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 |
|---|---|---|---|---|
| X-ray thoracic spine 3 views CPT 72072 | $172.24 | $465.50 | $13.80 – $23.72 | 2 |
| X-ray thoracolumbar spine >=2 views CPT 72080 | $141.43 | $382.25 | $13.80 – $19.77 | 2 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | $143.38 | $387.50 | $25.88 – $25.88 | 1 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views CPT 72082 | $148.46 | $401.25 | $46.72 – $46.72 | 1 |
| X-ray tibia/fibula 2 views (both sides) CPT 73590 | $232.18 | $627.50 | $10.66 – $20.49 | 2 |
| X-ray toe(s) > 2 views (both sides) CPT 73660 | $200.91 | $543.00 | $7.98 – $21.57 | 2 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast CPT 74246 | $321.62 | $869.25 | $43.60 – $93.06 | 2 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study CPT 74240 | $299.98 | $810.75 | $43.60 – $78.69 | 2 |
| X-ray wrist 2 views (both sides) CPT 73100 | $246.42 | $666.00 | $10.19 – $20.85 | 2 |
| X-ray xm phrnx&/crv esoph c+ CPT 74210 | not published | not published | $23.05 – $60.01 | 2 |
| Xylose absorption test blood &/or urine CPT 84620 | not published | not published | $12.51 – $18.44 | 2 |
| Yersinia antibody CPT 86793 | not published | not published | $13.81 – $20.53 | 2 |
| Ziconotide injection HCPCS J2278 | $2,571.72 | $6,950.60 | $6.78 – $6.78 | 1 |
| Zika virus dna/rna amp probe CPT 87662 | not published | not published | $58.24 – $58.24 | 1 |
| Zika virus igm antibody CPT 86794 | not published | not published | $19.12 – $19.12 | 1 |
| Zoster vaccine-live inj CPT 90736 | not published | not published | $161.60 – $161.60 | 1 |
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.