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 |
|---|---|---|---|---|
| Pr removal drug delivery implant CPT 11982 | not published | not published | $112.97 – $119.54 | 2 |
| Pr removal foreign body external auditory canal without anesthesia CPT 69200 | $113.04 | $305.50 | $52.63 – $61.78 | 2 |
| Pr removal intrauterine device CPT 58301 | $113.31 | $306.25 | $75.56 – $79.90 | 2 |
| Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm CPT 12032 | $215.62 | $582.75 | $209.13 – $214.30 | 2 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm CPT 12011 | $107.30 | $290.00 | $62.02 – $118.45 | 2 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm CPT 12013 | $125.34 | $338.75 | $65.63 – $135.00 | 2 |
| Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm CPT 12001 | $129.50 | $350.00 | $49.75 – $114.55 | 2 |
| Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm CPT 12002 | $146.43 | $395.75 | $65.94 – $127.02 | 2 |
| Pr split-thickness autograft trunk/arm/leg 1st 100 sq cm/<tbsa infant/child CPT 15100 | not published | not published | $776.07 – $788.35 | 2 |
| Pr subsequent hospital care e/m normal newborn per day CPT 99462 | not published | not published | $37.23 – $49.34 | 2 |
| Prtl exc bone olecrn process CPT 24147 | not published | not published | $676.55 – $680.49 | 2 |
| Prtl exc bone radial h/n CPT 24145 | not published | not published | $641.54 – $653.24 | 2 |
| Prtl exchange transfuse nb CPT 36456 | not published | not published | $120.82 – $120.82 | 1 |
| Prtl excision bone clavicle CPT 23180 | not published | not published | $727.19 – $744.31 | 2 |
| Prtl excision bone scapula CPT 23182 | not published | not published | $717.58 – $720.94 | 2 |
| Pr tube thoracostomy w/connection to drainage open CPT 32551 | $1,074.85 | $2,905.00 | $178.81 – $211.93 | 2 |
| PSA (Prostate) Test CPT 84153 | $76.96 | $208.00 | $19.28 – $28.64 | 2 |
| Psychoanalysis CPT 90845 | not published | not published | $100.65 – $101.76 | 2 |
| Psychotherapy group therapy CPT 90853 | not published | not published | $28.36 – $36.33 | 2 |
| Psychotherapy patient individual therapy 30 minutes CPT 90832 | not published | not published | $70.84 – $70.84 | 1 |
| Psychotherapy patient individual therapy 45 minutes CPT 90834 | not published | not published | $94.45 – $94.45 | 1 |
| Psychotherapy patient individual therapy 60 minutes CPT 90837 | not published | not published | $142.05 – $142.05 | 1 |
| Psytx complex interactive CPT 90785 | not published | not published | $15.61 – $15.61 | 1 |
| Psytx pt w/e&m 16-37 min CPT 90833 | not published | not published | $73.37 – $73.37 | 1 |
| Psytx pt w/e&m 38-52 min CPT 90836 | not published | not published | $92.90 – $92.90 | 1 |
| Psytx pt w/e&m 53+ min CPT 90838 | not published | not published | $122.75 – $122.75 | 1 |
| Pt application of modality >=1 area electrical stimulation each 15 minutes CPT 97032 | $25.07 | $67.75 | $19.59 – $20.61 | 2 |
| Pt application of modality >=1 area hot/cold packs CPT 97010 | not published | not published | $5.50 – $6.40 | 2 |
| Pt application of modality >=1 area iontophoresis each 15 minutes CPT 97033 | $32.38 | $87.50 | $23.53 – $28.43 | 2 |
| Pt application of modality >=1 area ultrasound each 15 minutes CPT 97035 | $29.05 | $78.50 | $13.95 – $14.13 | 2 |
| Pt application of modality traction mechanical CPT 97012 | not published | not published | $17.60 – $17.74 | 2 |
| Pten gene dup/delet variant CPT 81323 | not published | not published | $99.97 – $99.97 | 1 |
| Pten gene full sequence CPT 81321 | not published | not published | $685.54 – $685.54 | 1 |
| Pten gene known fam variant CPT 81322 | not published | not published | $66.65 – $66.65 | 1 |
| Pterygomaxillary fossa surg any appr 31040 CPT 31040 | not published | not published | $811.28 – $825.86 | 2 |
| Pt evaluation high complexity patient/family CPT 97163 | $74.56 | $201.50 | $87.76 – $87.76 | 1 |
| Pt evaluation low complexity patient/family CPT 97161 | $74.56 | $201.50 | $87.76 – $87.76 | 1 |
| Pt evaluation moderate complexity patient/family CPT 97162 | $74.56 | $201.50 | $87.76 – $87.76 | 1 |
| Pt init/spiromet rec/review/interp 94016 CPT 94016 | not published | not published | $28.39 – $30.95 | 2 |
| Pt re-evaluation patient/family CPT 97164 | $40.89 | $110.50 | $59.34 – $59.34 | 1 |
| Pt repositioning canalith procedure(s) per day CPT 95992 | not published | not published | $41.72 – $45.72 | 2 |
| Pt therapeutic procedure >=1 area gait training each 15 minutes CPT 97116 | $30.43 | $82.25 | $29.81 – $30.67 | 2 |
| Pt therapeutic procedure >=1 area massage each 15 minutes CPT 97124 | $19.61 | $53.00 | $27.07 – $28.27 | 2 |
| Pt wheelchair management each 15 minutes CPT 97542 | $29.60 | $80.00 | $32.95 – $33.44 | 2 |
| Pul art balloon repr percut CPT 92997 | not published | not published | $736.20 – $782.69 | 2 |
| Pul art balloon repr percut CPT 92998 | not published | not published | $364.10 – $400.27 | 2 |
| Pulm endartercomy w/bypass 33916 CPT 33916 | not published | not published | $1,977.19 – $4,772.48 | 2 |
| Pulmonary decortication partial 32225 CPT 32225 | not published | not published | $1,115.48 – $1,151.04 | 2 |
| Pulmonary vent imaging CPT 78579 | $328.56 | $888.00 | $171.03 – $171.03 | 1 |
| Pulse ox continuous overnight monitoring CPT 94762 | $78.07 | $211.00 | $24.80 – $31.63 | 2 |
| Pulse ox multiple CPT 94761 | $52.91 | $143.00 | $4.68 – $5.75 | 2 |
| Pulse ox single CPT 94760 | $24.88 | $67.25 | $2.98 – $3.25 | 2 |
| Punc of shunt for asp or inj CPT 61070 | $668.13 | $1,805.75 | $64.04 – $89.77 | 2 |
| Puncture arterial withdrawal blood for diagnosis CPT 36600 | $69.01 | $186.50 | $17.37 – $18.78 | 2 |
| Puncture aspiration abscess/hematoma/bulla/cyst CPT 10160 | $191.94 | $518.75 | $103.96 – $104.57 | 2 |
| Puncture/clear windpipe 31612 CPT 31612 | $2,427.76 | $6,561.50 | $54.42 – $56.58 | 2 |
| Puncture spinal lumbar diagnostic CPT 62270 | $507.55 | $1,371.75 | $87.57 – $90.10 | 2 |
| Pvb thoracic 2nd+ inj site CPT 64462 | not published | not published | $61.78 – $61.78 | 1 |
| Pvb thoracic cont infusion CPT 64463 | not published | not published | $101.61 – $101.61 | 1 |
| Pvb thoracic single inj site CPT 64461 | $514.58 | $1,390.75 | $98.36 – $98.36 | 1 |
| Pyloroplasty 43800 CPT 43800 | not published | not published | $1,013.93 – $1,044.68 | 2 |
| Pyruvate CPT 84210 | $81.03 | $219.00 | $11.47 – $16.90 | 2 |
| Pyruvate kinase CPT 84220 | $46.16 | $124.75 | $9.90 – $14.70 | 2 |
| Quant diff pulm perf and vent w/imaging CPT 78598 | $664.15 | $1,795.00 | $279.19 – $279.19 | 1 |
| Quant diff pulm perf w/imaging CPT 78597 | $328.56 | $888.00 | $175.70 – $175.70 | 1 |
| Quest t3 uptake CPT 84479 | $37.28 | $100.75 | $6.78 – $10.07 | 2 |
| Rabies ig heat-treated human im/subq 90376 CPT 90376 | $815.67 | $2,204.50 | $106.51 – $106.51 | 1 |
| Rabies immune globulin (pf) 300 unit/ml intramuscular solution CPT 90375 | $4,350.89 | $11,759.15 | $145.53 – $145.53 | 1 |
| Rabies vaccine id CPT 90676 | not published | not published | not published | 0 |
| Radiation handling CPT 77790 | not published | not published | $15.10 – $38.05 | 2 |
| Radiation physics consult CPT 77336 | not published | not published | $67.67 – $80.89 | 2 |
| Radiation therapy dose plan CPT 77300 | $139.21 | $376.25 | $34.86 – $38.32 | 2 |
| Radiation treatment aid(s) CPT 77332 | not published | not published | $33.37 – $44.56 | 2 |
| Radiation treatment aid(s) CPT 77333 | $298.50 | $806.75 | $29.14 – $58.93 | 2 |
| Radiation treatment aid(s) CPT 77334 | $447.24 | $1,208.75 | $72.58 – $76.64 | 2 |
| Radiation treatment delivery CPT 77401 | not published | not published | $25.15 – $34.72 | 2 |
| Radiation treatment delivery CPT 77402 | not published | not published | $148.70 – $148.70 | 1 |
| Radiation treatment delivery CPT 77412 | not published | not published | $225.81 – $225.81 | 1 |
| Radical abdominal hysterectomy 58210 CPT 58210 | not published | not published | $2,012.27 – $2,064.58 | 2 |
| Radical resection of elbow CPT 24149 | not published | not published | $1,263.87 – $1,293.45 | 2 |
| Radical resection sternum 21630 CPT 21630 | not published | not published | $1,352.82 – $1,410.23 | 2 |
| Radic resect abd tumor<5cm 22904 CPT 22904 | not published | not published | $1,172.93 – $1,172.93 | 1 |
| Radic resect shoulder tumor 5cm/> 23078 CPT 23078 | not published | not published | $1,599.65 – $1,599.65 | 1 |
| Radiology port images(s) CPT 77417 | not published | not published | $11.15 – $17.52 | 2 |
| Radiotherapy dose plan imrt CPT 77301 | not published | not published | $494.78 – $1,570.54 | 2 |
| Radphm lcl tmr plnr bdy sgl day img CPT 78802 | $587.75 | $1,588.50 | $54.25 – $297.51 | 2 |
| Radphm lcl tmr plnr bdy two day img CPT 78804 | $809.28 | $2,187.25 | $67.68 – $541.84 | 2 |
| Radphm lcl tmr spect/ct 2+ areas/2+ days CPT 78831 | not published | not published | $642.34 – $642.34 | 1 |
| Radphm lcl tomogr sgl area sgl day CPT 78803 | $727.51 | $1,966.25 | $68.92 – $305.77 | 2 |
| Radphm lcl tumor plr sgl day CPT 78800 | $398.21 | $1,076.25 | $41.29 – $167.80 | 2 |
| Radphm quant measure sgl area add-on CPT 78835 | not published | not published | $82.65 – $82.65 | 1 |
| Rad rescj tum dstl/shft hum CPT 24150 | not published | not published | $1,073.51 – $1,730.48 | 2 |
| Rad rescj tum shoulder<5 cm CPT 23077 | not published | not published | $1,272.58 – $1,313.84 | 2 |
| Rad rescj tum tiss a/e 5 cm+ CPT 24079 | not published | not published | $1,479.35 – $1,479.35 | 1 |
| Rad rescj tum tiss a/e <5cm CPT 24077 | not published | not published | $896.90 – $1,151.19 | 2 |
| Rad resec soft tis tum/ft/toe/<3cm 28046 CPT 28046 | not published | not published | $771.36 – $814.27 | 2 |
| Rad resect abd tumor 5 cm/> CPT 22905 | not published | not published | $1,489.34 – $1,489.34 | 1 |
| Rad resect hand tumor < 3 cm CPT 26117 | not published | not published | $701.05 – $820.36 | 2 |
| Rad resect hand tumor 3 cm/> CPT 26118 | not published | not published | $1,162.55 – $1,162.55 | 1 |
| Rad resection tum radial h/n CPT 24152 | not published | not published | $805.79 – $1,482.85 | 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.