CMS Price Transparency Data

Injection procedure for pain management

Facility: Ascension St John Sapulpa

Billing Code: G0260 (HCPCS)

The BaseRate · fair price medium confidence
A fair price for this
$650
about 0.9× the $721 Medicare rate · typically $227–$1,621
modeled estimate · not a bill or quote
Medicare pays $721 Fair price $650 Cash price $408 Hospital's list price $1,102

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

1 of 6 major insurers have a published price at this hospital

✓ Blue Cross Blue Shield UnitedHealthcareAetnaCignaHumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
Blue Cross Blue Shieldmajor $79 - $85 11%
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 1004 East Bryan, Sapulpa, OK 74066
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals