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 |
|---|---|---|---|---|
| Vaccine dtap-hep b-ipv im CPT 90723 | not published | not published | $75.19 – $75.19 | 1 |
| Vaccine dtap-ipv 4-6 years im CPT 90696 | not published | not published | not published | 0 |
| Vaccine dtap-ipv/hib im CPT 90698 | not published | not published | $72.91 – $72.91 | 1 |
| Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im CPT 90647 | not published | not published | $23.34 – $23.34 | 1 |
| Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im CPT 90648 | not published | not published | $22.83 – $22.83 | 1 |
| Vaccine hepatitis a (hepa) adult im CPT 90632 | not published | not published | $45.55 – $45.55 | 1 |
| Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im CPT 90636 | not published | not published | $86.54 – $86.54 | 1 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im CPT 90633 | not published | not published | $23.94 – $23.94 | 1 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 3 dose im CPT 90634 | not published | not published | not published | 0 |
| Vaccine hepatitis b (hepb) adolescent 2 dose im CPT 90743 | not published | not published | $50.44 – $50.44 | 1 |
| Vaccine hepatitis b (hepb) adult 3 dose im CPT 90746 | not published | not published | $51.79 – $51.79 | 1 |
| Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 | not published | not published | $26.64 – $26.64 | 1 |
| Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im CPT 90649 | not published | not published | $143.59 – $143.59 | 1 |
| Vaccine influenza (iiv) preservative free antigen content im CPT 90662 | not published | not published | not published | 0 |
| Vaccine influenza nos 0.5ml dose im CPT 90658 | not published | not published | $12.51 – $12.51 | 1 |
| Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im CPT 90656 | not published | not published | $12.54 – $12.54 | 1 |
| Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im CPT 90661 | not published | not published | not published | 0 |
| Vaccine influenza trivalent (iiv3) 0.25ml dose im CPT 90657 | not published | not published | $5.68 – $5.68 | 1 |
| Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im CPT 90734 | not published | not published | $114.68 – $114.68 | 1 |
| Vaccine mmr live subcutaneous CPT 90707 | not published | not published | $51.74 – $51.74 | 1 |
| Vaccine mmrv live subcutaneous CPT 90710 | not published | not published | $141.78 – $141.78 | 1 |
| Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im CPT 90732 | not published | not published | $41.37 – $41.37 | 1 |
| Vaccine pneumococcal conjugate 13 valent (pcv13) im CPT 90670 | not published | not published | $364.90 – $364.90 | 1 |
| Vaccine polio (ipv) subcutaneous/im CPT 90713 | not published | not published | $30.48 – $30.48 | 1 |
| Vaccine rabies im CPT 90675 | $595.40 | $1,609.20 | $154.89 – $154.89 | 1 |
| Vaccine rotavirus attenuated (rv1) live 2 dose oral CPT 90681 | not published | not published | not published | 0 |
| Vaccine rotavirus pentavalent (rv5) live 3 dose oral CPT 90680 | not published | not published | $76.54 – $76.54 | 1 |
| Vaccine tdap >=7 years im CPT 90715 | not published | not published | $37.03 – $37.03 | 1 |
| Vaccine td preservative free >= 7 years im CPT 90714 | not published | not published | $20.04 – $20.04 | 1 |
| Vaccine typhoid vicps im CPT 90691 | not published | not published | $43.61 – $43.61 | 1 |
| Vaccine varicella live subcutaneous CPT 90716 | not published | not published | $89.79 – $89.79 | 1 |
| Vaccine yellow fever live subcutaneous CPT 90717 | not published | not published | $59.49 – $59.49 | 1 |
| Vag hys/<250g/rmv tube/rpr entero 58263 CPT 58263 | not published | not published | $1,093.52 – $1,146.03 | 2 |
| Vag hyst incl t/o complex CPT 58291 | not published | not published | $1,374.34 – $1,451.53 | 2 |
| Vag hyst including t/o CPT 58262 | not published | not published | $1,018.61 – $1,063.20 | 2 |
| Vag hyst t/o & repair compl CPT 58292 | not published | not published | $1,449.61 – $1,530.37 | 2 |
| Vag hyst w/enterocele compl 58294 CPT 58294 | not published | not published | $1,344.54 – $1,411.44 | 2 |
| Vag hyst w/enterocele repair CPT 58270 | not published | not published | $974.87 – $1,019.69 | 2 |
| Vag hyst w/uro repair compl 58293 CPT 58293 | not published | not published | $1,509.04 – $1,589.52 | 2 |
| Vaginal bx CPT 58999 | not published | not published | not published | 0 |
| Vaginal delivery after cesarean delivery 59612 CPT 59612 | not published | not published | $1,005.20 – $1,036.39 | 2 |
| Vaginal Delivery (full care) CPT 59400 | not published | not published | $2,004.50 – $2,325.90 | 2 |
| Vaginal hysterectomy CPT 58260 | not published | not published | $912.10 – $950.60 | 2 |
| Vaginectomy partial w/nodes CPT 57109 | not published | not published | $1,849.63 – $1,959.45 | 2 |
| Vagotomy pfrmd w/prtl dstl gstrct 43635 CPT 43635 | not published | not published | $128.04 – $128.10 | 2 |
| Vagotomy & pylorus repair 43640 CPT 43640 | not published | not published | $1,277.94 – $1,324.28 | 2 |
| Valproic acid total therapeutic drug level CPT 80164 | $53.00 | $143.25 | $14.33 – $21.09 | 2 |
| Valvuloplasty aortic CPT 92986 | not published | not published | $1,491.31 – $1,681.01 | 2 |
| Valvuloplasty mitral CPT 92987 | not published | not published | $1,539.36 – $1,739.86 | 2 |
| Valvuloplasty pulmonary CPT 92990 | not published | not published | $1,225.87 – $1,339.19 | 2 |
| Valvuloplasty/tv without ring insert 33463 CPT 33463 | not published | not published | $3,506.73 – $3,545.96 | 2 |
| Valvuloplasty/tv w/ring insertion 33464 CPT 33464 | not published | not published | $2,768.26 – $2,850.43 | 2 |
| Vancomycin peak therapeutic drug level CPT 80202 | $90.84 | $245.50 | $14.33 – $21.09 | 2 |
| Vanomycin dna amp probe CPT 87500 | not published | not published | $37.00 – $54.64 | 2 |
| Varicella zoster antibody igg CPT 86787 | $128.11 | $346.25 | $13.55 – $20.06 | 2 |
| Varicella-zoster immue globin im CPT 90396 | not published | not published | not published | 0 |
| Vasc graft into carpal bone CPT 25430 | not published | not published | $773.78 – $802.96 | 2 |
| Vasectomy CPT 55250 | not published | not published | $252.89 – $278.19 | 2 |
| Vbac delivery 59610 CPT 59610 | not published | not published | $2,110.97 – $2,448.74 | 2 |
| Vbac/include postpartum care 59614 CPT 59614 | not published | not published | $1,124.15 – $1,287.37 | 2 |
| Vein bypass grft fem-popliteal 35583 CPT 35583 | not published | not published | $1,664.57 – $1,763.62 | 2 |
| Vein byp fem-tibial peroneal 35585 CPT 35585 | not published | not published | $1,930.69 – $2,065.26 | 2 |
| Vein gft fem a/p tib/pero/dis art 35566 CPT 35566 | not published | not published | $1,922.77 – $2,050.51 | 2 |
| Vein x-ray adrenal gland CPT 75840 | not published | not published | $71.05 – $92.70 | 2 |
| Vein x-ray adrenal glands CPT 75842 | not published | not published | $94.24 – $107.44 | 2 |
| Vein x-ray eye socket CPT 75880 | not published | not published | $43.27 – $112.46 | 2 |
| Vein x-ray kidney CPT 75831 | not published | not published | $71.95 – $85.87 | 2 |
| Vein x-ray liver CPT 75891 | not published | not published | $72.46 – $90.54 | 2 |
| Vein x-ray liver w/hemodynam CPT 75885 | not published | not published | $89.11 – $91.60 | 2 |
| Vein x-ray liver w/hemodynam CPT 75889 | not published | not published | $72.46 – $89.82 | 2 |
| Vein x-ray liver without hemodyn CPT 75887 | not published | not published | $90.19 – $91.60 | 2 |
| Vein x-ray skull CPT 75870 | not published | not published | $71.66 – $92.70 | 2 |
| Vein x-ray skull epidural CPT 75872 | not published | not published | $75.50 – $99.53 | 2 |
| Vein x-ray spleen/liver CPT 75810 | not published | not published | $72.85 – $72.85 | 1 |
| Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture) CPT 36410 | $14.80 | $40.00 | $10.58 – $10.73 | 2 |
| Venipuncture <3 yrs other vein CPT 36406 | not published | not published | $10.23 – $11.12 | 2 |
| Venogram ext bil s&i CPT 75822 | not published | not published | $66.71 – $85.51 | 2 |
| Venogram extremity supervision & interpretation unilateral CPT 75820 | not published | not published | $44.86 – $81.56 | 2 |
| Venous mech thrombectomy CPT 37187 | not published | not published | $450.39 – $521.02 | 2 |
| Venous m-thrombectomy add-on CPT 37188 | not published | not published | $319.26 – $376.64 | 2 |
| Venous sampling s&i CPT 75893 | not published | not published | $33.88 – $93.06 | 2 |
| Venous thrombosis imaging CPT 78457 | not published | not published | $48.14 – $146.24 | 2 |
| Ven thrombosis images bilat CPT 78458 | not published | not published | $56.92 – $168.52 | 2 |
| Ventilator each subsequent day CPT 94003 | $286.84 | $775.25 | $74.93 – $79.15 | 2 |
| Ventilator initial day CPT 94002 | $354.55 | $958.25 | $104.17 – $109.90 | 2 |
| Ventricular puncture prev burr hole without inj 61020 CPT 61020 | not published | not published | $113.18 – $141.77 | 2 |
| Ventriculomyotomy/ihss 33416 CPT 33416 | not published | not published | $2,298.60 – $2,406.75 | 2 |
| Version cephalic external CPT 59412 | not published | not published | $115.95 – $119.83 | 2 |
| Vertebral corpectomy partial/complete 63082 CPT 63082 | not published | not published | $302.18 – $309.34 | 2 |
| Very long chain fatty acids CPT 82726 | $150.96 | $408.00 | $19.02 – $28.11 | 2 |
| V-exc/lip/w/pri linear closure 40520 CPT 40520 | not published | not published | $391.95 – $395.79 | 2 |
| Viper venom prothrombin time CPT 85612 | not published | not published | $10.16 – $14.91 | 2 |
| Virus isolation addl studies ea CPT 87253 | not published | not published | $21.37 – $28.53 | 2 |
| Visual audiometry (vra) CPT 92579 | not published | not published | $42.55 – $49.33 | 2 |
| Vital capacity test CPT 94150 | $84.92 | $229.50 | $4.77 – $21.57 | 2 |
| Vitamin b-12 CPT 82607 | $49.67 | $134.25 | $15.90 – $23.47 | 2 |
| Vitamin D Test CPT 82306 | $131.17 | $354.50 | $31.27 – $46.09 | 2 |
| Vit for macular hole CPT 67042 | not published | not published | $1,253.81 – $1,553.61 | 2 |
| Vit for macular pucker CPT 67041 | not published | not published | $1,252.73 – $1,354.12 | 2 |
| Vit for membrane dissect CPT 67043 | not published | not published | $1,324.76 – $1,628.23 | 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.