Ascension St. John Broken Arrow (St. John Broken Arrow, Inc.)
1000 W Boise Cir Broken Arrow OK 74012|3029 West Main St, Jenks, OK · Ascension · · NPI 1497988596
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Clsd tx/fem shaft fx/manipulation 27502 CPT 27502 | $2,587.60 | $6,993.50 | $840.79 – $868.96 | 2 |
| Clsd tx finger tendon w/wo perq pin 26432 CPT 26432 | not published | not published | $514.12 – $524.97 | 2 |
| Clsd tx fracture of radius 25500 CPT 25500 | $394.79 | $1,067.00 | $240.76 – $269.34 | 2 |
| Clsd tx/fx grt toe/phalanx/phalang 28490 CPT 28490 | $376.11 | $1,016.50 | $121.99 – $134.35 | 2 |
| Clsd tx/fx/phalanx/phalang/manip 28515 CPT 28515 | $122.38 | $330.75 | $147.76 – $154.55 | 2 |
| Clsd tx fx radius/ulna dist without manip 25600 CPT 25600 | $313.21 | $846.50 | $263.21 – $330.60 | 2 |
| Clsd tx fx radius/ulna dist w/manip 25605 CPT 25605 | $975.88 | $2,637.50 | $554.67 – $606.43 | 2 |
| Clsd tx fx radius/ulna without manip 25560 CPT 25560 | $283.05 | $765.00 | $239.49 – $269.65 | 2 |
| Clsd tx fx radius/ulna w/manip 25565 CPT 25565 | $882.64 | $2,385.50 | $499.51 – $507.79 | 2 |
| Clsd tx/grt hum tube fx without manip 23620 CPT 23620 | $482.85 | $1,305.00 | $251.04 – $274.51 | 2 |
| Clsd tx hip disloc without anes 27265 CPT 27265 | $302.66 | $818.00 | $421.18 – $434.65 | 2 |
| Clsd tx humeral fract without manip 24530 CPT 24530 | $264.18 | $714.00 | $344.75 – $370.69 | 2 |
| Clsd tx humerus fract without manip 24500 CPT 24500 | $394.79 | $1,067.00 | $320.00 – $350.61 | 2 |
| Clsd tx iphal jnt disl w/manip req anes CPT 26775 | $1,233.58 | $3,334.00 | $347.74 – $373.48 | 2 |
| Clsd tx mandibular fx without manip 21450 CPT 21450 | $483.22 | $1,306.00 | $475.45 – $530.24 | 2 |
| Clsd tx/metacar/interphal artic fx 26740 CPT 26740 | $376.11 | $1,016.50 | $209.62 – $231.18 | 2 |
| Clsd tx/metacarpal fx/sg without manip 26600 CPT 26600 | $131.17 | $354.50 | $255.82 – $295.21 | 2 |
| Clsd tx/metacarpal fx/sng/w manip 26605 CPT 26605 | $111.83 | $302.25 | $292.79 – $314.24 | 2 |
| Clsd tx metacarp fx w/manip&ext fix ea bone 26607 CPT 26607 | not published | not published | $466.08 – $494.14 | 2 |
| Clsd tx metatarsal fracture w/manip 28475 CPT 28475 | $345.77 | $934.50 | $248.26 – $258.60 | 2 |
| Clsd tx/metatarsal fx without manip 28470 CPT 28470 | $247.90 | $670.00 | $196.58 – $219.78 | 2 |
| Clsd tx/nasal bone fx/stabilize 21320 CPT 21320 | $1,888.11 | $5,103.00 | $148.28 – $149.89 | 2 |
| Clsd tx nose fx without manip 21310 CPT 21310 | not published | not published | $30.87 – $33.45 | 2 |
| Clsd tx of ankle fracture w/manip 28435 CPT 28435 | $2,628.48 | $7,104.00 | $311.44 – $313.08 | 2 |
| Clsd tx patella disloc without anes 27560 CPT 27560 | $278.06 | $751.50 | $342.33 – $359.53 | 2 |
| Clsd tx/patellar fx without manip 27520 CPT 27520 | $394.79 | $1,067.00 | $291.08 – $316.81 | 2 |
| Clsd tx pelvic ring fx CPT 27197 | $203.59 | $550.25 | $127.87 – $127.87 | 1 |
| Clsd tx pelvic ring fx CPT 27198 | not published | not published | $330.19 – $330.19 | 1 |
| Clsd tx prox fib/shaft fx w/manip 27781 CPT 27781 | $2,557.07 | $6,911.00 | $407.99 – $428.31 | 2 |
| Clsd tx/prox/mid phalnx fx/no manp 26720 CPT 26720 | $104.16 | $281.50 | $175.64 – $196.56 | 2 |
| Clsd tx/radial head/neck fx/no manip 24650 CPT 24650 | $247.53 | $669.00 | $231.55 – $256.78 | 2 |
| Clsd tx radius fracture w/manip 24655 CPT 24655 | $2,628.48 | $7,104.00 | $410.37 – $428.78 | 2 |
| Clsd tx/scapular fx without manip 23570 CPT 23570 | $247.16 | $668.00 | $233.86 – $256.33 | 2 |
| Clsd tx shoulder dislc/fx 23665 CPT 23665 | $2,628.48 | $7,104.00 | $409.89 – $428.66 | 2 |
| Clsd tx shoulder disloc w/anatom neck fx w/manip 23675 CPT 23675 | $2,628.48 | $7,104.00 | $529.13 – $544.05 | 2 |
| Clsd tx/shoulder dislo/manip/anest 23655 CPT 23655 | $2,132.50 | $5,763.50 | $405.22 – $435.64 | 2 |
| Clsd tx/talotarsal dislocat/anes 28575 CPT 28575 | not published | not published | $323.59 – $347.42 | 2 |
| Clsd tx temporomandibular dislocat 21480 CPT 21480 | $224.59 | $607.00 | $36.05 – $37.54 | 2 |
| Clsd tx toe dislocation without anes28660 CPT 28660 | $225.24 | $608.75 | $93.91 – $98.25 | 2 |
| Clsd tx trimall ankle fx without manip 27816 CPT 27816 | $264.74 | $715.50 | $283.74 – $310.82 | 2 |
| Clsd tx trimall ankle fx w/manip 27818 CPT 27818 | $832.32 | $2,249.50 | $468.59 – $472.47 | 2 |
| Clsd tx/ulnar shaft fx without manip 25530 CPT 25530 | $394.79 | $1,067.00 | $228.37 – $253.57 | 2 |
| Clsd tx vert body fx without manip req &w/csting/bracing CPT 22310 | not published | not published | $288.14 – $311.38 | 2 |
| Clsd tx wrist carpal fx without manip 25630 CPT 25630 | $394.79 | $1,067.00 | $277.41 – $302.01 | 2 |
| Clsd tx wrist scaphoid fx without manip 25622 CPT 25622 | $212.75 | $575.00 | $268.43 – $297.59 | 2 |
| Clsd tx wrist trans-scaph fx w/manip 25680 CPT 25680 | $227.74 | $615.50 | $489.33 – $522.89 | 2 |
| Clsd tx wrist ulnar styloid fx 25650 CPT 25650 | $239.02 | $646.00 | $294.62 – $322.02 | 2 |
| Clsd/ulnar fx/prox end without manip 24670 CPT 24670 | $376.11 | $1,016.50 | $259.50 – $281.66 | 2 |
| Cls tx of heel fracture w/manip 28405 CPT 28405 | not published | not published | $390.10 – $391.58 | 2 |
| Cltx carpl scphd fx w/mnpj CPT 25624 | not published | not published | $433.84 – $468.77 | 2 |
| Cltx gr hmrl tbrs fx w/mnpj CPT 23625 | $2,558.00 | $6,913.50 | $366.99 – $379.90 | 2 |
| Cltx hum epcndylr fx wo mnpj CPT 24560 | $244.02 | $659.50 | $281.41 – $308.58 | 2 |
| Cltx humrl cndylr fx w/mnpj CPT 24577 | not published | not published | $512.38 – $542.09 | 2 |
| Cltx humrl cndylr fx wo mnpj CPT 24576 | $376.11 | $1,016.50 | $298.83 – $327.32 | 2 |
| Cltx lunate dislc w/mnpj CPT 25690 | $2,691.75 | $7,275.00 | $491.15 – $513.27 | 2 |
| Cltx mndblr fx ntrdntl fixj CPT 21453 | not published | not published | $776.16 – $841.42 | 2 |
| Cltx mndblr fx w/mnpj CPT 21451 | $728.07 | $1,967.75 | $644.36 – $728.05 | 2 |
| Cltx mndblr/max alv ridge fx CPT 21440 | $1,288.53 | $3,482.50 | $453.10 – $503.05 | 2 |
| Cltx palatal/max fx wire fix CPT 21421 | not published | not published | $648.90 – $752.54 | 2 |
| Cltx post ankle fx CPT 27767 | $376.11 | $1,016.50 | $265.12 – $301.52 | 2 |
| Cltx post ankle fx w/mnpj CPT 27768 | $2,628.48 | $7,104.00 | $433.41 – $475.99 | 2 |
| Cltx scap fx w/mnpj +-tractj CPT 23575 | $2,628.48 | $7,104.00 | $375.51 – $403.58 | 2 |
| Cltx strnclav dislc w/mnpj CPT 23525 | $759.61 | $2,053.00 | $329.07 – $371.88 | 2 |
| Cltx thigh fx CPT 27267 | $2,345.99 | $6,340.50 | $448.99 – $472.68 | 2 |
| Cltx tmprmand dislc comp CPT 21485 | not published | not published | $575.66 – $628.17 | 2 |
| Cmbn ant pst colprhy CPT 57260 | not published | not published | $921.05 – $933.36 | 2 |
| C motor evoked lwr limbs CPT 95929 | $127.28 | $344.00 | $92.02 – $140.84 | 2 |
| C motor evoked uppr limbs CPT 95928 | $347.80 | $940.00 | $91.62 – $134.74 | 2 |
| C motor evoked upr&lwr limbs CPT 95939 | $200.36 | $541.50 | $390.20 – $390.20 | 1 |
| Cmptr ophth dx img ant segmt CPT 92132 | not published | not published | $14.73 – $14.73 | 1 |
| Cmptr ophth img optic nerve CPT 92133 | not published | not published | $15.10 – $15.10 | 1 |
| #cms hgb-carboxyhemoglobin CPT 82376 | not published | not published | $6.25 – $9.33 | 2 |
| #cms hgb-sulfhemoglobin CPT 83060 | not published | not published | $8.60 – $12.87 | 2 |
| #cmvcul-virus inoculation shell CPT 87254 | $132.28 | $357.50 | $20.59 – $30.45 | 2 |
| Cmv pcr-sendout CPT 87496 | $164.84 | $445.50 | $37.00 – $54.64 | 2 |
| Co2 monitor per day CPT 94681 | not published | not published | $11.66 – $44.56 | 2 |
| Coagulation time activated teg CPT 85347 | $18.78 | $50.75 | $4.43 – $6.63 | 2 |
| Coagulation time otr method CPT 85348 | not published | not published | $3.91 – $5.80 | 2 |
| Cochlear implt f/up exam <7 CPT 92601 | not published | not published | $135.09 – $168.88 | 2 |
| Cochlear implt f/up exam 7/> CPT 92603 | not published | not published | $135.55 – $152.99 | 2 |
| Cold agglutinin screen (arc) CPT 86156 | $31.08 | $84.00 | $7.04 – $10.43 | 2 |
| Cold agglutinin titer CPT 86157 | $40.89 | $110.50 | $8.60 – $12.55 | 2 |
| Colectomy/end colost/close dis seg 44143 CPT 44143 | not published | not published | $1,812.37 – $1,872.40 | 2 |
| Colectomy/ ileostomy without prctect 44150 CPT 44150 | not published | not published | $2,004.83 – $2,096.79 | 2 |
| Colectomy/ ileostomy w/prctect 44155 CPT 44155 | not published | not published | $2,249.34 – $2,341.98 | 2 |
| Colectomy partial w/anastomosis 44140 CPT 44140 | not published | not published | $1,471.50 – $1,509.18 | 2 |
| Colectomy prtl abdominal + transanal appr 44147 CPT 44147 | not published | not published | $2,075.60 – $2,191.53 | 2 |
| Colectomy prtl w/coloproctostomy 44145 CPT 44145 | not published | not published | $1,836.35 – $1,869.58 | 2 |
| Colectomy prtl w/coloproctostomy + colostomy 44146 CPT 44146 | not published | not published | $2,291.84 – $2,385.77 | 2 |
| Colectomy prtl w/remove terminal ileum+ileocolos 44160 CPT 44160 | not published | not published | $1,356.03 – $1,396.84 | 2 |
| Colectomy prtl w/skin level cecost/colostomy 44141 CPT 44141 | not published | not published | $1,936.34 – $2,050.72 | 2 |
| Colectomy/w colostomy or ileostomy 44144 CPT 44144 | not published | not published | $1,906.98 – $1,991.78 | 2 |
| Collar cerv 18.25x3.5in serp firm density sm HCPCS L0120 | $32.26 | $87.20 | $41.56 – $41.56 | 1 |
| Collar cerv ascend 172 reg HCPCS L0172 | $151.05 | $408.25 | $220.73 – $220.73 | 1 |
| Collection blood specimen from completely implantable venous access device CPT 36591 | $46.99 | $127.00 | $24.07 – $24.21 | 2 |
| Collection blood specimen using established central/peripheral catheter venous nos CPT 36592 | $77.05 | $208.25 | $26.60 – $26.96 | 2 |
| Collection of venous blood by venipuncture CPT 36415 | $8.97 | $24.25 | $3.40 – $3.90 | 2 |
| Colon motility 6 hr study CPT 91117 | not published | not published | $155.25 – $155.25 | 1 |
| Colonoscopy (diagnostic) CPT 45378 | not published | not published | $71.28 – $106.46 | 2 |
| Colonoscopy flex with decompression 45393 CPT 45393 | not published | not published | $289.92 – $289.92 | 1 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.