Pam Rehabilitation Hospital Of Tulsa prices

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
78804	NM Tumor Imaging Wb; 2+days	$29,462	$29,462	—	—	22
78815	NM Tumor Image Pet/CT Skul-T	$28,516	$28,516	—	—	23
43653	LAPAROSCOPY GASTROSTOMY	$26,838	$26,838	—	—	27
75860	Venography Jugular Cath RS&I	$13,970	$13,970	—	—	25
27301	DRAIN THIGH/KNEE LESION	$13,165	$13,165	—	—	27
78452	NM Hrt Muscle Image Spect	$12,633	$12,633	—	—	24
J2406	Oritavancin (Kimyrsa) 10 mg	$11,976	$11,976	—	—	23
75710	Angio Ext Unilat S&i	$11,345	$11,345	—	—	24
75625	Contrast Exam Abdominl Aorta	$11,345	$11,345	—	—	23
72295	RAD of Lower Spine Disk	$9,834	$9,834	—	—	24
73115	RAD Wrist Arthrgrp S&i Lt	$9,687	$9,687	—	—	21
78803	NM Rp Loclzj Tum Spect 1 Area	$9,594	$9,594	—	—	21
J1162	Digifab 40 mg	$8,574	$8,574	—	—	23
15002	Wound PrepTRK/ARM/LEG	$8,414	$8,414	—	—	27
73200	CT Upper Extrm W/O Dye Lt	$8,200	$8,200	—	—	24
14040	TIS TRNFR F/C/C/M/N/A/G/H/F	$7,993	$7,993	—	—	27
15271	Skin Sub Graft Trnk/Arm/Leg	$7,939	$7,939	—	—	31
32550	Insert Pleural Cath	$7,908	$7,908	—	—	29
72157	MRI Thoracic Spine W/O & W/Dye	$7,836	$7,836	—	—	23
72158	MRI Lumbar Spine W/O & W/Dye	$7,836	$7,836	—	—	24
70553	MRI Brain Stem W/O & W/Dye	$7,836	$7,836	—	—	21
72156	MRI Neck Spine W/O & W/Dye	$7,836	$7,836	—	—	23
72197	MRI Pelvis W/O & W/Dye	$7,836	$7,836	—	—	23
71552	MRI Chest W/&w/O Con	$7,836	$7,836	—	—	23
73220	MRI Upper Ext W/&w/O Dye	$7,836	$7,836	—	—	23
J1568	Immun Globg(Igg)/Malt/Iga Ov50	$7,751	$7,751	—	—	23
36558	Ins Tunneled CV CATH	$7,369	$7,369	—	—	30
74178	CT Abd & Pelv 1/> Regns w/wo c	$7,364	$7,364	—	—	26
73202	CT Uppr Extrm W/Wo Dye Lt	$7,010	$7,010	—	—	43
75810	RAD Vein Spleen/Liver	$6,816	$6,816	—	—	28
74177	CT Abdomen & Pelvis w/Contrast	$6,611	$6,611	—	—	26
73223	MRI Jnt Upr Extr Jnt W/O&w/Dye	$6,354	$6,354	—	—	26
10005	FNA BX W/US Gdn 1st Les	$6,185	$6,185	—	—	21
C8923	2d Tte W W/O Fol W/Contrast	$6,154	$6,154	—	—	25
75989	RAD Guid Perc Drain W/Cat	$6,130	$6,130	—	—	18
72285	RAD Cerv/Thor Spine Disk	$6,085	$6,085	—	—	20
74175	CT Angio Abdom W/O & W/Contras	$6,041	$6,041	—	—	25
78227	NM Hepatobiliary Duct ScanHIDA	$5,930	$5,930	—	—	19
73702	CT LO EXTR W/WO contrast BILAT	$5,640	$5,640	—	—	25
78582	NM Nuclear Scan of Lung	$5,639	$5,639	—	—	24
49082	Abd Paracentesis	$5,584	$5,584	—	—	29
75574	CT Angio Hrt W/3d Image	$5,551	$5,551	—	—	21
75825	RAD Venogrphy Caval Inferor W	$5,551	$5,551	—	—	22
70498	CT Angiography Neck	$5,378	$5,378	—	—	23
72195	MRI Pelvis W/O Dye	$5,263	$5,263	—	—	22
72130	CT Thoracic Spine w/o&w/contra	$5,204	$5,204	—	—	23
J3262	Tocilizumab 400 mg	$5,174	$5,174	—	—	23
70551	MRI Brain Stem W/O Dye	$5,044	$5,044	—	—	20
73721	MRI Jnt of Lwr Extre W/O Dye	$5,044	$5,044	—	—	22
70540	MRI Orbit/Face/Neck W/O Dye	$5,044	$5,044	—	—	24

Showing top 50 of 1,255 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.