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 |
|---|---|---|---|---|
| Gi trc img intral esophagus CPT 91111 | not published | not published | $66.50 – $700.59 | 2 |
| Gi wireless capsule measure CPT 91112 | not published | not published | $978.30 – $978.30 | 1 |
| Gjb2 gene full sequence CPT 81252 | not published | not published | $114.77 – $114.77 | 1 |
| Gjb2 gene known fam variants CPT 81253 | not published | not published | $69.83 – $69.83 | 1 |
| Gjb6 gene com variants CPT 81254 | not published | not published | $39.73 – $39.73 | 1 |
| Glaucoma surgery CPT 66150 | not published | not published | $857.08 – $943.24 | 2 |
| Glaucoma surgery CPT 66155 | not published | not published | $854.35 – $942.47 | 2 |
| Glaucoma surgery CPT 66160 | not published | not published | $975.36 – $1,065.45 | 2 |
| Glaucoma surgery CPT 66170 | not published | not published | $1,181.01 – $1,181.84 | 2 |
| Glucagon plasma - sendout CPT 82943 | $77.42 | $209.25 | $15.11 – $22.25 | 2 |
| Glucose 1 hr post dose CPT 82950 | $22.85 | $61.75 | $4.95 – $7.39 | 2 |
| Glucose-6-phosphate dhydrogenase screen CPT 82960 | not published | not published | $6.51 – $9.42 | 2 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | not published | not published | $2.35 – $3.64 | 2 |
| Glucose blood quantitative CPT 82947 | $25.35 | $68.50 | $4.17 – $6.12 | 2 |
| Glucose body fluid CPT 82945 | $27.01 | $73.00 | $4.17 – $6.12 | 2 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $46.25 | $125.00 | $13.55 – $20.04 | 2 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $12.12 | $32.75 | $4.17 – $6.11 | 2 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $61.33 | $165.75 | $19.54 – $28.93 | 2 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $59.48 | $160.75 | $19.54 – $28.83 | 2 |
| Gonioscopy CPT 92020 | not published | not published | $23.22 – $23.35 | 2 |
| Goniotomy CPT 65820 | not published | not published | $745.42 – $804.60 | 2 |
| Graft hand or finger tendon CPT 26416 | not published | not published | $824.12 – $926.00 | 2 |
| Graft repair of spine defect 63710 CPT 63710 | not published | not published | $1,188.04 – $1,207.99 | 2 |
| Great toe with reduction 28495 CPT 28495 | $329.30 | $890.00 | $157.56 – $162.69 | 2 |
| Growth hormone antibody CPT 86277 | not published | not published | $16.68 – $24.50 | 2 |
| Growth stimulation gene 2 CPT 83006 | not published | not published | $34.24 – $34.24 | 1 |
| Gstrct prtl dstl w/roux-en-y rcnstj 43633 CPT 43633 | not published | not published | $2,068.90 – $2,166.84 | 2 |
| Gstrst open wo constj tube CPT 43830 | not published | not published | $748.42 – $780.43 | 2 |
| G-tube reposition CPT 43761 | $536.50 | $1,450.00 | $116.88 – $127.95 | 2 |
| Gu dilat ureter/urethra s&i CPT 74485 | not published | not published | $34.57 – $66.48 | 2 |
| Guided cath fluid drainage 10030 CPT 10030 | $1,261.42 | $3,409.25 | $174.28 – $174.28 | 1 |
| Guide endoanchr sg-64 aaa 62cm HCPCS L8670 | $7,743.36 | $20,928.00 | $928.83 – $928.83 | 1 |
| Gum graft CPT 41870 | not published | not published | $336.71 – $336.71 | 1 |
| Gynecomastia (males) 19300 CPT 19300 | not published | not published | $413.55 – $452.14 | 2 |
| Hair removal by electrolysis 17380 CPT 17380 | not published | not published | $83.92 – $83.92 | 1 |
| Hair trnspl 1-15 punch grfts CPT 15775 | not published | not published | $250.03 – $263.86 | 2 |
| Hair trnspl >15 punch grafts CPT 15776 | not published | not published | $376.10 – $390.29 | 2 |
| Handle/convey/speciman/office-lab 99000 CPT 99000 | not published | not published | $7.09 – $7.09 | 1 |
| Hand tendon/muscle transfer CPT 26494 | not published | not published | $835.61 – $841.76 | 2 |
| Hand tendon reconstruction CPT 26500 | not published | not published | $655.04 – $662.59 | 2 |
| Hand tendon reconstruction CPT 26502 | not published | not published | $742.64 – $755.83 | 2 |
| Hand X-ray CPT 73130 | $262.70 | $710.00 | $10.66 – $22.28 | 2 |
| Haptoglobin quantitative CPT 83010 | $57.17 | $154.50 | $13.29 – $19.58 | 2 |
| Harvest allogeneic stem cell CPT 38205 | not published | not published | $93.51 – $96.30 | 2 |
| Harvest auto stem cells CPT 38206 | not published | not published | $93.51 – $96.30 | 2 |
| Harvest cultured skin graft 15040 CPT 15040 | not published | not published | $142.11 – $142.67 | 2 |
| Harvest eye tissue alograft CPT 68371 | not published | not published | $418.93 – $445.44 | 2 |
| Harvest femoropopliteal vein 35572 CPT 35572 | not published | not published | $398.18 – $433.29 | 2 |
| Harvest stem cell concentrte CPT 38215 | not published | not published | $55.99 – $63.39 | 2 |
| Harvest vein for bypass 35500 CPT 35500 | not published | not published | $368.31 – $401.03 | 2 |
| Hast w/i&r phys/qhp CPT 94452 | not published | not published | $18.31 – $43.83 | 2 |
| Hast w/oxygen titrate CPT 94453 | not published | not published | $23.73 – $61.80 | 2 |
| Hba1/hba2 full gene sequence CPT 81259 | not published | not published | $681.00 – $681.00 | 1 |
| Hba1/hba2 gene dup/del vrnts CPT 81269 | not published | not published | $229.72 – $229.72 | 1 |
| Hba1/hba2 gene fam vrnt CPT 81258 | not published | not published | $425.91 – $425.91 | 1 |
| Hbb full gene sequence CPT 81364 | not published | not published | $368.40 – $368.40 | 1 |
| Hbb gene com variants CPT 81361 | not published | not published | $198.41 – $198.41 | 1 |
| Hbb gene dup/del variants CPT 81363 | not published | not published | $229.72 – $229.72 | 1 |
| Hbb gene known fam variant CPT 81362 | not published | not published | $425.91 – $425.91 | 1 |
| Hc ea ha check monaural CPT 92594 | not published | not published | $20.51 – $20.51 | 1 |
| Hc fl sm bowel enteroclss tube w kub double contrast CPT 74251 | $425.78 | $1,150.75 | $43.60 – $113.18 | 2 |
| Hcg free betachain test CPT 84704 | not published | not published | $15.90 – $23.44 | 2 |
| Hcg qualitative CPT 84703 | $33.39 | $90.25 | $7.82 – $11.71 | 2 |
| Hcg quantitative CPT 84702 | $64.47 | $174.25 | $15.90 – $23.44 | 2 |
| Hc hearing aid chck binaurl CPT 92593 | not published | not published | $35.67 – $35.67 | 1 |
| Hc hearing aid chck monarl CPT 92592 | not published | not published | $21.78 – $21.78 | 1 |
| Hc hearing aid exam both ears CPT 92591 | not published | not published | $69.21 – $69.21 | 1 |
| Hc hearing aid exam one ear CPT 92590 | not published | not published | $54.05 – $54.05 | 1 |
| Hc metata joint dislocation anes CPT 28635 | $2,307.69 | $6,237.00 | $146.10 – $153.13 | 2 |
| Hc mohs micrographic h/n/h/f/g 1st stage 5 blocks CPT 17311 | not published | not published | $423.53 – $427.68 | 2 |
| Hc mohs micrographic h/n/h/f/g each addl stage CPT 17312 | not published | not published | $225.32 – $227.49 | 2 |
| Hc mohs trunk/arm/leg 1st stage 5 blocks CPT 17313 | not published | not published | $379.78 – $383.93 | 2 |
| Hc mohs trunk/arm/leg ea addl block any stage CPT 17315 | not published | not published | $59.61 – $60.01 | 2 |
| Hc mohs trunk/arm/leg ea stage after 1st stage CPT 17314 | not published | not published | $209.06 – $211.16 | 2 |
| Hc nm cardiac blood pool planar 1 stdy wal motn eject fract CPT 78481 | not published | not published | $65.56 – $134.02 | 2 |
| Hc nm fusion spect CT unlisted CPT 78999 | not published | not published | not published | 0 |
| Hc nm kidney imaging with flow CPT 78701 | not published | not published | $30.74 – $197.98 | 2 |
| Hc nm myocard infarct avid plnr tomo spect w/wo quant CPT 78469 | not published | not published | $59.96 – $192.24 | 2 |
| Hc pet myocardial imaging metabolic eval single study CPT 78459 | not published | not published | $97.70 – $97.70 | 1 |
| Hdr rdncl ntrstl/icav brchtx CPT 77770 | not published | not published | $224.22 – $224.22 | 1 |
| Hdr rdncl ntrstl/icav brchtx CPT 77771 | not published | not published | $408.54 – $408.54 | 1 |
| Hdr rdncl ntrstl/icav brchtx CPT 77772 | not published | not published | $646.42 – $646.42 | 1 |
| Hdr rdncl skn surf brachytx CPT 77767 | not published | not published | $173.55 – $173.55 | 1 |
| Hdr rdncl skn surf brachytx CPT 77768 | not published | not published | $285.66 – $285.66 | 1 |
| Head CT scan (with and without contrast) CPT 70470 | $1,065.14 | $2,878.75 | $80.04 – $129.34 | 2 |
| Head CT scan (with contrast) CPT 70460 | $883.28 | $2,387.25 | $71.19 – $106.71 | 2 |
| Head CT scan (without contrast) CPT 70450 | $891.79 | $2,410.25 | $53.78 – $74.01 | 2 |
| Heart first pass add-on CPT 78496 | not published | not published | $20.85 – $33.20 | 2 |
| Heart first pass multiple CPT 78483 | not published | not published | $99.49 – $180.74 | 2 |
| Heart image spect CPT 78494 | not published | not published | $77.59 – $175.71 | 2 |
| Heart infarct image CPT 78466 | not published | not published | $44.79 – $169.24 | 2 |
| Heart infarct image (ef) CPT 78468 | not published | not published | $53.14 – $163.85 | 2 |
| Heart tmr w/other procedure 33141 CPT 33141 | not published | not published | $150.23 – $180.43 | 2 |
| Heinz bodies direct CPT 85441 | not published | not published | $4.43 – $6.54 | 2 |
| Helicobacter pylori antibody igm CPT 86677 | $65.49 | $177.00 | $15.37 – $22.59 | 2 |
| Hemagglutination inhibition CPT 86280 | not published | not published | $8.60 – $12.76 | 2 |
| Hematocrit CPT 85014 | $19.24 | $52.00 | $2.61 – $3.69 | 2 |
| Hematopoietic nuclear tx CPT 79403 | $1,555.57 | $4,204.25 | $84.09 – $112.12 | 2 |
| Hemiepiphyseal arrest CPT 24470 | not published | not published | $690.12 – $736.58 | 2 |
| Hemodialysis one evaluation CPT 90935 | not published | not published | $80.46 – $81.49 | 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.