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 |
|---|---|---|---|---|
| Ankle arthroscopy/surgery CPT 29894 | not published | not published | $549.52 – $573.47 | 2 |
| Ankle arthroscopy/surgery CPT 29895 | not published | not published | $527.91 – $554.81 | 2 |
| Ankle arthroscopy/surgery CPT 29897 | not published | not published | $555.89 – $580.23 | 2 |
| Ankle arthroscopy/surgery CPT 29898 | not published | not published | $624.44 – $650.53 | 2 |
| Ankle arthroscopy/surgery CPT 29899 | not published | not published | $1,150.35 – $1,171.37 | 2 |
| Ankle X-ray CPT 73610 | $269.73 | $729.00 | $10.66 – $23.00 | 2 |
| Anl sp inf pmp w/mdreprg&fil CPT 62370 | not published | not published | $52.16 – $52.16 | 1 |
| Annual Physical, Established Patient (age 18-39) CPT 99395 | not published | not published | $83.97 – $99.02 | 2 |
| Annual Physical, Established Patient (age 40-64) CPT 99396 | not published | not published | $94.62 – $107.65 | 2 |
| Annual Physical, New Patient (age 18-39) CPT 99385 | not published | not published | $94.62 – $108.82 | 2 |
| Annual Physical, New Patient (age 40-64) CPT 99386 | not published | not published | $116.11 – $132.38 | 2 |
| Anodyne therapy charges pt CPT 97026 | not published | not published | $5.90 – $6.40 | 2 |
| Anogenital exam child w imag CPT 99170 | $71.50 | $193.25 | $98.31 – $115.49 | 2 |
| Anora (draw only) CPT 99001 | not published | not published | $8.36 – $8.36 | 1 |
| Anorectal myomectomy CPT 45108 | not published | not published | $376.00 – $403.79 | 2 |
| Anoscopy CPT 46611 | not published | not published | $91.20 – $91.65 | 2 |
| Anoscopy ablation lesion 46615 CPT 46615 | not published | not published | $103.70 – $110.32 | 2 |
| Anoscopy and biopsy CPT 46606 | not published | not published | $81.23 – $84.95 | 2 |
| Anoscopy and dilation 46604 CPT 46604 | not published | not published | $73.34 – $74.41 | 2 |
| Anoscopy control bleeding 46614 CPT 46614 | not published | not published | $72.11 – $77.08 | 2 |
| Anoscopy remove fb 46608 CPT 46608 | $496.91 | $1,343.00 | $89.57 – $93.41 | 2 |
| Anoscopy remove lesion 46610 CPT 46610 | not published | not published | $88.74 – $91.13 | 2 |
| Anoscopy remove lesions w/cautery/snare 46612 CPT 46612 | not published | not published | $103.00 – $108.45 | 2 |
| Ans parasymp & symp w/tilt CPT 95924 | not published | not published | $63.24 – $63.24 | 1 |
| Ant colporrhaphy/rpr cyctocele 57240 CPT 57240 | not published | not published | $742.82 – $762.90 | 2 |
| Antibody CPT 86744 | not published | not published | $13.81 – $20.53 | 2 |
| Antibody bacterium, not elsewhere specified CPT 86609 | $57.81 | $156.25 | $11.98 – $15.03 | 2 |
| Antibody elution rbc reference CPT 86860 | $107.12 | $289.50 | $13.03 – $13.03 | 1 |
| Antibody htlv/hiv confirm test CPT 86689 | $85.75 | $231.75 | $20.33 – $30.13 | 2 |
| Antibody htlv-i CPT 86687 | $41.44 | $112.00 | $8.86 – $13.06 | 2 |
| Antibody htlv-ii CPT 86688 | $66.60 | $180.00 | $7.96 – $9.99 | 2 |
| Antibody identification platelet antibodies heparin-pf4 igg CPT 86022 | $218.30 | $590.00 | $15.93 – $19.99 | 2 |
| Antibody id rbc panel CPT 86870 | $90.47 | $244.50 | $20.06 – $20.06 | 1 |
| Antibody influenza virus CPT 86710 | $53.19 | $143.75 | $14.33 – $21.10 | 2 |
| Antibody lymphocytic choriomeningitis CPT 86727 | $64.01 | $173.00 | $13.55 – $20.03 | 2 |
| Antibody screen rbc CPT 86850 | $34.13 | $92.25 | $5.96 – $10.94 | 2 |
| Antibody tetanus CPT 86774 | $87.41 | $236.25 | $15.63 – $23.04 | 2 |
| Antigen therapy services CPT 95145 | not published | not published | $3.53 – $3.90 | 2 |
| Antigen therapy services CPT 95146 | not published | not published | $3.53 – $3.90 | 2 |
| Antigen therapy services CPT 95147 | not published | not published | $3.53 – $3.90 | 2 |
| Antigen therapy services CPT 95148 | not published | not published | $3.53 – $3.90 | 2 |
| Antigen therapy services CPT 95149 | not published | not published | $3.53 – $3.90 | 2 |
| Antigen therapy services CPT 95165 | not published | not published | $3.53 – $3.90 | 2 |
| Antigen therapy services CPT 95170 | not published | not published | $3.53 – $3.90 | 2 |
| Ant instr 2-3 vert segm 22845 CPT 22845 | not published | not published | $829.71 – $847.95 | 2 |
| Ant instrumentation/4-7 vert seg 22846 CPT 22846 | not published | not published | $861.48 – $880.43 | 2 |
| Antinuclear antibodies CPT 86038 | $43.48 | $117.50 | $12.77 – $18.82 | 2 |
| Antinuclear antibodies titer CPT 86039 | $60.87 | $164.50 | $11.73 – $17.38 | 2 |
| Antiphosphatidylserine antibody CPT 86148 | $55.13 | $149.00 | $16.94 – $25.02 | 2 |
| Antistreptolysin o screen CPT 86063 | not published | not published | $5.99 – $8.98 | 2 |
| Antistreptolysin o titer CPT 86060 | $47.27 | $127.75 | $7.82 – $11.36 | 2 |
| Antithrombin iii activity CPT 85300 | $107.67 | $291.00 | $12.51 – $18.46 | 2 |
| Antithymocyte globuln rabbit HCPCS J7511 | $942.89 | $2,548.35 | $422.41 – $422.41 | 1 |
| Ant/post colporrhap/enterocele rpr 57265 CPT 57265 | not published | not published | $1,009.96 – $1,042.27 | 2 |
| Ant sgm img ir flrscn angrph CPT 92287 | not published | not published | $13.33 – $91.99 | 2 |
| Ant sgm img i&r speclr mic CPT 92286 | not published | not published | $16.54 – $41.50 | 2 |
| Aortic circulation assist 33971 CPT 33971 | not published | not published | $800.41 – $846.64 | 2 |
| Aortic dysfunction/dilation CPT 81410 | not published | not published | $572.04 – $572.04 | 1 |
| Aortic dysfunction/dilation CPT 81411 | not published | not published | $1,532.47 – $1,532.47 | 1 |
| Apc gene dup/delet variants CPT 81203 | not published | not published | $227.00 – $227.00 | 1 |
| Apc gene full sequence CPT 81201 | not published | not published | $885.30 – $885.30 | 1 |
| Apc gene known fam variants CPT 81202 | not published | not published | $317.80 – $317.80 | 1 |
| Aphakia prosth service temp CPT 92358 | not published | not published | $11.51 – $19.01 | 2 |
| Apheresis immunoads slctv CPT 36516 | not published | not published | $75.89 – $78.66 | 2 |
| Apheresis plasma CPT 36514 | $4,467.75 | $12,075.00 | $105.14 – $107.85 | 2 |
| Apheresis platelets CPT 36513 | $1,629.39 | $4,403.75 | $109.14 – $113.68 | 2 |
| Apheresis rbc CPT 36512 | $2,015.21 | $5,446.50 | $106.17 – $110.24 | 2 |
| Apheresis wbc CPT 36511 | $3,793.52 | $10,252.75 | $105.10 – $108.64 | 2 |
| Apl(pml-rara) quant - sendout CPT 81315 | $300.35 | $811.75 | $322.77 – $322.77 | 1 |
| Appendectomy CPT 44950 | not published | not published | $700.74 – $720.65 | 2 |
| Appendectomy add-on 44955 CPT 44955 | not published | not published | $95.26 – $95.95 | 2 |
| Appendectomy/open/rup/w/absc/peri 44960 CPT 44960 | not published | not published | $944.60 – $981.87 | 2 |
| Appendix Removal (Laparoscopic) CPT 44970 | not published | not published | $642.08 – $671.45 | 2 |
| App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm CPT 15277 | $1,255.13 | $3,392.25 | $256.12 – $256.12 | 1 |
| App high cost ss f/n/g/h/f >100sq cm addl 100sq cm CPT 15278 | $504.77 | $1,364.25 | $64.96 – $64.96 | 1 |
| App high cost ss f/n/g/h/f <100sq cm addl <25sq cm CPT 15276 | $185.56 | $501.50 | $28.67 – $28.67 | 1 |
| App high cost ss t/a/l >100sq cm 1st 100sq cm CPT 15273 | not published | not published | $228.19 – $228.19 | 1 |
| App high cost ss t/a/l >100sq cm addl 100sq cm CPT 15274 | not published | not published | $51.76 – $51.76 | 1 |
| App high cost ss t/a/l <100sq cm addl <25sq cm CPT 15272 | not published | not published | $19.59 – $19.59 | 1 |
| Appl bdy cst sho to hip 1thi CPT 29044 | not published | not published | $168.89 – $178.64 | 2 |
| Appl bdy cst sho to hip b th CPT 29046 | not published | not published | $182.84 – $204.65 | 2 |
| Appl bdy cst sho to hip head CPT 29040 | not published | not published | $161.42 – $172.86 | 2 |
| Appl body cast sho to hips CPT 29035 | not published | not published | $152.99 – $157.87 | 2 |
| Appl cast figure-of-eight CPT 29049 | not published | not published | $62.57 – $67.47 | 2 |
| Appl cast plaster velpeau CPT 29058 | not published | not published | $92.72 – $103.50 | 2 |
| Appl cast shoulder spica CPT 29055 | not published | not published | $147.67 – $151.09 | 2 |
| Appl halo type body cast CPT 29000 | not published | not published | $187.69 – $198.92 | 2 |
| Appl hip spica cast1&1/2 CPT 29325 | not published | not published | $194.66 – $195.42 | 2 |
| Appl hip spica cast 1 leg CPT 29305 | not published | not published | $172.02 – $173.88 | 2 |
| Application clubfoot cast CPT 29450 | not published | not published | $127.26 – $142.53 | 2 |
| Application finger splntstatic 29130 CPT 29130 | $201.47 | $544.50 | $31.92 – $32.78 | 2 |
| Application halo femoral CPT 20663 | not published | not published | $482.83 – $496.12 | 2 |
| Application halo pelvic CPT 20662 | not published | not published | $478.98 – $521.60 | 2 |
| Application long leg splint 29505 CPT 29505 | $190.37 | $514.50 | $52.64 – $54.76 | 2 |
| Application lower leg splint 29515 CPT 29515 | $251.42 | $679.50 | $54.95 – $55.21 | 2 |
| Application multi layer compression below knee (both sides) CPT 29581 | not published | not published | $14.51 – $14.51 | 1 |
| Application of body cast CPT 29010 | not published | not published | $153.09 – $173.18 | 2 |
| Application of body cast CPT 29015 | not published | not published | $179.02 – $186.80 | 2 |
| Application of cylinder cast 29365 CPT 29365 | not published | not published | $96.37 – $97.07 | 2 |
| Application of forearm cast 29075 CPT 29075 | $386.10 | $1,043.50 | $66.63 – $68.11 | 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.