Across Oklahoma's hospitals, clinics, and specialty centers, the same knee-related procedure can cost anywhere from a few hundred to hundreds of thousands of dollars — for the identical CPT billing code. This report exposes the staggering lack of pricing logic in the state's musculoskeletal care market.
A review of publicly available hospital chargemaster data across Oklahoma reveals a healthcare pricing environment that defies rational market logic. For every knee-related service examined — from a routine office visit to a total joint replacement — the price variation between providers is not marginal. It is catastrophic.
Patients seeking knee care in Oklahoma face a pricing landscape with no coherent structure. A physical therapy session billed under CPT 97110 costs $30 at one provider and $2,359 at another — a 78.6× difference for the identical service code. This is not a reflection of quality differences; it is a reflection of a system with no pricing accountability.
Across all 15 services analyzed, not a single procedure showed a price ratio below 3×. The median ratio across services is approximately 11×. For surgical procedures, the dollar gaps are staggering: a knee replacement (CPT 27447) ranges from $17,679 to $201,682 — a difference of $184,003 for the same operation.
Specialty and outpatient facilities consistently undercut hospital systems. The Surgery Center of Oklahoma posts the lowest prices on all three surgical procedures. Evolution Imaging offers MRI at $499 versus a hospital high of $11,172. Premier Physical Therapy charges $30–$150 for services billed at $1,225–$2,359 at hospital-based PT departments.
Large academic and integrated health systems dominate the high end. OU Health / OUMC holds the highest price for both knee replacement ($201,682) and single meniscectomy ($66,334). Hillcrest Medical Center charges the most for a cortisone injection ($11,438) and physical therapy ($2,359). SSM Health St. Anthony – Midwest tops the MSK ultrasound list at $3,822.
The dashboard below presents all 15 services and up to 16 providers in a single interactive view. Click any service in the left panel to update the chart and provider ranking. Bars are color-coded from green (lowest) to red (highest).
Interactive dashboard — click any service on the left to explore. All prices are gross chargemaster rates before insurance negotiation or discounting.
The following cards highlight the most significant price disparities across the 15 services analyzed, ranked by price ratio. Each card shows the lowest and highest reported prices and names the providers at each extreme.
The most extreme ratio in the dataset. Premier Physical Therapy charges $30 per 15-minute block while Hillcrest Medical Center bills $2,359 — nearly 79 times more for the same coded service. The average across 16 providers is $382.
Evolution Imaging offers the same MRI for $499 that St. Mary's Regional Medical Center charges $11,172 for — a $10,673 difference. The average across 16 providers is $4,424, meaning most patients are paying far above the market floor.
Evolution Imaging again anchors the low end at $199 while SSM Health St. Anthony – Midwest charges $3,822.25. Notably, Hillcrest Medical Center charges $3,036 — 15× more than the minimum — for the same diagnostic scan.
A basic three-view knee X-ray ranges from $130 (At-home Mobile Xray Service) to $1,990 (INTEGRIS Baptist). Two providers tie at the high end ($1,990), while the mobile imaging service undercuts all hospital prices by a factor of 5 or more.
A blind cortisone injection — a routine office procedure — costs $923 at Oklahoma State University Medical Center and $11,438 at Hillcrest Medical Center. Hillcrest's charge is more than 12× the minimum and $8,000 above the next-highest provider.
This facility fee — charged on top of the provider's professional fee — ranges from $125 to $1,509 across just five reporting providers. St. Mary's Regional Medical Center charges 12× more than SSM Health St. Anthony – OKC for the same visit type.
The largest dollar gap in the dataset: $184,003. The Surgery Center of Oklahoma performs the procedure at $17,679 while OU Health / OUMC lists $201,682. The average across 13 providers is $78,689 — over 4× the minimum.
A knee scope with single meniscal repair ranges from $6,215 (Surgery Center of Oklahoma) to $66,334 (OU Health / OUMC). SSM Health St. Anthony – Midwest charges $49,851 — nearly 8× the minimum — for the same procedure code.
A 30-minute physical therapy evaluation costs $150 at Premier Physical Therapy and $1,564 at Hillcrest Medical Center. The hospital-based PT departments charge 3–10× more than the independent clinic for the same evaluation complexity level.
The data reveals several structural patterns that explain — though do not justify — the extreme price variation across Oklahoma's knee care market.
Higher bars indicate greater pricing incoherence for that service
Absolute price difference between the most and least expensive provider
The most consistent pattern in the data is the systematic price premium charged by hospital-based facilities relative to independent specialty centers. This premium is not modest — it routinely exceeds 5× and in some cases approaches 80×.
Hospital systems justify higher chargemaster rates through arguments about overhead, teaching missions, emergency preparedness, and uncompensated care. However, these justifications do not explain why two hospitals within the same integrated system — such as SSM Health St. Anthony OKC and SSM Health St. Anthony Midwest — can charge materially different prices for the same procedure.
Independent facilities — the Surgery Center of Oklahoma, Evolution Imaging, Premier Physical Therapy, and the At-home Mobile Xray Service — consistently anchor the low end of every service category in which they participate. Their prices are not outliers; they represent what these services cost when delivered outside the hospital pricing structure.
Diagnostic imaging shows some of the most extreme ratios in the dataset. A knee MRI (CPT 73721) spans a 22.4× range, and an MSK ultrasound (CPT 76881) spans 19.2×. These are not complex, highly variable procedures — they are standardized imaging protocols with well-defined technical requirements.
Evolution Imaging, an outpatient imaging center, charges $499 for a knee MRI and $199 for an MSK ultrasound. The average hospital price for the MRI is $4,424 — nearly 9× higher. For a patient paying out of pocket or subject to a high-deductible plan, this difference is the difference between affordability and financial hardship.
The same dynamic applies to X-rays. A basic three-view knee X-ray costs $130 from a mobile imaging service versus $1,990 at a hospital — a 15.3× difference for a procedure that takes minutes and requires no specialized facility infrastructure beyond the imaging equipment itself.
For surgical procedures, the dollar gaps are largest in absolute terms but the ratios are comparatively moderate (10–11×). This is because even the lowest-cost surgical provider charges thousands of dollars, compressing the ratio relative to the extreme cases seen in physical therapy or imaging.
The Surgery Center of Oklahoma — a physician-owned facility that publishes its prices openly and does not accept insurance — charges $17,679 for a total knee replacement (CPT 27447). OU Health / OUMC, the state's flagship academic medical center, charges $201,682 for the same procedure. The $184,003 gap is not explained by complexity, outcomes, or technology. It reflects fundamentally different pricing philosophies: one based on transparent, market-rate cost recovery, and one based on a chargemaster system designed for insurance negotiation rather than patient-facing pricing.
The following table summarizes the 16 providers in this dataset, their facility type, and their general pricing posture across the services where they report data.
| Provider | Type | City / Region | Pricing Posture | Notable Extremes |
|---|---|---|---|---|
| Surgery Center of Oklahoma | Surgery Ctr | Oklahoma City | Consistently Lowest | Lowest price on all 3 surgical procedures; publishes prices openly |
| Evolution Imaging | Imaging Ctr | Oklahoma | Consistently Lowest | MRI at $499 vs. hospital avg $4,424; Ultrasound at $199 |
| Premier Physical Therapy | PT Clinic | Oklahoma | Consistently Lowest | $30/session vs. $2,359 at Hillcrest; $150 eval vs. $1,564 |
| At-home Mobile Xray Service – OK | Mobile | Statewide | Lowest (X-Ray) | $130 for knee X-ray vs. $1,990 at INTEGRIS Baptist |
| Comanche County Medical Center | Hospital | Lawton | Lower Range | Among lowest for office visits, X-ray, and PT; $127 new patient eval |
| Norman Regional Health System | Hospital | Norman | Mid-Range | Lowest follow-up visit at $147; mid-range on imaging and injections |
| Oklahoma State Univ. Medical Ctr | Hospital | Tulsa | Mid-Range | Lowest cortisone injection at $923; mid-range on most services |
| Mercy Hospital Oklahoma City | Hospital | Oklahoma City | Mid-Range | Lowest follow-up (99214) at $210; generally moderate pricing |
| Ascension St. John Medical Center | Hospital | Tulsa | Mid-Range | Lowest guided cortisone at $1,067; lowest single meniscectomy among hospitals |
| Saint Francis Hospital | Hospital | Tulsa | Mid-Range | Consistent mid-range pricing; same rates as Saint Francis – Muskogee |
| SSM Health St. Anthony – OKC | Hospital | Oklahoma City | Mid-Range | Lowest outpatient visit fee at $125; highest guided cortisone at $3,396 |
| INTEGRIS Baptist Medical Center | Hospital | Oklahoma City | Upper Range | Highest X-ray at $1,990; highest new patient eval (99204) at $1,529 |
| INTEGRIS Southwest Medical Center | Hospital | Oklahoma City | Upper Range | Mirrors INTEGRIS Baptist on many codes; high on office visits and imaging |
| SSM Health St. Anthony – Midwest | Hospital | Midwest City | Upper Range | Highest MSK ultrasound at $3,822; highest new patient eval (99203) at $1,034 |
| St. Mary's Regional Medical Center | Hospital | Enid | Upper Range | Highest MRI at $11,172; highest outpatient visit at $1,509; highest PT exercise at $2,359 (tied) |
| OU Health / OUMC | Hospital | Oklahoma City | Highest (Surgical) | Highest knee replacement at $201,682; highest single meniscectomy at $66,334; highest MRI at $7,950 |
| Hillcrest Medical Center | Hospital | Tulsa | Highest (Non-Surgical) | Highest cortisone injection at $11,438; highest PT exercise at $2,359; highest PT eval at $1,564 |
This analysis is grounded in publicly available price transparency data. The methodology is straightforward, reproducible, and deliberately conservative in its scope.
All prices are drawn from hospital chargemaster files and price transparency disclosures made publicly available under the CMS Hospital Price Transparency Rule (effective January 1, 2021). Specialty provider prices were obtained from their published price lists.
Services were selected to represent the full continuum of knee-related musculoskeletal care: office visits, diagnostic imaging, injections, physical therapy, and surgery. Each service is identified by its standard CPT or HCPCS billing code to ensure like-for-like comparison.
All prices reported are gross chargemaster rates — the list price before any insurance negotiation, contractual adjustment, or patient discount. These are the prices a self-pay or uninsured patient would be billed, and the starting point for all insurance negotiations.
Chargemaster prices do not reflect negotiated rates, which vary by payer. Not all providers report all services. Prices do not account for quality differences, complication rates, or ancillary service bundling. This analysis reflects pricing transparency, not clinical value.
The price variation documented in this report is not a market functioning as intended. It is a market that has never been required to function transparently. The following implications follow directly from the data.
An Oklahoma patient who receives a knee MRI at St. Mary's Regional Medical Center pays $10,673 more than a patient who receives the same scan at Evolution Imaging. Without price transparency tools, patients have no way to know this before they schedule their appointment. The CMS transparency rule is a necessary first step, but awareness and accessibility of this data remain critically low.
While insured patients pay negotiated rates rather than chargemaster prices, those negotiated rates are anchored to the chargemaster. A hospital that charges $201,682 for a knee replacement will negotiate a higher absolute rate than one that charges $17,679 — even if both are discounted by 40%. The chargemaster is the ceiling from which all prices descend, and extreme chargemaster prices produce extreme negotiated prices.
The Surgery Center of Oklahoma, Evolution Imaging, and Premier Physical Therapy are not loss-leaders or subsidized providers. They are profitable businesses that cover their costs at prices 5–80× lower than hospital competitors. Their existence proves that the services in this dataset can be delivered at a fraction of hospital chargemaster prices — and that the gap is structural, not clinical.
Self-insured employers and health plans have the leverage to implement reference-based pricing — paying a fixed multiple of Medicare rates regardless of provider chargemaster — for elective musculoskeletal procedures. Given that knee replacement Medicare rates are approximately $12,000–$15,000, a 150% reference price of $18,000–$22,500 would cover the Surgery Center of Oklahoma's price while eliminating the $200,000 outlier entirely.
Several providers in this dataset did not report prices for all services. The CMS price transparency rule requires hospitals to publish standard charges in a machine-readable format, but enforcement has been inconsistent. Incomplete reporting — whether intentional or not — leaves patients without the information they need to make cost-informed decisions. State-level enforcement mechanisms and patient-facing price comparison tools are urgently needed.
The data in this report is publicly available. The disparities are real. Share this analysis with patients, employers, policymakers, and anyone who believes that the price of a knee should not depend on which zip code you happen to be in.