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 |
|---|---|---|---|---|
| Rpr xtnsr tndn leg prim without grft ea tndn CPT 27664 | not published | not published | $396.91 – $400.11 | 2 |
| Rp therapy unlisted px CPT 79999 | not published | not published | not published | 0 |
| Rrp hypspad comp moblj&urtp CPT 54344 | not published | not published | $1,067.43 – $1,217.13 | 2 |
| Rsv assay w/optic CPT 87807 | $53.00 | $143.25 | $12.77 – $18.66 | 2 |
| Rubella antibody igg CPT 86762 | $60.40 | $163.25 | $15.11 – $22.40 | 2 |
| Rubeola antibody igg CPT 86765 | $50.23 | $135.75 | $13.55 – $20.06 | 2 |
| Russell viper venom diluted CPT 85613 | $60.22 | $162.75 | $10.16 – $14.91 | 2 |
| Salivary gland function exam CPT 78232 | not published | not published | $29.80 – $84.81 | 2 |
| Salivary gland imaging CPT 78230 | $272.41 | $736.25 | $28.06 – $160.26 | 2 |
| Salivary glnd img serial img CPT 78231 | not published | not published | $32.54 – $108.52 | 2 |
| Salmonella antibody CPT 86768 | $22.20 | $60.00 | $11.38 – $14.29 | 2 |
| Salpingostomy 58770 CPT 58770 | not published | not published | $964.59 – $973.06 | 2 |
| Same day nb discharge 99463 CPT 99463 | not published | not published | $93.22 – $131.77 | 2 |
| Sargramostim injection HCPCS J2820 | $451.34 | $1,219.85 | $23.75 – $23.75 | 1 |
| S bowel endoscope w/stent CPT 44379 | not published | not published | $469.36 – $514.66 | 2 |
| Sbsq nurs facil care/day unstabl/new prob 35 min 99310 CPT 99310 | not published | not published | $146.81 – $149.38 | 2 |
| Sbsq nursing facil care/day minor complj 15 min CPT 99308 | not published | not published | $74.69 – $75.69 | 2 |
| Sbsq nursing facil care/day new problem 25 min CPT 99309 | not published | not published | $99.15 – $100.22 | 2 |
| Sbsq nursing facility care/day e/m stable 10 min CPT 99307 | not published | not published | $48.87 – $48.95 | 2 |
| Scan duplex abd/pelvis/retroperitoneal complete CPT 93975 | $444.65 | $1,201.75 | $114.12 – $226.00 | 2 |
| Scan duplex abd/pelvis/retroperitoneal limited CPT 93976 | $348.91 | $943.00 | $75.74 – $112.82 | 2 |
| Scan duplex aorta/ivc/iliac or bypass grafts complete CPT 93978 | $188.52 | $509.50 | $41.01 – $153.42 | 2 |
| Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 | $163.45 | $441.75 | $27.49 – $96.29 | 2 |
| Scan duplex extracranial arteries unilateral/limited study CPT 93882 | $251.05 | $678.50 | $25.11 – $105.27 | 2 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $385.36 | $1,041.50 | $28.36 – $99.53 | 2 |
| Scan duplex lower extremity arteries complete bilateral CPT 93925 | $395.99 | $1,070.25 | $36.34 – $223.12 | 2 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $294.43 | $795.75 | $24.64 – $112.83 | 2 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $280.83 | $759.00 | $19.40 – $105.63 | 2 |
| Scan proc cranial extra CPT 61782 | not published | not published | $197.80 – $197.80 | 1 |
| Scan proc cranial intra 61781 CPT 61781 | not published | not published | $269.15 – $269.15 | 1 |
| Scan proc spinal CPT 61783 | not published | not published | $264.36 – $264.36 | 1 |
| Sclerotherapy fluid collection pq w/img CPT 49185 | $1,261.42 | $3,409.25 | $138.64 – $138.64 | 1 |
| Scope plantar fasciotomy CPT 29893 | not published | not published | $472.26 – $479.35 | 2 |
| Screening Mammogram CPT 77067 | $140.60 | $380.00 | $100.61 – $100.61 | 1 |
| Screen/visual acuity/bilat/quant 99173 CPT 99173 | not published | not published | $2.69 – $3.25 | 2 |
| Sc ther infusion reset pump CPT 96371 | $49.58 | $134.00 | $69.34 – $80.00 | 2 |
| Sec abd wall suture evisceration/dehsn 49900 CPT 49900 | not published | not published | $877.92 – $907.77 | 2 |
| Sec art mech thrmbc non-intracranial add-on CPT 37186 | not published | not published | $283.75 – $317.41 | 2 |
| Sedation moderate same physician performing a gastrointestinal endoscopic service >= 5 years initial 15 minutes intra-service time HCPCS G0500 | $66.51 | $179.75 | $6.24 – $6.24 | 1 |
| Sedimentation rate erythrocyte automated CPT 85652 | $20.81 | $56.25 | $2.87 – $4.20 | 2 |
| Segmentectomy 32484 CPT 32484 | not published | not published | $1,619.40 – $1,693.66 | 2 |
| Select picture audiometry CPT 92583 | not published | not published | $35.43 – $51.02 | 2 |
| Self-mgmt educ/train 2-4 pt 30min CPT 98961 | not published | not published | $12.65 – $13.65 | 2 |
| Self-mgmt educ/train 5-8 pt 30min CPT 98962 | not published | not published | $9.46 – $10.07 | 2 |
| Semen analysis presence/motility CPT 89321 | not published | not published | $12.77 – $18.76 | 2 |
| Semen analysis w/count CPT 89310 | not published | not published | $9.12 – $13.40 | 2 |
| Sensorimotor examination CPT 92060 | not published | not published | $20.62 – $26.96 | 2 |
| Sensorineural acuity lvl tst CPT 92575 | not published | not published | $37.65 – $59.29 | 2 |
| Separate eyelid adhesions CPT 68340 | not published | not published | $393.71 – $430.85 | 2 |
| Sept9 promoter methylation analysis CPT 81327 | not published | not published | $94.97 – $94.97 | 1 |
| Sequestrectomy olecrn proces CPT 24138 | not published | not published | $714.11 – $736.57 | 2 |
| Sequestrectomy radial h/n CPT 24136 | not published | not published | $651.64 – $654.03 | 2 |
| Sequestrectomy shft/dstl hum CPT 24134 | not published | not published | $821.47 – $822.36 | 2 |
| Serial casting application 97139app CPT 97139 | not published | not published | not published | 0 |
| Serpina1 gene CPT 81332 | $216.27 | $584.50 | $67.96 – $67.96 | 1 |
| Set radiation therapy field CPT 77280 | $350.76 | $948.00 | $43.56 – $242.15 | 2 |
| Set radiation therapy field CPT 77285 | not published | not published | $65.05 – $389.10 | 2 |
| Set radiation therapy field CPT 77290 | $647.59 | $1,750.25 | $96.62 – $443.34 | 2 |
| Set-up cardiovert-defibrill CPT 93745 | not published | not published | not published | 0 |
| Sever cranial nerve CPT 64771 | not published | not published | $644.14 – $660.72 | 2 |
| Sex transformation f to m CPT 55980 | not published | not published | not published | 0 |
| Sex transformation m to f CPT 55970 | not published | not published | not published | 0 |
| Sgmdsc w/band ligation CPT 45350 | not published | not published | $114.59 – $114.59 | 1 |
| Shave sgl skin lsn f/e/e/n/l/m 0.5cm/< CPT 11310 | not published | not published | $48.55 – $53.14 | 2 |
| Shave sgl skin lsn f/e/e/n/l/m 0.6-1.0cm CPT 11311 | not published | not published | $71.03 – $73.30 | 2 |
| Shave sgl skin lsn f/e/e/n/l/m 1.1-2cm CPT 11312 | not published | not published | $81.54 – $87.59 | 2 |
| Shave sgl skin lsn f/e/e/n/l/m >2cm CPT 11313 | not published | not published | $109.18 – $112.44 | 2 |
| Shave sgl skin lsn s/n/h/f/g 0.5cm/< CPT 11305 | not published | not published | $42.64 – $44.49 | 2 |
| Shave sgl skin lsn s/n/h/f/g 0.6-1.0 cm CPT 11306 | not published | not published | $58.59 – $64.42 | 2 |
| Shave sgl skin lsn s/n/h/f/g 1.1-2cm CPT 11307 | not published | not published | $75.22 – $75.83 | 2 |
| Shave sgl skin lsn s/n/h/f/g >2cm CPT 11308 | not published | not published | $83.29 – $91.45 | 2 |
| Shave sgl skin lsn t/a/l 0.5cm/< CPT 11300 | not published | not published | $33.56 – $39.59 | 2 |
| Shave sgl skin lsn t/a/l 0.6-1.0cm CPT 11301 | not published | not published | $56.97 – $60.10 | 2 |
| Shave sgl skin lsn t/a/l 1.1-2.0cm CPT 11302 | not published | not published | $70.54 – $70.63 | 2 |
| Shigella antibody CPT 86771 | not published | not published | $13.81 – $20.53 | 2 |
| Sho arthrs dx +- synovial bx CPT 29805 | not published | not published | $509.35 – $517.05 | 2 |
| Sho arthrs srg bicp tenodsis CPT 29828 | not published | not published | $1,006.18 – $1,010.48 | 2 |
| Sho arthrs srg capsulorraphy CPT 29806 | not published | not published | $1,173.66 – $1,176.57 | 2 |
| Sho arthrs srg compl synvct CPT 29821 | not published | not published | $641.41 – $645.79 | 2 |
| Sho arthrs srg lmtd dbrdmt CPT 29822 | not published | not published | $622.72 – $626.74 | 2 |
| Sho arthrs srg lss&rescj ads CPT 29825 | not published | not published | $634.08 – $639.61 | 2 |
| Sho arthrs srg prtl synvct CPT 29820 | not published | not published | $587.06 – $591.28 | 2 |
| Sho arthrs srg rmvl loose/fb CPT 29819 | not published | not published | $640.41 – $643.60 | 2 |
| Sho arthrs srg rpr slap les CPT 29807 | not published | not published | $1,144.02 – $1,145.41 | 2 |
| Sho arthrs srg xtnsv dbrdmt CPT 29823 | not published | not published | $679.63 – $686.05 | 2 |
| Shortening of hand tendon CPT 26479 | not published | not published | $648.11 – $651.00 | 2 |
| Shorten radius or ulna CPT 25390 | not published | not published | $847.20 – $908.43 | 2 |
| Shorten radius & ulna CPT 25392 | not published | not published | $1,126.07 – $1,177.06 | 2 |
| Shoulder Arthroscopy (Rotator Cuff Repair) CPT 29827 | not published | not published | $1,167.55 – $1,207.33 | 2 |
| Shoulder MRI (with and without contrast) CPT 73223 | $1,070.87 | $2,894.25 | $134.83 – $366.12 | 2 |
| Shoulder MRI (with contrast) CPT 73222 | $1,025.64 | $2,772.00 | $101.53 – $300.00 | 2 |
| Shoulder MRI (without contrast) CPT 73221 | $2,051.28 | $5,544.00 | $84.59 – $170.67 | 2 |
| Shoulder prosthesis removal CPT 23334 | not published | not published | $1,190.52 – $1,190.52 | 1 |
| Shoulder prosthesis removal CPT 23335 | not published | not published | $1,419.81 – $1,419.81 | 1 |
| Shoulder X-ray CPT 73030 | $263.81 | $713.00 | $11.52 – $19.77 | 2 |
| Shrinker prosth above knee HCPCS L8460 | $157.49 | $425.65 | $128.24 – $128.24 | 1 |
| Shrinker prosth below knee HCPCS L8440 | $90.54 | $244.70 | $73.73 – $73.73 | 1 |
| Shuntogram nonvascular supervision & interpretation CPT 75809 | $99.25 | $268.25 | $29.40 – $75.82 | 2 |
| Sialidase enzyme assay CPT 87905 | not published | not published | $12.77 – $19.02 | 2 |
| Sialography s&i CPT 70390 | $168.72 | $456.00 | $23.98 – $75.45 | 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.