Ascension St. John Jane Phillips (Jane Phillips Memorial Medical Center, Inc.)
3500 SE Frank Phillips Blvd, Bartlesville, OK · Ascension · · NPI 1215914254
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 |
|---|---|---|---|---|
| Chloride 24 hour urine CPT 82436 | $22.85 | $61.75 | $5.21 – $33.65 | 29 |
| Chlorothiazide sodium 500 mg intravenous solution HCPCS J1205 | $106.21 | $287.05 | $199.53 – $257.67 | 5 |
| Chlorpromazine 0.125 mg/ml IV syringe - cnr HCPCS J3230 | $47.84 | $129.30 | $21.29 – $21.29 | 5 |
| Chmotx admn plrl cav thrcnts CPT 96440 | $359.27 | $971.00 | $139.53 – $760.30 | 29 |
| Cholangiogram percutaneous compl CPT 47532 | $2,915.42 | $7,879.50 | $244.56 – $420.94 | 5 |
| Cholangiography and/or pancreatography intraoperative supervision & interpretation CPT 74300 | $244.48 | $660.75 | $22.65 – $542.92 | 6 |
| Cholecystectomy expl duct 47612 CPT 47612 | not published | not published | $1,382.85 – $2,693.42 | 7 |
| Cholecystectomy w/cholangiography 47605 CPT 47605 | not published | not published | $1,065.06 – $2,389.97 | 7 |
| Cholecystoenterostomy direct 47720 CPT 47720 | not published | not published | $1,229.48 – $2,450.04 | 7 |
| Cholecystostomy complete w/supervision & interpretation CPT 47490 | $1,424.41 | $3,849.75 | $367.01 – $705.92 | 7 |
| Cholesterol CPT 82465 | $18.32 | $49.50 | $4.35 – $10.59 | 29 |
| Cholesterol body fluid CPT 84999 | $187.01 | $505.44 | $60.18 – $252.72 | 6 |
| Cholesterol (Lipid) Test CPT 80061 | $66.42 | $179.50 | $13.39 – $30.13 | 29 |
| Cholinesterase CPT 82480 | $30.90 | $83.50 | $7.87 – $19.17 | 29 |
| Cholinesterase challenge CPT 95857 | not published | not published | $33.01 – $713.79 | 29 |
| Chorion biopsy CPT 59015 | not published | not published | $149.31 – $1,995.91 | 29 |
| Chrom analysis CPT 88273 | $108.80 | $294.05 | $33.88 – $79.86 | 29 |
| Chromatogram assay sugars CPT 84375 | not published | not published | $8.68 – $108.04 | 29 |
| Chromatography CPT 83021 | not published | not published | $18.06 – $89.93 | 29 |
| Chromogenic substrate assay CPT 85130 | not published | not published | $11.89 – $89.93 | 29 |
| Chromo high res and frag x - sendout CPT 81243 | $180.75 | $488.50 | $57.04 – $128.34 | 28 |
| Chromosome analys amniotic CPT 88269 | not published | not published | $173.66 – $390.74 | 29 |
| Chromosome analysis 100 CPT 88249 | $181.95 | $491.75 | $79.86 – $389.63 | 29 |
| Chromosome analysis 15-20 cell count CPT 88262 | $311.36 | $841.50 | $125.49 – $282.35 | 29 |
| Chromosome analysis 20-25 CPT 88245 | not published | not published | $157.13 – $389.63 | 29 |
| Chromosome analysis 45 CPT 88263 | not published | not published | $150.29 – $338.15 | 29 |
| Chromosome analysis 5 CPT 88261 | not published | not published | $186.32 – $594.76 | 29 |
| Chromosome analysis 50-100 CPT 88248 | not published | not published | $173.17 – $389.63 | 29 |
| Chromosome analys placenta CPT 88267 | not published | not published | $188.57 – $424.28 | 29 |
| Chromosome banding study CPT 88283 | not published | not published | $68.60 – $195.81 | 29 |
| Chromosome count additional CPT 88285 | not published | not published | $20.06 – $113.79 | 29 |
| Chromosome karyotype study CPT 88280 | not published | not published | $26.58 – $195.81 | 29 |
| Chromosome study additional CPT 88289 | $144.12 | $389.50 | $34.43 – $113.79 | 29 |
| Chronic urticaria - sendout CPT 86343 | not published | not published | $12.46 – $79.86 | 29 |
| Chylomicron screen, bf - sendout CPT 82664 | $59.57 | $161.00 | $36.22 – $138.38 | 29 |
| Cidofovir injection HCPCS J0740 | $1,060.92 | $2,867.35 | $698.36 – $1,109.19 | 5 |
| Cilastatin sodium injection HCPCS J0743 | $43.44 | $117.40 | $7.21 – $21.29 | 5 |
| Ciliary transsleral therapy CPT 66710 | not published | not published | $394.65 – $867.38 | 7 |
| Cine/video x-rays CPT 76120 | $187.41 | $506.50 | $23.59 – $259.34 | 29 |
| Cine/video x-rays add-on CPT 76125 | not published | not published | $17.74 – $259.34 | 6 |
| Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback HCPCS J0744 | $43.80 | $118.39 | $1.75 – $9.29 | 5 |
| Circum 28 days or older CPT 54161 | not published | not published | $220.30 – $415.76 | 7 |
| Circumcise/surg/28 days or < 54160 CPT 54160 | not published | not published | $161.83 – $1,529.98 | 29 |
| Circumcision (newborn) CPT 54150 | $149.02 | $402.75 | $110.98 – $209.82 | 7 |
| Cisplatin 1 mg/ml desensitization HCPCS J9060 | $52.43 | $141.70 | $3.29 – $21.29 | 5 |
| C-kit mutation liquid tumor - sendout CPT 81272 | $365.76 | $988.53 | $329.51 – $741.40 | 28 |
| Cladribine 10 mg/10 ml intravenous solution HCPCS J9065 | $347.10 | $938.10 | $35.28 – $50.53 | 5 |
| Claviculectomy partial CPT 23120 | not published | not published | $620.65 – $1,235.54 | 7 |
| Claviculectomy total CPT 23125 | not published | not published | $764.52 – $1,493.73 | 7 |
| Clean out mastoid cavity CPT 69222 | not published | not published | $147.24 – $1,167.30 | 29 |
| Clearance of airways CPT 31720 | $80.94 | $218.75 | $59.07 – $466.20 | 29 |
| Clearance of tear duct CPT 68530 | $535.39 | $1,447.00 | $269.43 – $685.22 | 29 |
| C-lens fitg corneosclrl lens CPT 92313 | not published | not published | $52.58 – $295.47 | 29 |
| C-lens fitg tech aphakia 1 CPT 92315 | not published | not published | $24.81 – $295.47 | 29 |
| C-lens fitg tech aphakia ou CPT 92316 | not published | not published | $37.06 – $295.47 | 29 |
| C-lens fitg tech corneosclrl CPT 92317 | not published | not published | $25.54 – $89.98 | 29 |
| Clitoroplasty intersex state CPT 56805 | not published | not published | $1,323.59 – $2,482.80 | 7 |
| Clofarabine 1 mg/ml intravenous solution HCPCS J9027 | $3,993.47 | $10,793.15 | $199.53 – $220.11 | 5 |
| Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution HCPCS J0735 | $387.33 | $1,046.85 | $21.29 – $35.22 | 5 |
| Close bronchial fistula 32815 CPT 32815 | not published | not published | $3,129.14 – $6,049.05 | 7 |
| Closed carpo/metacarpal disl thumb w/manip CPT 26641 | $230.88 | $624.00 | $244.38 – $709.83 | 29 |
| Closed carpo/metacarpal fx disl thumb w/manip CPT 26645 | $2,628.48 | $7,104.00 | $392.68 – $822.14 | 7 |
| Closed treatment of femoral fracture proximal end neck; wi CPT 27232 | $1,505.99 | $4,070.25 | $831.41 – $1,617.76 | 7 |
| Closed tx/acetabululm without manip 27220 CPT 27220 | $394.98 | $1,067.50 | $244.38 – $1,109.19 | 29 |
| Closed tx humerus fx with manip 23605 CPT 23605 | $3,388.46 | $9,158.00 | $446.02 – $897.81 | 7 |
| Closed tx humerus fx without manip 23600 CPT 23600 | $264.37 | $714.50 | $244.38 – $648.20 | 29 |
| Closed tx humerus fx w/manip 24505 CPT 24505 | $2,628.48 | $7,104.00 | $473.18 – $954.74 | 7 |
| Closed tx metatarsophalangeal jnt disl without anes CPT 28630 | $258.82 | $699.50 | $123.19 – $549.86 | 29 |
| Closed tx nose/jaw fx CPT 21345 | not published | not published | $712.79 – $1,428.22 | 7 |
| Closed tx orbit without manipulj CPT 21400 | $920.38 | $2,487.50 | $152.03 – $1,167.30 | 29 |
| Closed tx orbit w/manipulj CPT 21401 | not published | not published | $316.05 – $629.47 | 7 |
| Closed tx post hip arthroplasty disloc w/anes 27266 CPT 27266 | $2,569.28 | $6,944.00 | $630.29 – $1,226.98 | 7 |
| Closed tx septal&nose fx CPT 21337 | $1,861.19 | $5,030.25 | $303.76 – $632.60 | 7 |
| Closed tx sesamoid fx 28530 CPT 28530 | not published | not published | $108.56 – $549.86 | 29 |
| Closed tx/talus fracture without manip 28430 CPT 28430 | $376.11 | $1,016.50 | $210.28 – $549.86 | 29 |
| Closed tx vert fx w/manj CPT 22315 | not published | not published | $817.03 – $1,624.78 | 7 |
| Close lac/mouth vest/2.5 cm or < 40830 CPT 40830 | $315.52 | $852.75 | $169.55 – $532.31 | 29 |
| Close mastoid fistula CPT 69700 | not published | not published | $751.85 – $1,478.13 | 7 |
| Close median sternotomy separation 21750 CPT 21750 | not published | not published | $765.90 – $1,476.59 | 7 |
| Close tear duct opening CPT 68760 | not published | not published | $146.07 – $685.22 | 29 |
| Close tear duct opening CPT 68761 | not published | not published | $118.28 – $685.22 | 29 |
| Close tear system fistula CPT 68770 | not published | not published | $598.83 – $1,386.87 | 7 |
| Clostridium toxin a w/optic CPT 87803 | not published | not published | $12.77 – $56.64 | 29 |
| Clos txnose fx without stablz 21315 CPT 21315 | $916.49 | $2,477.00 | $158.91 – $326.83 | 7 |
| Closure enterostomy lg/sm intestine 44620 CPT 44620 | not published | not published | $941.59 – $1,854.11 | 7 |
| Closure enterostomy lg/sm intestine anast 44626 CPT 44626 | not published | not published | $1,779.12 – $3,425.07 | 7 |
| Closure enterostomy lg/sm intestine oth/thn 44625 CPT 44625 | not published | not published | $1,116.59 – $2,183.28 | 7 |
| Closure intestinal cutaneous fistula 44640 CPT 44640 | not published | not published | $1,550.99 – $2,993.71 | 7 |
| Closure laceration vestibule mouth > 2.5 cm cmplx CPT 40831 | $730.75 | $1,975.00 | $238.42 – $1,167.30 | 29 |
| Closure of eyelid by suture CPT 67875 | not published | not published | $100.82 – $2,220.10 | 29 |
| Closure of salivary fistula CPT 42600 | not published | not published | $380.27 – $755.84 | 7 |
| Closure of windpipe lesion 31820 CPT 31820 | not published | not published | $359.09 – $707.47 | 7 |
| Closure paravalvlr leak pq CPT 33999 | not published | not published | $476.38 – $2,820.93 | 28 |
| Clot factor fletcher fact CPT 85292 | not published | not published | $18.93 – $100.82 | 29 |
| Clot factor viii reltd antgn CPT 85244 | not published | not published | $20.42 – $100.82 | 29 |
| Clot factor wght kininogen CPT 85293 | not published | not published | $18.93 – $100.82 | 29 |
| Clot factor xii hageman CPT 85280 | $95.74 | $258.75 | $19.35 – $100.82 | 29 |
| Clot factor xiii fibrin scrn CPT 85291 | not published | not published | $9.11 – $100.82 | 29 |
| Clot factor xiii fibrin stab CPT 85290 | $84.27 | $227.75 | $16.34 – $100.82 | 29 |
| Clotting assay whole blood CPT 85396 | $59.39 | $160.50 | $15.24 – $37.41 | 7 |
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.