Physician
Urology
Urology
TULSA, OK
MERCY HOSPITAL FORT SMITH
ASCENSION ST JOHN BROKEN ARROW
healthcare.ascension.org/locations/oklahoma/oktul/broken-arrow-ascension-st-john-broken-arrow
ASCENSION ST JOHN JANE PHILLIPS
Based on specialty. Actual services may vary — contact the provider's office to confirm.
Based on CMS Medicare Provider Utilization data for 2023. These represent what this physician charged Medicare, not necessarily what you would pay. Compare with other physicians
| Procedure | Avg Charge | Medicare Allowed | Medicare Paid | Services |
|---|---|---|---|---|
50590 Shock wave crushing of kidney stones | $1,793 | $533 | $426 | 25 |
52332 Insertion of stent in ureter using an endoscope | $1,371 | $127 | $96 | 29 |
J9217 Leuprolide acetate (for depot suspension), 7.5 mg | $750 | $170 | $135 | 121 |
52310 Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope | $680 | $293 | $220 | 13 |
52000 Diagnostic exam of bladder and urethra using an endoscope | $550 | $217 | $164 | 102 |
99204 New patient office or other outpatient visit, 45-59 minutes | $465 | $154 | $110 | 70 |
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | $395 | $123 | $99 | 21 |
74176 Ct scan of abdomen and pelvis without contrast | $337 | $97 | $77 | 13 |
51720 Instillation of anti-cancer drug into bladder | $310 | $78 | $62 | 14 |
99203 New patient office or other outpatient visit, 30-44 minutes | $300 | $104 | $70 | 39 |
99214 Established patient office or other outpatient visit, 30-39 minutes | $300 | $119 | $89 | 283 |
99221 Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes | $290 | $78 | $62 | 13 |
51705 Simple change of bladder tube | $250 | $89 | $72 | 54 |
51700 Simple bladder irrigation and/or instillation | $230 | $68 | $54 | 67 |
99202 New patient office or other outpatient visit, 15-29 minutes | $205 | $65 | $40 | 22 |
99213 Established patient office or other outpatient visit, 20-29 minutes | $200 | $84 | $62 | 301 |
51702 Simple insertion of temporary bladder tube | $190 | $56 | $44 | 53 |
76872 Ultrasound scan of pelvic region through rectum | $153 | $94 | $72 | 23 |
51701 Insertion of temporary bladder tube | $150 | $40 | $30 | 87 |
99212 Established patient office or other outpatient visit, 10-19 minutes | $120 | $53 | $37 | 243 |
99231 Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes | $110 | $47 | $38 | 26 |
84403 Testosterone (hormone) level, total | $105 | $25 | $25 | 30 |
84154 Psa (prostate specific antigen) measurement, free | $103 | $18 | $18 | 18 |
96402 Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle | $100 | $31 | $22 | 30 |
76775 Limited ultrasound scan behind abdominal cavity | $96 | $29 | $22 | 23 |
99439 Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month | $80 | $45 | $35 | 92 |
84153 Psa (prostate specific antigen) measurement, total | $80 | $18 | $18 | 180 |
51798 Ultrasound measurement of bladder capacity after voiding | $70 | $9 | $7 | 576 |
96372 Injection of drug or substance under skin or into muscle | $70 | $13 | $10 | 110 |
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month | $65 | $59 | $43 | 955 |
74018 X-ray of abdomen, 1 view | $37 | $20 | $14 | 64 |
81001 Manual urinalysis test with examination using microscope, automated | $13 | $3 | $3 | 11 |
81003 Automated urinalysis test | $12 | $2 | $2 | 811 |
36415 Insertion of needle into vein for collection of blood sample | $10 | $8 | $8 | 219 |
J1644 Injection, heparin sodium, per 1000 units | $5 | $0 | $0 | 1,200 |
J1071 Injection, testosterone cypionate, 1 mg | $0 | $0 | $0 | 15,105 |
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Physician identity data from the NPPES NPI Registry. Last synced 3/28/2026.