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 |
|---|---|---|---|---|
| Prep skin to 100cm2 other CPT 15004 | $892.44 | $2,412.00 | $301.99 – $318.25 | 2 |
| Prep skin to 100cm2 trk/ext CPT 15002 | not published | not published | $253.33 – $254.49 | 2 |
| Prep skn trk/ext adl 100cm2 CPT 15003 | not published | not published | $51.38 – $51.90 | 2 |
| Pressure max expiratory/inspiratory CPT 94799 | $232.27 | $627.75 | $5.50 – $5.50 | 1 |
| Pressure velocity wire add ves CPT 93572 | not published | not published | $95.79 – $95.79 | 1 |
| Pretreatment serum by diff red cell adsorption patient rbc/known phenotype each adsorption ref CPT 86977 | not published | not published | $14.59 – $14.59 | 1 |
| Pretreat rbc absorption reference CPT 86978 | $19.61 | $53.00 | $14.59 – $14.59 | 1 |
| Pretreat rbc density gradient separation reference CPT 86972 | $119.51 | $323.00 | $17.46 – $17.46 | 1 |
| Pretreat rbc w chem/drugs reference CPT 86970 | $207.39 | $560.50 | $10.94 – $10.94 | 1 |
| Pretreat rbc w enzyme reference CPT 86971 | not published | not published | $10.94 – $10.94 | 1 |
| Pr evaluation psychiatric diagnostic w/medical services CPT 90792 | not published | not published | $159.80 – $159.80 | 1 |
| Pr excision benign lesion scalp/neck/hands/feet/genitalia <= 0.5 cm CPT 11420 | $1,907.07 | $5,154.25 | $86.60 – $89.11 | 2 |
| Pr excision benign lesion trunk/arms/legs 3.1 - 4.0 cm CPT 11404 | not published | not published | $167.86 – $177.84 | 2 |
| Pr excision nail/nail matrix partial/complete permanent removal CPT 11750 | $503.29 | $1,360.25 | $124.09 – $191.53 | 2 |
| Pr gastrorrhaphy suture perforated duodenal or gastric ulcer/wound/ injury CPT 43840 | not published | not published | $1,447.30 – $1,528.10 | 2 |
| Prgrmg dev eval impltbl sys CPT 93260 | not published | not published | $21.57 – $21.57 | 1 |
| Prgrmg dev eval pm/ldls pm CPT 93279 | not published | not published | $17.97 – $21.50 | 2 |
| Prgrmg dev eval scrms ip CPT 93285 | not published | not published | $16.17 – $20.31 | 2 |
| Prgrmg eval implantable dfb CPT 93282 | not published | not published | $20.85 – $26.28 | 2 |
| Prgrmg eval implantable dfb CPT 93283 | not published | not published | $24.07 – $29.87 | 2 |
| Prgrmg eval implantable dfb CPT 93284 | not published | not published | $27.67 – $33.86 | 2 |
| Prgr stim/pace a/iv drug CPT 93623 | not published | not published | $58.65 – $8,949.00 | 2 |
| Pr hospital ip/obs care initial high level per day CPT 99223 | not published | not published | $224.49 – $224.63 | 2 |
| Pr hospital ip/obs care initial moderate level per day CPT 99222 | not published | not published | $151.74 – $152.46 | 2 |
| Pr hospital ip/obs care initial straightforward or low level per day CPT 99221 | not published | not published | $111.73 – $112.48 | 2 |
| Pr hospital ip/obs care subsequent high level per day CPT 99233 | not published | not published | $115.70 – $119.05 | 2 |
| Pr hospital ip/obs care subsequent moderate level per day CPT 99232 | not published | not published | $80.04 – $83.09 | 2 |
| Pr hospital ip/obs care subsequent straightforward or low level per day CPT 99231 | not published | not published | $43.57 – $46.08 | 2 |
| Prim art mech thrmbc non-intracranial CPT 37184 | not published | not published | $514.14 – $560.90 | 2 |
| Prim art mech thrmbc non-intracranial add-on CPT 37185 | not published | not published | $193.03 – $206.99 | 2 |
| Pr incision & drainage abscess complicated/multiple CPT 10061 | $313.30 | $846.75 | $180.89 – $196.30 | 2 |
| Pr incision & drainage abscess simple/single CPT 10060 | $238.65 | $645.00 | $100.77 – $105.84 | 2 |
| Pr incision & drainage abscess vulva/perineal CPT 56405 | $168.72 | $456.00 | $118.31 – $119.68 | 2 |
| Pr incision & removal foreign body subcutaneous tissues simple CPT 10120 | $429.94 | $1,162.00 | $99.06 – $111.96 | 2 |
| Pr management transitional care high w/in 7 days of discharge CPT 99496 | not published | not published | $177.18 – $177.18 | 1 |
| Pr management transitional care moderate w/in 14 days of discharge CPT 99495 | not published | not published | $122.33 – $122.33 | 1 |
| Pr moderate sedation same physician >= 5 years initial 15 minutes CPT 99152 | $66.51 | $179.75 | $13.79 – $13.79 | 1 |
| Pr neuroplasty and/or transposition ulnar nerve at elbow CPT 64718 | not published | not published | $610.17 – $646.00 | 2 |
| Probe nasolacrimal duct CPT 68810 | not published | not published | $137.54 – $188.61 | 2 |
| Probe nasolacrimal duct CPT 68811 | not published | not published | $147.50 – $205.55 | 2 |
| Probe nasolacrimal duct CPT 68815 | not published | not published | $239.11 – $260.53 | 2 |
| Probe nl duct w/balloon CPT 68816 | not published | not published | $176.55 – $248.98 | 2 |
| Procainamide 100 mg/ml injection (wrapper) HCPCS J2690 | $9.25 | $25.00 | $4.93 – $4.93 | 1 |
| Procalcitonin CPT 84145 | $101.10 | $273.25 | $41.71 – $41.71 | 1 |
| Proctectomy combined abd pull-thru px 45112 CPT 45112 | not published | not published | $2,095.60 – $2,119.42 | 2 |
| Proctectomy complete abd w/clst 45110 CPT 45110 | not published | not published | $2,023.89 – $2,075.44 | 2 |
| Proctosigmoidoscopy ablate CPT 45320 | not published | not published | $117.22 – $121.24 | 2 |
| Proctosigmoidoscopy control bleed 45317 CPT 45317 | not published | not published | $126.48 – $128.07 | 2 |
| Proctosigmoidoscopy dilate 45303 CPT 45303 | not published | not published | $95.31 – $97.45 | 2 |
| Proctosigmoidoscopy dx 45300 CPT 45300 | $346.88 | $937.50 | $55.42 – $60.35 | 2 |
| Proctosigmoidoscopy removal CPT 45308 | not published | not published | $91.80 – $94.14 | 2 |
| Proctosigmoidoscopy removal CPT 45309 | not published | not published | $100.39 – $106.29 | 2 |
| Proctosigmoidoscopy tumor removal 45315 CPT 45315 | not published | not published | $118.39 – $121.09 | 2 |
| Proctosigmoidoscopy volvul CPT 45321 | not published | not published | $114.16 – $117.36 | 2 |
| Proctosigmoidoscopy w/bx 45305 CPT 45305 | not published | not published | $82.21 – $85.36 | 2 |
| Proctosigmoidoscopy w/fb remove 45307 CPT 45307 | $2,773.89 | $7,497.00 | $108.45 – $109.57 | 2 |
| Proctosigmoidoscopy w/stent CPT 45327 | not published | not published | $127.88 – $136.74 | 2 |
| Progesterone CPT 84144 | $66.14 | $178.75 | $21.89 – $32.48 | 2 |
| Prolactin CPT 84146 | $101.75 | $275.00 | $20.33 – $30.17 | 2 |
| Proph rta dtchmnt crtx dthrm CPT 67141 | not published | not published | $481.85 – $526.76 | 2 |
| Proph rta dtchmnt pc CPT 67145 | not published | not published | $492.91 – $538.00 | 2 |
| Proph tx w/wo mthylmthcrylt CPT 24498 | not published | not published | $953.22 – $961.78 | 2 |
| Prophylactic tx radius CPT 25490 | not published | not published | $790.12 – $826.19 | 2 |
| Prophylactic tx radius&ulna CPT 25492 | not published | not published | $996.86 – $1,053.94 | 2 |
| Prophylactic tx ulna CPT 25491 | not published | not published | $813.76 – $871.61 | 2 |
| Prostate biopsy, any mthd HCPCS G0416 | $599.68 | $1,620.75 | $305.04 – $492.64 | 2 |
| Prostatectomy (turp) CPT 52601 | not published | not published | $952.29 – $1,039.05 | 2 |
| Prostate laser enucleation CPT 52649 | not published | not published | $925.15 – $1,230.56 | 2 |
| Prostatic microwave thermotx CPT 53850 | not published | not published | $678.34 – $712.00 | 2 |
| Prostatic rf thermotx CPT 53852 | not published | not published | $698.55 – $774.00 | 2 |
| Protein c activity CPT 85303 | $91.85 | $248.25 | $14.59 – $21.54 | 2 |
| Protein electrophoretic fractionation & quantitation serum CPT 84165 | $47.82 | $129.25 | $11.20 – $16.72 | 2 |
| Protein s total CPT 85305 | $85.10 | $230.00 | $12.25 – $18.07 | 2 |
| Protein total 24 hour urine CPT 84156 | $32.10 | $86.75 | $3.91 – $5.71 | 2 |
| Protein total body fluid CPT 84157 | $27.94 | $75.50 | $3.91 – $5.71 | 2 |
| Protein total serum plasma whole blood CPT 84155 | $40.70 | $110.00 | $3.91 – $5.71 | 2 |
| Prothrombin time substitution plasma fractions each CPT 85611 | $17.48 | $47.25 | $4.17 – $6.14 | 2 |
| Proton treatment complex CPT 77525 | not published | not published | not published | 0 |
| Proton trmt intermediate CPT 77523 | not published | not published | not published | 0 |
| Proton trmt simple w/comp CPT 77522 | not published | not published | not published | 0 |
| Proton trmt simple without comp CPT 77520 | not published | not published | not published | 0 |
| Protoporphyrin rbc screen CPT 84203 | not published | not published | $9.12 – $13.40 | 2 |
| Prp i/hern init block >5 yr CPT 49507 | not published | not published | $652.78 – $686.53 | 2 |
| Pr planning advance care 1st 30 minutes CPT 99497 | not published | not published | $85.24 – $85.24 | 1 |
| Prq cardiac angio addl art CPT 92921 | not published | not published | $19,696.00 – $19,696.00 | 1 |
| Prq card revasc chronic addl CPT 92944 | not published | not published | $21,711.00 – $21,711.00 | 1 |
| Prq card revasc mi 1 vsl CPT 92941 | not published | not published | $757.51 – $21,711.00 | 2 |
| Prq card stent w/angio addl CPT 92929 | not published | not published | $21,711.00 – $21,711.00 | 1 |
| Prq revasc byp graft 1 art and/or branches CPT 92937 | not published | not published | $673.50 – $21,711.00 | 2 |
| Prq revasc byp graft addl CPT 92938 | not published | not published | $21,711.00 – $21,711.00 | 1 |
| Prq skel fix clcnl fx w/mnpj CPT 28406 | not published | not published | $568.75 – $570.91 | 2 |
| Prq skel fix epcndylr hum fx CPT 24566 | not published | not published | $754.93 – $785.01 | 2 |
| Prq skel fix sprcndlr hum fx CPT 24538 | not published | not published | $808.20 – $816.90 | 2 |
| Prq skel fix talus fx w/mnpj CPT 28436 | not published | not published | $454.77 – $483.04 | 2 |
| Prq skel fix tarsl fx w/mnpj CPT 28456 | not published | not published | $289.33 – $338.22 | 2 |
| Prq tcat plmt ntrac st 1 les CPT 92928 | not published | not published | $673.91 – $21,711.00 | 2 |
| Prq trlml c athrc st angiop1 CPT 92933 | not published | not published | $755.97 – $21,711.00 | 2 |
| Prq trluml c angiop 1art&/br CPT 92920 | not published | not published | $605.50 – $19,696.00 | 2 |
| Prq trluml c athrc 1 art&/br CPT 92924 | not published | not published | $722.70 – $19,696.00 | 2 |
| Prq trluml revsc ch occ ant CPT 92943 | not published | not published | $756.77 – $21,711.00 | 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.