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 |
|---|---|---|---|---|
| Administration immunization 1 vaccine CPT 90471 | $29.05 | $78.50 | $24.21 – $26.70 | 2 |
| Administration immunization each additional component CPT 90461 | not published | not published | $13.67 – $13.67 | 1 |
| Administration immunization each additional vaccine CPT 90472 | $27.66 | $74.75 | $9.72 – $13.67 | 2 |
| Administration immunization first component each vaccine CPT 90460 | not published | not published | $26.70 – $26.70 | 1 |
| Administration immunization intranasal/oral route 1 vaccine CPT 90473 | not published | not published | $10.26 – $26.70 | 2 |
| Administration immunization intranasal/oral route each additional vaccine CPT 90474 | not published | not published | $9.32 – $13.67 | 2 |
| Adrenal cortex & medulla img CPT 78075 | $716.04 | $1,935.25 | $46.74 – $429.01 | 2 |
| Adrenalectomy expl w/exc retro tumor 60545 CPT 60545 | not published | not published | $1,368.96 – $1,396.41 | 2 |
| Advance care planning each additional 30 min 99498 CPT 99498 | not published | not published | $79.36 – $79.36 | 1 |
| _afb id by dna probe rflx ast CPT 87149 | not published | not published | $21.11 – $31.22 | 2 |
| #afb mycobacteria suscep. #1 CPT 87190 | $12.03 | $32.50 | $5.99 – $8.80 | 2 |
| _afb org id by sequencing rflx ast-sendout CPT 87153 | not published | not published | $179.60 – $179.60 | 1 |
| After cataract laser surgery CPT 66821 | not published | not published | $299.98 – $333.15 | 2 |
| Air conduction bilat CPT 92552 | not published | not published | $23.10 – $31.98 | 2 |
| Air injection into abdomen 49400 CPT 49400 | $209.33 | $565.75 | $106.20 – $119.66 | 2 |
| Airway resistance by impulse oscillometry 94728 CPT 94728 | $269.36 | $728.00 | $27.31 – $27.31 | 1 |
| Albumin body fluid quantitative each specimen CPT 82042 | $39.50 | $106.75 | $5.47 – $8.06 | 2 |
| Albumin (human), 25%, 50ml HCPCS P9047 | $138.05 | $373.12 | $58.19 – $58.19 | 1 |
| Albumin ischemia modified CPT 82045 | not published | not published | $35.70 – $52.85 | 2 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $38.30 | $103.50 | $5.99 – $9.00 | 2 |
| Albumin serum plasma or whole blood CPT 82040 | $28.21 | $76.25 | $5.21 – $7.71 | 2 |
| Alcohol (ethanol) any specimen except urine/breath CPT 82077 | not published | not published | $19.60 – $19.60 | 1 |
| Alkaline phosphatase CPT 84075 | $27.29 | $73.75 | $5.47 – $8.06 | 2 |
| Allergen alpha lactalbumin ige CPT 86008 | $24.48 | $66.15 | $20.35 – $20.35 | 1 |
| Allergen egg white ige CPT 86003 | $36.82 | $99.50 | $5.47 – $8.13 | 2 |
| Allergen specific ige qual multi scrn ea CPT 86005 | not published | not published | $8.34 – $12.41 | 2 |
| Allergy injections; 2 or more 95117 CPT 95117 | not published | not published | $10.43 – $13.74 | 2 |
| Allergy injection; single 95115 CPT 95115 | not published | not published | $8.99 – $11.35 | 2 |
| Allergy Skin Testing CPT 95004 | not published | not published | $6.34 – $6.88 | 2 |
| Allg patch or app # of tests 95044 CPT 95044 | not published | not published | $5.75 – $6.67 | 2 |
| Allgrft implnt knee w/scope CPT 29867 | not published | not published | $1,400.31 – $1,416.85 | 2 |
| All tstg perq&iq drugs/biol CPT 95018 | not published | not published | $7.87 – $7.87 | 1 |
| All tstg perq&iq w/venoms CPT 95017 | not published | not published | $3.94 – $3.94 | 1 |
| Alpha-fetoprotein afp-l3 frac & total CPT 82107 | not published | not published | $68.01 – $100.29 | 2 |
| Alpha-fetoprotein amniotic CPT 82106 | $54.95 | $148.50 | $17.72 – $26.12 | 2 |
| Alpha-fetoprotein tumor marker CPT 82105 | $69.84 | $188.75 | $17.72 – $26.12 | 2 |
| Alt/sgpt CPT 84460 | $31.73 | $85.75 | $5.47 – $8.25 | 2 |
| Aluminum - quest CPT 82108 | $81.49 | $220.25 | $23.21 – $29.14 | 2 |
| Alveoloplasty each quadrant CPT 41874 | not published | not published | $275.16 – $286.97 | 2 |
| Alys cplx sp/pn npgt w/prgrm CPT 95972 | $183.89 | $497.00 | $46.66 – $93.18 | 2 |
| Ambl bp mntr w/sw a/r CPT 93788 | not published | not published | $5.39 – $18.23 | 2 |
| Amino acid screen, urine CPT 82128 | not published | not published | $14.59 – $21.60 | 2 |
| Amino acid single qual CPT 82127 | not published | not published | $14.59 – $21.60 | 2 |
| Amino acids quant 2-5 CPT 82136 | not published | not published | $17.72 – $26.26 | 2 |
| Aminolevulinic acid delta CPT 82135 | $48.14 | $130.10 | $17.46 – $25.62 | 2 |
| Ammonia CPT 82140 | $60.31 | $163.00 | $15.37 – $22.69 | 2 |
| Amniocentesisdiagnostic 59000 CPT 59000 | $368.15 | $995.00 | $90.92 – $93.58 | 2 |
| Amniocentesis therapeutic CPT 59001 | not published | not published | $202.15 – $214.14 | 2 |
| Amniotic fluid scan CPT 82143 | not published | not published | $7.30 – $10.69 | 2 |
| Amp f/th 1/2 jt/phalanx w/neurect local flap CPT 26952 | $1,922.98 | $5,197.25 | $679.70 – $684.80 | 2 |
| Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J0289 | $28.90 | $78.10 | $15.24 – $15.24 | 1 |
| Amp metatarsal w/toe single 28810 CPT 28810 | not published | not published | $480.01 – $497.57 | 2 |
| Amp thigh through femur re-amp 27596 CPT 27596 | not published | not published | $806.99 – $820.81 | 2 |
| Amputate hand at wrist CPT 25922 | not published | not published | $562.06 – $628.76 | 2 |
| Amputate metacarpal bone 26910 CPT 26910 | $3,227.33 | $8,722.50 | $754.80 – $770.36 | 2 |
| Amputate thigh through femur 27590 CPT 27590 | not published | not published | $900.84 – $929.26 | 2 |
| Amputation follow-up surgery CPT 24925 | not published | not published | $572.06 – $602.97 | 2 |
| Amputation follow-up surgery CPT 25907 | not published | not published | $667.65 – $699.42 | 2 |
| Amputation follow-up surgery CPT 25909 | not published | not published | $749.96 – $789.73 | 2 |
| Amputation follow-up surgery CPT 25929 | not published | not published | $611.02 – $627.31 | 2 |
| Amputation follow-up surgery CPT 25931 | not published | not published | $760.71 – $785.37 | 2 |
| Amputation follow-up surgery CPT 27594 | not published | not published | $560.04 – $562.64 | 2 |
| Amputation follow-up surgery CPT 27884 | not published | not published | $642.08 – $653.39 | 2 |
| Amputation leg thr tib/fib 27880 CPT 27880 | not published | not published | $1,032.03 – $1,044.47 | 2 |
| Amputation leg; tib/fib f/u 27886 CPT 27886 | not published | not published | $733.83 – $745.51 | 2 |
| Amputation of foot at ankle CPT 27889 | not published | not published | $728.67 – $773.51 | 2 |
| Amputation of lower leg CPT 27882 | not published | not published | $673.78 – $705.33 | 2 |
| Amputation of midtarsal 28800 CPT 28800 | not published | not published | $602.81 – $647.41 | 2 |
| Amputation thru metatarsal CPT 28805 | not published | not published | $821.20 – $859.05 | 2 |
| Amputation toe interphalangeal joint CPT 28825 | not published | not published | $410.37 – $446.41 | 2 |
| Amputation toe metatarsophalangeal joint CPT 28820 | not published | not published | $390.68 – $437.75 | 2 |
| Amylase CPT 82150 | $30.16 | $81.50 | $6.78 – $10.09 | 2 |
| Ana ds-dna CPT 86226 | not published | not published | $12.77 – $18.85 | 2 |
| Anal pressure record CPT 91122 | not published | not published | $111.52 – $139.41 | 2 |
| Anal/urinary muscle study CPT 51784 | not published | not published | $31.98 – $97.98 | 2 |
| Anal/urinary muscle study CPT 51785 | $403.02 | $1,089.25 | $98.09 – $177.85 | 2 |
| Analysis gene f2 20210g>a variant CPT 81240 | $219.13 | $592.25 | $76.61 – $76.61 | 1 |
| Analysis gene f5 leiden variant CPT 81241 | $219.13 | $592.25 | $95.14 – $95.14 | 1 |
| Analysis nerve CPT 88356 | not published | not published | $87.33 – $163.07 | 2 |
| Analysis tumor CPT 88358 | not published | not published | $34.34 – $43.12 | 2 |
| Analyze neurostimulator simple w/reprogramming 95971 CPT 95971 | $142.54 | $385.25 | $45.48 – $48.99 | 2 |
| Anastamo/extrahep bil duct/gi trac 47760 CPT 47760 | not published | not published | $2,406.49 – $2,537.19 | 2 |
| Anastamo/roux-en-y/extrahep bil/gi 47780 CPT 47780 | not published | not published | $2,633.46 – $2,787.11 | 2 |
| Anastomosis of facial/other nerve 64868 CPT 64868 | not published | not published | $1,142.71 – $1,160.40 | 2 |
| Anca screen with reflex to titer -quest CPT 86021 | $118.40 | $320.00 | $13.55 – $16.99 | 2 |
| An cholangiogram percutaneous compl CPT 47531 | $375.64 | $1,015.25 | $80.35 – $80.35 | 1 |
| Androstanediol CPT 82154 | not published | not published | $30.49 – $44.89 | 2 |
| An fluoro guide for cvp CPT 77001 | $49.12 | $132.75 | $23.69 – $66.11 | 2 |
| Angio balloon ctrl dialysis seg add-on CPT 36907 | not published | not published | $141.92 – $141.92 | 1 |
| Angioplasty fem/pop unilat 37224 CPT 37224 | not published | not published | $511.15 – $511.15 | 1 |
| Angioplasty/iliac/init ves/unilat 37220 CPT 37220 | not published | not published | $462.42 – $462.42 | 1 |
| Angioplasty tib/pero/unilat/ea add 37232 CPT 37232 | not published | not published | $233.24 – $233.24 | 1 |
| Angiotensin ii CPT 82163 | not published | not published | $21.63 – $31.95 | 2 |
| Angio tib/peroneal/init ves/unila 37228 CPT 37228 | not published | not published | $626.71 – $626.71 | 1 |
| Angio trnslmnl balloon same artery ea addl CPT 37247 | not published | not published | $200.49 – $200.49 | 1 |
| Angio trnslmnl balloon same artery ini CPT 37246 | not published | not published | $404.22 – $404.22 | 1 |
| Angio trnslmnl balloon same vein ea addl CPT 37249 | not published | not published | $170.57 – $170.57 | 1 |
| Angio trnslmnl balloon same vein ini CPT 37248 | not published | not published | $347.55 – $347.55 | 1 |
| Ankle arthroscopy/surgery CPT 29891 | not published | not published | $741.69 – $762.26 | 2 |
| Ankle arthroscopy/surgery CPT 29892 | not published | not published | $719.19 – $781.81 | 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.