TULSA SPINE & SPECIALTY HOSPITAL

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
SUP-306176	KIT SURGICAL INCEPTIV	$120,159	$30,040	—	—	14
SUP-179088	IMPLANT KIT INTELLIS MRI PERC	$114,415	$28,604	—	—	42
SUP-306175	KIT NEUROSTIMULATOR INCEPTIV PERCUTANEOUS 16 COMPONENT	$114,316	$28,579	—	—	42
SUP-875375	IMPL GENERATOR ASPIRE SR 106	$112,866	$28,216	—	—	42
SUP-186672	KIT SURGICAL INCEPTIV	$98,978	$24,744	—	—	14
SUP-186917	GENERATOR NEUROSTIMULATOR INSPIRE 1 TORQUE HEX WRENCH LEAD CONNECTOR PORT STERILE INSPIRE PROGRAMMER	$89,640	$22,410	—	—	42
SUP-181367	NEUROSTIMULATOR IMPLANTABLE INCEPTIV MRI STERILE LATEX FREE DISPOSABLE	$87,150	$21,788	—	—	14
SUP-857802	KIT INTELLIS SENSOR	$83,000	$20,750	—	—	14
SUP-844688	GENERATOR NEUROSTIMULATOR PROCLAIM L1.34 CM X W4.95 CM X H6.1 CM 32 CC PULSE DORSAL ROOT GANGLION	$83,000	$20,750	—	—	42
SUP-186657	GRAFT VASCULAR ANGIOGRAFT 2 BRANCH L1 CM AORTA ILIAC DISTAL INFRARENAL ALLOGRAFT	$79,660	$19,915	—	—	42
SUP-104688	GENERATOR NEUROSTIMULATOR PROCLAIM ELITE THK1.34 CM 25.5-MA 2-1200HZ 30.4 CU CM L1.95 IN X H2.19 IN	$78,518	$19,630	—	—	42
SUP-302405	SYS IPG REPLACEMENT VANTA	$77,252	$19,313	—	—	42
SUP-861059	GENERATOR NEUROSTIMULATOR	$75,634	$18,908	—	—	42
SUP-875737	GENERATOR NEUROSTIMULATOR PROCLAIM ELITE THK1.34 CM 25.5-MA L1.95 IN X H2.19 IN 5 IMPLANTABLE PULSE	$72,625	$18,156	—	—	42
SUP-94617	NEUROSTIMULATOR IMPLANTABLE ACTIVA PC L49 MM X H65 MM 67 GM 2 CHANNEL PRIMARY CELL BATTERY	$71,380	$17,845	—	—	42
SUP-165235	ACCESSORY NEUROSTIMULATOR VANTA SPINAL CORD STIMULATION CHRONIC PAIN	$70,550	$17,638	—	—	14
PX-36062362	Insertion of programmable spinal canal drug infusion pump	$57,597	$14,399	—	—	17
SUP-884031	GRAFT BONE RIGHT MEDIAL FEMORAL HEMICONDYLE OSTEOCHONDRAL CUSTOM FRESH SPECIAL	$49,444	$12,361	—	—	14
SUP-869240	GRAFT BONE RIGHT MEDIAL FEMORAL HEMICONDYLE ALLOGRAFT ASEPTIC FRESH	$48,431	$12,108	—	—	18
SUP-154655	GRAFT SOFT TISSUE LEFT LATERAL FEMORAL HEMICONDYLE OSTEOCHONDRAL FRESH	$48,335	$12,084	—	—	10
SUP-177871	PUMP INFUSION SYNCHROMED III 40 ML	$46,480	$11,620	—	—	42
SUP-177872	PUMP INFUSION SYNCHROMED III 20 ML	$46,480	$11,620	—	—	42
SUP-866264	BASEPLATE GLENOID COMPREHENSIVE FAST GUIDE STERILE LATEX FREE VAULT RECONSTRUCTION SYSTEM	$44,945	$11,236	—	—	10
SUP-21885	CONTROLLER NEUROSTIMULATOR PROCLAIM ELITE 7	$40,478	$10,119	—	—	50
SUP-845978	SYS PRIME REPLACMENT KIT	$38,743	$9,686	—	—	22
SUP-32215	PUMP INTRATHECAL SYNCHROMED II TITANIUM 20 ML RESERVOIR PROGRAMMABLE	$38,579	$9,645	—	—	42
SUP-133083	NEUROSTIMULATOR IMPLANTABLE ACTIVA SC	$37,475	$9,369	—	—	42
SUP-147181	NEUROSTIMULATOR IMPLANTABLE ACTIVA SC L2.4 MM X H2.2 IN 45 GM PRIMARY CELL 1 CHANNEL NONRECHARGEABLE	$37,475	$9,369	—	—	42
SUP-179599	COMPONENT FEMORAL TRIATHLON 3 LEFT REVISION	$37,465	$9,366	—	—	8
SUP-186162	COMPONENT FEMORAL TRIATHLON 2 RIGHT REVISION	$37,465	$9,366	—	—	13
SUP-188327	COMPONENT FEMORAL TRIATHLON 4 KNEE RIGHT HINGE STERILE LATEX FREE	$37,465	$9,366	—	—	19
SUP-873480	SPACER SPINAL ELSA D20 MM W50 MM X H7-14 MM	$37,350	$9,338	—	—	14
SUP-181237	STIMULATOR NERVE SPRINT EXTENSA XT PERIPHERAL NONSTERILE LATEX FREE DISPOSABLE	$34,445	$8,611	—	—	39
SUP-881277	CAGE LATERAL SPACER 12 X 50MM	$33,657	$8,414	—	—	14
SUP-181236	STIMULATOR NERVE SPRINT EXTENSA NONSTERILE LATEX FREE DISPOSABLE	$32,370	$8,093	—	—	14
SUP-202293	CAGE SPINAL MODULUS 15 D L38 MM X W28 MM X H8 MM STERILE LATEX FREE ALIF	$29,056	$7,264	—	—	14
SUP-876938	CAGE SPINAL F3D 0 D STRAIGHT L26 MM X W10 MM X H11 MM	$29,050	$7,263	—	—	14
SUP-876970	CAGE SPINAL F3D 0 D STRAIGHT L22 MM X W10 MM X H8 MM	$29,050	$7,263	—	—	14
SUP-172323	SPACER 37X29X14	$28,946	$7,237	—	—	14
SUP-177678	SPACER SPINAL TITANIUM 12 D LARGE L42 MM X W32 MM X H14 MM	$28,946	$7,237	—	—	14
SUP-860631	SPACER SPINAL CATALYFT PL40 SHORT H7 MM	$28,789	$7,197	—	—	14
SUP-860632	SPACER SPINAL CATALYFT PL40 SHORT H9 MM	$28,789	$7,197	—	—	14
PX-36063663	Revision of spinal neurostimulator electrode array using fluoroscopic guidance	$28,425	$7,106	—	—	17
SUP-98496	SPACER SPINAL PILLAR PEEK 12 D D28 MM OVOID W33 MM X H12.5 MM RADIOPAQUE MEDIAL ORIENT SCREW HOLE ST	$28,062	$7,016	—	—	14
SUP-845777	SPACER SPINAL PILLAR PEEK 12 D D32 MM OVOID W40 MM X H12.5 MM RADIOPAQUE MEDIAL ORIENT SCREW HOLE ST	$28,062	$7,016	—	—	14
SUP-172947	CAGE SPINAL CAPRI 7 D L13 MM X W16 MM X H16 MM STERILE LATEX FREE CORPECTOMY	$27,276	$6,819	—	—	8
SUP-53460	KIT BONE GRAFT INFUSE LARGE II 8 CC	$27,266	$6,816	—	—	16
SUP-879163	CAGE SPINAL ENDOSKELETON TAS TITANIUM 7 D D24 MM LARGE W36 MM X H12 MM RADIOPAQUE LARGE WINDOW SMOOT	$26,871	$6,718	—	—	14
SUP-879214	CAGE SPINAL ENDOSKELETON TAS TITANIUM 12 D D24 MM LARGE W36 MM X H15 MM RADIOPAQUE LARGE WINDOW SMOO	$26,871	$6,718	—	—	14
SUP-876284	SPACER HUMERAL INSPACE LARGE	$26,560	$6,640	—	—	6

Showing top 50 of 10,760 priced procedures, sorted by gross charge.

Data straight from this hospital's federally-mandated machine-readable file (45 CFR § 180). The compliance grade reflects how completely the hospital published the six required data elements, not the quality of care.