates

$2,625

list

Cataract surgery with lens implant

CPT 66984

—

cash

$693 to $1,216

7 negotiated rates

—

list

Cesarean delivery with prenatal and postpartum care

CPT 59510

—

cash

$2,270 to $4,333

7 negotiated rates

—

list

Cesarean section hospital stay, no complications

MS-DRG 788

—

cash

$700 to $16,493

21 negotiated rates

—

list

Chlamydia test (DNA)

CPT 87491 · lowest of 12 lines · metro median $42

$42

cash

$44 to $249

64 negotiated rates

$115

list

Colonoscopy (diagnostic)

CPT 45378

—

cash

$211 to $409

7 negotiated rates

—

list

Colonoscopy with biopsy

CPT 45380

—

cash

$229 to $488

7 negotiated rates

—

list

Colonoscopy with polyp removal

CPT 45385

—

cash

$291 to $580

7 negotiated rates

—

list

Complete blood count (CBC) with differential

CPT 85025 · metro median $45

$45

cash

$10 to $14

13 negotiated rates

$123

list

Comprehensive metabolic panel (blood test)

CPT 80053 · lowest of 2 lines · metro median $41

$41

cash

$13 to $110

19 negotiated rates

$110

list

Diagnostic mammogram (both breasts)

CPT 77066 · metro median $209

$209

cash

$122 to $304

12 negotiated rates

$565

list

Electrocardiogram (ECG) with interpretation

CPT 93000

—

cash

$18 to $120

7 negotiated rates

—

list

Established patient office visit (about 40 minutes)

CPT 99215 · lowest of 2 lines · metro median $264

$264

cash

$122 to $186

116 negotiated rates

$715

list

Family psychotherapy with the patient

CPT 90847 · metro median $210

$210

cash

$119 to $179

13 negotiated rates

$569

list

Family psychotherapy without the patient

CPT 90846 · metro median $210

$210

cash

$107 to $151

13 negotiated rates

$569

list

Gallbladder removal (laparoscopic)

CPT 47562

—

cash

$736 to $1,219

7 negotiated rates

—

list

Gonorrhea test (DNA)

CPT 87591 · lowest of 12 lines · metro median $42

$42

cash

$44 to $249

64 negotiated rates

$115

list

Group psychotherapy

CPT 90853 · metro median $127

$210

cash

$28 to $48

13 negotiated rates

$569

list

Hip or knee replacement, no major complications

MS-DRG 470

—

cash

$700 to $16,493

21 negotiated rates

—

list

Hospital stay for digestive disorders, no complications

MS-DRG 392

—

cash

$1,593 to $16,493

21 negotiated rates

—

list

Hysterectomy for non-cancer reasons, no complications

MS-DRG 743

—

cash

$1,593 to $16,493

21 negotiated rates

—

list

Inguinal hernia repair (age 5 and up)

CPT 49505

—

cash

$556 to $964

7 negotiated rates

—

list

Knee arthroscopy with meniscus repair

CPT 29881

—

cash

$594 to $1,001

7 negotiated rates

—

list

Laser treatment after cataract surgery (YAG)

CPT 66821

—

cash

$300 to $586

7 negotiated rates

—

list

Left heart catheterization

CPT 93452

—

cash

$591 to $1,588

6 negotiated rates

—

list

Lipid panel (cholesterol test)

CPT 80061 · lowest of 4 lines · metro median $28

$28

cash

$17 to $180

28 negotiated rates

$75

list

Liver function panel

CPT 80076 · lowest of 2 lines · metro median $44

$44

cash

$10 to $120

19 negotiated rates

$120

list

MRI of the brain, with and without contrast

CPT 70553 · metro median $1,279

$1,279

cash

$266 to $1,591

20 negotiated rates

$3,457

list

MRI of the knee or other lower joint, no contrast

CPT 73721 · lowest of 10 lines · metro median $977

$977

cash

$171 to $1,591

88 negotiated rates

$2,640

list

MRI of the lower back (lumbar spine), no contrast

CPT 72148 · lowest of 3 lines · metro median $925

$925

cash

$151 to $1,591

36 negotiated rates

$2,500

list

MRI of the neck (cervical spine), no contrast

CPT 72141 · lowest of 5 lines · metro median $963

$963

cash

$152 to $1,591

52 negotiated rates

$2,603

list

Neck (cervical) spinal fusion, no complications

MS-DRG 473

—

cash

$1,593 to $16,493

21 negotiated rates

—

list

Nerve block injection, lower back, with imaging guidance

CPT 64483 · lowest of 3 lines · metro median $643

$643

cash

$124 to $215

28 negotiated rates

$1,737

list

New patient office visit (about 30 minutes)

CPT 99203 · lowest of 3 lines · metro median $165

$165

cash

$84 to $129

116 negotiated rates

$447

list

New patient office visit (about 45 minutes)

CPT 99204 · lowest of 4 lines · metro median $127

$127

cash

$141 to $220

104 negotiated rates

$342

list

New patient office visit (about 60 minutes)

CPT 99205 · lowest of 3 lines · metro median $161

$157

cash

$183 to $283

98 negotiated rates

$425

list

PSA test (prostate)

CPT 84153 · lowest of 2 lines · metro median $77

$77

cash

$23 to $208

19 negotiated rates

$208

list

Partial thromboplastin time (blood clotting test)

CPT 85730 · metro median $22

$22

cash

$7 to $15

13 negotiated rates

$60

list

Physical therapy, therapeutic exercise (15 minutes)

CPT 97110 · lowest of 12 lines · metro median $33

$33

cash

$34 to $60

88 negotiated rates

$89

list

Pregnancy ultrasound (after first trimester)

CPT 76805 · metro median $566

$566

cash

$94 to $267

13 negotiated rates

$1,531

list

Preventive visit, new patient age 18 to 39

CPT 99385

—

cash

$95 to $166

7 negotiated rates

—

list

Preventive visit, new patient age 40 to 64

CPT 99386

—

cash

$116 to $201

7 negotiated rates

—

list

Prostate biopsy

CPT 55700 · metro median $2,412

$2,412

cash

$148 to $258

19 negotiated rates

$6,520

list

Prostate removal (laparoscopic)

CPT 55866

—

cash

$1,631 to $3,206

7 negotiated rates

—

list

Prothrombin time (blood clotting test)

CPT 85610 · lowest of 4 lines · metro median $12

$12

cash

$5 to $10

32 negotiated rates

$34

list

Psychotherapy, 30 minutes

CPT 90832 · metro median $210

$210

cash

$71 to $71

2 negotiated rates

$569

list

Psychotherapy, 45 minutes

CPT 90834 · metro median $210

$210

cash

$94 to $94

2 negotiated rates

$569

list

Psychotherapy, 60 minutes

CPT 90837 · metro median $210

$210

cash

$142 to $142

2 negotiated rates

$569

list

Removal of a breast lump (biopsy by excision)

CPT 19120

—

cash

$429 to $761

7 negotiated rates

—

list

Screening mammogram (both breasts)

CPT 77067 · lowest of 3 lines · metro median $141

$141

cash

$101 to $245

24 negotiated rates

$380

list

Shoulder arthroscopy with decompression

CPT 29826

—

cash

$198 to $736

7 negotiated rates

—

list

Sleep study (overnight, attended)

CPT 95810

—

cash

$508 to $3,688

9 negotiated rates

—

list

Spinal injection, lower back, no imaging guidance

CPT 62322 · metro median $520

$520

cash

$98 to $170

12 negotiated rates

$1,406

list

Spinal injection, lower back, with imaging guidance

CPT 62323 · lowest of 2 lines · metro median $661

$661

cash

$113 to $194

18 negotiated rates

$1,786

list

TSH test (thyroid)

CPT 84443 · lowest of 8 lines · metro median $22

$22

cash

$21 to $225

46 negotiated rates

$60

list

Tonsils and adenoids removal (under age 12)

CPT 42820

—

cash

$320 to $548

7 negotiated rates

—

list

Transvaginal ultrasound

CPT 76830 · metro median $379

$379

cash

$89 to $137

13 negotiated rates

$1,024

list

Ultrasound of the abdomen (complete)

CPT 76700 · metro median $527

$527

cash

$84 to $252

13 negotiated rates

$1,424

list

Upper endoscopy (EGD)

CPT 43235

—

cash

$140 to $273

7 negotiated rates

—

list

Upper endoscopy with biopsy

CPT 43239

—

cash

$158 to $323

7 negotiated rates

—

list

Urinalysis with microscope

CPT 81001 · metro median $33

$33

cash

$4 to $8

25 negotiated rates

$89

list

Vaginal delivery after a previous cesarean

CPT 59610

—

cash

$2,111 to $4,109

7 negotiated rates

—

list

Vaginal delivery hospital stay, no complications

MS-DRG 807

—

cash

$700 to $16,493

21 negotiated rates

—

list

Vaginal delivery with prenatal and postpartum care

CPT 59400

—

cash

$2,005 to $3,922

7 negotiated rates

—

list

X-ray of the lower spine (4 or more views)

CPT 72110 · metro median $227

$227

cash

$33 to $89

13 negotiated rates

$614

list

Source files

The machine-readable files this hospital lists in its cms-hpt.txt. Every price above comes from one of them.

https://healthcare.ascension.org/-/media/project/ascension/healthcare/price-transparency-files/ok-csv/730662663_st-john-sapulpa-inc_standardcharges.csv
Ascension St. John Sapulpa (St. John Sapulpa, Inc.) · parsed · tall v3.0.0 · file dated 2026-01-01 · 21.5 MB · 2276 price rows read · read Nov 2026