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 |
|---|---|---|---|---|
| Ghs moderate sedation < 5 yr, 30 min CPT 99151 | $51.89 | $140.25 | $26.51 – $26.51 | 1 |
| Ghs moderate sedation < 5 yr, 30 min, other CPT 99155 | $39.31 | $106.25 | $103.75 – $103.75 | 1 |
| Ghs moderate sedation, > 5 yr, 30 min, other CPT 99156 | $48.01 | $129.75 | $85.28 – $85.28 | 1 |
| Ghs moderate sedation ea addtl 15 min CPT 99153 | $53.00 | $143.25 | $11.15 – $11.15 | 1 |
| Ghs moderate sedation ea addtl 15 min, other CPT 99157 | $38.30 | $103.50 | $64.65 – $64.65 | 1 |
| Ghs musc test done w/n test comp CPT 95886 | not published | not published | $45.26 – $45.26 | 1 |
| Ghs musc tst done w/nerv tst lim CPT 95885 | not published | not published | $40.24 – $40.24 | 1 |
| Ghs musc tst done w/n tst non ext CPT 95887 | not published | not published | $43.11 – $43.11 | 1 |
| Ghs nailbed repair/nail removal CPT 11760 | $193.60 | $523.25 | $125.81 – $141.77 | 2 |
| Ghs nerve blk intercostal, ea addtl level CPT 64421 | not published | not published | $102.66 – $103.92 | 2 |
| Ghs nerve blk intercostal, single level CPT 64420 | $750.55 | $2,028.50 | $75.45 – $75.61 | 2 |
| Ghs nerve block axillary nerve CPT 64417 | $1,090.39 | $2,947.00 | $79.22 – $85.10 | 2 |
| Ghs nerve block brachial plexus CPT 64415 | $1,165.69 | $3,150.50 | $74.02 – $85.99 | 2 |
| Ghs nerve block celiac plexus CPT 64530 | $342.71 | $926.25 | $101.82 – $103.32 | 2 |
| Ghs nerve block interscaline CPT 64510 | not published | not published | $77.59 – $81.38 | 2 |
| Ghs nerve block lumbar or thoracic symp CPT 64520 | $342.71 | $926.25 | $87.57 – $89.93 | 2 |
| Ghs nerve block sciatic nerve CPT 64445 | $1,709.77 | $4,621.00 | $81.60 – $92.66 | 2 |
| Ghs nerve block suprascapular CPT 64418 | $1,198.62 | $3,239.50 | $83.87 – $85.13 | 2 |
| Ghs ng placement w fluoro guidance CPT 43752 | $107.30 | $290.00 | $46.34 – $49.73 | 2 |
| Ghs o2 saturation CPT 82810 | not published | not published | $9.12 – $13.59 | 2 |
| Ghs o2 uptake rest & exercise CPT 94680 | not published | not published | $15.27 – $44.91 | 2 |
| Ghs o2 uptake rest & indirect CPT 94690 | $50.41 | $136.25 | $4.37 – $48.15 | 2 |
| Ghs ob unlisted IV or art inj or infusion CPT 96379 | not published | not published | not published | 0 |
| Ghs opcc repair cvp without subq port CPT 36575 | $828.52 | $2,239.25 | $39.58 – $47.26 | 2 |
| Ghs opcc repair cvp w subq port CPT 36576 | not published | not published | $206.64 – $223.05 | 2 |
| Ghs optokenetic CPT 92544 | not published | not published | $2.52 – $16.07 | 2 |
| Ghs oscillating trac CPT 92545 | not published | not published | $2.17 – $14.27 | 2 |
| Ghs osteopathic manipulative tx, 1-2 regions CPT 98925 | $24.88 | $67.25 | $26.66 – $26.87 | 2 |
| Ghs osteopathic manipulative tx, 3-4 regions CPT 98926 | $31.73 | $85.75 | $39.33 – $40.09 | 2 |
| Ghs ot dds rom CPT 95851 | not published | not published | $8.68 – $9.79 | 2 |
| Ghs ot prosthetic training/15 min CPT 97761 | $28.77 | $77.75 | $34.44 – $35.95 | 2 |
| Ghs ot sensory integrative tech/15min CPT 97533 | $29.42 | $79.50 | $31.68 – $31.94 | 2 |
| Ghs ot work hardening-additional hours CPT 97546 | not published | not published | $54.05 – $54.05 | 1 |
| Ghs pacing - transcutaneous CPT 92953 | $479.43 | $1,295.75 | $1.14 – $14.56 | 2 |
| Ghs paravert facet/nerve cerv ea add bil CPT 64492 | not published | not published | $68.52 – $68.52 | 1 |
| Ghs paravert facet/nerve lumb ea add bil CPT 64495 | not published | not published | $59.12 – $59.12 | 1 |
| Ghs path - pap (papanicolau) smear - vagina CPT 88141 | not published | not published | $21.34 – $35.08 | 2 |
| Ghs peritonsillar abscess i andd CPT 42700 | $369.72 | $999.25 | $147.67 – $148.67 | 2 |
| Ghs phenylketonurid CPT 84030 | not published | not published | $3.57 – $4.48 | 2 |
| Ghs picc line insert < 5 CPT 36568 | $1,127.39 | $3,047.00 | $96.52 – $118.76 | 2 |
| Ghs plngl fx pm cl CPT 26725 | $141.53 | $382.50 | $311.62 – $327.22 | 2 |
| Ghs plt ct-manual CPT 85032 | not published | not published | $4.43 – $6.71 | 2 |
| Ghs polysom <6 yrs 4/> parameters CPT 95782 | not published | not published | $907.65 – $907.65 | 1 |
| Ghs pos nystagmus CPT 92542 | not published | not published | $2.88 – $20.55 | 2 |
| Ghs ppd (tb intradermal) CPT 86580 | $25.25 | $68.25 | $5.07 – $8.27 | 2 |
| Ghs prostatic acid phosphatase (mayo) CPT 84066 | $47.82 | $129.25 | $10.16 – $15.04 | 2 |
| Ghs protein, misc fluid CPT 84160 | not published | not published | $5.47 – $8.06 | 2 |
| Ghs protoporphyrins fract CPT 84202 | $53.00 | $143.25 | $15.11 – $22.34 | 2 |
| Ghs pseudocholinesterase,dibucain-inhibi CPT 82638 | $45.05 | $121.75 | $13.03 – $19.07 | 2 |
| Ghs pt - work hardening/int 2hrs CPT 97545 | not published | not published | $135.82 – $135.82 | 1 |
| Ghs quinidine CPT 80194 | not published | not published | $15.37 – $22.73 | 2 |
| Ghs refill of implantable pump CPT 95990 | not published | not published | $63.94 – $91.99 | 2 |
| Ghs removal intranasal foreign body CPT 30300 | $107.67 | $291.00 | $113.48 – $126.58 | 2 |
| Ghs removal pharyngeal foreign body CPT 42809 | $348.36 | $941.50 | $135.96 – $143.51 | 2 |
| Ghs repair extensor tendon hand, ea tendon CPT 26410 | $1,554.46 | $4,201.25 | $588.01 – $595.17 | 2 |
| Ghs repair tendon ext forearm/wrist ea CPT 25270 | not published | not published | $534.17 – $585.06 | 2 |
| Ghs respiratory syncytical virus igg/m CPT 86756 | $30.16 | $81.50 | $13.55 – $20.07 | 2 |
| Ghs reticulocyte count CPT 85044 | not published | not published | $4.43 – $6.71 | 2 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | not published | not published | $12.77 – $18.66 | 2 |
| Ghs sedimentation rate CPT 85651 | not published | not published | $3.65 – $5.53 | 2 |
| Ghs semen analysis fert CPT 89320 | not published | not published | $12.77 – $18.76 | 2 |
| Ghs semen analysis, post-vas CPT 89300 | not published | not published | $9.38 – $13.90 | 2 |
| Ghs sensitivity (per antimicro) CPT 87184 | $29.14 | $78.75 | $7.30 – $10.74 | 2 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $201.10 | $543.50 | $107.76 – $186.81 | 2 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $191.94 | $518.75 | $145.37 – $250.21 | 2 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $161.78 | $437.25 | $132.45 – $236.24 | 2 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | $216.08 | $584.00 | $176.61 – $298.09 | 2 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $136.16 | $368.00 | $84.59 – $162.89 | 2 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $178.34 | $482.00 | $82.51 – $149.60 | 2 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $102.49 | $277.00 | $106.72 – $204.86 | 2 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | $275.56 | $744.75 | $165.52 – $269.84 | 2 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | $223.85 | $605.00 | $199.91 – $367.44 | 2 |
| Ghs sleep study unattended CPT 95800 | not published | not published | $127.90 – $127.90 | 1 |
| Ghs somatosensory testing lower extremit CPT 95926 | $365.01 | $986.50 | $33.37 – $108.52 | 2 |
| Ghs somatosensory testing upper & lower limbs CPT 95938 | $385.54 | $1,042.00 | $300.73 – $300.73 | 1 |
| Ghs speech-gen aug dev eval iii, st CPT 92608 | not published | not published | $31.76 – $57.27 | 2 |
| Ghs sphenopalatine ganglion block CPT 64505 | $605.69 | $1,637.00 | $95.40 – $97.20 | 2 |
| Ghs spont nystagmus CPT 92541 | not published | not published | $3.60 – $24.92 | 2 |
| Ghs sp train/fitting sp device - kx CPT 92609 | $85.75 | $231.75 | $88.06 – $119.33 | 2 |
| Ghs st - eval for alt comm CPT 92567 | not published | not published | $12.11 – $18.31 | 2 |
| Ghs strapping shoulder - 29240 CPT 29240 | $126.82 | $342.75 | $20.57 – $50.20 | 2 |
| Ghs st - re-eval for alt comm CPT 92597 | not published | not published | $54.75 – $79.76 | 2 |
| Ghs subcutaneous infus, for therapy ea. add. hr CPT 96370 | $66.51 | $179.75 | $16.32 – $18.38 | 2 |
| Ghs subcutaneous infus. for therapy init 1 hr CPT 96369 | $144.58 | $390.75 | $166.24 – $181.75 | 2 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $583.03 | $1,575.75 | $204.34 – $207.50 | 2 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | $265.85 | $718.50 | $148.07 – $150.85 | 2 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | $1,242.46 | $3,358.00 | $251.79 – $262.44 | 2 |
| Ghs trypsin (fecal) CPT 84488 | not published | not published | $7.82 – $11.36 | 2 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $135.42 | $366.00 | $278.41 – $294.70 | 2 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | not published | not published | $262.85 – $275.76 | 2 |
| Ghs urine, hydroxproline total CPT 83505 | not published | not published | $25.54 – $37.84 | 2 |
| Ghs urine, porphyrins quant CPT 84120 | $321.25 | $868.25 | $15.63 – $22.90 | 2 |
| Ghs vaginal delivery only CPT 59409 | $968.66 | $2,618.00 | $897.66 – $918.73 | 2 |
| Ghs windowing of cast CPT 29730 | not published | not published | $50.04 – $52.64 | 2 |
| Giardia lamblia antibody CPT 86674 | $85.93 | $232.25 | $15.63 – $22.92 | 2 |
| Gi endoscopic ultrasound CPT 76975 | not published | not published | $51.51 – $51.51 | 1 |
| Gi inhouse confirmation CPT 87045 | $46.34 | $125.25 | $9.90 – $14.70 | 2 |
| Gingivoplasty each quadrant CPT 41872 | not published | not published | $277.90 – $291.46 | 2 |
| Gi protein loss CPT 78282 | not published | not published | $23.98 – $23.98 | 1 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | not published | not published | $238.27 – $700.59 | 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.