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 |
|---|---|---|---|---|
| Tubal Ligation (Laparoscopic) CPT 58670 | not published | not published | $400.77 – $418.00 | 2 |
| Tube trach disp innr can 5 xlt HCPCS A7521 | $114.81 | $310.30 | $91.37 – $91.37 | 1 |
| Tube trach fen sz 6 uncuffed HCPCS A7520 | $1,120.18 | $3,027.50 | $92.23 – $92.23 | 1 |
| Tumor cell deplete of harvst CPT 38211 | not published | not published | $84.57 – $95.46 | 2 |
| Tvh >250 gms 58290 CPT 58290 | not published | not published | $1,273.33 – $1,335.33 | 2 |
| Tvh w/mmk 58267 CPT 58267 | not published | not published | $1,160.06 – $1,218.08 | 2 |
| Tx atrial fib pulm vein isol CPT 93656 | not published | not published | $1,273.90 – $11,285.00 | 2 |
| Tx closed distal humerus fx CPT 24999 | $135.14 | $365.25 | $182.63 – $182.63 | 1 |
| Tx closed hip disl traumatic without anes CPT 27250 | $294.34 | $795.50 | $205.25 – $265.88 | 2 |
| Tx closed tib fx proximal w/w/o manip w/skel trac CPT 27532 | not published | not published | $622.14 – $631.63 | 2 |
| Tx closed tib shaft fx without manip CPT 27750 | $256.97 | $694.50 | $319.27 – $342.16 | 2 |
| Tx contour defects >10.0 cc CPT 11954 | not published | not published | $128.04 – $129.16 | 2 |
| Tx contour defects 1.1-5.0cc 11951 CPT 11951 | not published | not published | $79.75 – $80.96 | 2 |
| Tx ectopic pregnancy abdl pregnancy 59130 CPT 59130 | not published | not published | $1,041.03 – $1,057.08 | 2 |
| Tx ectopic pregnancy ntrstl prtl rescj uter 59136 CPT 59136 | not published | not published | $985.51 – $999.66 | 2 |
| Tx l/r atrial fib addl CPT 93657 | not published | not published | $482.10 – $11,285.00 | 2 |
| Tx open art fx mcp/iphlngl jnt incl int fixtn ea CPT 26746 | $1,679.52 | $4,539.25 | $752.58 – $812.94 | 2 |
| Tx open dstl phlngl fx f/t internal fixation ea CPT 26765 | $2,930.49 | $7,920.25 | $495.49 – $543.43 | 2 |
| Tx open iphlngl jt disl internal fixation sngl CPT 26785 | $3,238.80 | $8,753.50 | $541.93 – $595.59 | 2 |
| Tx open nsl fx uncomp CPT 21325 | not published | not published | $490.47 – $508.11 | 2 |
| Tx open nsl sptl fx CPT 21336 | not published | not published | $678.04 – $697.57 | 2 |
| Tx phalangeal shaft fx open prox/middle ea CPT 26735 | $1,391.29 | $3,760.25 | $611.43 – $650.31 | 2 |
| Tx septic abortion surgical 59830 CPT 59830 | not published | not published | $486.31 – $493.03 | 2 |
| Tx tarsal bone fx without manip 28450 CPT 28450 | $376.11 | $1,016.50 | $195.31 – $207.56 | 2 |
| Tympanic membrane repair CPT 69610 | not published | not published | $321.59 – $331.55 | 2 |
| Tympanolysis transcanal 69450 CPT 69450 | not published | not published | $574.77 – $586.98 | 2 |
| Tympanometry & reflex thresh CPT 92550 | not published | not published | $23.26 – $23.26 | 1 |
| Tympanostomy/ven tube/loc/top anes 69433 CPT 69433 | not published | not published | $140.19 – $143.52 | 2 |
| Tympp antrt/mastoidotomy prosthesis torp 69637 CPT 69637 | not published | not published | $1,484.50 – $1,513.99 | 2 |
| Tympp antrt/mastoid without ossic chain recnst 69635 CPT 69635 | not published | not published | $1,315.55 – $1,336.12 | 2 |
| Ua w/micro/comp poc CPT 81000 | not published | not published | $3.39 – $4.94 | 2 |
| Ugt1a1 gene analy common variants CPT 81350 | not published | not published | $265.59 – $265.59 | 1 |
| Ultrasound abdomen aorta screening study aaa CPT 76706 | not published | not published | $67.19 – $67.19 | 1 |
| Ultrasound bone density measure CPT 76977 | not published | not published | $3.44 – $4.68 | 2 |
| Ultrasound breast complete CPT 76641 | $695.23 | $1,879.00 | $72.22 – $72.22 | 1 |
| Ultrasound breast unilateral limited (both sides) CPT 76642 | $695.23 | $1,879.00 | $55.33 – $55.33 | 1 |
| Ultrasound chest CPT 76604 | $263.90 | $713.25 | $34.35 – $62.52 | 2 |
| Ultrasound doppler velocimetry fetal umbilical artery CPT 76820 | $340.03 | $919.00 | $23.00 – $30.70 | 2 |
| Ultrasound dx ophth b-scan CPT 76512 | $256.50 | $693.25 | $40.25 – $45.58 | 2 |
| Ultrasound elastography ea l target les CPT 76983 | $114.33 | $309.00 | $38.73 – $38.73 | 1 |
| Ultrasound elastography parenchyma CPT 76981 | $114.33 | $309.00 | $80.21 – $80.21 | 1 |
| Ultrasound encephalogram CPT 76506 | $226.26 | $611.50 | $40.47 – $87.67 | 2 |
| Ultrasound exam k transpl w/doppler CPT 76776 | $398.49 | $1,077.00 | $47.67 – $121.44 | 2 |
| Ultrasound fetal biophysical profile without non-stress testing CPT 76819 | $294.06 | $794.75 | $47.35 – $52.10 | 2 |
| Ultrasound guidance for vascular access CPT 76937 | $155.49 | $420.25 | $17.24 – $19.33 | 2 |
| Ultrasound guided needle placement supervision & interpretation CPT 76942 | $289.99 | $783.75 | $28.39 – $42.26 | 2 |
| Ultrasound guide intraoperative CPT 76998 | $193.42 | $522.75 | $75.63 – $75.63 | 1 |
| Ultrasound guide tissue ablation CPT 76940 | not published | not published | $72.39 – $72.39 | 1 |
| Ultrasound hips infant dynamic CPT 76885 | $175.75 | $475.00 | $46.34 – $60.01 | 2 |
| Ultrasound infant hips ltd without stress CPT 76886 | $93.80 | $253.50 | $38.32 – $60.01 | 2 |
| Ultrasound joint complete left CPT 76881 | $205.63 | $555.75 | $88.38 – $88.38 | 1 |
| Ultrasound joint/nonvascular extremity limited left CPT 76882 | $154.75 | $418.25 | $11.51 – $11.51 | 1 |
| Ultrasound ob >=14wks ea addl gest CPT 76810 | $192.22 | $519.50 | $44.19 – $56.28 | 2 |
| Ultrasound pregnant uterus < 14 weeks each additional gestation CPT 76802 | $125.34 | $338.75 | $22.63 – $35.01 | 2 |
| Ultrasound pregnant uterus detailed fetal exam single/1st gestation CPT 76811 | $479.89 | $1,297.00 | $87.32 – $116.04 | 2 |
| Ultrasound pregnant uterus follow up per fetus CPT 76816 | $446.22 | $1,206.00 | $52.19 – $73.66 | 2 |
| Ultrasound pregnant uterus limited >= 1 fetuses CPT 76815 | $350.02 | $946.00 | $40.13 – $53.17 | 2 |
| Ultrasound pregnant uterus transvaginal CPT 76817 | $272.04 | $735.25 | $46.01 – $60.72 | 2 |
| Ultrasound prostate/transrectal CPT 76872 | $295.45 | $798.50 | $44.69 – $62.88 | 2 |
| Ultrasound retroperitoneal limited CPT 76775 | $277.13 | $749.00 | $30.19 – $37.24 | 2 |
| Ultrasound scrotum and contents CPT 76870 | $299.15 | $808.50 | $36.65 – $40.45 | 2 |
| Ultrasound spinal canal and contents CPT 76800 | $175.01 | $473.00 | $60.01 – $67.20 | 2 |
| Ultrasound transabd ea addl gest CPT 76812 | $137.55 | $371.75 | $108.53 – $115.69 | 2 |
| Ultrasound transvaginal non obstetric CPT 76830 | $378.88 | $1,024.00 | $42.80 – $89.46 | 2 |
| Ultrasound trgt dyn mbubb 1st les CPT 76978 | not published | not published | $243.84 – $243.84 | 1 |
| Ultraviolet therapy CPT 97028 | not published | not published | $7.23 – $7.93 | 2 |
| Umbilical artery cath newborn 36660 CPT 36660 | not published | not published | $82.11 – $83.39 | 2 |
| Umbilical cord occlud w/us CPT 59072 | not published | not published | $529.06 – $558.13 | 2 |
| Umbilicoplasty 15847 CPT 15847 | not published | not published | $518.35 – $518.35 | 1 |
| Unlisted all/immlg svc/px CPT 95199 | not published | not published | not published | 0 |
| Unlisted chemotherapy px CPT 96549 | not published | not published | not published | 0 |
| Unlisted cranfcl&maxlfcl px CPT 21299 | not published | not published | $289.13 – $289.13 | 1 |
| Unlisted CT procedure CPT 76497 | not published | not published | not published | 0 |
| Unlisted cv px dx nuc med CPT 78499 | not published | not published | not published | 0 |
| Unlisted cytogenetic study CPT 88299 | not published | not published | not published | 0 |
| Unlisted cytopathology px CPT 88199 | not published | not published | not published | 0 |
| Unlisted dx gi procedure CPT 91299 | not published | not published | not published | 0 |
| Unlisted endocrine px dx nuc CPT 78099 | not published | not published | not published | 0 |
| Unlisted fetal invas px w/us CPT 59897 | not published | not published | not published | 0 |
| Unlisted fluoroscopic px CPT 76496 | not published | not published | not published | 0 |
| Unlisted gi px dx nuc med CPT 78299 | not published | not published | not published | 0 |
| Unlisted gu px dx nuc med CPT 78799 | not published | not published | not published | 0 |
| Unlisted hystsc px uterus CPT 58579 | not published | not published | not published | 0 |
| Unlisted laparoscopic liver biopy 47379 CPT 47379 | not published | not published | not published | 0 |
| Unlisted laparoscopic procedure 49659 CPT 49659 | not published | not published | not published | 0 |
| Unlisted laparoscopic reduction intestine 44238 CPT 44238 | not published | not published | not published | 0 |
| Unlisted laparoscopy procedure biliary tract 47579 CPT 47579 | not published | not published | not published | 0 |
| Unlisted laps px appendix CPT 44979 | not published | not published | not published | 0 |
| Unlisted laps px bladder CPT 51999 | not published | not published | not published | 0 |
| Unlisted laps px endoc sys CPT 60659 | not published | not published | not published | 0 |
| Unlisted laps px esoph CPT 43289 | not published | not published | not published | 0 |
| Unlisted laps px lymphtc sys CPT 38589 | not published | not published | not published | 0 |
| Unlisted laps px ovidct ovry CPT 58679 | not published | not published | not published | 0 |
| Unlisted laps px renal CPT 50549 | not published | not published | not published | 0 |
| Unlisted laps px spleen CPT 38129 | not published | not published | not published | 0 |
| Unlisted laps px testis CPT 54699 | not published | not published | not published | 0 |
| Unlisted laps px ureter CPT 50949 | not published | not published | not published | 0 |
| Unlisted laps px uterus CPT 58578 | not published | not published | not published | 0 |
| Unlisted maxlfcl prosth px CPT 21089 | not published | not published | not published | 0 |
| Unlisted misc path test CPT 89240 | not published | not published | not published | 0 |
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.