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 |
|---|---|---|---|---|
| Mayo brcmg brucella antibody igm CPT 86622 | $92.50 | $250.00 | $9.38 – $13.90 | 2 |
| Mayo c1 esterase inhibitor CPT 83883 | $47.18 | $127.50 | $14.33 – $21.17 | 2 |
| Mayo carnitine total and free quantitative each specimen plasma CPT 82379 | $106.93 | $289.00 | $17.72 – $26.26 | 2 |
| Mayo cd20b mononuclear cell antigen nos quantitative each CPT 86356 | $121.46 | $328.26 | $28.14 – $41.69 | 2 |
| Mayo cdcom hla class ii typing low resolution one locus each CPT 81376 | not published | not published | $190.29 – $190.29 | 1 |
| Mayo ceruloplasmin CPT 82390 | $44.22 | $119.50 | $11.20 – $16.72 | 2 |
| Mayo chemiluminescent parathyroid related peptide CPT 82397 | $97.59 | $263.75 | $14.85 – $21.98 | 2 |
| Mayo chikv chikungunya antibodies igg CPT 86790 | $170.94 | $462.00 | $13.55 – $17.83 | 2 |
| Mayo chlap chlamydia pneumoniae antibody igg CPT 86631 | $59.11 | $159.75 | $12.51 – $18.41 | 2 |
| Mayo chlap chlamydia pneumoniae antibody igm CPT 86632 | $53.65 | $145.00 | $13.29 – $19.75 | 2 |
| Mayo chrcb tissue culture non-neoplastic disorders lymphocyte CPT 88230 | $346.32 | $936.00 | $122.99 – $181.37 | 2 |
| Mayo chromium CPT 82495 | $134.22 | $362.75 | $21.37 – $31.58 | 2 |
| Mayo coccidioides antibody CPT 86635 | $58.37 | $157.75 | $11.99 – $17.86 | 2 |
| Mayo cocou cortisone urine CPT 82542 | $195.82 | $529.25 | $19.02 – $28.11 | 2 |
| Mayo cortisol free CPT 82530 | $120.34 | $325.25 | $17.72 – $26.01 | 2 |
| Mayo coxiella brunetii (q fever) igg antibody CPT 86638 | $79.83 | $215.75 | $12.77 – $18.88 | 2 |
| Mayo cyanide CPT 82600 | $71.97 | $194.50 | $20.59 – $30.20 | 2 |
| Mayo cytopathology in situ hybridization urinary tract 3-5 probes each specimen manual CPT 88120 | not published | not published | $580.96 – $580.96 | 1 |
| Mayo deoxyribonuclease antibody titer CPT 86215 | $43.75 | $118.25 | $14.07 – $20.62 | 2 |
| Mayo dhea (dehydroepiandrosterone) CPT 82626 | $117.85 | $318.50 | $26.58 – $39.35 | 2 |
| Mayo dihydrotestosterone CPT 82642 | $93.98 | $254.00 | $33.23 – $33.23 | 1 |
| Mayo dipstick analyte single step qualitative/semiqualitative synovial fluid CPT 83518 | not published | not published | $8.86 – $13.20 | 2 |
| Mayo efpo chloride stool CPT 82438 | $62.62 | $169.25 | $5.21 – $7.60 | 2 |
| Mayo estriol CPT 82677 | $98.70 | $266.75 | $25.54 – $37.65 | 2 |
| Mayo estrone CPT 82679 | $75.20 | $203.25 | $26.32 – $38.85 | 2 |
| Mayo ethosuximide therapeutic drug level CPT 80168 | $66.51 | $179.75 | $17.20 – $25.44 | 2 |
| Mayo everolimus therapeutic drug level CPT 80169 | $75.85 | $205.00 | $21.38 – $21.38 | 1 |
| Mayo factor ii CPT 85210 | $96.76 | $261.50 | $13.81 – $20.21 | 2 |
| Mayo factor v CPT 85220 | $104.16 | $281.50 | $18.50 – $27.48 | 2 |
| Mayo factor vii CPT 85230 | $97.22 | $262.75 | $18.76 – $27.88 | 2 |
| Mayo factor viii vw factor antigen CPT 85246 | $100.46 | $271.50 | $24.23 – $35.72 | 2 |
| Mayo factor viii vw factor multimetric analysis CPT 85247 | $147.63 | $399.00 | $24.23 – $35.72 | 2 |
| Mayo factor viii vw factor ristocetin cofactor CPT 85245 | $92.41 | $249.75 | $24.23 – $35.72 | 2 |
| Mayo factor x CPT 85260 | $103.69 | $280.25 | $18.76 – $27.88 | 2 |
| Mayo factor xi CPT 85270 | $97.68 | $264.00 | $18.76 – $27.88 | 2 |
| Mayo fat/lipids feces quantitative CPT 82710 | $70.67 | $191.00 | $17.72 – $26.16 | 2 |
| Mayo fbl culture fungi blood CPT 87103 | $45.70 | $123.50 | $9.64 – $14.04 | 2 |
| Mayo fdp/fsp paracoagulation CPT 85366 | not published | not published | $9.12 – $13.42 | 2 |
| Mayo ffspg allergen clam igg CPT 86001 | $22.66 | $61.25 | $5.47 – $8.13 | 2 |
| Mayo fibrinogen antigen CPT 85385 | $71.87 | $194.25 | $8.86 – $13.22 | 2 |
| Mayo gabapentin bld/srm/plasma therapeutic drug level CPT 80171 | $70.39 | $190.25 | $20.63 – $20.63 | 1 |
| Mayo hemosiderin qualitative urine CPT 83070 | $27.01 | $73.00 | $4.95 – $7.39 | 2 |
| Mayo hip12 infectious agent nucleic acid amplified probe hiv-1 rna qualitative CPT 87535 | $170.57 | $461.00 | $37.00 – $54.64 | 2 |
| Mayo hip12 infectious agent nucleic acid amplified probe hiv-2 CPT 87538 | $158.64 | $428.75 | $37.00 – $54.64 | 2 |
| Mayo hiser histoplasma antibodies immunodiffusion CPT 86698 | $36.82 | $99.50 | $13.29 – $19.45 | 2 |
| Mayo hla typing a/b/c single antigen CPT 86812 | not published | not published | $27.10 – $38.95 | 2 |
| Mayo hvdip HIV 1 antibody CPT 86701 | $16.28 | $44.00 | $9.38 – $13.84 | 2 |
| Mayo hvdip HIV 2 antibody CPT 86702 | $22.02 | $59.50 | $14.33 – $21.04 | 2 |
| Mayo hydroxyprogesterone 17-d CPT 83498 | $106.65 | $288.25 | $28.66 – $42.30 | 2 |
| Mayo immunoassay c1 esterase inhibitor antibody quantitative CPT 83520 | $229.31 | $619.75 | $13.55 – $20.16 | 2 |
| Mayo immunoassay infectious agent antibody quantitative diptheria igg CPT 86317 | $95.46 | $258.00 | $15.90 – $23.34 | 2 |
| Mayo immunoassay tumor antigen quantitative ca 27.29 CPT 86300 | $71.87 | $194.25 | $21.89 – $32.40 | 2 |
| Mayo immunoassay tumor antigen quantitative chromogranin a CPT 86316 | $172.70 | $466.75 | $21.89 – $32.40 | 2 |
| Mayo infectious agent antigen immunoassay direct optical observation cryptococcus CPT 87899 | $28.21 | $76.25 | $12.77 – $18.66 | 2 |
| Mayo infectious agent antigen immunoassay ql/sq multi step aspergillus bal CPT 87305 | $150.13 | $405.75 | $12.77 – $18.66 | 2 |
| Mayo infectious agent nucleic acid amplified probe enterovirus CPT 87498 | $219.13 | $592.25 | $37.00 – $54.64 | 2 |
| Mayo infectious agent nucleic acid amplified probe mycoplasma genitalium urine CPT 87563 | $44.81 | $121.10 | $39.83 – $39.83 | 1 |
| Mayo infectious agent nucleic acid amplified probe mycoplasma pneumoniae CPT 87581 | $225.15 | $608.50 | $37.00 – $54.64 | 2 |
| Mayo infectious agent nucleic acid quantification cytomegalovirus CPT 87497 | $197.58 | $534.00 | $45.08 – $66.69 | 2 |
| Mayo infectious disease hepatitis c chronic six biochemical assays CPT 81596 | $146.89 | $397.00 | $81.94 – $81.94 | 1 |
| Mayo infliximab therapeutic drug level CPT 80230 | $167.06 | $451.50 | $43.78 – $43.78 | 1 |
| Mayo inhab inhibin a CPT 86336 | $103.23 | $279.00 | $16.42 – $24.27 | 2 |
| Mayo insft insulin free CPT 83527 | $37.74 | $102.00 | $13.55 – $20.16 | 2 |
| Mayo insulin antibodies CPT 86337 | $93.24 | $252.00 | $22.67 – $33.34 | 2 |
| Mayo iodine CPT 83789 | $113.50 | $306.75 | $19.02 – $28.11 | 2 |
| Mayo itraconazole therapeutic drug level CPT 80189 | $77.70 | $210.00 | $30.77 – $30.77 | 1 |
| Mayo lacosamide therapeutic drug level CPT 80235 | $79.27 | $214.25 | $30.77 – $30.77 | 1 |
| Mayo lamotrigine therapeutic drug level CPT 80175 | $73.91 | $199.75 | $20.63 – $20.63 | 1 |
| Mayo ld_i lactate dehydrogenase isoenzymes CPT 83625 | $44.03 | $119.00 | $13.55 – $19.92 | 2 |
| Mayo legionella antibody CPT 86713 | $72.89 | $197.00 | $16.16 – $23.82 | 2 |
| Mayo leptospira antibody igm CPT 86720 | $79.64 | $215.25 | $13.81 – $20.53 | 2 |
| Mayo lipoprotein electrophoresis CPT 83700 | $27.10 | $73.25 | $11.99 – $17.52 | 2 |
| Mayo lywb borrelia burgdorferi (lyme disease) antibody igg confirmatory CPT 86617 | $88.10 | $238.10 | $16.42 – $24.12 | 2 |
| Mayo manganese CPT 83785 | $64.57 | $174.50 | $26.06 – $33.46 | 2 |
| Mayo metanephrines plasma CPT 83835 | $139.31 | $376.50 | $17.98 – $26.38 | 2 |
| Mayo microsomal antibody liver-kidney CPT 86376 | $82.33 | $222.50 | $15.37 – $22.65 | 2 |
| Mayo mitotane (lysodren) therapeutic drug level CPT 80299 | $167.61 | $453.00 | $14.33 – $21.33 | 2 |
| Mayo molecular pathology procedure level 2 apoe genotype CPT 81401 | $990.03 | $2,675.75 | $155.50 – $155.50 | 1 |
| Mayo mpl sequence analysis exon 10 CPT 81339 | not published | not published | $210.20 – $210.20 | 1 |
| Mayo muramidase CPT 85549 | $64.38 | $174.00 | $19.80 – $29.19 | 2 |
| Mayo mycophenolic acid therapeutic drug level CPT 80180 | $70.39 | $190.25 | $28.10 – $28.10 | 1 |
| Mayo myoglobin CPT 83874 | $59.11 | $159.75 | $13.55 – $20.11 | 2 |
| Mayo nickel CPT 83885 | not published | not published | $25.80 – $38.16 | 2 |
| Mayo organic acid methylmalonic single quantitative CPT 83921 | $222.74 | $602.00 | $17.46 – $25.62 | 2 |
| Mayo organic acids qualitative each specimen CPT 83919 | $96.02 | $259.50 | $17.46 – $25.62 | 2 |
| Mayo oxalate 24 hour urine CPT 83945 | $48.31 | $130.58 | $13.55 – $20.04 | 2 |
| Mayo pancreatic elastase fecal qualitative or semi quantitative CPT 82656 | not published | not published | $12.25 – $17.96 | 2 |
| Mayo parvs parvovirus b19 antibody igg CPT 86747 | $43.48 | $117.50 | $15.90 – $23.40 | 2 |
| Mayo paval fluorescent antibody screen agna type 1 CPT 86255 | $377.68 | $1,020.75 | $12.77 – $18.76 | 2 |
| Mayo pborb infectious agent nucleic acid amplified probe borrelia burgdorferi (lyme) CPT 87476 | $184.17 | $497.75 | $37.00 – $54.64 | 2 |
| Mayo phospholipid neutralization hexagonal lupus anticoagulant CPT 85598 | not published | not published | $27.99 – $27.99 | 1 |
| Mayo pntft phenytoin free therapeutic drug level CPT 80186 | $46.62 | $126.00 | $14.59 – $21.43 | 2 |
| Mayo pqnu porphobilinogen urine quantitative 24 hour urine CPT 84110 | $62.53 | $169.00 | $8.86 – $13.14 | 2 |
| Mayo pregnenolone CPT 84140 | not published | not published | $21.89 – $32.19 | 2 |
| Mayo prmb primidone therapeutic drug level CPT 80188 | $66.32 | $179.25 | $17.46 – $25.83 | 2 |
| Mayo proinsulin CPT 84206 | $102.49 | $277.00 | $18.76 – $27.73 | 2 |
| Mayo psaft prostate specific antigen free CPT 84154 | $100.64 | $272.00 | $19.28 – $28.64 | 2 |
| Mayo radioimmunoassay procollagen i intact n-terminal antibody quantitative CPT 83519 | $211.64 | $572.00 | $14.33 – $21.03 | 2 |
| Mayo rbcme osmotic fragility rbc incubated CPT 85557 | not published | not published | $14.07 – $20.79 | 2 |
| Mayo receptor assay transferrin soluble CPT 84238 | $125.34 | $338.75 | $38.57 – $56.93 | 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.