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 |
|---|---|---|---|---|
| C-reactive protein, quantitative CPT 86406 | $113.50 | $306.75 | $10.64 – $62.53 | 29 |
| Creat artery-vein fistula autograft 36825 CPT 36825 | not published | not published | $690.29 – $1,748.02 | 7 |
| Create eardrum opening CPT 69436 | not published | not published | $174.42 – $345.55 | 7 |
| Create passage to kidney CPT 52334 | not published | not published | $289.41 – $545.24 | 7 |
| Create tear duct drain CPT 68745 | not published | not published | $767.39 – $1,675.49 | 7 |
| Create tear duct drain CPT 68750 | not published | not published | $787.86 – $1,727.74 | 7 |
| Create tear sac drain CPT 68720 | not published | not published | $764.81 – $1,648.19 | 7 |
| Creatine isoforms CPT 82554 | not published | not published | $11.87 – $108.04 | 29 |
| Creatine kinase CPT 82550 | $44.22 | $119.50 | $6.51 – $60.18 | 29 |
| Creatine kinase isoenzymes CPT 82552 | $44.22 | $119.50 | $13.39 – $60.18 | 29 |
| Creatine kinase mb CPT 82553 | $42.55 | $115.00 | $11.55 – $108.04 | 29 |
| Creatine - sendout CPT 82540 | $53.10 | $143.50 | $4.64 – $33.65 | 29 |
| Creatinine CPT 82565 | $19.70 | $53.25 | $5.12 – $12.46 | 29 |
| Creatinine 24 hour urine CPT 82570 | $186.61 | $504.35 | $5.18 – $12.59 | 29 |
| Creatinine clearance urine CPT 82575 | $50.88 | $137.50 | $9.46 – $60.18 | 29 |
| #creutz-prot.,western blot CPT 84182 | $365.93 | $989.00 | $15.11 – $65.72 | 29 |
| Cricopharyngeal myotomy 43030 CPT 43030 | not published | not published | $576.06 – $1,123.23 | 7 |
| Cricotracheal resection CPT 31592 | not published | not published | $1,857.90 – $3,205.24 | 5 |
| Crisis psychotherapy 90839 CPT 90839 | not published | not published | $148.06 – $368.28 | 23 |
| Crisis psychotherapy additional 30 mins 90840 CPT 90840 | not published | not published | $70.84 – $114.28 | 6 |
| Critical care 30-74 minutes CPT 99291 | $1,211.94 | $3,275.50 | $248.97 – $1,931.42 | 28 |
| Critical care each additional 30 minutes CPT 99292 | $282.50 | $763.50 | $124.85 – $189.79 | 6 |
| Crnec exc tum/bone les skull CPT 61500 | not published | not published | $1,450.81 – $2,808.07 | 7 |
| Crnop skull defect>5 cm diam CPT 62141 | not published | not published | $1,233.94 – $2,405.57 | 7 |
| Cross-over vein graft CPT 34520 | not published | not published | $1,201.81 – $2,205.90 | 7 |
| Crotalidae poly immune fab HCPCS J0840 | $3,996.74 | $10,802.00 | $1,395.94 – $4,015.56 | 5 |
| Crtj pericardial window/prtl resecj w/drg/bx CPT 33025 | not published | not published | $898.78 – $1,726.19 | 7 |
| Cryoablate prostate CPT 55873 | not published | not published | $859.39 – $1,617.76 | 7 |
| Cryocautery of cervix 57511 CPT 57511 | not published | not published | $144.62 – $697.27 | 29 |
| Cryofibrinogen qualitative - sendout CPT 82585 | $24.98 | $67.50 | $9.12 – $31.82 | 29 |
| Cryopreservation embryo(s) CPT 89258 | not published | not published | $113.79 – $1,872.50 | 27 |
| Cryopreservation oocyte(s) CPT 89337 | not published | not published | $174.57 – $392.78 | 22 |
| Cryopreservation sperm CPT 89259 | not published | not published | $113.79 – $392.78 | 27 |
| Cryopreserve stem cells CPT 38207 | not published | not published | $52.87 – $1,002.11 | 29 |
| Cryopreserve testicular tiss CPT 89335 | not published | not published | $54.43 – $122.47 | 27 |
| Cryosurg ablate fa each CPT 19105 | not published | not published | $225.72 – $411.06 | 7 |
| Cryosurgery penis lesion(s) 54056 CPT 54056 | not published | not published | $117.83 – $455.47 | 29 |
| Cryotherapy of acne 17340 CPT 17340 | not published | not published | $51.85 – $136.15 | 29 |
| Cryptococcus abs qn - sendout CPT 86641 | $52.63 | $142.25 | $14.41 – $79.86 | 29 |
| Cryptosporidium antigen CPT 87272 | not published | not published | $11.98 – $62.53 | 29 |
| Crystal identification light microscopy CPT 89060 | $23.50 | $63.50 | $7.33 – $17.40 | 29 |
| C-Section Delivery (full care) CPT 59510 | not published | not published | $2,269.84 – $4,333.20 | 7 |
| C-section delivery incl p/p care 59515 CPT 59515 | not published | not published | $1,250.16 – $1,421.75 | 2 |
| Csf leakage imaging CPT 78650 | $1,171.61 | $3,166.50 | $38.65 – $680.97 | 7 |
| Csf shunt reprogram 62252 CPT 62252 | $296.93 | $802.50 | $39.17 – $687.47 | 29 |
| Csf ventriculography CPT 78635 | not published | not published | $38.75 – $1,233.83 | 29 |
| CT 3d report other modality w/workstation CPT 76377 | $191.01 | $516.25 | $31.62 – $148.98 | 7 |
| Cta abdomen without & /or w/contrast CPT 74175 | $1,341.62 | $3,626.00 | $120.13 – $828.39 | 29 |
| Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast CPT 75635 | $1,528.75 | $4,131.75 | $153.62 – $919.65 | 29 |
| Cta lower extremity without & w/contrast (both sides) CPT 73706 | $2,658.27 | $7,184.50 | $120.93 – $827.60 | 29 |
| Cta neck without &/or w/contrast CPT 70498 | $1,315.72 | $3,556.00 | $111.11 – $1,049.91 | 29 |
| CT Angiogram of Abdomen and Pelvis CPT 74174 | $2,483.63 | $6,712.50 | $265.51 – $1,017.93 | 28 |
| CT Angiogram of the Chest (for blood clot) CPT 71275 | $1,499.24 | $4,052.00 | $121.36 – $824.48 | 29 |
| CT Angiogram of the Head CPT 70496 | $1,328.95 | $3,591.75 | $110.71 – $1,016.37 | 29 |
| CT angio hrt w/3d image CPT 75574 | $1,166.70 | $3,153.25 | $265.52 – $934.46 | 28 |
| CT angio pelvis CPT 72191 | $1,012.14 | $2,735.50 | $114.32 – $817.46 | 29 |
| Cta upper extremity w &/or without contrast left CPT 73206 | $1,229.70 | $3,323.50 | $115.11 – $748.82 | 29 |
| CT bone density axial CPT 77078 | not published | not published | $15.60 – $265.21 | 29 |
| CT colonography dx CPT 74261 | not published | not published | $108.33 – $1,089.69 | 28 |
| CT colonography dx w/dye CPT 74262 | not published | not published | $181.36 – $1,200.46 | 28 |
| CT colonography screening CPT 74263 | not published | not published | $246.25 – $1,568.62 | 28 |
| CT guidance for needle placement CPT 77012 | $584.14 | $1,578.75 | $67.56 – $487.52 | 7 |
| CT guidance for percutaneous drain w/catheter placement supervision & interpretation CPT 75989 | $562.49 | $1,520.25 | $63.24 – $542.92 | 7 |
| CT guid cryo ablat intramuscular CPT 20999 | $2,614.14 | $7,065.25 | $244.38 – $6,090.54 | 28 |
| CT guid parench tis ablat CPT 77013 | $325.51 | $879.75 | $252.95 – $487.52 | 6 |
| CT heart w/evaluation of calcium without contrast CPT 75571 | $277.50 | $750.00 | $44.73 – $230.89 | 28 |
| CT hrt c+ strux cgen hrt ds CPT 75573 | not published | not published | $265.16 – $868.17 | 28 |
| CT hrt w/3d image CPT 75572 | not published | not published | $199.06 – $818.62 | 28 |
| CT limited or localized follow-up study CPT 76380 | $275.00 | $743.25 | $60.01 – $340.10 | 29 |
| CT lower extremity w/contrast (both sides) CPT 73701 | $1,978.58 | $5,347.50 | $73.39 – $530.41 | 29 |
| CT lower extremity without contrast (both sides) CPT 73700 | $1,646.50 | $4,450.00 | $68.52 – $427.45 | 29 |
| CT lwr extremity w/o&w/dye CPT 73702 | $1,581.38 | $4,274.00 | $77.00 – $662.23 | 29 |
| CT neck soft tissue w/contrast CPT 70491 | $917.14 | $2,478.75 | $86.79 – $548.35 | 29 |
| CT neck soft tissue without contrast CPT 70490 | $725.29 | $1,960.25 | $80.91 – $456.32 | 29 |
| CT neck soft tissue without & w/contrast CPT 70492 | $1,042.01 | $2,816.25 | $90.87 – $652.10 | 29 |
| CT orbit/sella/fossa w/wo contrast CPT 70482 | $1,023.14 | $2,765.25 | $90.87 – $723.86 | 29 |
| CT orbit/sella/ or posterior outer inner or middle ear w/contrast CPT 70481 | $753.23 | $2,035.75 | $86.79 – $654.44 | 29 |
| CT orbit/sella/ or posterior outer inner or middle ear without contrast CPT 70480 | $790.88 | $2,137.50 | $80.51 – $565.52 | 29 |
| Ctrl nosebld postir subsq 30906 CPT 30906 | $130.33 | $352.25 | $153.22 – $532.31 | 29 |
| CT scan for therapy guide CPT 77014 | $360.75 | $975.00 | $52.59 – $487.52 | 7 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $1,216.01 | $3,286.50 | $255.45 – $825.26 | 28 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $1,187.61 | $3,209.75 | $222.39 – $818.62 | 28 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $920.93 | $2,489.00 | $114.61 – $554.06 | 28 |
| CT thoracic spine w/contrast CPT 72129 | $859.79 | $2,323.75 | $77.00 – $537.43 | 29 |
| CT thoracic spine without contrast CPT 72128 | $843.69 | $2,280.25 | $73.00 – $429.02 | 29 |
| CT thorax low dose for lung screening without contrast CPT 71271 | $952.66 | $2,574.75 | $97.66 – $243.74 | 23 |
| CT t-spine w /wo contrast CPT 72130 | $715.30 | $1,933.25 | $80.04 – $641.96 | 29 |
| CT upper extremity w/contrast (both sides) CPT 73201 | $1,771.19 | $4,787.00 | $73.00 – $818.62 | 29 |
| CT upper extremity without contrast (both sides) CPT 73200 | $1,587.30 | $4,290.00 | $68.52 – $426.66 | 29 |
| CT uppr extremity w/o&w/dye CPT 73202 | $1,476.49 | $3,990.50 | $76.61 – $663.03 | 29 |
| Cultr oocyte/embryo <4 days CPT 89250 | not published | not published | $174.57 – $1,530.91 | 28 |
| Cultr oocyte/embryo <4 days CPT 89251 | not published | not published | $174.57 – $1,592.41 | 28 |
| Cult skin graft fnhfg 15155 CPT 15155 | not published | not published | $732.78 – $1,500.75 | 7 |
| Cult skin grft t/arm/leg CPT 15150 | not published | not published | $691.59 – $1,340.07 | 7 |
| Culture aerobic additional method definitive id each CPT 87077 | $27.38 | $74.00 | $8.08 – $56.64 | 29 |
| Culture afb any source CPT 87116 | $51.34 | $138.75 | $10.80 – $26.28 | 29 |
| Culture anaerobic additional method definitive id each CPT 87076 | $35.34 | $95.50 | $8.08 – $56.64 | 29 |
| Culture anaerobic except blood CPT 87075 | $65.49 | $177.00 | $9.47 – $56.64 | 29 |
| Culture bact stool aero addl path ea CPT 87046 | $19.43 | $52.50 | $9.44 – $22.95 | 29 |
| Culture body fluid CPT 87070 | $60.22 | $162.75 | $8.62 – $56.64 | 29 |
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.