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 |
|---|---|---|---|---|
| Fluoro polarize fetal lung CPT 83663 | $62.81 | $169.75 | $20.06 – $29.44 | 2 |
| Fluoroscopy up to 1 hour CPT 76000 | $164.47 | $444.50 | $10.66 – $39.17 | 2 |
| Fmri brain by phys/psych CPT 70555 | not published | not published | $161.38 – $161.38 | 1 |
| Fmri brain by tech CPT 70554 | not published | not published | $133.75 – $347.07 | 2 |
| Foam stability fetal lung CPT 83662 | not published | not published | $20.06 – $29.44 | 2 |
| Folic acid CPT 82746 | $58.28 | $157.50 | $15.63 – $22.89 | 2 |
| Follow-up angiography CPT 75898 | not published | not published | $46.00 – $46.00 | 1 |
| Follow-up surgery of eye CPT 66250 | not published | not published | $551.27 – $602.15 | 2 |
| Foot X-ray CPT 73630 | $273.99 | $740.50 | $10.66 – $20.85 | 2 |
| Forehead flap w/vasc pedicle 15731 CPT 15731 | not published | not published | $1,104.98 – $1,110.85 | 2 |
| Forensic cytopathology CPT 88125 | not published | not published | $5.93 – $7.91 | 2 |
| Foreskn manip w/lss preputial ads+stretching 54450 CPT 54450 | $174.73 | $472.25 | $65.48 – $74.79 | 2 |
| Fosaprepitant 150 mg intravenous powder for solution HCPCS J1453 | $4.31 | $11.64 | $1.59 – $1.59 | 1 |
| Fosphenytoin 50 mg pe/ml injection (wrapper) HCPCS Q2009 | $21.86 | $59.07 | $0.51 – $0.51 | 1 |
| Fractionation ketosteroids CPT 83593 | not published | not published | $27.62 – $40.95 | 2 |
| Fracture assessment via dxa CPT 77086 | $87.14 | $235.50 | $26.96 – $26.96 | 1 |
| _fragile x methylation-sendout CPT 81244 | $105.10 | $284.06 | $50.95 – $50.95 | 1 |
| Fragmenting of kidney stone CPT 50590 | not published | not published | $636.60 – $704.24 | 2 |
| Freeing of bowel adhesion 44005 CPT 44005 | not published | not published | $1,197.98 – $1,231.82 | 2 |
| Free/remove chest lining 32320 CPT 32320 | not published | not published | $1,796.11 – $1,856.31 | 2 |
| Frenectomy 41115 CPT 41115 | not published | not published | $159.95 – $160.05 | 2 |
| Frenotomy 40806 CPT 40806 | not published | not published | $36.02 – $36.04 | 2 |
| Frenulotomy of penis CPT 54164 | not published | not published | $214.63 – $235.20 | 2 |
| Fresh frozen plasma thawing ea un CPT 86927 | $100.73 | $272.25 | $7.04 – $7.04 | 1 |
| Frozen blood freeze/thaw CPT 86932 | not published | not published | $54.46 – $54.46 | 1 |
| Frozen blood prep CPT 86930 | not published | not published | $54.46 – $54.46 | 1 |
| Frozen blood thaw CPT 86931 | not published | not published | $40.91 – $40.91 | 1 |
| Frozen cell preparation CPT 88241 | not published | not published | $10.68 – $14.29 | 2 |
| Fructosamine glycated protein CPT 82985 | $59.76 | $161.50 | $15.90 – $23.47 | 2 |
| Ftl cgen abnor four anal CPT 81511 | not published | not published | $174.22 – $174.22 | 1 |
| Full mouth x-ray of teeth CPT 70320 | not published | not published | $13.80 – $41.33 | 2 |
| Full thick gft/nose/ear/lid/lip/20sqcm or< 15260 CPT 15260 | not published | not published | $926.95 – $947.46 | 2 |
| Full thick gft/scalp/arm/leg/20sqcm or< 15220 CPT 15220 | not published | not published | $668.45 – $676.48 | 2 |
| Full thick gft/scalp/arm/leg/add 20sqcm 15221 CPT 15221 | not published | not published | $80.24 – $82.42 | 2 |
| Full thick gft w/close donor fccmnaghf <=20sqcm 15240 CPT 15240 | $1,160.51 | $3,136.50 | $853.66 – $880.81 | 2 |
| Fundus photography with i&r 92250 CPT 92250 | not published | not published | $27.30 – $44.56 | 2 |
| Fuse bile ducts and bowel 47785 CPT 47785 | not published | not published | $3,438.51 – $3,657.24 | 2 |
| Fuse pancreas cyst and bowel 48520 CPT 48520 | not published | not published | $1,188.77 – $1,226.65 | 2 |
| Fusion/graft of finger joint CPT 26862 | not published | not published | $764.17 – $773.11 | 2 |
| Fusion/graft of hand joint CPT 26844 | not published | not published | $866.20 – $877.66 | 2 |
| Fusion of ankle joint open CPT 27870 | not published | not published | $1,140.92 – $1,169.00 | 2 |
| Fusion of big toe joint CPT 28750 | not published | not published | $651.35 – $669.96 | 2 |
| Fusion of big toe joint CPT 28755 | not published | not published | $365.49 – $381.19 | 2 |
| Fusion of finger joint CPT 26860 | not published | not published | $581.00 – $595.35 | 2 |
| Fusion of finger tendons CPT 26471 | not published | not published | $640.88 – $651.73 | 2 |
| Fusion of finger tendons CPT 26474 | not published | not published | $613.35 – $635.09 | 2 |
| Fusion of foot bones CPT 28730 | not published | not published | $809.95 – $942.38 | 2 |
| Fusion of foot bones CPT 28735 | not published | not published | $870.18 – $903.86 | 2 |
| Fusion of foot bones CPT 28740 | not published | not published | $689.73 – $705.97 | 2 |
| Fusion of hand joint CPT 26843 | not published | not published | $774.43 – $785.43 | 2 |
| Fusion of knuckle CPT 26850 | not published | not published | $732.21 – $735.81 | 2 |
| Fusion of knuckle joint CPT 26516 | not published | not published | $740.63 – $745.66 | 2 |
| Fusion of knuckle joints CPT 26517 | not published | not published | $838.52 – $875.63 | 2 |
| Fusion of knuckle joints CPT 26518 | not published | not published | $882.71 – $884.37 | 2 |
| Fusion of knuckle with graft CPT 26852 | not published | not published | $843.14 – $849.92 | 2 |
| Fusion of spermatic ducts CPT 54900 | not published | not published | $938.38 – $950.72 | 2 |
| Fusion of spermatic ducts CPT 54901 | not published | not published | $1,189.12 – $1,348.99 | 2 |
| Fusion of tendons at wrist CPT 25300 | not published | not published | $741.14 – $745.18 | 2 |
| Fusion of tendons at wrist CPT 25301 | not published | not published | $704.94 – $706.06 | 2 |
| Fusion of thumb CPT 26841 | not published | not published | $767.29 – $771.38 | 2 |
| Fusion of tibiofibular joint CPT 27871 | not published | not published | $753.82 – $763.80 | 2 |
| Fusion of toes CPT 28280 | not published | not published | $387.44 – $417.39 | 2 |
| G6pc gene CPT 81250 | $314.78 | $850.75 | $66.39 – $66.39 | 1 |
| G6pd full gene sequence CPT 81249 | not published | not published | $681.00 – $681.00 | 1 |
| G6pd gene alys cmn variant CPT 81247 | not published | not published | $198.41 – $198.41 | 1 |
| G6pd known familial variant CPT 81248 | not published | not published | $425.91 – $425.91 | 1 |
| Galac-1-phosphate uridyltran - sendout CPT 82775 | $96.94 | $262.00 | $22.15 – $32.80 | 2 |
| Galactokinase - sendout CPT 82759 | not published | not published | $22.67 – $33.45 | 2 |
| Galactose transferase test CPT 82776 | not published | not published | $8.86 – $13.06 | 2 |
| Galectin-3 CPT 82777 | not published | not published | $34.24 – $34.24 | 1 |
| Gallbladder Removal (Laparoscopic) CPT 47562 | not published | not published | $735.82 – $800.23 | 2 |
| Gammaglobulin iga CPT 82784 | $72.15 | $195.00 | $9.90 – $14.48 | 2 |
| Gammaglobulin ige CPT 82785 | $58.18 | $157.25 | $17.46 – $25.63 | 2 |
| Gamma glutamyltransferase CPT 82977 | $49.03 | $132.50 | $7.56 – $11.21 | 2 |
| Gardner vag dna quant CPT 87512 | $63.27 | $171.00 | $19.90 – $24.97 | 2 |
| Gastric analy w/ph ea spec CPT 82930 | not published | not published | $8.48 – $8.48 | 1 |
| Gastric emptying imag study CPT 78265 | $585.53 | $1,582.50 | $333.80 – $333.80 | 1 |
| Gastric emptying imag study CPT 78266 | not published | not published | $429.72 – $429.72 | 1 |
| Gastric motility studies CPT 91020 | not published | not published | $93.89 – $159.89 | 2 |
| Gastric mucosa imaging CPT 78261 | not published | not published | $43.60 – $223.49 | 2 |
| Gastrin test CPT 82938 | not published | not published | $18.76 – $27.55 | 2 |
| Gastroesophageal reflux study CPT 78262 | $395.62 | $1,069.25 | $42.33 – $220.97 | 2 |
| Gastroesophageal reflux test CPT 91034 | not published | not published | $63.58 – $138.69 | 2 |
| Gastrojejunostomy;w/o vagotomy 43820 CPT 43820 | not published | not published | $1,427.07 – $1,508.64 | 2 |
| Gastrostomy open neonatal CPT 43831 | not published | not published | $622.06 – $626.58 | 2 |
| Gated heart multiple CPT 78473 | not published | not published | $96.59 – $229.96 | 2 |
| Gba gene CPT 81251 | not published | not published | $53.63 – $53.63 | 1 |
| General health panel CPT 80050 | $161.14 | $435.50 | $29.19 – $29.19 | 1 |
| Genetic tstg severe inh cond CPT 81443 | $1,358.64 | $3,672.00 | $2,779.12 – $2,779.12 | 1 |
| Genioplasty augmentation CPT 21120 | not published | not published | $518.75 – $525.00 | 2 |
| Geniop sldg augmentation CPT 21123 | not published | not published | $933.88 – $992.55 | 2 |
| Geniop sldg osteot 1 CPT 21121 | not published | not published | $702.73 – $736.91 | 2 |
| Geniop sldg osteot 2/> CPT 21122 | not published | not published | $725.34 – $775.36 | 2 |
| Genome sequence analysis CPT 81425 | not published | not published | $5,710.41 – $5,710.41 | 1 |
| Gentamicin peak therapeutic drug level CPT 80170 | $88.43 | $239.00 | $17.20 – $25.50 | 2 |
| G-esoph reflx tst w/electrod CPT 91035 | not published | not published | $103.81 – $400.95 | 2 |
| Ghs abscess perianal iandd CPT 46050 | $1,410.90 | $3,813.25 | $98.31 – $107.09 | 2 |
| Ghs abscess postoperative iandd complex CPT 10180 | $1,244.68 | $3,364.00 | $190.85 – $195.37 | 2 |
| Ghs acetylcholinesterase, rbc CPT 82482 | $44.12 | $119.25 | $8.08 – $11.95 | 2 |
| Ghs alcohol, methyl (methanol)-medtox CPT 84600 | $103.14 | $278.75 | $16.94 – $25.04 | 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.