healthcosts.net

Ascension St. John Jane Phillips (Jane Phillips Memorial Medical Center, Inc.)

3500 SE Frank Phillips Blvd, Bartlesville, OK · Ascension · · NPI 1215914254

Source: hospital's published price file ↗ · Published Jan 1, 2026 · Ingested Sep 8, 2026

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
Depo-estradiol cypionate inj HCPCS J1000 $17.80 $48.10 $13.94 – $21.29 5
Dermabrasion other than face CPT 15782 not published not published $435.61 – $844.76 7
Dermabrasion segmental face 15781 CPT 15781 not published not published $455.82 – $1,612.78 29
Dermabrasion suprfl any site CPT 15783 not published not published $395.37 – $915.79 29
Dermabrasion total face CPT 15780 not published not published $699.20 – $1,406.38 7
Derma-fat-fascia graft 15770 CPT 15770 not published not published $710.00 – $1,439.92 7
Dermagraft HCPCS Q4106 $67.62 $182.75 $61.35 – $75.44 5
Derm autograft face/nck/hf/g CPT 15135 not published not published $811.11 – $1,635.70 7
Derm autograft trnk/arm/leg CPT 15130 not published not published $605.50 – $1,199.67 7
Descend thora aorta rpr/lt sub art 33880 CPT 33880 not published not published $2,058.03 – $3,961.73 7
Design custom breast implant CPT 19396 not published not published $149.62 – $314.35 7
Design mlc device for imrt CPT 77338 $1,282.33 $3,465.75 $291.41 – $1,028.85 28
Desmopressin 4 mcg/ml injection solution HCPCS J2597 $69.11 $186.78 $8.40 – $9.29 5
Desoxycorticosterone CPT 82633 not published not published $30.98 – $111.67 29
Des thora aorta/ea add prox prosth 33884 CPT 33884 not published not published $473.67 – $900.92 7
Des thora aorta rpr without left sub art 33881 CPT 33881 not published not published $1,767.33 – $3,400.11 7
Des thor aorta/prox ext prosth/ini 33883 CPT 33883 not published not published $1,280.69 – $2,459.41 7
Dest mal lesion feenlm <0.5cm 17280 CPT 17280 not published not published $96.72 – $455.47 29
Dest mal lesion feenlm 0.6-1cm 17281 CPT 17281 not published not published $135.45 – $455.47 29
Dest mal lesion feenlm 1.1 - 2.0 cm 17282 CPT 17282 not published not published $157.52 – $455.47 29
Dest mal lesion snhfg <0.5cm 17270 CPT 17270 not published not published $106.54 – $455.47 29
Dest mal lesion snhfg 0.6-1cm 17271 CPT 17271 not published not published $119.99 – $455.47 29
Dest mal lesion snhfg 1.1-2cm 17272 CPT 17272 not published not published $139.39 – $455.47 29
Dest mal lesion tal <0.5 17260 CPT 17260 not published not published $73.08 – $455.47 29
Dest mal lesion tal 0.6-1.0cm 17261 CPT 17261 not published not published $98.31 – $455.47 29
Dest mal lesion tal 1.1-2.0cm 17262 CPT 17262 not published not published $126.20 – $455.47 29
Dest mal lesion tal 2.1-3.0cm 17263 CPT 17263 not published not published $139.93 – $455.47 29
Destroy cervthor facet jnt 64633 CPT 64633 $2,998.30 $8,103.50 $251.13 – $475.82 6
Destroy cth facet jnt addl 64634 CPT 64634 $1,616.72 $4,369.50 $76.84 – $144.31 6
Destroy internal hemorrhoids destroy 46930 CPT 46930 $693.94 $1,875.50 $159.51 – $315.12 7
Destroy premlg lesns;1st lesn 17000 CPT 17000 $79.64 $215.25 $57.60 – $455.47 29
Destroy vulva lesion extensive 56515 CPT 56515 not published not published $221.71 – $428.23 7
Destroy vulva lesion simple 56501 CPT 56501 not published not published $125.58 – $246.49 7
Destruct ben lesion 15/> 17111 CPT 17111 not published not published $89.78 – $455.47 29
Destruct cut vasl lesions 10-50cm 17107 CPT 17107 not published not published $380.63 – $1,403.12 29
Destruct cut vasl lesions <10cm 17106 CPT 17106 not published not published $303.49 – $915.79 29
Destruct cut vasl lesions >50cm 17108 CPT 17108 not published not published $524.17 – $1,118.55 7
Destruction 2-14 lesions 17003 CPT 17003 not published not published $2.71 – $9.36 7
Destruction anal lesion(s) CPT 46910 not published not published $141.56 – $288.62 7
Destruction anal lesion(s) CPT 46924 not published not published $198.57 – $396.25 7
Destruction anal lesion(s) smpl chem 46900 CPT 46900 not published not published $147.56 – $915.79 29
Destruction benign lesions < 14 lesions CPT 17110 $104.90 $283.50 $71.54 – $455.47 29
Destruction by injection tx of nerve 64630 CPT 64630 not published not published $212.59 – $2,040.73 29
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides) CPT 64636 $1,616.72 $4,369.50 $67.08 – $127.14 6
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides) CPT 64635 $2,998.30 $8,103.50 $247.60 – $468.79 6
Destruction ciliary body CPT 66700 not published not published $395.75 – $837.74 7
Destruction ciliary body CPT 66720 not published not published $414.45 – $908.73 7
Destruction ciliary body CPT 66740 not published not published $396.25 – $829.93 7
Destruction cryosurgery anal lesion(s) simpl 46916 CPT 46916 not published not published $154.35 – $455.47 29
Destruction laser surgery anal lesions 46917 CPT 46917 not published not published $142.54 – $287.05 7
Destruction les conjunctiva CPT 68135 not published not published $152.03 – $326.04 7
Destruction mal lsn s/n/h/f/g 2.1-3cm CPT 17273 not published not published $157.59 – $915.79 29
Destruction mal lsn s/n/h/f/g 3.1-4cm CPT 17274 not published not published $193.86 – $915.79 29
Destruction mal lsn t/a/l 3.1-4cm CPT 17264 not published not published $149.65 – $915.79 29
Destruction mal lsn t/a/l >4cm CPT 17266 not published not published $174.67 – $915.79 29
Destruction penis lesion(s) chem 54050 CPT 54050 not published not published $114.43 – $915.79 29
Destruction penis lesion(s) exten 54065 CPT 54065 not published not published $191.03 – $368.96 7
Destruction premal lesions 15/> 17004 CPT 17004 not published not published $109.47 – $915.79 29
Destruction rectal tumor 45190 CPT 45190 not published not published $729.70 – $1,475.02 7
Destruction vag lesions complex 57065 CPT 57065 not published not published $192.01 – $369.73 7
Destruction vag lesions simple 57061 CPT 57061 not published not published $106.97 – $209.82 7
Destruct penis les/smp/electrodesi 54055 CPT 54055 not published not published $102.05 – $195.79 7
Detect agent nos dna dir CPT 87797 not published not published $21.11 – $113.14 29
Detect agnt mult dna direc CPT 87800 not published not published $42.21 – $98.26 29
Developmental screen/score/document 96110 CPT 96110 $76.59 $207.00 $9.70 – $12.47 2
Devel tst phys/qhp 1st hr CPT 96112 not published not published $159.39 – $358.63 22
Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 $80.11 $216.50 $13.40 – $201.83 29
Dexamethasone 4 mg tablet HCPCS J8540 $8.88 $24.00 $0.28 – $0.64 5
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 $9.25 $25.00 $0.18 – $0.23 5
Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 $240.74 $650.65 $199.53 – $230.47 5
Dextran 40 infusion HCPCS J7100 $34.02 $91.95 $21.29 – $51.23 5
Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 $31.45 $85.00 $0.78 – $21.29 5
Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 $48.56 $131.25 $1.71 – $21.29 5
Dextrose 5 % IV bolus HCPCS J7070 $48.58 $131.29 $3.39 – $21.29 5
Dhea-s (dehydroepiand sulfate) CPT 82627 $75.48 $204.00 $22.23 – $111.67 29
Diabetes (HbA1c) Test CPT 83036 $137.09 $370.50 $9.71 – $60.18 29
Diab manage trn ind/group HCPCS G0109 $21.28 $57.50 $14.24 – $26.54 7
Diag bronchoscope/catheter CPT 31643 not published not published $200.94 – $386.11 7
Diag laparo separate proc 49320 CPT 49320 not published not published $359.39 – $697.34 7
Diagnostic anoscopy CPT 46601 not published not published $105.51 – $914.67 23
Diagnostic anoscopy & biopsy CPT 46607 not published not published $142.96 – $142.96 1
Diagnostic anoscopy spx 46600 CPT 46600 $93.89 $253.75 $42.00 – $295.47 29
Diagnostic laryngoscopy 31505 CPT 31505 $95.83 $259.00 $53.65 – $445.00 29
Diagnostic laryngoscopy 31575 CPT 31575 $229.40 $620.00 $74.31 – $445.00 29
Diagnostic Mammogram (both breasts) CPT 77066 $208.87 $564.50 $96.50 – $304.29 27
Diagnostic Mammogram (one breast) CPT 77065 $161.69 $437.00 $75.75 – $239.64 27
Diagnostic radio unlisted proc CPT 76499 $59.39 $160.50 $52.15 – $201.83 28
Dialysis circuit perm vascular embolization 36909 CPT 36909 $14,037.62 $37,939.50 $201.81 – $347.87 5
Dialysis one evaluation CPT 90945 $532.43 $1,439.00 $84.70 – $976.07 29
Diathermy eg microwave CPT 97024 not published not published $6.30 – $14.69 29
Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 $101.58 $274.55 $0.12 – $0.15 5
Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 $50.35 $136.09 $6.13 – $21.29 5
Dicyclomine injection HCPCS J0500 $67.84 $183.35 $43.86 – $56.63 5
Diffusing capacity CPT 94729 $71.04 $192.00 $45.99 – $108.84 6
Digital analysis of eeg CPT 95957 not published not published $121.97 – $815.63 7
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 $166.61 $450.30 $5.80 – $21.29 5
Digoxin immune fab 40 mg intravenous solution HCPCS J1162 $3,856.16 $10,422.05 $1,395.94 – $2,127.64 5
Digoxin total therapeutic drug level CPT 80162 $57.72 $156.00 $13.28 – $129.19 29
Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 $162.23 $438.45 $43.86 – $75.70 5
Dilate biliary duct/ampulla CPT 47542 $1,356.51 $3,666.25 $156.52 – $258.62 5

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.