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 |
|---|---|---|---|---|
| Enzyme cell activity ra CPT 82658 | not published | not published | $19.02 – $28.11 | 2 |
| Enzyme histochemistry CPT 88319 | $145.60 | $393.50 | $32.21 – $62.16 | 2 |
| Ep & ablate supravent arrhyt CPT 93653 | not published | not published | $948.21 – $11,285.00 | 2 |
| Ep & ablate ventric tachy CPT 93654 | not published | not published | $1,269.86 – $11,285.00 | 2 |
| Epidrm a-grft face/nck/hf/g 15115 CPT 15115 | $2,386.96 | $6,451.25 | $774.96 – $831.86 | 2 |
| Epidrm a-grft f/n/hf/g addl CPT 15116 | not published | not published | $166.08 – $168.37 | 2 |
| Epidrm agrft t/a/l 1st 100 CPT 15110 | not published | not published | $766.81 – $804.10 | 2 |
| Epidrm autogrft t/a/l add-on CPT 15111 | not published | not published | $116.61 – $122.28 | 2 |
| Epidural/lumbar/sacral/ea add level64484 CPT 64484 | not published | not published | $58.40 – $79.06 | 2 |
| Epidural lysis mult sessions CPT 62263 | not published | not published | $358.44 – $430.56 | 2 |
| Epidural lysis on single day 62264 CPT 62264 | not published | not published | $266.54 – $266.59 | 2 |
| Epiglottidectomy CPT 31420 | not published | not published | $909.07 – $915.83 | 2 |
| Epilepsy gen seq alys panel CPT 81419 | $1,163.17 | $3,143.70 | $2,779.12 – $2,779.12 | 1 |
| Ep induct arrhy by elect pacing CPT 93618 | not published | not published | $175.85 – $8,949.00 | 2 |
| Epiphysl arrst dstl rds&ulna CPT 25455 | not published | not published | $753.51 – $796.50 | 2 |
| Epiphysl arrst dstl rds/ulna CPT 25450 | not published | not published | $573.06 – $659.75 | 2 |
| Episiotomy/vag rpr oth/thn attending phys 59300 CPT 59300 | not published | not published | $165.78 – $169.21 | 2 |
| Epoetin alfa, 100 units esrd HCPCS Q4081 | $34.97 | $94.50 | $0.96 – $0.96 | 1 |
| Epstein barr early antigen antibody CPT 86663 | $46.44 | $125.50 | $13.81 – $20.43 | 2 |
| Epstein barr nuclear antigen antibody CPT 86664 | $42.83 | $115.75 | $16.16 – $23.81 | 2 |
| Epstein barr viral capsid antigen antibody igm CPT 86665 | $43.38 | $117.25 | $19.02 – $28.25 | 2 |
| Ercp biliary & pancreas CPT 74330 | $421.80 | $1,140.00 | $56.92 – $56.92 | 1 |
| Ercp bil/panc duct; each stent plcmt 43274 CPT 43274 | not published | not published | $530.87 – $530.87 | 1 |
| Ercp ea duct/ampulla dilate CPT 43277 | not published | not published | $434.04 – $434.04 | 1 |
| Ercp lesion ablate w/dilate 43278 CPT 43278 | not published | not published | $496.52 – $496.52 | 1 |
| Ercp lithotripsy calculi CPT 43265 | not published | not published | $496.91 – $681.22 | 2 |
| Ercp remove duct calculi 43264 CPT 43264 | not published | not published | $417.26 – $606.90 | 2 |
| Ercp remove forgn body duct 43275 CPT 43275 | not published | not published | $431.69 – $431.69 | 1 |
| Ercp sphincter pressure meas CPT 43263 | not published | not published | $410.17 – $499.88 | 2 |
| Ercp stent exchange w/dilate CPT 43276 | not published | not published | $552.75 – $552.75 | 1 |
| Ercp w/specimen collection CPT 43260 | not published | not published | $369.24 – $409.18 | 2 |
| ER Visit (level 1, minor) CPT 99281 | $141.62 | $382.75 | $23.74 – $25.27 | 2 |
| ER Visit (level 2) CPT 99282 | $314.96 | $851.25 | $46.32 – $46.32 | 1 |
| ER Visit (level 3) CPT 99283 | $529.47 | $1,431.00 | $69.41 – $69.41 | 1 |
| ER Visit (level 4) CPT 99284 | $757.95 | $2,048.50 | $131.75 – $131.75 | 1 |
| ER Visit (level 5, high severity) CPT 99285 | $1,152.46 | $3,114.75 | $194.56 – $194.56 | 1 |
| Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1364 | $107.65 | $290.95 | $7.57 – $7.57 | 1 |
| Esophageal dilat s&i CPT 74360 | not published | not published | $35.07 – $35.07 | 1 |
| Esophageal lengthening add on code 43338 CPT 43338 | not published | not published | $132.43 – $132.43 | 1 |
| Esophageal motility CPT 78258 | not published | not published | $47.14 – $198.70 | 2 |
| Esophageal recording CPT 93615 | not published | not published | $15.73 – $8,949.00 | 2 |
| Esophageal recording CPT 93616 | not published | not published | $25.19 – $8,949.00 | 2 |
| Esophagomyotomy abdominal 43330 CPT 43330 | not published | not published | $1,450.79 – $1,501.32 | 2 |
| Esophagomyotomy thoracic 43331 CPT 43331 | not published | not published | $1,509.35 – $1,567.25 | 2 |
| Esophagosc dilate balloon 30 CPT 43214 | not published | not published | $219.68 – $219.68 | 1 |
| Esophagosc flex trnsn biopsy CPT 43198 | not published | not published | $112.42 – $112.42 | 1 |
| Esophagoscop mucosal resect CPT 43211 | not published | not published | $269.56 – $269.56 | 1 |
| Esophagoscop stent placement CPT 43212 | not published | not published | $217.25 – $217.25 | 1 |
| Esophagoscop ultrasound exam CPT 43231 | not published | not published | $182.58 – $222.89 | 2 |
| Esophagoscopy balloon <30mm CPT 43220 | not published | not published | $134.13 – $147.70 | 2 |
| Esophagoscopy control bleed CPT 43227 | not published | not published | $188.42 – $245.90 | 2 |
| Esophagoscopy flex biopsy CPT 43202 | not published | not published | $117.31 – $132.88 | 2 |
| Esophagoscopy/flex/diagnostic 43200 CPT 43200 | not published | not published | $98.96 – $119.02 | 2 |
| Esophagoscopy flex dx brush CPT 43197 | not published | not published | $94.07 – $94.07 | 1 |
| Esophagoscopy flex remove fb CPT 43215 | not published | not published | $161.47 – $179.78 | 2 |
| Esophagoscopy lesion ablate CPT 43229 | not published | not published | $225.50 – $225.50 | 1 |
| Esophagoscopy lesion removal CPT 43216 | not published | not published | $153.19 – $167.43 | 2 |
| Esophagoscopy retro balloon CPT 43213 | not published | not published | $295.42 – $295.42 | 1 |
| Esophagoscopy rigid balloon CPT 43195 | not published | not published | $207.66 – $207.66 | 1 |
| Esophagoscopy/rigid/diagnostic 43191 CPT 43191 | not published | not published | $172.84 – $172.84 | 1 |
| Esophagoscopy rigid trnso 43180 CPT 43180 | not published | not published | $613.43 – $613.43 | 1 |
| Esophagoscopy snare les remv CPT 43217 | not published | not published | $183.35 – $197.82 | 2 |
| Esophagoscopy w/us needle bx CPT 43232 | not published | not published | $226.30 – $307.65 | 2 |
| Esophagoscp guide wire dilat 43196 CPT 43196 | not published | not published | $221.78 – $221.78 | 1 |
| Esophagoscp rig trnso biopsy CPT 43193 | not published | not published | $190.11 – $190.11 | 1 |
| Esophagoscp rig trnso inject CPT 43192 | not published | not published | $190.45 – $190.45 | 1 |
| Esophagoscp rig trnso rem fb CPT 43194 | not published | not published | $218.85 – $218.85 | 1 |
| Esophagus endoscopy/ligation CPT 43205 | not published | not published | $161.06 – $262.78 | 2 |
| Esophagus motility study CPT 91010 | not published | not published | $81.89 – $109.95 | 2 |
| Esoph balloon distension tst CPT 91040 | not published | not published | $65.98 – $381.19 | 2 |
| Esoph egd dilation <30 mm CPT 43249 | not published | not published | $175.48 – $204.21 | 2 |
| Esoph endoscopy dilation CPT 43226 | not published | not published | $148.62 – $164.72 | 2 |
| Esoph fundoplasty lap 43327 CPT 43327 | not published | not published | $920.09 – $920.09 | 1 |
| Esoph fundoplasty thor 43328 CPT 43328 | not published | not published | $1,274.24 – $1,274.24 | 1 |
| Esophgl motil w/stim/perfus CPT 91013 | not published | not published | $14.01 – $14.01 | 1 |
| Esoph imped function test CPT 91037 | not published | not published | $64.38 – $110.66 | 2 |
| Esoph imped funct test > 1hr CPT 91038 | not published | not published | $72.87 – $395.57 | 2 |
| Esoph optical endomicroscopy CPT 43206 | not published | not published | $152.06 – $152.06 | 1 |
| Esoph scope w/sclerosis inj CPT 43204 | not published | not published | $154.77 – $262.03 | 2 |
| Esoph scope w/submucous inj CPT 43201 | not published | not published | $116.95 – $150.23 | 2 |
| Essure 58565 CPT 58565 | not published | not published | $477.46 – $509.08 | 2 |
| Establish access to aorta CPT 36160 | not published | not published | $141.66 – $165.65 | 2 |
| Establish access to artery CPT 36100 | not published | not published | $175.58 – $196.27 | 2 |
| Establish brain cavity shunt CPT 62223 | not published | not published | $1,109.09 – $1,168.62 | 2 |
| Established Patient Office Visit (level 1) CPT 99211 | $92.87 | $251.00 | $10.21 – $10.66 | 2 |
| Established Patient Office Visit (level 2) CPT 99212 | $131.07 | $354.25 | $28.20 – $28.36 | 2 |
| Established Patient Office Visit (level 3) CPT 99213 | $165.39 | $447.00 | $55.58 – $56.44 | 2 |
| Established Patient Office Visit (level 4) CPT 99214 | $213.21 | $576.25 | $85.98 – $87.04 | 2 |
| Established Patient Office Visit (level 5) CPT 99215 | $264.46 | $714.75 | $122.03 – $123.07 | 2 |
| Estradiol total CPT 82670 | $88.43 | $239.00 | $29.45 – $43.49 | 2 |
| Estrogens total-sendout CPT 82672 | $83.71 | $226.25 | $22.93 – $33.78 | 2 |
| Ethmoidectomy extranasal total 31205 CPT 31205 | not published | not published | $922.29 – $969.46 | 2 |
| Ethylene glycol -sendout CPT 82693 | $64.75 | $175.00 | $15.63 – $23.20 | 2 |
| Etoposide 50 mg cap HCPCS J8560 | $110.87 | $299.65 | $0.46 – $0.46 | 1 |
| Euglobulin lysis CPT 85360 | $84.92 | $229.50 | $8.86 – $13.09 | 2 |
| Evacuate mole of uterus CPT 59870 | not published | not published | $522.15 – $526.34 | 2 |
| Eval aud rehab status/first hr 92626 CPT 92626 | not published | not published | $84.73 – $95.91 | 2 |
| Eval/fit voice prosthesis iii, st CPT 92607 | not published | not published | $138.65 – $165.67 | 2 |
| Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen CPT 84112 | $122.29 | $330.50 | $100.29 – $100.29 | 1 |
| Evaluation heart device CPT 93640 | not published | not published | $240.18 – $8,949.00 | 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.