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 |
|---|---|---|---|---|
| Destruction ciliary body CPT 66720 | not published | not published | $414.45 – $439.85 | 2 |
| Destruction ciliary body CPT 66740 | not published | not published | $396.25 – $425.21 | 2 |
| Destruction cryosurgery anal lesion(s) simpl 46916 CPT 46916 | not published | not published | $154.35 – $157.75 | 2 |
| Destruction laser surgery anal lesions 46917 CPT 46917 | not published | not published | $142.54 – $146.61 | 2 |
| Destruction les conjunctiva CPT 68135 | not published | not published | $152.03 – $162.95 | 2 |
| Destruction mal lsn s/n/h/f/g 2.1-3cm CPT 17273 | not published | not published | $157.59 – $159.77 | 2 |
| Destruction mal lsn s/n/h/f/g 3.1-4cm CPT 17274 | not published | not published | $193.86 – $195.83 | 2 |
| Destruction mal lsn t/a/l 3.1-4cm CPT 17264 | not published | not published | $149.65 – $151.68 | 2 |
| Destruction mal lsn t/a/l >4cm CPT 17266 | not published | not published | $174.67 – $178.80 | 2 |
| Destruction penis lesion(s) chem 54050 CPT 54050 | not published | not published | $114.43 – $115.91 | 2 |
| Destruction penis lesion(s) exten 54065 CPT 54065 | not published | not published | $191.03 – $191.16 | 2 |
| Destruction premal lesions 15/> 17004 CPT 17004 | not published | not published | $109.47 – $147.15 | 2 |
| Destruction rectal tumor 45190 CPT 45190 | not published | not published | $729.70 – $773.54 | 2 |
| Destruction vag lesions complex 57065 CPT 57065 | not published | not published | $192.01 – $194.60 | 2 |
| Destruction vag lesions simple 57061 CPT 57061 | not published | not published | $106.97 – $108.59 | 2 |
| Destruct penis les/smp/electrodesi 54055 CPT 54055 | not published | not published | $102.05 – $105.85 | 2 |
| Detect agent nos dna dir CPT 87797 | not published | not published | $21.11 – $31.22 | 2 |
| Detect agnt mult dna direc CPT 87800 | not published | not published | $42.21 – $62.46 | 2 |
| Developmental screen/score/document 96110 CPT 96110 | $76.59 | $207.00 | $9.70 – $12.47 | 2 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | $80.11 | $216.50 | $13.40 – $17.25 | 2 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $75.48 | $204.00 | $23.45 – $34.62 | 2 |
| Diabetes (HbA1c) Test CPT 83036 | $137.09 | $370.50 | $10.16 – $13.45 | 2 |
| Diag bronchoscope/catheter CPT 31643 | not published | not published | $200.94 – $213.35 | 2 |
| Diag laparo separate proc 49320 CPT 49320 | not published | not published | $359.39 – $363.54 | 2 |
| Diagnostic anoscopy CPT 46601 | not published | not published | $105.51 – $105.51 | 1 |
| Diagnostic anoscopy & biopsy CPT 46607 | not published | not published | $142.96 – $142.96 | 1 |
| Diagnostic anoscopy spx 46600 CPT 46600 | $93.89 | $253.75 | $42.00 – $45.10 | 2 |
| Diagnostic laryngoscopy 31505 CPT 31505 | $95.83 | $259.00 | $53.65 – $53.98 | 2 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $229.40 | $620.00 | $74.31 – $86.50 | 2 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $208.87 | $564.50 | $121.80 – $121.80 | 1 |
| Diagnostic Mammogram (one breast) CPT 77065 | $161.69 | $437.00 | $95.22 – $95.22 | 1 |
| Diagnostic radio unlisted proc CPT 76499 | not published | not published | not published | 0 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | not published | not published | $201.81 – $201.81 | 1 |
| Dialysis one evaluation CPT 90945 | not published | not published | $84.70 – $94.51 | 2 |
| Diathermy eg microwave CPT 97024 | not published | not published | $6.30 – $7.12 | 2 |
| Diffusing capacity CPT 94729 | $71.04 | $192.00 | $45.99 – $45.99 | 1 |
| Digital analysis of eeg CPT 95957 | not published | not published | $121.97 – $203.01 | 2 |
| Digoxin total therapeutic drug level CPT 80162 | $57.72 | $156.00 | $14.07 – $20.67 | 2 |
| Dilate biliary duct/ampulla CPT 47542 | not published | not published | $156.52 – $156.52 | 1 |
| Dilate esophagus CPT 43453 | not published | not published | $97.45 – $111.89 | 2 |
| Dilate esophagus 1/mult pass CPT 43450 | not published | not published | $89.98 – $103.01 | 2 |
| Dilate ic vasospasm ea add vsl diff territory CPT 61642 | not published | not published | $396.01 – $536.31 | 2 |
| Dilate ic vasospasm ea add vsl same territory CPT 61641 | not published | not published | $198.00 – $268.16 | 2 |
| Dilate ic vasospasm init CPT 61640 | not published | not published | $563.80 – $763.11 | 2 |
| Dilate tear duct opening CPT 68801 | $547.97 | $1,481.00 | $84.46 – $103.87 | 2 |
| Dilate urethra stricture CPT 53600 | $254.65 | $688.25 | $72.02 – $82.10 | 2 |
| Dilate urethra stricture CPT 53601 | not published | not published | $60.47 – $68.33 | 2 |
| Dilate urethra stricture CPT 53605 | not published | not published | $73.43 – $82.99 | 2 |
| Dilate urethra stricture CPT 53621 | $269.73 | $729.00 | $81.69 – $92.54 | 2 |
| Dilation/female urethra/initial 53660 CPT 53660 | $207.39 | $560.50 | $46.94 – $51.90 | 2 |
| Dilation of anal sphincter CPT 45905 | not published | not published | $179.68 – $186.58 | 2 |
| Dilation of cervical canal 57800 CPT 57800 | not published | not published | $53.71 – $55.89 | 2 |
| Dilation of rectal stricture 45910 CPT 45910 | not published | not published | $213.17 – $214.89 | 2 |
| Dilation of salivary duct CPT 42660 | not published | not published | $87.51 – $99.10 | 2 |
| Dilation of urethra CPT 53661 | not published | not published | $45.56 – $51.17 | 2 |
| Dilation of urethra CPT 53665 | not published | not published | $43.96 – $48.56 | 2 |
| Dilation of vagina CPT 57400 | not published | not published | $149.47 – $156.72 | 2 |
| Dilation salivary duct 42650 CPT 42650 | not published | not published | $64.85 – $65.26 | 2 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | $1,310.45 | $3,541.75 | $98.81 – $111.47 | 2 |
| Diphtheria-tetanus toxoids 0.5 ml (peds) CPT 90702 | not published | not published | $29.06 – $29.06 | 1 |
| Dir nsl mucous membrane test CPT 95065 | not published | not published | $23.01 – $25.51 | 2 |
| Disability dlco CPT 94727 | $89.45 | $241.75 | $30.19 – $30.19 | 1 |
| Disaccharidases CPT 82657 | $174.09 | $470.50 | $19.02 – $28.11 | 2 |
| Disarticulation sho sec clsr CPT 23921 | not published | not published | $431.43 – $507.90 | 2 |
| Discectomy ant dcmprn cord thoracic 1 ntrspc 63077 CPT 63077 | not published | not published | $1,659.82 – $1,673.94 | 2 |
| Discectomy ant dcmprn cord thoracic ea ntrsp 63078 CPT 63078 | not published | not published | $220.08 – $228.19 | 2 |
| Discography cerv/thor spine CPT 72285 | not published | not published | $52.82 – $70.00 | 2 |
| Dissolve clot heart vessel CPT 92975 | not published | not published | $429.23 – $497.23 | 2 |
| Dist revas ligation hemo CPT 36838 | not published | not published | $1,313.62 – $1,413.52 | 2 |
| Diverticulectomy/hypophar/esoph 43130 CPT 43130 | not published | not published | $875.92 – $891.35 | 2 |
| Division of fallopian tube 58605 CPT 58605 | not published | not published | $361.03 – $377.08 | 2 |
| Dmd dup/delet analysis CPT 81161 | not published | not published | $160.17 – $160.17 | 1 |
| Dmpk gene detc abnor allele CPT 81234 | not published | not published | $155.50 – $155.50 | 1 |
| Dna antibody native/double stranded CPT 86225 | $65.77 | $177.75 | $14.59 – $21.39 | 2 |
| Dna gardnerella CPT 87510 | $66.05 | $178.50 | $21.11 – $31.22 | 2 |
| Dna probe chlamydia CPT 87490 | not published | not published | $21.11 – $31.22 | 2 |
| Dna probe gc CPT 87590 | not published | not published | $21.11 – $31.22 | 2 |
| Dna trichomonas CPT 87660 | $66.05 | $178.50 | $21.11 – $31.22 | 2 |
| Doppler echo complete CPT 93320 | $265.66 | $718.00 | $25.28 – $36.29 | 2 |
| Doppler intravascular pressure flow initial vessel CPT 93571 | not published | not published | $121.63 – $121.63 | 1 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $280.46 | $758.00 | $28.25 – $117.13 | 2 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $194.71 | $526.25 | $15.50 – $77.25 | 2 |
| Dornhoffer fixed part w/window HCPCS L8614 | $32,112.76 | $86,791.25 | $32,295.99 – $32,295.99 | 1 |
| Dpyd gene common variants CPT 81232 | not published | not published | $198.41 – $198.41 | 1 |
| Drainage absc/cyst/hmtma/vestibule mouth smpl CPT 40800 | $579.70 | $1,566.75 | $133.74 – $144.38 | 2 |
| Drainage ext aud canal abscess 69020 CPT 69020 | not published | not published | $151.97 – $153.38 | 2 |
| Drainage external ear complex 69005 CPT 69005 | not published | not published | $171.57 – $172.62 | 2 |
| Drainage external ear simple 69000 CPT 69000 | $579.70 | $1,566.75 | $126.25 – $129.50 | 2 |
| Drainage lymph node lesion 38300 CPT 38300 | $1,062.27 | $2,871.00 | $196.35 – $199.58 | 2 |
| Drainage lymph node lesion 38305 CPT 38305 | not published | not published | $503.55 – $508.05 | 2 |
| Drainage mouth roof lesion CPT 42000 | $315.33 | $852.25 | $111.16 – $115.15 | 2 |
| Drainage of arm bursa 23931 CPT 23931 | not published | not published | $167.62 – $173.63 | 2 |
| Drainage of bladder abscess CPT 51080 | not published | not published | $458.19 – $501.50 | 2 |
| Drainage of eye CPT 65800 | $1,095.20 | $2,960.00 | $100.84 – $136.44 | 2 |
| Drainage of eye CPT 65810 | $3,667.81 | $9,913.00 | $464.60 – $502.16 | 2 |
| Drainage of eye CPT 65815 | not published | not published | $471.74 – $515.62 | 2 |
| Drainage of forearm bursa CPT 25031 | not published | not published | $394.38 – $400.62 | 2 |
| Drainage of kidney lesion CPT 50390 | $685.43 | $1,852.50 | $109.78 – $125.32 | 2 |
| Drainage of mouth lesion CPT 41005 | not published | not published | $134.88 – $136.85 | 2 |
| Drainage of mouth lesion CPT 41006 | not published | not published | $280.85 – $299.92 | 2 |
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.