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 |
|---|---|---|---|---|
| Incision of urethra CPT 53020 | not published | not published | $109.61 – $123.48 | 2 |
| Incision of urethra CPT 53025 | not published | not published | $79.92 – $80.84 | 2 |
| Incision of windpipe CPT 31601 | not published | not published | $240.74 – $304.43 | 2 |
| Incision of windpipe CPT 31610 | not published | not published | $775.24 – $778.69 | 2 |
| Incision of wrist capsule CPT 25085 | not published | not published | $488.82 – $496.83 | 2 |
| Incision secondary cataract CPT 66820 | not published | not published | $389.12 – $420.44 | 2 |
| Incision tendon sheath CPT 26055 | not published | not published | $307.53 – $333.69 | 2 |
| Incisn of toe tndn CPT 28010 | not published | not published | $230.02 – $238.55 | 2 |
| Incisn windpipe CPT 31600 | not published | not published | $447.18 – $464.11 | 2 |
| Induced ab 1+vag supp d&c CPT 59856 | not published | not published | $546.20 – $559.00 | 2 |
| Induced ab 1+ vag sup w/dlv fetus CPT 59855 | not published | not published | $463.60 – $472.08 | 2 |
| Induced abortion d&c CPT 59840 | not published | not published | $230.22 – $237.72 | 2 |
| Induced abortion dilat&evac CPT 59841 | not published | not published | $403.30 – $406.01 | 2 |
| Infect ag drug suscept pheno predict CPT 87900 | $158.55 | $428.50 | $82.44 – $147.95 | 2 |
| Infect ag eia chlamydia trachomatis CPT 87320 | not published | not published | $12.77 – $18.66 | 2 |
| Infect ag eia influenza a or b ea CPT 87400 | not published | not published | $12.77 – $18.66 | 2 |
| Infect ag genotype na cytomegalovirus CPT 87910 | $358.99 | $970.25 | $400.83 – $400.83 | 1 |
| Infect ag genotype na dna hepatitis b CPT 87912 | $202.30 | $546.75 | $400.83 – $400.83 | 1 |
| Infect ag genotype na hiv-1 other region CPT 87906 | $310.41 | $838.95 | $146.11 – $146.11 | 1 |
| Infect ag genotype na hiv-1 revr trn/prt CPT 87901 | $367.32 | $992.75 | $164.88 – $292.21 | 2 |
| Infect ag ia direct hiv-1 antgn CPT 87806 | not published | not published | $37.49 – $37.49 | 1 |
| Infect ag ia optc obs chlamydia trach CPT 87810 | not published | not published | $12.77 – $18.66 | 2 |
| Infect ag ia optc obs influenza CPT 87804 | $65.58 | $177.25 | $12.77 – $18.66 | 2 |
| Infect ag if ea plyvlnt antsrm CPT 87300 | $18.78 | $50.75 | $12.77 – $18.66 | 2 |
| Infect ag if hep delta agent CPT 87380 | $78.26 | $211.50 | $17.20 – $25.55 | 2 |
| Infect ag if influenza a CPT 87276 | $40.61 | $109.75 | $12.77 – $18.66 | 2 |
| Infect ag if influenza b CPT 87275 | $43.38 | $117.25 | $12.77 – $18.66 | 2 |
| Infect ag if legionella pneumophila CPT 87278 | $64.75 | $175.00 | $12.77 – $18.66 | 2 |
| Infect ag if nos ea CPT 87299 | $60.40 | $163.25 | $12.77 – $18.66 | 2 |
| Infect ag if pneumocystis carinii CPT 87281 | $56.15 | $151.75 | $12.77 – $18.66 | 2 |
| Infect ag if varicella zoster CPT 87290 | not published | not published | $12.77 – $18.66 | 2 |
| Infect ag na chlamydia trachomatis qnt CPT 87492 | not published | not published | $19.90 – $24.97 | 2 |
| Infect ag na hep b amp CPT 87516 | not published | not published | $37.00 – $54.64 | 2 |
| Infect ag na herpes simplex quant CPT 87530 | $190.46 | $514.75 | $45.08 – $66.69 | 2 |
| Infect ag na hpv high-risk types CPT 87624 | $136.25 | $368.25 | $54.64 – $54.64 | 1 |
| Infect ag na influenza r/amp 1st 2 types CPT 87502 | $294.06 | $794.75 | $132.49 – $132.49 | 1 |
| Infect ag na influenza revr/amp ea type CPT 87501 | $121.55 | $328.50 | $79.89 – $79.89 | 1 |
| Infect ag na resp virus 12-25 targets CPT 87633 | $336.15 | $908.50 | $648.90 – $648.90 | 1 |
| Infect ag phenotype na hiv-1 1-10 drugs CPT 87903 | not published | not published | $515.43 – $760.80 | 2 |
| Infect ag phenotype na hiv-1 ea addl drg CPT 87904 | not published | not published | $27.62 – $40.59 | 2 |
| Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin CPT 87324 | $40.70 | $110.00 | $12.77 – $18.66 | 2 |
| Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans CPT 87327 | $51.15 | $138.25 | $12.77 – $18.66 | 2 |
| Infectious agent antigen immunoassay ql/sq multi step cryptosporidium CPT 87328 | $43.38 | $117.25 | $12.77 – $18.66 | 2 |
| Infectious agent antigen immunoassay ql/sq multi step giardia CPT 87329 | $44.77 | $121.00 | $12.77 – $18.66 | 2 |
| Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool CPT 87338 | $112.85 | $305.00 | $11.90 – $14.93 | 2 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn CPT 87340 | $35.80 | $96.75 | $10.94 – $16.08 | 2 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization CPT 87341 | $21.46 | $58.00 | $10.94 – $16.08 | 2 |
| Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies CPT 87389 | $32.28 | $87.25 | $37.49 – $37.49 | 1 |
| Infectious agent antigen immunoassay ql/sq multi step legionella urine CPT 87449 | $98.51 | $266.25 | $12.77 – $18.66 | 2 |
| Infectious agent antigen immunoassay ql/sq multi step rotavirus CPT 87425 | $71.41 | $193.00 | $12.77 – $18.66 | 2 |
| Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin CPT 87427 | not published | not published | $12.77 – $18.66 | 2 |
| Infectious agent nucleic acid amplified probe CPT 87798 | $386.17 | $1,043.70 | $25.85 – $39.83 | 2 |
| Infectious agent nucleic acid amplified probe chlamydia trachomatis CPT 87491 | $92.04 | $248.75 | $37.00 – $54.64 | 2 |
| Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s) CPT 87493 | $77.42 | $209.25 | $54.64 – $54.64 | 1 |
| Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets CPT 87483 | $372.96 | $1,008.00 | $473.05 – $473.05 | 1 |
| Infectious agent nucleic acid amplified probe hsv-1 CPT 87529 | $157.62 | $426.00 | $37.00 – $54.64 | 2 |
| Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus CPT 87641 | $13.60 | $36.75 | $18.38 – $54.64 | 2 |
| Infectious agent nucleic acid amplified probe mycobacteria tuberculosis CPT 87556 | $165.58 | $447.50 | $37.00 – $54.64 | 2 |
| Infectious agent nucleic acid amplified probe neisseria gonorrhoeae CPT 87591 | $92.04 | $248.75 | $37.00 – $54.64 | 2 |
| Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 CPT 87635 | $37.46 | $101.25 | $51.31 – $51.31 | 1 |
| Infectious agent nucleic acid amplified probe streptococcus group a CPT 87651 | not published | not published | $37.00 – $54.64 | 2 |
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | $58.74 | $158.75 | $54.64 – $54.64 | 1 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | $462.63 | $1,250.34 | $648.90 – $648.90 | 1 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets CPT 87505 | not published | not published | $199.74 – $199.74 | 1 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets CPT 87506 | not published | not published | $332.29 – $332.29 | 1 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | $197.40 | $533.50 | $45.08 – $66.69 | 2 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | $203.50 | $550.00 | $45.08 – $66.69 | 2 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $222.28 | $600.75 | $45.08 – $66.69 | 2 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $200.08 | $540.75 | $89.64 – $132.49 | 2 |
| Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets CPT 87631 | $443.35 | $1,198.25 | $199.74 – $199.74 | 1 |
| Influenza dna amp prob addl CPT 87503 | $75.80 | $204.87 | $32.34 – $32.34 | 1 |
| Influenza virus vaccine, live trivalent intranasal CPT 90660 | not published | not published | $24.55 – $24.55 | 1 |
| Infratemporal approach/skull CPT 61591 | not published | not published | $3,435.80 – $3,436.03 | 2 |
| Infuse radioactive materials CPT 77750 | not published | not published | $100.10 – $115.71 | 2 |
| Ingest challenge ea addl 60 min CPT 95079 | not published | not published | $74.93 – $74.93 | 1 |
| Ingest challenge ini 120 min CPT 95076 | not published | not published | $81.98 – $81.98 | 1 |
| Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis CPT 94642 | not published | not published | $46.96 – $46.96 | 1 |
| Initial hosp neonate 28 d/less than not critically ill 99477 CPT 99477 | not published | not published | $393.24 – $419.31 | 2 |
| Initial nursing facility care/day 35 minutes CPT 99305 | not published | not published | $138.99 – $143.61 | 2 |
| Initial nursing facility care/day 45 minutes CPT 99306 | not published | not published | $178.78 – $184.06 | 2 |
| Initial nursing facility care/day low severity 99304 CPT 99304 | not published | not published | $99.28 – $100.65 | 2 |
| Initiation & management bipap/cpap initial day CPT 94660 | $103.69 | $280.25 | $42.86 – $44.78 | 2 |
| Inj, clevidipine butyrate HCPCS C9248 | $17.45 | $47.16 | $6.67 – $6.67 | 1 |
| Inj disk cerv-thor ea lev CPT 62291 | not published | not published | $189.48 – $190.71 | 2 |
| Inj dupuytren cord w/enzyme CPT 20527 | not published | not published | $73.92 – $73.92 | 1 |
| Inj dx for sinogram CPT 20501 | $139.12 | $376.00 | $43.22 – $48.37 | 2 |
| Injection arthrography hip without anesthesia (both sides) CPT 27093 | $212.66 | $574.75 | $78.93 – $84.70 | 2 |
| Injection carpal tunnel therapeutic (both sides) CPT 20526 | $424.02 | $1,146.00 | $64.28 – $65.83 | 2 |
| Injection during cath supravalvular aortography CPT 93567 | not published | not published | $59.79 – $59.79 | 1 |
| Injection epidural blood patch or clot CPT 62273 | $402.84 | $1,088.75 | $127.60 – $129.74 | 2 |
| Injection eye drug CPT 67028 | not published | not published | $109.39 – $175.88 | 2 |
| Injection for arthrography wrist (both sides) CPT 25246 | $175.29 | $473.75 | $85.03 – $92.15 | 2 |
| Injection for bladder x-ray CPT 51600 | $128.95 | $348.50 | $50.28 – $56.57 | 2 |
| Injection for hip x-ray CPT 27095 | $202.48 | $547.25 | $93.58 – $96.76 | 2 |
| Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides) CPT 23350 | $141.06 | $381.25 | $57.68 – $63.40 | 2 |
| Injection for spleen x-ray CPT 38200 | not published | not published | $153.69 – $166.95 | 2 |
| Injection for tear sac x-ray CPT 68850 | not published | not published | $61.74 – $64.19 | 2 |
| Injection for ureter x-ray CPT 50684 | not published | not published | $56.16 – $61.41 | 2 |
| Injection for ureter x-ray CPT 50690 | $99.81 | $269.75 | $78.95 – $87.13 | 2 |
| Injection into brain canal CPT 61026 | $459.45 | $1,241.75 | $116.83 – $142.74 | 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.