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 |
|---|---|---|---|---|
| Intraoral i+d tongue/floor lingual 41000 CPT 41000 | not published | not published | $119.62 – $124.12 | 2 |
| Intrapul surf admin endo tube CPT 94610 | $100.64 | $272.00 | $62.75 – $76.78 | 2 |
| Intrauterine transfusion ftl CPT 36460 | not published | not published | $389.66 – $408.26 | 2 |
| Intraventricular pacing CPT 93612 | not published | not published | $71.59 – $8,949.00 | 2 |
| Intrinsic factor antibody CPT 86340 | $59.66 | $161.25 | $15.90 – $23.47 | 2 |
| Intrm oph exam est patient CPT 92012 | not published | not published | $56.88 – $58.34 | 2 |
| Intro cath dialysis circuit CPT 36901 | not published | not published | $165.15 – $165.15 | 1 |
| Intro cath dialysis circuit w/pta CPT 36902 | not published | not published | $246.16 – $246.16 | 1 |
| Intro cath dialysis circuit w/stent plcmnt CPT 36903 | not published | not published | $337.07 – $337.07 | 1 |
| Intro catheter aorta CPT 36200 | not published | not published | $160.69 – $190.90 | 2 |
| Intro cath svc/ivc CPT 36010 | not published | not published | $125.35 – $153.29 | 2 |
| Intro long gi tube CPT 44500 | $481.00 | $1,300.00 | $22.02 – $31.03 | 2 |
| Intro long gi tube w/mult fluo CPT 74340 | not published | not published | $33.88 – $33.88 | 1 |
| Intro windpipe wire/tube CPT 31730 | not published | not published | $169.30 – $174.07 | 2 |
| Intrvasc Ultrasound noncoronary 1st vessel CPT 37252 | not published | not published | $105.59 – $105.59 | 1 |
| Intrvasc Ultrasound noncoronary addl vessel CPT 37253 | not published | not published | $85.13 – $85.13 | 1 |
| Intubation endotracheal emergency procedure CPT 31500 | $263.53 | $712.25 | $132.58 – $160.91 | 2 |
| Io anal gast n-stim subsq CPT 95981 | not published | not published | $19.44 – $19.79 | 2 |
| Io ga n-stim subsq w/reprog CPT 95982 | not published | not published | $39.92 – $40.55 | 2 |
| Ionm in operatng room 15 min CPT 95940 | $82.79 | $223.75 | $36.33 – $36.33 | 1 |
| Iron CPT 83540 | $70.67 | $191.00 | $6.78 – $8.67 | 2 |
| Iron binding capacity CPT 83550 | $24.14 | $65.25 | $9.12 – $13.61 | 2 |
| Iron stain peripheral blood CPT 85536 | not published | not published | $6.78 – $10.07 | 2 |
| Irradiation of blood product each unit reference CPT 86945 | $71.04 | $192.00 | $15.37 – $15.37 | 1 |
| Irrigation implantable venous access device for drug delivery systems CPT 96523 | $100.36 | $271.25 | $25.34 – $28.07 | 2 |
| Irrigation sphenoid sinus CPT 31002 | not published | not published | $203.60 – $211.27 | 2 |
| Irrigation vagina and/or appl medicament tx disease CPT 57150 | not published | not published | $32.51 – $35.02 | 2 |
| Island pedicle flap graft CPT 15740 | not published | not published | $934.03 – $940.79 | 2 |
| Ivc venogram s&i CPT 75825 | not published | not published | $71.85 – $80.12 | 2 |
| IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour CPT 96367 | $75.94 | $205.25 | $32.19 – $39.18 | 2 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $71.87 | $194.25 | $21.67 – $23.49 | 2 |
| IV infusion therapy/prophylaxis/diagnosis each additional 1 hour CPT 96366 | $67.62 | $182.75 | $19.92 – $25.16 | 2 |
| IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour CPT 96365 | $229.40 | $620.00 | $71.10 – $76.87 | 2 |
| IV inj ra drug dx study CPT 78808 | $145.60 | $393.50 | $46.88 – $49.87 | 2 |
| IV njx tst vasc flo flap/grf CPT 15860 | not published | not published | $123.52 – $128.06 | 2 |
| Ivp w/nephrotomography CPT 74415 | $322.92 | $872.75 | $30.74 – $113.18 | 2 |
| Ivp w/wo kub w/wo tomography CPT 74400 | $330.32 | $892.75 | $30.74 – $86.59 | 2 |
| Jak2 targeted sequence analysis CPT 81279 | $215.62 | $582.75 | $210.20 – $210.20 | 1 |
| Jaw arthroscopy/surgery CPT 29800 | not published | not published | $563.45 – $578.92 | 2 |
| Jaw arthroscopy/surgery CPT 29804 | not published | not published | $702.42 – $710.54 | 2 |
| Jejunstmy tube plcmt CPT 44372 | not published | not published | $275.12 – $298.69 | 2 |
| John cunningham antibody CPT 86711 | not published | not published | $22.40 – $22.40 | 1 |
| J-tube placement CPT 44015 | not published | not published | $161.78 – $164.22 | 2 |
| Keratoprosthesis CPT 65770 | not published | not published | $1,435.01 – $1,523.66 | 2 |
| Ketogenic steroids fract CPT 83582 | not published | not published | $14.85 – $22.06 | 2 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $64.10 | $173.25 | $8.60 – $12.72 | 2 |
| Kidney endoscopy CPT 50551 | not published | not published | $333.78 – $378.27 | 2 |
| Kidney endoscopy CPT 50553 | not published | not published | $354.71 – $399.85 | 2 |
| Kidney endoscopy CPT 50570 | not published | not published | $560.01 – $634.60 | 2 |
| Kidney endoscopy CPT 50575 | not published | not published | $812.30 – $923.16 | 2 |
| Kidney endoscopy & biopsy CPT 50555 | not published | not published | $386.82 – $437.69 | 2 |
| Kidney endoscopy & biopsy CPT 50574 | not published | not published | $642.24 – $729.69 | 2 |
| Kidney endoscopy & treatment CPT 50557 | not published | not published | $392.65 – $444.49 | 2 |
| Kidney endoscopy & treatment CPT 50561 | not published | not published | $446.97 – $507.97 | 2 |
| Kidney endoscopy & treatment CPT 50576 | not published | not published | $640.66 – $728.57 | 2 |
| Kidney endoscopy & treatment CPT 50580 | not published | not published | $690.55 – $780.80 | 2 |
| Kidney function study CPT 78725 | not published | not published | $23.59 – $93.07 | 2 |
| Kidney imaging morphology CPT 78700 | $769.51 | $2,079.75 | $28.46 – $157.38 | 2 |
| Kidney imag w/bld flow multi CPT 78709 | $1,257.54 | $3,398.75 | $89.00 – $312.95 | 2 |
| Kidney img w/bldflw sgl without rx CPT 78707 | $782.83 | $2,115.75 | $60.53 – $196.55 | 2 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $400.16 | $1,081.50 | $46.34 – $77.97 | 2 |
| Kit gene analys d816 variant CPT 81273 | $269.27 | $727.75 | $142.71 – $142.71 | 1 |
| Kit sound processor cochlear osia 2 HCPCS L8691 | $22,008.58 | $59,482.65 | $4,499.08 – $4,499.08 | 1 |
| Knee Arthroscopy (Cartilage Repair) CPT 29877 | not published | not published | $670.83 – $683.10 | 2 |
| Knee arthroscopy/drainage CPT 29871 | not published | not published | $556.58 – $564.88 | 2 |
| Knee arthroscopy dx CPT 29870 | not published | not published | $441.53 – $450.37 | 2 |
| Knee Arthroscopy (Meniscus Repair) CPT 29881 | not published | not published | $593.82 – $698.99 | 2 |
| Knee arthroscopy/surgery CPT 29850 | not published | not published | $629.11 – $667.53 | 2 |
| Knee arthroscopy/surgery CPT 29851 | not published | not published | $998.63 – $1,035.07 | 2 |
| Knee arthroscopy/surgery CPT 29873 | not published | not published | $552.05 – $570.90 | 2 |
| Knee arthroscopy/surgery CPT 29874 | not published | not published | $584.72 – $590.65 | 2 |
| Knee arthroscopy/surgery CPT 29875 | not published | not published | $538.28 – $543.18 | 2 |
| Knee arthroscopy/surgery CPT 29876 | not published | not published | $709.77 – $723.70 | 2 |
| Knee arthroscopy/surgery CPT 29879 | not published | not published | $718.77 – $728.91 | 2 |
| Knee arthroscopy/surgery CPT 29880 | not published | not published | $617.52 – $751.06 | 2 |
| Knee arthroscopy/surgery CPT 29882 | not published | not published | $758.58 – $772.95 | 2 |
| Knee arthroscopy/surgery CPT 29883 | not published | not published | $927.09 – $932.05 | 2 |
| Knee arthroscopy/surgery CPT 29884 | not published | not published | $668.80 – $674.97 | 2 |
| Knee arthroscopy/surgery CPT 29886 | not published | not published | $684.31 – $698.47 | 2 |
| Knee arthroscopy/surgery CPT 29887 | not published | not published | $808.20 – $814.41 | 2 |
| Knee arthroscopy/surgery CPT 29888 | not published | not published | $1,090.38 – $1,101.97 | 2 |
| Knee arthroscopy/surgery CPT 29889 | not published | not published | $1,344.84 – $1,351.23 | 2 |
| Knee MRI (with and without contrast) CPT 73723 | $1,070.87 | $2,894.25 | $135.23 – $366.83 | 2 |
| Knee MRI (with contrast) CPT 73722 | $1,113.05 | $3,008.25 | $101.93 – $303.24 | 2 |
| Knee MRI (without contrast) CPT 73721 | $1,953.60 | $5,280.00 | $84.59 – $170.67 | 2 |
| Knee X-ray CPT 73564 | $303.22 | $819.50 | $13.80 – $28.75 | 2 |
| Kras gene addl variants CPT 81276 | $128.52 | $347.35 | $225.38 – $225.38 | 1 |
| Kras gene variants exon 2 CPT 81275 | $128.52 | $347.35 | $225.38 – $225.38 | 1 |
| Lab draw < 3 yrs fem/jugular 36400 CPT 36400 | $77.89 | $210.50 | $20.54 – $21.89 | 2 |
| Lab draw <3 yrs scalp vein 36405 CPT 36405 | not published | not published | $18.41 – $19.00 | 2 |
| Labioplasty 56800 CPT 56800 | not published | not published | $265.71 – $279.09 | 2 |
| Lactate dehydrogenase (ldh) CPT 83615 | $27.84 | $75.25 | $6.25 – $9.40 | 2 |
| Lactic acid CPT 83605 | $163.91 | $443.00 | $11.20 – $16.63 | 2 |
| Lactoferrin fecal qualitative CPT 83630 | not published | not published | $20.59 – $30.57 | 2 |
| Lactoferrin fecal quant CPT 83631 | not published | not published | $20.59 – $30.57 | 2 |
| Lam facetec & foramot crv CPT 63045 | not published | not published | $1,372.47 – $1,440.98 | 2 |
| Lam facetec & foramot lumbar CPT 63047 | not published | not published | $1,194.65 – $1,229.15 | 2 |
| Lam facetec & foramot thrc CPT 63046 | not published | not published | $1,311.87 – $1,365.16 | 2 |
| Lamie bx/exc idrl spine lesn lmbr 63282 CPT 63282 | not published | not published | $2,131.47 – $2,215.50 | 2 |
| Lamie bx/exc idrl spine lesn thrc 63281 CPT 63281 | not published | not published | $2,259.68 – $2,356.52 | 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.