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 |
|---|---|---|---|---|
| Clsd/shoulder dislo/manip/no anest 23650 CPT 23650 | $283.05 | $765.00 | $244.38 – $613.09 | 29 |
| Clsd tx bimalleol ank fx without manip 27808 CPT 27808 | $394.79 | $1,067.00 | $244.38 – $635.71 | 29 |
| Clsd tx carpo/metacarpl disl thmb manip ea without anes CPT 26670 | $450.48 | $1,217.50 | $244.38 – $636.50 | 29 |
| Clsd tx clav dislc without manip 23520 CPT 23520 | $2,628.48 | $7,104.00 | $225.20 – $491.42 | 7 |
| Clsd tx clavicle dislocation without manip 23540 CPT 23540 | $235.32 | $636.00 | $219.05 – $549.86 | 29 |
| Clsd tx clavicle fracture w/manip 23505 CPT 23505 | $1,321.64 | $3,572.00 | $340.75 – $701.24 | 7 |
| Clsd tx/clavicular fx without manip 23500 CPT 23500 | $258.82 | $699.50 | $214.70 – $549.86 | 29 |
| Clsd tx coccygeal fracture 27200 CPT 27200 | $188.05 | $508.25 | $183.19 – $549.86 | 29 |
| Clsd tx/dis phalan fx without manip/ea 26750 CPT 26750 | $115.07 | $311.00 | $174.93 – $549.86 | 29 |
| Clsd tx dist fib fx w/manip 27788 CPT 27788 | $278.06 | $751.50 | $244.38 – $817.46 | 29 |
| Clsd tx/dis tib/wt bear no manip 27824 CPT 27824 | $266.40 | $720.00 | $244.38 – $641.18 | 29 |
| Clsd tx elbow dislocation child 24640 CPT 24640 | $292.49 | $790.50 | $92.21 – $549.86 | 29 |
| Clsd tx/fem shaft fx/manipulation 27502 CPT 27502 | $2,587.60 | $6,993.50 | $840.79 – $1,634.93 | 7 |
| Clsd tx finger tendon w/wo perq pin 26432 CPT 26432 | not published | not published | $514.12 – $1,031.97 | 7 |
| Clsd tx fracture of radius 25500 CPT 25500 | $394.79 | $1,067.00 | $240.76 – $549.86 | 29 |
| Clsd tx/fx grt toe/phalanx/phalang 28490 CPT 28490 | $376.11 | $1,016.50 | $121.99 – $549.86 | 29 |
| Clsd tx/fx/phalanx/phalang/manip 28515 CPT 28515 | $122.38 | $330.75 | $147.76 – $549.86 | 29 |
| Clsd tx fx radius/ulna dist without manip 25600 CPT 25600 | $313.21 | $846.50 | $244.38 – $652.88 | 29 |
| Clsd tx fx radius/ulna dist w/manip 25605 CPT 25605 | $975.88 | $2,637.50 | $554.67 – $1,089.69 | 7 |
| Clsd tx fx radius/ulna without manip 25560 CPT 25560 | $283.05 | $765.00 | $239.49 – $549.86 | 29 |
| Clsd tx fx radius/ulna w/manip 25565 CPT 25565 | $882.64 | $2,385.50 | $499.51 – $997.65 | 7 |
| Clsd tx/grt hum tube fx without manip 23620 CPT 23620 | $482.85 | $1,305.00 | $244.38 – $549.86 | 29 |
| Clsd tx hip disloc without anes 27265 CPT 27265 | $302.66 | $818.00 | $244.38 – $854.91 | 29 |
| Clsd tx humeral fract without manip 24530 CPT 24530 | $264.18 | $714.00 | $244.38 – $723.86 | 29 |
| Clsd tx humerus fract without manip 24500 CPT 24500 | $394.79 | $1,067.00 | $244.38 – $685.64 | 29 |
| Clsd tx iphal jnt disl w/manip req anes CPT 26775 | $1,233.58 | $3,334.00 | $270.56 – $733.99 | 29 |
| Clsd tx mandibular fx without manip 21450 CPT 21450 | $483.22 | $1,306.00 | $475.45 – $1,167.30 | 29 |
| Clsd tx/metacar/interphal artic fx 26740 CPT 26740 | $376.11 | $1,016.50 | $209.62 – $549.86 | 29 |
| Clsd tx/metacarpal fx/sg without manip 26600 CPT 26600 | $131.17 | $354.50 | $244.38 – $582.67 | 29 |
| Clsd tx/metacarpal fx/sng/w manip 26605 CPT 26605 | $111.83 | $302.25 | $244.38 – $617.00 | 29 |
| Clsd tx metacarp fx w/manip&ext fix ea bone 26607 CPT 26607 | not published | not published | $466.08 – $958.64 | 7 |
| Clsd tx metatarsal fracture w/manip 28475 CPT 28475 | $345.77 | $934.50 | $244.38 – $549.86 | 29 |
| Clsd tx/metatarsal fx without manip 28470 CPT 28470 | $247.90 | $670.00 | $196.58 – $549.86 | 29 |
| Clsd tx/nasal bone fx/stabilize 21320 CPT 21320 | $1,888.11 | $5,103.00 | $148.28 – $289.39 | 7 |
| Clsd tx nose fx without manip 21310 CPT 21310 | not published | not published | $30.87 – $59.29 | 7 |
| Clsd tx of ankle fracture w/manip 28435 CPT 28435 | $2,628.48 | $7,104.00 | $311.44 – $677.83 | 7 |
| Clsd tx patella disloc without anes 27560 CPT 27560 | $278.06 | $751.50 | $244.38 – $714.51 | 29 |
| Clsd tx/patellar fx without manip 27520 CPT 27520 | $394.79 | $1,067.00 | $244.38 – $623.24 | 29 |
| Clsd tx pelvic ring fx CPT 27197 | $203.59 | $550.25 | $127.87 – $549.86 | 27 |
| Clsd tx pelvic ring fx CPT 27198 | not published | not published | $244.38 – $569.92 | 27 |
| Clsd tx prox fib/shaft fx w/manip 27781 CPT 27781 | $2,557.07 | $6,911.00 | $407.99 – $818.24 | 7 |
| Clsd tx/prox/mid phalnx fx/no manp 26720 CPT 26720 | $104.16 | $281.50 | $175.64 – $549.86 | 29 |
| Clsd tx/radial head/neck fx/no manip 24650 CPT 24650 | $247.53 | $669.00 | $231.55 – $549.86 | 29 |
| Clsd tx radius fracture w/manip 24655 CPT 24655 | $2,628.48 | $7,104.00 | $410.37 – $842.42 | 7 |
| Clsd tx/scapular fx without manip 23570 CPT 23570 | $247.16 | $668.00 | $233.86 – $549.86 | 29 |
| Clsd tx shoulder dislc/fx 23665 CPT 23665 | $2,628.48 | $7,104.00 | $409.89 – $834.63 | 7 |
| Clsd tx shoulder disloc w/anatom neck fx w/manip 23675 CPT 23675 | $2,628.48 | $7,104.00 | $529.13 – $1,053.81 | 7 |
| Clsd tx/shoulder dislo/manip/anest 23655 CPT 23655 | $2,132.50 | $5,763.50 | $405.22 – $843.20 | 7 |
| Clsd tx/talotarsal dislocat/anes 28575 CPT 28575 | not published | not published | $323.59 – $695.00 | 7 |
| Clsd tx temporomandibular dislocat 21480 CPT 21480 | $224.59 | $607.00 | $36.05 – $549.86 | 29 |
| Clsd tx toe dislocation without anes28660 CPT 28660 | $225.24 | $608.75 | $93.91 – $549.86 | 29 |
| Clsd tx trimall ankle fx without manip 27816 CPT 27816 | $264.74 | $715.50 | $244.38 – $603.74 | 29 |
| Clsd tx trimall ankle fx w/manip 27818 CPT 27818 | $832.32 | $2,249.50 | $468.59 – $924.33 | 7 |
| Clsd tx/ulnar shaft fx without manip 25530 CPT 25530 | $394.79 | $1,067.00 | $228.37 – $549.86 | 29 |
| Clsd tx vert body fx without manip req &w/csting/bracing CPT 22310 | not published | not published | $244.38 – $596.72 | 29 |
| Clsd tx wrist carpal fx without manip 25630 CPT 25630 | $394.79 | $1,067.00 | $244.38 – $590.48 | 29 |
| Clsd tx wrist scaphoid fx without manip 25622 CPT 25622 | $212.75 | $575.00 | $244.38 – $584.23 | 29 |
| Clsd tx wrist trans-scaph fx w/manip 25680 CPT 25680 | $227.74 | $615.50 | $244.38 – $1,013.25 | 29 |
| Clsd tx wrist ulnar styloid fx 25650 CPT 25650 | $239.02 | $646.00 | $244.38 – $633.37 | 29 |
| Clsd/ulnar fx/prox end without manip 24670 CPT 24670 | $376.11 | $1,016.50 | $244.38 – $553.82 | 29 |
| Cls tx of heel fracture w/manip 28405 CPT 28405 | not published | not published | $244.38 – $735.56 | 29 |
| Cltx carpl scphd fx w/mnpj CPT 25624 | not published | not published | $433.84 – $910.28 | 7 |
| Cltx gr hmrl tbrs fx w/mnpj CPT 23625 | $2,558.00 | $6,913.50 | $366.99 – $746.48 | 7 |
| Cltx hum epcndylr fx wo mnpj CPT 24560 | $244.02 | $659.50 | $244.38 – $607.64 | 29 |
| Cltx humrl cndylr fx w/mnpj CPT 24577 | not published | not published | $512.38 – $1,055.37 | 7 |
| Cltx humrl cndylr fx wo mnpj CPT 24576 | $376.11 | $1,016.50 | $244.38 – $643.52 | 29 |
| Cltx lunate dislc w/mnpj CPT 25690 | $2,691.75 | $7,275.00 | $491.15 – $1,010.91 | 7 |
| Cltx mndblr fx ntrdntl fixj CPT 21453 | not published | not published | $776.16 – $1,661.45 | 7 |
| Cltx mndblr fx w/mnpj CPT 21451 | $728.07 | $1,967.75 | $644.36 – $1,350.22 | 7 |
| Cltx mndblr/max alv ridge fx CPT 21440 | $1,288.53 | $3,482.50 | $453.10 – $998.43 | 7 |
| Cltx palatal/max fx wire fix CPT 21421 | not published | not published | $648.90 – $1,413.39 | 7 |
| Cltx post ankle fx CPT 27767 | $376.11 | $1,016.50 | $244.38 – $597.49 | 29 |
| Cltx post ankle fx w/mnpj CPT 27768 | $2,628.48 | $7,104.00 | $433.41 – $926.67 | 7 |
| Cltx scap fx w/mnpj +-tractj CPT 23575 | $2,628.48 | $7,104.00 | $375.51 – $787.83 | 7 |
| Cltx strnclav dislc w/mnpj CPT 23525 | $759.61 | $2,053.00 | $244.38 – $733.99 | 29 |
| Cltx thigh fx CPT 27267 | $2,345.99 | $6,340.50 | $448.99 – $923.54 | 7 |
| Cltx tmprmand dislc comp CPT 21485 | not published | not published | $575.66 – $1,237.11 | 7 |
| Cmbn ant pst colprhy CPT 57260 | not published | not published | $921.05 – $1,799.50 | 7 |
| C motor evoked lwr limbs CPT 95929 | $127.28 | $344.00 | $92.02 – $1,216.24 | 29 |
| C motor evoked uppr limbs CPT 95928 | $347.80 | $940.00 | $91.62 – $597.49 | 7 |
| C motor evoked upr&lwr limbs CPT 95939 | $200.36 | $541.50 | $390.20 – $1,024.95 | 6 |
| Cmptr ophth dx img ant segmt CPT 92132 | not published | not published | $14.73 – $136.15 | 28 |
| Cmptr ophth img optic nerve CPT 92133 | not published | not published | $15.10 – $136.15 | 28 |
| #cms hgb-carboxyhemoglobin CPT 82376 | not published | not published | $6.25 – $60.18 | 29 |
| #cms hgb-sulfhemoglobin CPT 83060 | not published | not published | $8.60 – $108.04 | 29 |
| #cmvcul-virus inoculation shell CPT 87254 | $132.28 | $357.50 | $19.56 – $113.14 | 29 |
| Cmv pcr-sendout CPT 87496 | $164.84 | $445.50 | $35.09 – $113.14 | 29 |
| Co2 monitor per day CPT 94681 | not published | not published | $11.66 – $713.79 | 29 |
| Coagulation factor viia 1,000 mcg/ml inj 1 ml HCPCS J7189 | $746.08 | $2,016.43 | $1.98 – $2.87 | 5 |
| Coagulation time activated teg CPT 85347 | $18.78 | $50.75 | $4.28 – $38.30 | 29 |
| Coagulation time otr method CPT 85348 | not published | not published | $3.91 – $38.30 | 29 |
| Cochlear implt f/up exam <7 CPT 92601 | not published | not published | $135.09 – $358.63 | 29 |
| Cochlear implt f/up exam 7/> CPT 92603 | not published | not published | $135.55 – $358.63 | 29 |
| Cold agglutinin screen (arc) CPT 86156 | $31.08 | $84.00 | $7.04 – $62.53 | 29 |
| Cold agglutinin titer CPT 86157 | $40.89 | $110.50 | $8.06 – $62.53 | 29 |
| Colectomy/end colost/close dis seg 44143 CPT 44143 | not published | not published | $1,812.37 – $3,549.10 | 7 |
| Colectomy/ ileostomy without prctect 44150 CPT 44150 | not published | not published | $2,004.83 – $3,997.61 | 7 |
| Colectomy/ ileostomy w/prctect 44155 CPT 44155 | not published | not published | $2,249.34 – $4,454.70 | 7 |
| Colectomy partial w/anastomosis 44140 CPT 44140 | not published | not published | $1,471.50 – $2,857.21 | 7 |
| Colectomy prtl abdominal + transanal appr 44147 CPT 44147 | not published | not published | $2,075.60 – $4,143.46 | 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.