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 |
|---|---|---|---|---|
| Sialolithotomy 42330 CPT 42330 | $1,805.60 | $4,880.00 | $181.48 – $182.47 | 2 |
| Sickling rbc CPT 85660 | $25.81 | $69.75 | $5.73 – $8.58 | 2 |
| Sigmoidoscopy and biopsy CPT 45331 | not published | not published | $81.39 – $86.46 | 2 |
| Sigmoidoscopy flex decompression 45337 CPT 45337 | not published | not published | $132.11 – $164.65 | 2 |
| Sigmoidoscopy for bleeding CPT 45334 | not published | not published | $134.11 – $192.07 | 2 |
| Sigmoidoscopy/submucosal injection 45335 CPT 45335 | not published | not published | $75.17 – $105.56 | 2 |
| Sigmoidoscopy w/ablation CPT 45346 | not published | not published | $183.36 – $183.36 | 1 |
| Sigmoidoscopy w/fb removal 45332 CPT 45332 | not published | not published | $119.66 – $127.29 | 2 |
| Sigmoidoscopy w/plcmt stent CPT 45347 | not published | not published | $176.45 – $176.45 | 1 |
| Sigmoidoscopy w/resection CPT 45349 | not published | not published | $226.72 – $226.72 | 1 |
| Sigmoidoscopy w/tumr remove CPT 45338 | not published | not published | $137.24 – $164.72 | 2 |
| Sigmoidoscopy w/ultrasound CPT 45341 | not published | not published | $141.16 – $183.29 | 2 |
| Sigmoidoscopy w/us guide bx CPT 45342 | not published | not published | $193.88 – $280.81 | 2 |
| Sigmoid/rmv tumor/polyp/hot bx for 45333 CPT 45333 | not published | not published | $106.78 – $126.60 | 2 |
| Signal avg ecg w or without ecg 93278 CPT 93278 | not published | not published | $16.00 – $18.33 | 2 |
| Sig w/tndsc balloon dilation CPT 45340 | not published | not published | $88.05 – $133.28 | 2 |
| Simple cystometrogram 51725 CPT 51725 | not published | not published | $97.04 – $112.10 | 2 |
| Sinus CT scan (with and without contrast) CPT 70488 | $786.90 | $2,126.75 | $89.07 – $142.28 | 2 |
| Sinus CT scan (with contrast) CPT 70487 | $741.48 | $2,004.00 | $82.24 – $112.10 | 2 |
| Sinus CT scan (without contrast) CPT 70486 | $756.00 | $2,043.25 | $71.66 – $97.37 | 2 |
| Sinus/juglr venogram s&i CPT 75860 | not published | not published | $73.36 – $88.75 | 2 |
| Sinusotomy maxillary sinus 31020 CPT 31020 | not published | not published | $365.52 – $382.26 | 2 |
| Sinusotomy sinus remove polyps 31032 CPT 31032 | not published | not published | $610.62 – $618.48 | 2 |
| Sinusotomy sphenoid w/wo bx 31050 CPT 31050 | not published | not published | $518.93 – $524.41 | 2 |
| Skin and muscle repair face CPT 15845 | not published | not published | $1,037.99 – $1,097.05 | 2 |
| Skin full graft 20sq cm less 15200 CPT 15200 | not published | not published | $710.42 – $740.70 | 2 |
| Skin full graft add-on 15241 CPT 15241 | not published | not published | $124.85 – $128.64 | 2 |
| Skin pedicle flap arms/legs CPT 15572 | not published | not published | $785.88 – $823.06 | 2 |
| Skin pedicle flap trunk CPT 15570 | not published | not published | $777.67 – $811.00 | 2 |
| Skin split graft addl 100sq cm 15101 CPT 15101 | not published | not published | $123.86 – $125.56 | 2 |
| Skin test unlisted antigen ea CPT 86486 | $26.09 | $70.50 | $3.51 – $5.04 | 2 |
| Sleep study attended CPT 95807 | not published | not published | $99.31 – $408.54 | 2 |
| Sleep Study (Polysomnography) CPT 95810 | not published | not published | $209.89 – $507.72 | 2 |
| Sleep study unattended CPT 95806 | not published | not published | $100.11 – $109.58 | 2 |
| Sling arm deluxe w/pad xs HCPCS A4565 | $103.58 | $279.95 | $14.95 – $14.95 | 1 |
| Slitting of prepuce CPT 54000 | not published | not published | $119.87 – $131.37 | 2 |
| Slitting of prepuce CPT 54001 | not published | not published | $154.66 – $170.60 | 2 |
| Slp eval for nonspeech dev ea addl 30 mins CPT 92618 | not published | not published | $36.92 – $36.92 | 1 |
| Slp eval non-spch gen comm dev CPT 92605 | not published | not published | $99.02 – $99.02 | 1 |
| Slp pure tone screening CPT 92551 | not published | not published | $11.45 – $12.22 | 2 |
| Slp stdy unatnd w/anal CPT 95801 | not published | not published | $42.04 – $42.04 | 1 |
| Slp ther svc non-spch gen CPT 92606 | not published | not published | $79.36 – $79.36 | 1 |
| Small bowel endoscopy CPT 44360 | not published | not published | $164.18 – $184.41 | 2 |
| Small bowel endoscopy CPT 44364 | not published | not published | $233.71 – $259.74 | 2 |
| Small bowel endoscopy CPT 44366 | not published | not published | $274.70 – $306.18 | 2 |
| Small bowel endoscopy CPT 44369 | not published | not published | $281.72 – $312.82 | 2 |
| Small bowel endoscopy CPT 44376 | not published | not published | $325.60 – $357.34 | 2 |
| Small bowel endoscopy CPT 44378 | not published | not published | $441.08 – $485.82 | 2 |
| Small bowel endoscopy CPT 44382 | not published | not published | $82.98 – $96.15 | 2 |
| Small bowel endoscopy CPT 44384 | not published | not published | $174.89 – $174.89 | 1 |
| Small bowel endoscopy >2nd w/remove 44363 CPT 44363 | not published | not published | $219.26 – $241.32 | 2 |
| Small bowel endoscopy 44365 CPT 44365 | not published | not published | $206.10 – $231.20 | 2 |
| Small bowel endoscopy/biopsy CPT 44361 | not published | not published | $181.35 – $203.31 | 2 |
| Small bowel endoscopy/biopsy CPT 44377 | not published | not published | $343.09 – $378.58 | 2 |
| Small bowel endoscopy br/wa CPT 44380 | not published | not published | $63.54 – $79.88 | 2 |
| Small bowel endoscopy br/wa CPT 44381 | not published | not published | $96.23 – $96.23 | 1 |
| Small bowel endoscopy/stent 44370 CPT 44370 | not published | not published | $304.68 – $336.69 | 2 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $23.13 | $62.50 | $5.73 – $8.39 | 2 |
| Smear gram stain CPT 87205 | $42.37 | $114.50 | $4.43 – $6.65 | 2 |
| Smear nasal eosinophil CPT 89190 | $21.65 | $58.50 | $4.95 – $7.39 | 2 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $52.08 | $140.75 | $6.25 – $9.33 | 2 |
| Smear wet mount CPT 87210 | $21.74 | $58.75 | $4.43 – $6.65 | 2 |
| Smn1 gene full gene sequence CPT 81336 | not published | not published | $342.03 – $342.03 | 1 |
| Smpd1 gene common variants CPT 81330 | not published | not published | $53.34 – $53.34 | 1 |
| Snrpn/ube3a gene CPT 81331 | $479.34 | $1,295.50 | $57.96 – $57.96 | 1 |
| Sodium 24 hour urine CPT 84300 | $47.18 | $127.50 | $5.21 – $7.57 | 2 |
| Sodium serum/plasma/whole blood CPT 84295 | $24.88 | $67.25 | $4.95 – $7.49 | 2 |
| Somatosensory testing CPT 95927 | $358.35 | $968.50 | $34.07 – $112.10 | 2 |
| Somatropin injection HCPCS J2941 | $339.59 | $917.80 | $58.84 – $58.84 | 1 |
| Sp bone algrft morsel add-on CPT 20930 | not published | not published | $138.18 – $138.18 | 1 |
| Special physics consult CPT 77370 | not published | not published | $124.40 – $128.44 | 2 |
| Special radiation dosimetry CPT 77331 | not published | not published | $19.41 – $20.51 | 2 |
| Special radiation treatment CPT 77470 | not published | not published | $39.53 – $129.52 | 2 |
| Special teletx port plan CPT 77321 | not published | not published | $44.56 – $58.77 | 2 |
| Specific gravity body fluid CPT 84315 | $14.99 | $40.50 | $2.61 – $3.90 | 2 |
| Specimen fat stain CPT 89125 | not published | not published | $4.43 – $6.73 | 2 |
| Speech audiometry complete CPT 92556 | not published | not published | $26.47 – $38.45 | 2 |
| Speech evaluation complex CPT 70371 | not published | not published | $48.51 – $51.32 | 2 |
| Speech recep thresh CPT 92555 | not published | not published | $17.12 – $23.72 | 2 |
| Sperm antibody test CPT 89325 | not published | not published | $11.20 – $16.62 | 2 |
| Sperm identification CPT 89257 | not published | not published | not published | 0 |
| Sperm isolation complex CPT 89261 | not published | not published | not published | 0 |
| Sperm isolation simple CPT 89260 | not published | not published | not published | 0 |
| Sperm washing 58323 CPT 58323 | not published | not published | $13.34 – $14.85 | 2 |
| Sphenoid sinus surgery CPT 31051 | not published | not published | $686.71 – $692.71 | 2 |
| Sphincteroplasty inc/prolapse adult 46750 CPT 46750 | not published | not published | $825.47 – $841.84 | 2 |
| Spinal bone allograftstructural 20931 CPT 20931 | not published | not published | $127.35 – $128.59 | 2 |
| Spinal bone autograftlocal 20936 CPT 20936 | not published | not published | $147.29 – $147.29 | 1 |
| Spirmtry w/brnchdil inf-2 yr CPT 94012 | not published | not published | $164.72 – $164.72 | 1 |
| Spirometry bronchodilation responsiveness pre/post bronchodilator administration CPT 94060 | $159.01 | $429.75 | $18.02 – $48.51 | 2 |
| Spirometry up to 2 yrs old CPT 94011 | not published | not published | $102.26 – $102.26 | 1 |
| Spleen imaging CPT 78185 | not published | not published | $25.32 – $201.58 | 2 |
| Splenectomy total open 38100 CPT 38100 | not published | not published | $1,245.51 – $1,297.96 | 2 |
| Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 % CPT 15120 | not published | not published | $770.73 – $852.06 | 2 |
| Split blood or products CPT 86985 | $65.12 | $176.00 | $10.94 – $10.94 | 1 |
| Sputum specimen collection CPT 89220 | not published | not published | $10.55 – $16.54 | 2 |
| Srs linear based CPT 77372 | not published | not published | $892.56 – $1,094.09 | 2 |
| Srs multisource CPT 77371 | not published | not published | $1,491.30 – $1,491.30 | 1 |
| Staggered spondaic word test CPT 92572 | not published | not published | $18.63 – $31.98 | 2 |
| Staging lapro hodgkins disease/lymphoma 49220 CPT 49220 | not published | not published | $1,055.11 – $1,089.69 | 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.