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 |
|---|---|---|---|---|
| Mr elastography CPT 76391 | not published | not published | $179.61 – $179.61 | 1 |
| MRI brain w/dye CPT 70558 | not published | not published | $200.40 – $200.40 | 1 |
| MRI brain without dye CPT 70557 | not published | not published | $183.36 – $183.36 | 1 |
| MRI brain without & w/dye CPT 70559 | not published | not published | $203.38 – $203.38 | 1 |
| MRI breast c- unilateral CPT 77046 | $663.69 | $1,793.75 | $172.28 – $172.28 | 1 |
| MRI breast c-+ w/cad uni CPT 77048 | not published | not published | $283.93 – $283.93 | 1 |
| MRI breast without cont bi CPT 77047 | $869.96 | $2,351.25 | $171.59 – $171.59 | 1 |
| MRI breast w IV cont bi CPT 77049 | not published | not published | $282.54 – $282.54 | 1 |
| MRI cardiac morph & func wo IV cont CPT 75557 | $717.52 | $1,939.25 | $152.98 – $206.23 | 2 |
| MRI cardiac morph & func wwo IV cont CPT 75561 | $884.49 | $2,390.50 | $168.98 – $300.00 | 2 |
| MRI cardiac morph & func wwo IV cont w/stress img CPT 75563 | not published | not published | $201.28 – $363.60 | 2 |
| MRI chest without contrast CPT 71550 | $901.97 | $2,437.75 | $91.34 – $225.99 | 2 |
| MRI chest without & w/contrast CPT 71552 | $1,182.06 | $3,194.75 | $142.78 – $427.19 | 2 |
| MRI chest w IV cont CPT 71551 | $927.41 | $2,506.50 | $108.17 – $379.41 | 2 |
| MRI fetal ea addl gestation CPT 74713 | not published | not published | $141.21 – $141.21 | 1 |
| MRI fetal sngl/1st gestation CPT 74712 | not published | not published | $112.82 – $112.82 | 1 |
| MRI guid ndl plc s&i CPT 77021 | $388.78 | $1,050.75 | $95.29 – $329.82 | 2 |
| MRI guid parenchymal tiss ablation CPT 77022 | not published | not published | $265.24 – $265.24 | 1 |
| MRI loex nonjt w IV cont CPT 73719 | $1,953.60 | $5,280.00 | $101.53 – $265.51 | 2 |
| MRI lower extremity other than joint without contrast (both sides) CPT 73718 | $2,051.28 | $5,544.00 | $84.59 – $226.35 | 2 |
| MRI lower extremity other than joint without & w/contrast (both sides) CPT 73720 | $2,141.75 | $5,788.50 | $135.23 – $399.17 | 2 |
| MRI orbit/face/neck without contrast CPT 70540 | $932.86 | $2,521.25 | $84.59 – $226.35 | 2 |
| MRI orbit/face/neck without & w/contrast CPT 70543 | $1,270.49 | $3,433.75 | $134.83 – $312.58 | 2 |
| MRI orbit fac&nck w IV cont CPT 70542 | $940.26 | $2,541.25 | $101.53 – $260.85 | 2 |
| MRI tmj CPT 70336 | $372.68 | $1,007.25 | $92.97 – $226.35 | 2 |
| MRI upper extremity other than joint without contrast (both sides) CPT 73218 | $1,932.33 | $5,222.50 | $84.19 – $226.35 | 2 |
| MRI upper extremity other than joint without & w/contrast (both sides) CPT 73220 | $2,248.86 | $6,078.00 | $135.23 – $396.65 | 2 |
| MRI upper extremity w/dye CPT 73219 | $1,854.07 | $5,011.00 | $101.53 – $324.08 | 2 |
| Mr spectroscopy CPT 76390 | $442.89 | $1,197.00 | $86.43 – $379.40 | 2 |
| Msh2 gene dup/delete variant CPT 81297 | not published | not published | $173.13 – $173.13 | 1 |
| Msh2 gene full seq CPT 81295 | not published | not published | $173.13 – $173.13 | 1 |
| Msh2 gene known variants CPT 81296 | not published | not published | $147.83 – $147.83 | 1 |
| Msh6 gene dup/delete variant CPT 81300 | not published | not published | $184.52 – $184.52 | 1 |
| Msh6 gene full seq CPT 81298 | not published | not published | $328.48 – $328.48 | 1 |
| Msh6 gene known variants CPT 81299 | not published | not published | $184.02 – $184.02 | 1 |
| Mthfr gene analy common variants CPT 81291 | $383.14 | $1,035.50 | $67.96 – $67.96 | 1 |
| M.tuberculo dna dir probe CPT 87555 | not published | not published | $21.11 – $31.22 | 2 |
| Mucin synovial fluid CPT 83872 | not published | not published | $6.25 – $9.13 | 2 |
| Mucopolysaccharides CPT 83864 | not published | not published | $21.11 – $31.01 | 2 |
| Multi family grp psychotherapy CPT 90849 | not published | not published | $34.47 – $37.02 | 2 |
| Multiple sleep latency test CPT 95805 | not published | not published | $113.11 – $374.05 | 2 |
| Mumps antibody igg CPT 86735 | $45.23 | $122.25 | $13.81 – $20.32 | 2 |
| Muscle-skin graft arm CPT 15736 | not published | not published | $1,261.52 – $1,280.12 | 2 |
| Muscle-skin graft leg CPT 15738 | not published | not published | $1,365.17 – $1,397.70 | 2 |
| Muscle-skin graft trunk CPT 15734 | not published | not published | $1,461.78 – $1,481.96 | 2 |
| Muscle test cran nerv unilat CPT 95867 | $149.11 | $403.00 | $33.06 – $55.69 | 2 |
| Muscle test hemidiaphragm CPT 95866 | not published | not published | $29.98 – $68.63 | 2 |
| Muscle test larynx CPT 95865 | not published | not published | $33.96 – $62.52 | 2 |
| Muscle test one fiber CPT 95872 | not published | not published | $28.97 – $42.76 | 2 |
| Muscle transfers CPT 23397 | not published | not published | $1,264.32 – $1,273.88 | 2 |
| Muscle transfer shoulder/arm CPT 23395 | not published | not published | $1,416.72 – $1,420.24 | 2 |
| Musc/tdn transfer upr a/e 1 CPT 24301 | not published | not published | $823.98 – $824.85 | 2 |
| Mycobacteria dna amp probe CPT 87551 | $145.04 | $392.00 | $37.00 – $54.64 | 2 |
| Mycoplasma antibody igm CPT 86738 | $25.35 | $68.50 | $14.07 – $20.61 | 2 |
| Myd88 gene p.leu265pro vrnt CPT 81305 | $275.65 | $745.00 | $199.08 – $199.08 | 1 |
| Myelogphy 2/> spine regions CPT 72270 | $542.14 | $1,465.25 | $60.72 – $83.65 | 2 |
| Myelography l-s spine CPT 72265 | $482.85 | $1,305.00 | $51.38 – $52.05 | 2 |
| Myelography neck spine CPT 72240 | $436.60 | $1,180.00 | $53.54 – $56.99 | 2 |
| Myelography thoracic spine CPT 72255 | $464.81 | $1,256.25 | $52.46 – $55.80 | 2 |
| Myelography via inj w/s&i 2+ regions CPT 62305 | $911.87 | $2,464.50 | $142.23 – $142.23 | 1 |
| Myelography via inj w/s&i cervical CPT 62302 | $690.14 | $1,865.25 | $138.70 – $138.70 | 1 |
| Myelography via inj w/s&i lumbosacral CPT 62304 | $849.61 | $2,296.25 | $135.98 – $135.98 | 1 |
| Myelography via inj w/s&i thoracic CPT 62303 | $715.86 | $1,934.75 | $139.78 – $139.78 | 1 |
| Myeloperoxidase ab multi step qualitative/semiquantitative CPT 83516 | $295.72 | $799.25 | $12.25 – $17.96 | 2 |
| Myocardial resection 33542 CPT 33542 | not published | not published | $2,976.58 – $3,053.41 | 2 |
| Myocrd img pet 1std rst/strs CPT 78491 | not published | not published | $98.80 – $98.80 | 1 |
| Myocrd img pet mlt rst&strs CPT 78492 | not published | not published | $124.41 – $124.41 | 1 |
| Myomectomy abdom complex CPT 58146 | not published | not published | $1,277.60 – $1,341.49 | 2 |
| Myomectomy abdom method CPT 58140 | not published | not published | $1,017.31 – $1,051.79 | 2 |
| Myomectomy vag method CPT 58145 | not published | not published | $604.16 – $620.13 | 2 |
| Myringoplasty CPT 69620 | not published | not published | $531.16 – $531.34 | 2 |
| Narcosynthesis CPT 90865 | not published | not published | $143.78 – $165.78 | 2 |
| Nasal endoscopy dx uni/bi separate proc CPT 31231 | $139.12 | $376.00 | $72.22 – $86.50 | 2 |
| Nasal endoscopy with removal of nasal foreign body CPT 30999 | not published | not published | not published | 0 |
| Nasal function studies CPT 92512 | not published | not published | $31.77 – $33.95 | 2 |
| Nasal/sinus endoscopy surg CPT 31287 | not published | not published | $257.76 – $272.51 | 2 |
| Nasal/sinus endoscopy surg w/bx 31237 CPT 31237 | not published | not published | $178.39 – $210.12 | 2 |
| Nasal/sinus endo spendt remove tiss 31288 CPT 31288 | not published | not published | $299.08 – $316.27 | 2 |
| Nasal/sinus endo surg w/concha bullosa resct 31240 CPT 31240 | not published | not published | $178.09 – $186.42 | 2 |
| Nasal/sinus endo w/ethmoidectomy part 31254 CPT 31254 | not published | not published | $303.75 – $320.45 | 2 |
| Nasal/sinus endo w/ethmoidectomy tot 31255 CPT 31255 | not published | not published | $445.50 – $474.06 | 2 |
| Nasal/sinus endo w/front sinus expl 31276 CPT 31276 | not published | not published | $562.20 – $598.15 | 2 |
| Nasal/sinus maxillary endoscopy dx 31233 CPT 31233 | not published | not published | $151.18 – $157.51 | 2 |
| Nasal/sinus sphenoid endoscopy dx 31235 CPT 31235 | not published | not published | $178.93 – $188.41 | 2 |
| Nasal sinus therapy CPT 30210 | not published | not published | $105.63 – $107.22 | 2 |
| Nasopharyngoscopy w/endoscope CPT 92511 | $90.19 | $243.75 | $41.77 – $68.16 | 2 |
| Natalizumab 300 mg/15 ml intravenous solution HCPCS J2323 | $39.09 | $105.65 | $8.13 – $8.13 | 1 |
| Natriuretic peptide CPT 83880 | $83.62 | $226.00 | $35.70 – $52.85 | 2 |
| Natural killer cells total count CPT 86357 | $106.28 | $287.25 | $38.03 – $47.70 | 2 |
| Navigational bronchoscopy 31627 CPT 31627 | not published | not published | $111.08 – $111.08 | 1 |
| N block inj common digit CPT 64632 | not published | not published | $76.75 – $82.84 | 2 |
| N block inj hypogas plxs CPT 64517 | not published | not published | $136.67 – $138.59 | 2 |
| Nctrnl pen tmscn&/rgdity tst CPT 54250 | not published | not published | $11.15 – $13.74 | 2 |
| Ndl emg musc 1 xtr/non-limb CPT 95870 | $51.71 | $139.75 | $23.12 – $73.66 | 2 |
| Ndl oculoelectromyography 1+ CPT 92265 | not published | not published | $34.46 – $39.17 | 2 |
| Neck (Cervical Spine) CT scan (with and without contrast) CPT 72127 | $920.65 | $2,488.25 | $79.64 – $208.75 | 2 |
| Neck (Cervical Spine) CT scan (with contrast) CPT 72126 | $855.16 | $2,311.25 | $76.61 – $169.23 | 2 |
| Neck (Cervical Spine) CT scan (without contrast) CPT 72125 | $826.21 | $2,233.00 | $73.00 – $112.82 | 2 |
| Neck (Cervical Spine) MRI (with and without contrast) CPT 72156 | $1,276.04 | $3,448.75 | $161.19 – $268.03 | 2 |
| Neck (Cervical Spine) MRI (with contrast) CPT 72142 | $972.27 | $2,627.75 | $120.57 – $238.21 | 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.