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 |
|---|---|---|---|---|
| Partial thyroid excision CPT 60210 | not published | not published | $777.74 – $787.42 | 2 |
| Partial thyroid lobect w/contratlat stot lobec 60212 CPT 60212 | not published | not published | $1,119.42 – $1,125.74 | 2 |
| Part removal of metatarsal CPT 28110 | not published | not published | $320.21 – $331.87 | 2 |
| Part removal of metatarsal CPT 28113 | not published | not published | $469.54 – $473.55 | 2 |
| Part removal of metatarsal 28112 CPT 28112 | not published | not published | $346.67 – $363.11 | 2 |
| Passy muir valve metal trach HCPCS L8501 | $160.47 | $433.70 | $201.57 – $201.57 | 1 |
| Patient recorded spirometry CPT 94014 | not published | not published | $22.89 – $60.01 | 2 |
| Patient recorded spirometry CPT 94015 | not published | not published | $25.80 – $31.62 | 2 |
| Pdgfra gene CPT 81314 | not published | not published | $376.62 – $376.62 | 1 |
| Pedcle fh/ch/ch/m/n/ax/g/h/f CPT 15574 | not published | not published | $830.22 – $844.52 | 2 |
| Ped home apnea mntr att only CPT 94775 | not published | not published | not published | 0 |
| Ped home apnea mntr dl&alys CPT 94776 | not published | not published | not published | 0 |
| Pedicle enel/ntroral 15576 CPT 15576 | not published | not published | $728.62 – $739.78 | 2 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $813.08 | $2,197.50 | $76.61 – $201.20 | 2 |
| Pelvic CT scan (with contrast) CPT 72193 | $971.25 | $2,625.00 | $73.00 – $169.58 | 2 |
| Pelvic CT scan (without contrast) CPT 72192 | $943.69 | $2,550.50 | $68.92 – $92.34 | 2 |
| Pelvic MRI (with and without contrast) CPT 72197 | $1,192.60 | $3,223.25 | $141.98 – $396.65 | 2 |
| Pelvic MRI (with contrast) CPT 72196 | $842.49 | $2,277.00 | $108.97 – $327.31 | 2 |
| Pelvic MRI (without contrast) CPT 72195 | $889.67 | $2,404.50 | $91.34 – $225.99 | 2 |
| Pelvic Ultrasound (complete) CPT 76856 | $485.35 | $1,311.75 | $43.20 – $77.25 | 2 |
| Pelvic Ultrasound (limited) CPT 76857 | $301.27 | $814.25 | $23.72 – $24.38 | 2 |
| Penile injection CPT 54235 | $222.46 | $601.25 | $81.98 – $91.62 | 2 |
| Penile vascular study CPT 93980 | $319.22 | $862.75 | $60.72 – $80.49 | 2 |
| Penile vascular study CPT 93981 | not published | not published | $27.59 – $52.46 | 2 |
| Penile venous occlusion CPT 37790 | not published | not published | $547.06 – $589.92 | 2 |
| Penis plastic surgery CPT 54360 | not published | not published | $810.47 – $913.12 | 2 |
| Penis study CPT 54240 | not published | not published | $35.57 – $38.83 | 2 |
| Pentobarbital sodium inj HCPCS J2515 | $64.60 | $174.60 | $11.96 – $11.96 | 1 |
| Perc cryo ablate renal tum CPT 50593 | $14,222.62 | $38,439.50 | $527.20 – $585.86 | 2 |
| Perc rf ablate renal tumor CPT 50592 | $12,484.54 | $33,742.00 | $392.97 – $459.19 | 2 |
| Percut ablate liver rf CPT 47382 | $6,242.27 | $16,871.00 | $856.83 – $1,005.06 | 2 |
| Pericardiectomy/sub or com/w bypas 33031 CPT 33031 | not published | not published | $1,689.43 – $2,798.64 | 2 |
| Pericardiotomy/clot/for bod remove 33020 CPT 33020 | not published | not published | $990.11 – $1,020.73 | 2 |
| Peri-implt capslc brst compl CPT 19371 | not published | not published | $847.84 – $862.18 | 2 |
| Perineoplasty rpr per nonob CPT 56810 | not published | not published | $287.23 – $300.23 | 2 |
| Peripheral vascular rehab CPT 93668 | not published | not published | $18.63 – $19.41 | 2 |
| Peri-proc device eval icd CPT 93287 | not published | not published | $13.65 – $15.12 | 2 |
| Peri-proc device eval pm CPT 93286 | not published | not published | $12.22 – $13.34 | 2 |
| Peritoneal cath sub q resv per CPT 49419 | not published | not published | $496.10 – $497.10 | 2 |
| Peritoneogram rs&i CPT 74190 | $295.26 | $798.00 | $30.27 – $30.27 | 1 |
| Perit-vens shunt pat tst CPT 78291 | $272.41 | $736.25 | $55.59 – $224.92 | 2 |
| Perq art m-thrombect &/nfs CPT 61645 | not published | not published | $892.45 – $892.45 | 1 |
| Perq clsr tcat l atr apndge CPT 33340 | not published | not published | $903.78 – $903.78 | 1 |
| Perq dev breast 1st mr guide CPT 19287 | $1,606.36 | $4,341.50 | $147.16 – $147.16 | 1 |
| Perq dev breast 1st strtctc CPT 19283 | $541.31 | $1,463.00 | $116.11 – $116.11 | 1 |
| Perq nl/pl lithotrp cplx>2cm CPT 50081 | not published | not published | $1,439.85 – $1,613.32 | 2 |
| Perq nl/pl lithotrp smpl<2cm CPT 50080 | not published | not published | $979.43 – $1,096.84 | 2 |
| Perq plmt bile duct stent CPT 47538 | not published | not published | $271.04 – $271.04 | 1 |
| Perq plmt bile duct stent CPT 47539 | not published | not published | $492.07 – $492.07 | 1 |
| Perq plmt bile duct stent CPT 47540 | not published | not published | $509.62 – $509.62 | 1 |
| Perq skel fix rad/uln dislc CPT 25671 | not published | not published | $554.48 – $577.73 | 2 |
| Perq skel fix ulnar styld fx CPT 25651 | not published | not published | $503.22 – $525.23 | 2 |
| Perqt bx lung/mediastinum 32405 CPT 32405 | not published | not published | $103.04 – $122.82 | 2 |
| Perq transcath closure each CPT 93592 | not published | not published | $495.73 – $495.73 | 1 |
| Perq transcath closure pda CPT 93582 | not published | not published | $745.77 – $745.77 | 1 |
| Perq transcath cls aortic CPT 93591 | not published | not published | $1,124.15 – $1,124.15 | 1 |
| Perq transcath cls mitral CPT 93590 | not published | not published | $1,354.68 – $1,354.68 | 1 |
| Perq transcath septal reduxn CPT 93583 | not published | not published | $844.37 – $844.37 | 1 |
| Perq tx big toe fracture w/manip 28496 CPT 28496 | not published | not published | $241.01 – $257.94 | 2 |
| Perq tx malar fracture CPT 21355 | not published | not published | $351.63 – $366.79 | 2 |
| Perq tx mndblr fx xtrnl fixj CPT 21452 | not published | not published | $341.68 – $359.94 | 2 |
| Perq tx nasoethmoid fx CPT 21340 | not published | not published | $882.67 – $882.88 | 2 |
| Pertussis ag if CPT 87265 | $82.42 | $222.75 | $12.77 – $18.66 | 2 |
| Pet CT skull-mid thgh initial CPT 78815 | not published | not published | $154.30 – $154.30 | 1 |
| Pet CT whole body initial CPT 78816 | not published | not published | $158.31 – $158.31 | 1 |
| Pet fdg brain metoblic eval sb CPT 78608 | not published | not published | $94.41 – $94.41 | 1 |
| Pet image full body CPT 78813 | not published | not published | $127.30 – $127.30 | 1 |
| Pet image ltd area CPT 78811 | not published | not published | $98.55 – $98.55 | 1 |
| Pet image skull-thigh CPT 78812 | not published | not published | $122.82 – $122.82 | 1 |
| Pet image w/ct lmtd CPT 78814 | not published | not published | $139.46 – $139.46 | 1 |
| Pet scan brain perf study CPT 78609 | not published | not published | $83.40 – $91.62 | 2 |
| Phalangectomy ea toe 28150 CPT 28150 | not published | not published | $310.55 – $330.05 | 2 |
| Ph body fluid CPT 83986 | $30.25 | $81.75 | $3.65 – $5.57 | 2 |
| Phencyclidine (pcp) CPT 83992 | not published | not published | $15.63 – $22.89 | 2 |
| Phenobarbital therapeutic drug level CPT 80184 | $59.57 | $161.00 | $11.99 – $17.83 | 2 |
| Phentolaine mesylate inj HCPCS J2760 | $198.12 | $535.45 | $53.82 – $53.82 | 1 |
| Phenytoin total therapeutic drug level CPT 80185 | $68.54 | $185.25 | $14.07 – $20.63 | 2 |
| Phlebotomy therapeutic CPT 99195 | $74.83 | $202.25 | $77.51 – $101.72 | 2 |
| Phleb veins 1 extrm 10-20 stab CPT 37765 | not published | not published | $508.50 – $528.48 | 2 |
| Phleb veins 1 extrm >20 stab CPT 37766 | not published | not published | $621.99 – $644.22 | 2 |
| Phosphorus CPT 84100 | $32.93 | $89.00 | $4.95 – $7.38 | 2 |
| Phosphorus 24 hour urine CPT 84105 | $26.36 | $71.25 | $5.47 – $8.06 | 2 |
| Photchmtx tar&uvb/ptrltm&uvb CPT 96910 | not published | not published | $68.93 – $72.22 | 2 |
| Photochemotherapy puva CPT 96912 | not published | not published | $88.35 – $92.70 | 2 |
| Photochemotherapy uv-a or b CPT 96913 | not published | not published | $122.50 – $131.51 | 2 |
| Photo patch test CPT 95052 | not published | not published | $6.83 – $7.47 | 2 |
| Photopheresis CPT 36522 | not published | not published | $114.10 – $120.78 | 2 |
| Photosensitivity tests CPT 95056 | not published | not published | $37.76 – $44.91 | 2 |
| Phys blood bank serv authrj CPT 86079 | not published | not published | $37.99 – $57.73 | 2 |
| Phys blood bank serv reactj CPT 86078 | not published | not published | $37.73 – $57.73 | 2 |
| Phys blood bank serv xmatch CPT 86077 | not published | not published | $37.73 – $58.09 | 2 |
| Pierce earlobes 69090 CPT 69090 | not published | not published | $33.66 – $33.66 | 1 |
| Pik3ca gene trgt seq alys CPT 81309 | not published | not published | $311.93 – $311.93 | 1 |
| Pinch graft 1/mlt c> sm ulcer tip/oth area 2cm 15050 CPT 15050 | not published | not published | $469.80 – $484.77 | 2 |
| Pin finger dislocation CPT 26776 | not published | not published | $461.40 – $478.79 | 2 |
| Pin finger fracture each CPT 26756 | not published | not published | $432.84 – $450.15 | 2 |
| Pin hand dislocation CPT 26676 | not published | not published | $525.25 – $541.04 | 2 |
| Pin knuckle dislocation CPT 26706 | not published | not published | $457.65 – $477.85 | 2 |
| Pinworm exam CPT 87172 | $17.58 | $47.50 | $4.43 – $6.65 | 2 |
| Place breast rad tube/caths CPT 19298 | not published | not published | $354.09 – $384.43 | 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.