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 |
|---|---|---|---|---|
| Critical care 30-74 minutes CPT 99291 | $1,211.94 | $3,275.50 | $248.97 – $248.97 | 1 |
| Critical care each additional 30 minutes CPT 99292 | $282.50 | $763.50 | $124.85 – $124.85 | 1 |
| Crnec exc tum/bone les skull CPT 61500 | not published | not published | $1,450.81 – $1,477.65 | 2 |
| Crnop skull defect>5 cm diam CPT 62141 | not published | not published | $1,233.94 – $1,280.39 | 2 |
| Cross-over vein graft CPT 34520 | not published | not published | $1,201.81 – $1,255.83 | 2 |
| Crtj pericardial window/prtl resecj w/drg/bx CPT 33025 | not published | not published | $898.78 – $942.30 | 2 |
| Cryoablate prostate CPT 55873 | not published | not published | $859.39 – $1,436.38 | 2 |
| Cryocautery of cervix 57511 CPT 57511 | not published | not published | $144.62 – $148.99 | 2 |
| Cryofibrinogen qualitative - sendout CPT 82585 | $24.98 | $67.50 | $9.12 – $13.36 | 2 |
| Cryopreservation embryo(s) CPT 89258 | not published | not published | not published | 0 |
| Cryopreservation sperm CPT 89259 | not published | not published | not published | 0 |
| Cryopreserve stem cells CPT 38207 | not published | not published | $52.87 – $59.56 | 2 |
| Cryopreserve testicular tiss CPT 89335 | not published | not published | not published | 0 |
| Cryosurg ablate fa each CPT 19105 | not published | not published | $225.72 – $233.64 | 2 |
| Cryosurgery penis lesion(s) 54056 CPT 54056 | not published | not published | $117.83 – $120.93 | 2 |
| Cryotherapy of acne 17340 CPT 17340 | not published | not published | $51.85 – $54.06 | 2 |
| Cryptococcus abs qn - sendout CPT 86641 | $52.63 | $142.25 | $15.11 – $22.44 | 2 |
| Cryptosporidium antigen CPT 87272 | not published | not published | $12.77 – $18.66 | 2 |
| Crystal identification light microscopy CPT 89060 | $23.50 | $63.50 | $7.56 – $11.13 | 2 |
| C-Section Delivery (full care) CPT 59510 | not published | not published | $2,269.84 – $2,581.82 | 2 |
| C-section delivery incl p/p care 59515 CPT 59515 | not published | not published | $1,250.16 – $1,421.75 | 2 |
| Csf leakage imaging CPT 78650 | $1,171.61 | $3,166.50 | $38.65 – $317.63 | 2 |
| Csf shunt reprogram 62252 CPT 62252 | $296.93 | $802.50 | $39.17 – $52.64 | 2 |
| Csf ventriculography CPT 78635 | not published | not published | $38.75 – $327.69 | 2 |
| CT 3d report other modality w/workstation CPT 76377 | $191.01 | $516.25 | $31.62 – $50.95 | 2 |
| Cta abdomen without & /or w/contrast CPT 74175 | $1,341.62 | $3,626.00 | $120.13 – $218.81 | 2 |
| Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast CPT 75635 | $1,528.75 | $4,131.75 | $153.62 – $265.16 | 2 |
| Cta lower extremity without & w/contrast (both sides) CPT 73706 | $2,658.27 | $7,184.50 | $120.93 – $263.73 | 2 |
| Cta neck without &/or w/contrast CPT 70498 | $1,315.72 | $3,556.00 | $111.11 – $206.96 | 2 |
| CT Angiogram of Abdomen and Pelvis CPT 74174 | $2,483.63 | $6,712.50 | $265.51 – $265.51 | 1 |
| CT Angiogram of the Chest (for blood clot) CPT 71275 | $1,499.24 | $4,052.00 | $121.36 – $211.27 | 2 |
| CT Angiogram of the Head CPT 70496 | $1,328.95 | $3,591.75 | $110.71 – $207.67 | 2 |
| CT angio hrt w/3d image CPT 75574 | $1,166.70 | $3,153.25 | $265.52 – $265.52 | 1 |
| CT angio pelvis CPT 72191 | $1,012.14 | $2,735.50 | $114.32 – $217.74 | 2 |
| Cta upper extremity w &/or without contrast left CPT 73206 | $1,229.70 | $3,323.50 | $115.11 – $241.09 | 2 |
| CT bone density axial CPT 77078 | not published | not published | $15.60 – $60.01 | 2 |
| CT colonography dx CPT 74261 | not published | not published | $112.82 – $112.82 | 1 |
| CT colonography dx w/dye CPT 74262 | not published | not published | $265.15 – $265.15 | 1 |
| CT colonography screening CPT 74263 | not published | not published | $648.14 – $648.14 | 1 |
| CT guidance for needle placement CPT 77012 | $584.14 | $1,578.75 | $67.56 – $73.39 | 2 |
| CT guidance for percutaneous drain w/catheter placement supervision & interpretation CPT 75989 | $562.49 | $1,520.25 | $63.24 – $75.20 | 2 |
| CT guid cryo ablat intramuscular CPT 20999 | not published | not published | $3,532.63 – $3,532.63 | 1 |
| CT guid parench tis ablat CPT 77013 | $325.51 | $879.75 | $252.95 – $252.95 | 1 |
| CT heart w/evaluation of calcium without contrast CPT 75571 | $277.50 | $750.00 | $60.01 – $60.01 | 1 |
| CT hrt c+ strux cgen hrt ds CPT 75573 | not published | not published | $265.16 – $265.16 | 1 |
| CT hrt w/3d image CPT 75572 | not published | not published | $199.06 – $199.06 | 1 |
| CT limited or localized follow-up study CPT 76380 | $275.00 | $743.25 | $60.01 – $61.47 | 2 |
| CT lower extremity w/contrast (both sides) CPT 73701 | $1,978.58 | $5,347.50 | $73.39 – $169.58 | 2 |
| CT lower extremity without contrast (both sides) CPT 73700 | $1,646.50 | $4,450.00 | $68.52 – $112.82 | 2 |
| CT lwr extremity w/o&w/dye CPT 73702 | $1,581.38 | $4,274.00 | $77.00 – $215.21 | 2 |
| CT neck soft tissue w/contrast CPT 70491 | $917.14 | $2,478.75 | $86.79 – $167.79 | 2 |
| CT neck soft tissue without contrast CPT 70490 | $725.29 | $1,960.25 | $80.91 – $112.82 | 2 |
| CT neck soft tissue without & w/contrast CPT 70492 | $1,042.01 | $2,816.25 | $90.87 – $207.31 | 2 |
| CT orbit/sella/fossa w/wo contrast CPT 70482 | $1,023.14 | $2,765.25 | $90.87 – $231.03 | 2 |
| CT orbit/sella/ or posterior outer inner or middle ear w/contrast CPT 70481 | $753.23 | $2,035.75 | $86.79 – $208.75 | 2 |
| CT orbit/sella/ or posterior outer inner or middle ear without contrast CPT 70480 | $790.88 | $2,137.50 | $80.51 – $112.82 | 2 |
| Ctrl nosebld postir subsq 30906 CPT 30906 | $130.33 | $352.25 | $153.22 – $157.42 | 2 |
| CT scan for therapy guide CPT 77014 | $360.75 | $975.00 | $52.59 – $75.45 | 2 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $1,216.01 | $3,286.50 | $255.45 – $255.45 | 1 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $1,187.61 | $3,209.75 | $222.39 – $222.39 | 1 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $920.93 | $2,489.00 | $114.61 – $114.61 | 1 |
| CT thoracic spine w/contrast CPT 72129 | $859.79 | $2,323.75 | $77.00 – $169.94 | 2 |
| CT thoracic spine without contrast CPT 72128 | $843.69 | $2,280.25 | $73.00 – $112.82 | 2 |
| CT thorax low dose for lung screening without contrast CPT 71271 | $952.66 | $2,574.75 | $97.66 – $97.66 | 1 |
| CT t-spine w /wo contrast CPT 72130 | $715.30 | $1,933.25 | $80.04 – $209.82 | 2 |
| CT upper extremity w/contrast (both sides) CPT 73201 | $1,771.19 | $4,787.00 | $73.00 – $165.99 | 2 |
| CT upper extremity without contrast (both sides) CPT 73200 | $1,587.30 | $4,290.00 | $68.52 – $112.82 | 2 |
| CT uppr extremity w/o&w/dye CPT 73202 | $1,476.49 | $3,990.50 | $76.61 – $218.44 | 2 |
| Cultr oocyte/embryo <4 days CPT 89250 | not published | not published | $1,530.91 – $1,530.91 | 1 |
| Cultr oocyte/embryo <4 days CPT 89251 | not published | not published | $1,592.41 – $1,592.41 | 1 |
| Cult skin graft fnhfg 15155 CPT 15155 | not published | not published | $732.78 – $747.18 | 2 |
| Cult skin grft t/arm/leg CPT 15150 | not published | not published | $691.59 – $697.12 | 2 |
| Culture aerobic additional method definitive id each CPT 87077 | $27.38 | $74.00 | $8.60 – $12.58 | 2 |
| Culture afb any source CPT 87116 | $51.34 | $138.75 | $11.47 – $16.82 | 2 |
| Culture anaerobic additional method definitive id each CPT 87076 | $35.34 | $95.50 | $8.60 – $12.58 | 2 |
| Culture anaerobic except blood CPT 87075 | $65.49 | $177.00 | $9.90 – $14.74 | 2 |
| Culture bact stool aero addl path ea CPT 87046 | $19.43 | $52.50 | $9.90 – $14.70 | 2 |
| Culture body fluid CPT 87070 | $60.22 | $162.75 | $9.12 – $13.42 | 2 |
| Culture fungi definitive id mold CPT 87107 | $27.10 | $73.25 | $10.94 – $16.07 | 2 |
| Culture fungi definitive id yeast CPT 87106 | $41.90 | $113.25 | $10.94 – $16.07 | 2 |
| Culture fungi other (except blood) CPT 87102 | $45.51 | $123.00 | $8.86 – $13.09 | 2 |
| Culture fungi skin/hair/nail CPT 87101 | $36.45 | $98.50 | $8.08 – $11.88 | 2 |
| Culture mycobacteria definitive id each isolate CPT 87118 | not published | not published | $11.47 – $17.04 | 2 |
| Culture mycoplasma any source CPT 87109 | $90.37 | $244.25 | $16.16 – $23.96 | 2 |
| Culture quantitative aerobic other source CPT 87071 | not published | not published | $9.90 – $14.70 | 2 |
| Culture screening strep group a CPT 87081 | $43.29 | $117.00 | $7.04 – $10.32 | 2 |
| Culture typing added method CPT 87158 | not published | not published | $5.47 – $8.15 | 2 |
| Culture typing immunologic CPT 87147 | $29.32 | $79.25 | $5.47 – $8.06 | 2 |
| Culture typing nucleic acid probe amplified per culture/isolate each organism CPT 87150 | not published | not published | $54.64 – $54.64 | 1 |
| Culture urine each isolate CPT 87088 | $17.48 | $47.25 | $7.62 – $9.58 | 2 |
| Culture virus isolation CPT 87250 | not published | not published | $20.59 – $30.45 | 2 |
| Curette/treat cornea CPT 65435 | $1,317.39 | $3,560.50 | $71.41 – $75.60 | 2 |
| Curette/treat cornea CPT 65436 | not published | not published | $370.95 – $402.10 | 2 |
| Cv line/pic reposition CPT 36597 | not published | not published | $69.50 – $78.32 | 2 |
| Cv stress test i&r only 93018 CPT 93018 | not published | not published | $16.54 – $19.94 | 2 |
| Cv stress test/supervision only 93016 CPT 93016 | not published | not published | $24.81 – $30.06 | 2 |
| Cyanocobalamin unsat binding capacity CPT 82608 | not published | not published | $15.11 – $22.29 | 2 |
| Cyclic citrullinated peptide antibody CPT 86200 | $65.68 | $177.50 | $13.55 – $20.16 | 2 |
| Cyclosporine 2 hour CPT 80158 | $87.88 | $237.50 | $19.02 – $28.10 | 2 |
| Cyp2c19 gene com variants CPT 81225 | $657.12 | $1,776.00 | $333.01 – $333.01 | 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.