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 |
|---|---|---|---|---|
| Revision of penis CPT 54420 | $1,609.22 | $4,349.25 | $790.58 – $887.98 | 2 |
| Revision of penis CPT 54430 | $1,609.22 | $4,349.25 | $717.27 – $803.45 | 2 |
| Revision of penis CPT 54435 | $4,367.48 | $11,804.00 | $465.85 – $517.75 | 2 |
| Revision of pharyngeal walls CPT 42892 | not published | not published | $2,003.51 – $2,109.28 | 2 |
| Revision of radius CPT 25350 | not published | not published | $738.64 – $800.65 | 2 |
| Revision of radius CPT 25355 | not published | not published | $837.45 – $902.71 | 2 |
| Revision of sciatic nerve CPT 64712 | not published | not published | $601.75 – $639.94 | 2 |
| Revision of scrotum CPT 55175 | not published | not published | $406.31 – $446.01 | 2 |
| Revision of scrotum CPT 55180 | not published | not published | $771.14 – $852.72 | 2 |
| Revision of spinal shunt CPT 63744 | not published | not published | $687.68 – $737.56 | 2 |
| Revision of testis CPT 54660 | not published | not published | $405.31 – $439.98 | 2 |
| Revision of thigh muscles CPT 27430 | not published | not published | $811.25 – $812.65 | 2 |
| Revision of toe CPT 28312 | not published | not published | $352.70 – $367.31 | 2 |
| Revision of tricuspid valve w/bypass 33460 CPT 33460 | not published | not published | $2,754.53 – $2,804.46 | 2 |
| Revision of ulna CPT 25360 | not published | not published | $716.12 – $776.40 | 2 |
| Revision of unstable kneecap CPT 27420 | not published | not published | $817.11 – $819.72 | 2 |
| Revision of unstable kneecap CPT 27422 | not published | not published | $816.28 – $816.87 | 2 |
| Revision of urethra CPT 53450 | not published | not published | $456.67 – $506.71 | 2 |
| Revision of urethra CPT 53460 | not published | not published | $512.83 – $570.26 | 2 |
| Revision of urethra CPT 57220 | not published | not published | $350.32 – $362.59 | 2 |
| Revision open av fistula without thromb CPT 36832 | not published | not published | $698.84 – $863.68 | 2 |
| Revision orbitofacial bones CPT 21275 | not published | not published | $887.84 – $925.63 | 2 |
| Revision/removal of kneecap CPT 27424 | not published | not published | $818.48 – $823.56 | 2 |
| Revision tips CPT 37183 | not published | not published | $433.26 – $520.75 | 2 |
| Revis reconst shoulder joint CPT 23473 | not published | not published | $1,807.95 – $1,807.95 | 1 |
| Revis reconst shoulder joint CPT 23474 | not published | not published | $1,953.97 – $1,953.97 | 1 |
| Revj fem anast autog vn grf CPT 35884 | not published | not published | $1,427.16 – $1,564.70 | 2 |
| Revj fem anast nonautog grf CPT 35883 | not published | not published | $1,388.77 – $1,481.93 | 2 |
| Revj mstdc rsltg compl mstdc CPT 69601 | not published | not published | $1,140.64 – $1,143.72 | 2 |
| Revj mstdc rsltg tympanplsty CPT 69604 | not published | not published | $1,212.23 – $1,226.12 | 2 |
| Revj prior hypspad repair CPT 54352 | not published | not published | $1,598.57 – $1,825.26 | 2 |
| Rev mastoidectomy rsltg modf rad mstdc 69602 CPT 69602 | not published | not published | $1,188.37 – $1,190.00 | 2 |
| Rev-rem impl neurostim gen-rec CPT 63688 | not published | not published | $393.87 – $411.10 | 2 |
| Rev/rmv perph nstim eltrd ra CPT 64585 | not published | not published | $158.36 – $178.33 | 2 |
| Rev/rmv prph sac/gstr npg/r CPT 64595 | not published | not published | $139.14 – $156.98 | 2 |
| Revsc opn/prq tib/pero stent CPT 37234 | not published | not published | $327.65 – $327.65 | 1 |
| Rheumatoid factor qualitative CPT 86430 | not published | not published | $5.99 – $8.83 | 2 |
| Rheumatoid factor quantitative CPT 86431 | $26.36 | $71.25 | $5.99 – $8.83 | 2 |
| Rhinp prim lat&alr crtlge&/elvtn nsl tip CPT 30400 | not published | not published | $1,081.94 – $1,097.34 | 2 |
| Rho(d) immune globulin (rhig) human full dose im CPT 90384 | not published | not published | $111.30 – $111.30 | 1 |
| Rib cartilage graft CPT 21230 | not published | not published | $825.95 – $844.63 | 2 |
| Right ventric recording CPT 93603 | not published | not published | $76.27 – $8,949.00 | 2 |
| Ring fx reform 11-13x17mm HCPCS L8610 | $1,059.07 | $2,862.35 | $1,106.93 – $1,106.93 | 1 |
| Rmv anterior spine instrumentation 22855 CPT 22855 | not published | not published | $1,221.09 – $1,236.23 | 2 |
| Rmv implant contraceptive capsule 11976 CPT 11976 | not published | not published | $105.71 – $111.55 | 2 |
| Rmvl esophgl sphnctr dev CPT 43285 | not published | not published | $735.12 – $735.12 | 1 |
| Rmvl ext fixj sys under anes CPT 20694 | not published | not published | $365.25 – $369.62 | 2 |
| Rmvl fb upr arm/elbow deep CPT 24201 | $3,295.59 | $8,907.00 | $391.15 – $396.95 | 2 |
| Rmvl fecal impaction/fb spx under anes CPT 45915 | not published | not published | $238.68 – $250.65 | 2 |
| Rmvl foreign body upper arm/elbow subcutaneous CPT 24200 | $3,165.91 | $8,556.50 | $145.93 – $152.62 | 2 |
| Rmvl icd by tv extr CPT 33244 | not published | not published | $965.12 – $1,049.85 | 2 |
| Rmvl icd gen w/rplc icd gen dual lead sys CPT 33263 | not published | not published | $434.80 – $87,973.00 | 2 |
| Rmvl icd gen w/rplc icd gen mlt lead sys CPT 33264 | not published | not published | $453.39 – $87,973.00 | 2 |
| Rmvl icd gen w/rplc icd gen sgl lead sys CPT 33262 | not published | not published | $417.28 – $87,973.00 | 2 |
| Rmvl icd pulse gen only CPT 33241 | not published | not published | $238.95 – $276.11 | 2 |
| Rmvl left heart vent thor inscn ecmo CPT 33989 | not published | not published | $567.16 – $567.16 | 1 |
| Rmvl lung xcp tot pneumonectomy sleeve lob 32486 CPT 32486 | not published | not published | $2,660.74 – $2,714.01 | 2 |
| Rmvl ndwellg tun pleural cath CPT 32552 | not published | not published | $176.98 – $176.98 | 1 |
| Rmvl perm pm pulse gen CPT 33233 | not published | not published | $254.54 – $291.33 | 2 |
| Rmvl pm gen w/rplc pm gen mlt lead sys CPT 33229 | not published | not published | $418.62 – $31,789.00 | 2 |
| Rmvl pm gen w/rplc pm gen sgl lead sys CPT 33227 | not published | not published | $377.85 – $31,789.00 | 2 |
| Rmvl pq iabp CPT 33968 | not published | not published | $38.39 – $42.43 | 2 |
| Rmvl pq vad left hrt vein sep session CPT 33992 | not published | not published | $228.46 – $228.46 | 1 |
| Rmvl prosthhumrl&ulnar cmpnt CPT 24160 | not published | not published | $656.04 – $1,402.45 | 2 |
| Rmvl sq defib electrode CPT 33272 | not published | not published | $390.53 – $87,973.00 | 2 |
| Rmvl tiss expndr without implant insrtn CPT 11971 | not published | not published | $316.14 – $344.11 | 2 |
| Rmvl tongs/halo anthr indiv CPT 20665 | $348.36 | $941.50 | $100.02 – $110.99 | 2 |
| Rmvl tv pm lead dual CPT 33235 | not published | not published | $713.55 – $770.80 | 2 |
| Rmvl tv pm lead sgl CPT 33234 | not published | not published | $543.61 – $597.34 | 2 |
| Rmv prosth mat/mesh/abd wall/infec 11008 CPT 11008 | not published | not published | $311.21 – $314.54 | 2 |
| Rmv suture/anesthesia/not local 15850 CPT 15850 | not published | not published | $46.58 – $48.80 | 2 |
| Ropivacaine 0.2 % epidural pca - 1 hour dose limit HCPCS J2795 | $9.95 | $26.90 | $0.07 – $0.07 | 1 |
| Rotavirus antibody CPT 86759 | not published | not published | $13.81 – $20.53 | 2 |
| Rplcmt oi implt skl prq esp CPT 69717 | not published | not published | $1,241.32 – $1,253.88 | 2 |
| Rpl non-tun cvc wo sbq prt/pmp CPT 36580 | $1,063.20 | $2,873.50 | $75.75 – $85.34 | 2 |
| Rp loclzj tum 2+area 1+d img CPT 78801 | $627.52 | $1,696.00 | $50.07 – $234.99 | 2 |
| Rp loclzj tum spect w/ct 1 CPT 78830 | not published | not published | $434.19 – $434.19 | 1 |
| Rp loclzj tum spect w/ct 2 CPT 78832 | not published | not published | $847.80 – $847.80 | 1 |
| Rpl picc wo subq port/pump incl image guidnc w/s&i CPT 36584 | $877.73 | $2,372.25 | $74.83 – $86.96 | 2 |
| Rpl tun-cvad w subq port CPT 36582 | not published | not published | $328.19 – $355.08 | 2 |
| Rpl tun-cvad w subq pump CPT 36583 | not published | not published | $355.83 – $362.10 | 2 |
| Rpl tun cvc wo subq port CPT 36581 | not published | not published | $206.58 – $241.47 | 2 |
| Rpr blood ves w/vein graft/up ext 35236 CPT 35236 | not published | not published | $1,123.57 – $1,190.76 | 2 |
| Rpr blood vsl grf oth vein lo ex CPT 35286 | not published | not published | $1,067.40 – $1,147.15 | 2 |
| Rpr choanal atresia ntranasl CPT 30540 | not published | not published | $718.66 – $743.79 | 2 |
| Rpr choanal atresia trsnpltn CPT 30545 | not published | not published | $961.65 – $1,043.00 | 2 |
| Rpr csf leak/pseudomeng/laminectomy63709 CPT 63709 | not published | not published | $1,189.85 – $1,229.09 | 2 |
| Rpr diaphragm hernia/chronic/not neonate 39541 CPT 39541 | not published | not published | $1,048.11 – $1,060.29 | 2 |
| Rpr diaphragm lac/any approach 39501 CPT 39501 | not published | not published | $949.08 – $951.86 | 2 |
| Rpr fem hernia init blocked CPT 49553 | not published | not published | $677.56 – $704.34 | 2 |
| Rpr hern preemie reduc CPT 49491 | not published | not published | $841.09 – $876.20 | 2 |
| Rpr hypspad comp dsj & urtp CPT 54348 | not published | not published | $1,142.21 – $1,292.20 | 2 |
| Rpr hypspad comp simple CPT 54340 | not published | not published | $634.42 – $704.03 | 2 |
| Rpr ing hernia baby blocked CPT 49496 | not published | not published | $609.02 – $647.38 | 2 |
| Rpr ing hernia baby reduc CPT 49495 | not published | not published | $423.11 – $426.88 | 2 |
| Rpr ing hernia init blocked CPT 49501 | not published | not published | $642.99 – $675.73 | 2 |
| Rpr ing hernia init reduce CPT 49500 | not published | not published | $422.46 – $437.75 | 2 |
| Rpr ing hern premie blocked CPT 49492 | not published | not published | $1,028.57 – $1,072.08 | 2 |
| Rpr&refit spct prsth aphakia CPT 92371 | not published | not published | $11.86 – $14.94 | 2 |
| Rpr rem hernia init reduce CPT 49550 | not published | not published | $618.66 – $642.23 | 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.