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 |
|---|---|---|---|---|
| Drainage of mouth lesion CPT 41007 | not published | not published | $272.31 – $290.62 | 2 |
| Drainage of mouth lesion CPT 41008 | not published | not published | $291.32 – $301.59 | 2 |
| Drainage of mouth lesion CPT 41009 | not published | not published | $315.93 – $327.25 | 2 |
| Drainage of mouth lesion CPT 41015 | not published | not published | $361.28 – $389.08 | 2 |
| Drainage of mouth lesion CPT 41016 | not published | not published | $374.87 – $390.69 | 2 |
| Drainage of mouth lesion CPT 41017 | not published | not published | $376.47 – $393.20 | 2 |
| Drainage of mouth lesion CPT 41018 | not published | not published | $442.72 – $460.07 | 2 |
| Drainage of nose lesion int 30000 CPT 30000 | $326.80 | $883.25 | $126.51 – $127.62 | 2 |
| Drainage of nose lesion sept 30020 CPT 30020 | $425.59 | $1,150.25 | $127.31 – $128.70 | 2 |
| Drainage of pelvis bursa CPT 26991 | not published | not published | $564.68 – $574.56 | 2 |
| Drainage of pelvis lesion 26990 CPT 26990 | not published | not published | $665.69 – $685.39 | 2 |
| Drainage of prostate abscess CPT 52700 | not published | not published | $495.03 – $540.34 | 2 |
| Drainage of prostate abscess CPT 55720 | not published | not published | $506.63 – $576.85 | 2 |
| Drainage of prostate abscess CPT 55725 | not published | not published | $728.47 – $731.85 | 2 |
| Drainage of rectal abscess CPT 45005 | $1,318.50 | $3,563.50 | $164.09 – $177.46 | 2 |
| Drainage of rectal abscess 45020 CPT 45020 | not published | not published | $583.59 – $637.08 | 2 |
| Drainage of salivary gland CPT 42305 | not published | not published | $478.87 – $479.75 | 2 |
| Drainage of salivary gland CPT 42320 | not published | not published | $192.86 – $195.41 | 2 |
| Drainage of throat abscess CPT 42725 | not published | not published | $908.20 – $912.59 | 2 |
| Drainage of urethra abscess CPT 53040 | $2,186.61 | $5,909.75 | $439.06 – $487.30 | 2 |
| Drainage of urethra abscess 53060 CPT 53060 | not published | not published | $183.42 – $191.07 | 2 |
| Drainage of urinary leakage CPT 53080 | not published | not published | $469.25 – $537.91 | 2 |
| Drainage of urinary leakage CPT 53085 | not published | not published | $738.14 – $771.11 | 2 |
| Drain bladder by trocar/cath CPT 51101 | not published | not published | $58.87 – $65.91 | 2 |
| Drain blood from under nail 11740 CPT 11740 | $64.29 | $173.75 | $34.47 – $35.21 | 2 |
| Drain cath image guided peri/retroperitoneal transvag/transrectal CPT 49407 | not published | not published | $241.31 – $241.31 | 1 |
| Drain cath image guided visceral pq CPT 49405 | $817.05 | $2,208.25 | $226.78 – $226.78 | 1 |
| Drain cerebro spinal fluid 62272 CPT 62272 | $735.84 | $1,988.75 | $94.01 – $94.89 | 2 |
| Drain chest lesion CPT 21502 | not published | not published | $562.42 – $572.17 | 2 |
| Drain chst dry seal exp thorastat HCPCS A7041 | $58.28 | $157.50 | $148.45 – $148.45 | 1 |
| Drain finger abscess;simple 26010 CPT 26010 | $178.90 | $483.50 | $140.21 – $148.65 | 2 |
| Drain lower leg bursa CPT 27604 | not published | not published | $371.23 – $376.85 | 2 |
| Drain lower leg lesion 27603 CPT 27603 | not published | not published | $421.23 – $425.75 | 2 |
| Drain neck/chest lesion 21501 CPT 21501 | not published | not published | $338.36 – $350.58 | 2 |
| Drain open lung lesion 32200 CPT 32200 | not published | not published | $1,265.75 – $1,288.85 | 2 |
| Drain ovarn cyst abd CPT 58805 | not published | not published | $444.93 – $461.02 | 2 |
| Drain ovary abscess open CPT 58820 | not published | not published | $354.25 – $356.97 | 2 |
| Drain pancreatic pseudocyst 48510 CPT 48510 | not published | not published | $1,160.16 – $1,219.01 | 2 |
| Drain penis lesion CPT 54015 | not published | not published | $345.61 – $387.41 | 2 |
| Drain shoulder bone lesion CPT 23035 | not published | not published | $746.44 – $746.65 | 2 |
| Drain shoulder bursa 23031 CPT 23031 | not published | not published | $231.40 – $240.17 | 2 |
| Drain shoulder lesion CPT 23030 | not published | not published | $280.07 – $281.62 | 2 |
| Drain thigh/knee lesion 27301 CPT 27301 | not published | not published | $537.79 – $551.34 | 2 |
| Drain thyroid/tongue cyst CPT 60000 | not published | not published | $155.80 – $158.81 | 2 |
| Drain to peritoneal cavity CPT 49062 | not published | not published | $824.34 – $829.54 | 2 |
| Dress/debride pt-tck burn/5-10% bs 16025 CPT 16025 | $162.15 | $438.25 | $123.51 – $128.59 | 2 |
| Dress/debride pt-thick burn/<5% bs 16020 CPT 16020 | $148.93 | $402.50 | $59.17 – $62.18 | 2 |
| Dress/debrid prtl-thick burn l 16030 CPT 16030 | $220.61 | $596.25 | $146.03 – $148.57 | 2 |
| Dressing change not for burn w/anes 15852 CPT 15852 | not published | not published | $52.74 – $54.53 | 2 |
| Drill hole evac+/drg subdural hematoma 61108 CPT 61108 | not published | not published | $937.30 – $1,010.27 | 2 |
| Drill hole implt ventricular cath/device 61107 CPT 61107 | $1,577.31 | $4,263.00 | $355.18 – $358.48 | 2 |
| Drng appendix abscess open 44900 CPT 44900 | not published | not published | $826.82 – $860.36 | 2 |
| Drng hand tendon sheath 26020 CPT 26020 | $1,334.22 | $3,606.00 | $451.76 – $470.24 | 2 |
| Drng of eyelid abscess 67700 CPT 67700 | $529.10 | $1,430.00 | $114.91 – $125.37 | 2 |
| Drng of finger abscess comp 26011 CPT 26011 | $1,468.35 | $3,968.50 | $196.22 – $201.11 | 2 |
| Drng of hydrocele 55000 CPT 55000 | not published | not published | $95.37 – $105.35 | 2 |
| Drng of mouth lesion 40801 CPT 40801 | not published | not published | $236.02 – $246.85 | 2 |
| Drng of ovarian cyst(s) 58800 CPT 58800 | not published | not published | $325.48 – $338.29 | 2 |
| Drng of palm multi bursas 26030 CPT 26030 | not published | not published | $524.70 – $537.80 | 2 |
| Drng of palm single bursa 26025 CPT 26025 | not published | not published | $442.42 – $459.10 | 2 |
| Drng of pelvic abscess transrectal 45000 CPT 45000 | not published | not published | $445.87 – $470.51 | 2 |
| Drng of salivary cyst 42409 CPT 42409 | not published | not published | $244.94 – $245.18 | 2 |
| Drng of scrotum abscess 55100 CPT 55100 | $1,468.35 | $3,968.50 | $183.73 – $196.83 | 2 |
| Drng open retroperitoneal abscess 49060 CPT 49060 | not published | not published | $1,215.59 – $1,234.51 | 2 |
| Drng open subdiaphragmatic/subphrenic absc 49040 CPT 49040 | not published | not published | $1,086.01 – $1,121.14 | 2 |
| Drng ovary abscess perqt 58822 CPT 58822 | not published | not published | $769.85 – $807.92 | 2 |
| Drng peritoneal abscess open 49020 CPT 49020 | not published | not published | $1,734.89 – $1,788.49 | 2 |
| Drng salivary gland simple 42300 CPT 42300 | $957.38 | $2,587.50 | $166.27 – $168.17 | 2 |
| Drng salivary gland submax/subling 42310 CPT 42310 | not published | not published | $135.69 – $136.53 | 2 |
| Drug admin & hemodynmic meas CPT 93463 | not published | not published | $111.03 – $111.03 | 1 |
| Drug assay caffeine CPT 80155 | $89.17 | $241.00 | $22.02 – $22.02 | 1 |
| Drug assay posaconazole CPT 80187 | $107.30 | $290.00 | $30.77 – $30.77 | 1 |
| Drug assay rufinamide CPT 80210 | not published | not published | $30.77 – $30.77 | 1 |
| Drug assay vedolizumab CPT 80280 | not published | not published | $43.78 – $43.78 | 1 |
| Drug assay voriconazole CPT 80285 | $116.64 | $315.25 | $30.77 – $30.77 | 1 |
| Drug of abuse screen urine CPT 80305 | not published | not published | $16.98 – $16.98 | 1 |
| Drug screen quant tiagabine CPT 80199 | $55.04 | $148.75 | $28.11 – $28.11 | 1 |
| Drug test def 15-21 classes HCPCS G0482 | $142.17 | $384.25 | $231.93 – $231.93 | 1 |
| Drug test def 1-7 classes HCPCS G0480 | $157.16 | $424.75 | $133.53 – $133.53 | 1 |
| Drug test def 22+ classes HCPCS G0483 | $426.24 | $1,152.00 | $288.14 – $288.14 | 1 |
| Drug test def 8-14 classes HCPCS G0481 | $161.88 | $437.50 | $182.72 – $182.72 | 1 |
| Drug test prsmv instrmnt CPT 80306 | not published | not published | $22.64 – $22.64 | 1 |
| Drug test(s) presumptive any class instrument chemistry analyzers CPT 80307 | $268.90 | $726.75 | $90.58 – $90.58 | 1 |
| Drvvt confirm - quest CPT 85597 | $85.47 | $231.00 | $19.02 – $27.99 | 2 |
| Dstrj extensive retinopathy CPT 67227 | not published | not published | $278.91 – $571.73 | 2 |
| Dstr mal les s/n/h/f/g >4.0 CPT 17276 | $213.86 | $578.00 | $233.79 – $234.39 | 2 |
| Dstr mal ls f/e/e/n/l/m2.1-3 CPT 17283 | not published | not published | $197.70 – $199.32 | 2 |
| Dstr mal ls f/e/e/n/l/m3.1-4 CPT 17284 | not published | not published | $233.07 – $236.17 | 2 |
| Dstr mal ls f/e/e/n/l/m>4.0 CPT 17286 | not published | not published | $313.40 – $318.23 | 2 |
| Ductogram sgl duct CPT 77053 | $171.22 | $462.75 | $22.65 – $40.96 | 2 |
| Duodenal motility study CPT 91022 | not published | not published | $93.42 – $96.28 | 2 |
| Dup scan/hemodialysis access 93990 CPT 93990 | $256.04 | $692.00 | $15.39 – $112.83 | 2 |
| Dup scan/lwr xtr vasc stdy bilat 93924 CPT 93924 | $278.24 | $752.00 | $32.09 – $149.12 | 2 |
| Dup scan/ue art/graft/bilat/comp 93930 CPT 93930 | $358.35 | $968.50 | $29.12 – $170.67 | 2 |
| Dxa bone density axl vrt fx CPT 77085 | not published | not published | $40.96 – $40.96 | 1 |
| Dx bronchoscope/brush 31623 CPT 31623 | $1,898.47 | $5,131.00 | $151.84 – $176.32 | 2 |
| Dx bronchoscope/lavage 31624 CPT 31624 | $1,161.06 | $3,138.00 | $153.65 – $176.72 | 2 |
| Dx bronchoscope/wash 31622 CPT 31622 | $2,211.40 | $5,976.75 | $149.25 – $173.90 | 2 |
| Dx dark adaptation exam i&r CPT 92284 | not published | not published | $14.34 – $50.67 | 2 |
| Dx duod intub w/asp spec 43756 CPT 43756 | not published | not published | $56.59 – $56.59 | 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.