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 |
|---|---|---|---|---|
| Epidrm a-grft f/n/hf/g addl CPT 15116 | $548.34 | $1,482.00 | $166.08 – $289.39 | 7 |
| Epidrm agrft t/a/l 1st 100 CPT 15110 | $1,641.97 | $4,437.75 | $766.81 – $1,612.29 | 7 |
| Epidrm autogrft t/a/l add-on CPT 15111 | $857.75 | $2,318.25 | $116.61 – $219.18 | 7 |
| Epidural/lumbar/sacral/ea add level64484 CPT 64484 | not published | not published | $58.40 – $113.88 | 7 |
| Epidural lysis mult sessions CPT 62263 | not published | not published | $358.44 – $2,040.73 | 29 |
| Epidural lysis on single day 62264 CPT 62264 | not published | not published | $266.54 – $2,040.73 | 29 |
| Epiglottidectomy CPT 31420 | not published | not published | $909.07 – $1,784.69 | 7 |
| Epilepsy gen seq alys panel CPT 81419 | $1,163.17 | $3,143.70 | $2,779.12 – $2,779.12 | 1 |
| Ep induct arrhy by elect pacing CPT 93618 | $1,382.88 | $3,737.50 | $175.85 – $8,949.00 | 7 |
| Epiphysl arrst dstl rds&ulna CPT 25455 | not published | not published | $753.51 – $1,266.75 | 7 |
| Epiphysl arrst dstl rds/ulna CPT 25450 | not published | not published | $573.06 – $1,296.40 | 7 |
| Epirubicin 200 mg/100 ml intravenous solution HCPCS J9178 | $656.07 | $1,773.15 | $1.92 – $21.29 | 5 |
| Episiotomy/vag rpr oth/thn attending phys 59300 CPT 59300 | $1,428.39 | $3,860.50 | $165.78 – $319.82 | 7 |
| Epoetin alfa, 100 units esrd HCPCS Q4081 | $34.97 | $94.50 | $0.96 – $4.64 | 6 |
| Epoetin alfa-epbx 40,000 unit/ml injection solution HCPCS Q5106 | $536.54 | $1,450.10 | $18.54 – $18.54 | 3 |
| Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr HCPCS J0885 | $417.79 | $1,129.17 | $18.03 – $21.29 | 5 |
| Epoprostenol (arginine) 1 mg in 50 ml ns inhalation syringe - cnr HCPCS J1325 | $27.27 | $73.70 | $21.29 – $26.58 | 5 |
| Epstein barr early antigen antibody CPT 86663 | $46.44 | $125.50 | $13.12 – $79.86 | 29 |
| Epstein barr nuclear antigen antibody CPT 86664 | $42.83 | $115.75 | $15.29 – $79.86 | 29 |
| Epstein barr viral capsid antigen antibody igm CPT 86665 | $43.38 | $117.25 | $18.14 – $44.15 | 29 |
| Eptifibatide 0.75 mg/ml intravenous solution HCPCS J1327 | $66.06 | $178.55 | $38.31 – $47.10 | 5 |
| Ercp biliary & pancreas CPT 74330 | $421.80 | $1,140.00 | $56.92 – $542.92 | 6 |
| Ercp bil/panc duct; each stent plcmt 43274 CPT 43274 | not published | not published | $530.87 – $992.18 | 6 |
| Ercp ea duct/ampulla dilate CPT 43277 | not published | not published | $434.04 – $822.92 | 6 |
| Ercp lesion ablate w/dilate 43278 CPT 43278 | not published | not published | $496.52 – $936.02 | 6 |
| Ercp lithotripsy calculi CPT 43265 | $2,717.19 | $7,343.75 | $496.91 – $1,238.68 | 7 |
| Ercp remove duct calculi 43264 CPT 43264 | not published | not published | $417.26 – $1,103.72 | 7 |
| Ercp remove forgn body duct 43275 CPT 43275 | not published | not published | $431.69 – $817.46 | 6 |
| Ercp sphincter pressure meas CPT 43263 | not published | not published | $410.17 – $910.28 | 7 |
| Ercp stent exchange w/dilate CPT 43276 | not published | not published | $552.75 – $1,031.97 | 6 |
| Ercp w/specimen collection CPT 43260 | not published | not published | $369.24 – $745.71 | 7 |
| Eribulin 1 mg/2 ml (0.5 mg/ml) intravenous solution HCPCS J9179 | $1,346.95 | $3,640.40 | $155.69 – $199.53 | 5 |
| Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr HCPCS J1335 | $64.55 | $174.45 | $43.86 – $57.21 | 5 |
| ER Visit (level 1, minor) CPT 99281 | $141.62 | $382.75 | $23.57 – $201.83 | 29 |
| ER Visit (level 2) CPT 99282 | $314.96 | $851.25 | $46.32 – $362.99 | 28 |
| ER Visit (level 3) CPT 99283 | $529.47 | $1,431.00 | $69.41 – $634.68 | 28 |
| ER Visit (level 4) CPT 99284 | $757.95 | $2,048.50 | $131.75 – $976.07 | 28 |
| ER Visit (level 5, high severity) CPT 99285 | $1,152.46 | $3,114.75 | $194.56 – $1,405.35 | 28 |
| Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1364 | $107.65 | $290.95 | $7.57 – $47.09 | 6 |
| Esophageal dilat s&i CPT 74360 | not published | not published | $35.07 – $542.92 | 6 |
| Esophageal lengthening add on code 43338 CPT 43338 | not published | not published | $132.43 – $217.68 | 6 |
| Esophageal motility CPT 78258 | not published | not published | $47.14 – $921.08 | 29 |
| Esophageal recording CPT 93615 | $624.56 | $1,688.00 | $15.73 – $8,949.00 | 7 |
| Esophageal recording CPT 93616 | not published | not published | $25.19 – $8,949.00 | 7 |
| Esophagomyotomy abdominal 43330 CPT 43330 | not published | not published | $1,450.79 – $2,837.71 | 7 |
| Esophagomyotomy thoracic 43331 CPT 43331 | not published | not published | $1,509.35 – $2,888.41 | 7 |
| Esophagosc dilate balloon 30 CPT 43214 | not published | not published | $219.68 – $404.84 | 6 |
| Esophagosc flex trnsn biopsy CPT 43198 | not published | not published | $112.42 – $2,149.09 | 28 |
| Esophagoscop mucosal resect CPT 43211 | not published | not published | $269.56 – $503.12 | 6 |
| Esophagoscop stent placement CPT 43212 | not published | not published | $217.25 – $397.03 | 6 |
| Esophagoscop ultrasound exam CPT 43231 | not published | not published | $182.58 – $409.51 | 7 |
| Esophagoscopy balloon <30mm CPT 43220 | not published | not published | $134.13 – $274.56 | 7 |
| Esophagoscopy control bleed CPT 43227 | not published | not published | $188.42 – $458.66 | 7 |
| Esophagoscopy flex biopsy CPT 43202 | not published | not published | $117.31 – $250.38 | 7 |
| Esophagoscopy/flex/diagnostic 43200 CPT 43200 | not published | not published | $98.96 – $2,149.09 | 29 |
| Esophagoscopy flex dx brush CPT 43197 | not published | not published | $94.07 – $2,149.09 | 28 |
| Esophagoscopy flex remove fb CPT 43215 | not published | not published | $161.47 – $333.06 | 7 |
| Esophagoscopy lesion ablate CPT 43229 | not published | not published | $225.50 – $426.66 | 6 |
| Esophagoscopy lesion removal CPT 43216 | not published | not published | $153.19 – $320.59 | 7 |
| Esophagoscopy retro balloon CPT 43213 | not published | not published | $295.42 – $559.28 | 6 |
| Esophagoscopy rigid balloon CPT 43195 | not published | not published | $207.66 – $368.96 | 6 |
| Esophagoscopy/rigid/diagnostic 43191 CPT 43191 | not published | not published | $172.84 – $258.96 | 6 |
| Esophagoscopy rigid trnso 43180 CPT 43180 | not published | not published | $613.43 – $976.15 | 5 |
| Esophagoscopy snare les remv CPT 43217 | not published | not published | $183.35 – $372.07 | 7 |
| Esophagoscopy w/us needle bx CPT 43232 | not published | not published | $226.30 – $561.61 | 7 |
| Esophagoscp guide wire dilat 43196 CPT 43196 | not published | not published | $221.78 – $404.05 | 6 |
| Esophagoscp rig trnso biopsy CPT 43193 | not published | not published | $190.11 – $368.17 | 6 |
| Esophagoscp rig trnso inject CPT 43192 | not published | not published | $190.45 – $308.89 | 6 |
| Esophagoscp rig trnso rem fb CPT 43194 | not published | not published | $218.85 – $336.19 | 6 |
| Esophagus endoscopy/ligation CPT 43205 | not published | not published | $161.06 – $482.84 | 7 |
| Esophagus motility study CPT 91010 | not published | not published | $81.89 – $1,216.24 | 29 |
| Esoph balloon distension tst CPT 91040 | not published | not published | $65.98 – $1,216.24 | 29 |
| Esoph egd dilation <30 mm CPT 43249 | not published | not published | $175.48 – $374.41 | 7 |
| Esoph endoscopy dilation CPT 43226 | not published | not published | $148.62 – $304.22 | 7 |
| Esoph fundoplasty lap 43327 CPT 43327 | not published | not published | $920.09 – $1,735.55 | 6 |
| Esoph fundoplasty thor 43328 CPT 43328 | not published | not published | $1,274.24 – $2,478.90 | 6 |
| Esophgl motil w/stim/perfus CPT 91013 | not published | not published | $14.01 – $51.48 | 6 |
| Esoph imped function test CPT 91037 | not published | not published | $64.38 – $713.79 | 29 |
| Esoph imped funct test > 1hr CPT 91038 | not published | not published | $72.87 – $1,216.24 | 29 |
| Esoph optical endomicroscopy CPT 43206 | not published | not published | $152.06 – $294.84 | 6 |
| Esoph scope w/sclerosis inj CPT 43204 | not published | not published | $154.77 – $485.18 | 7 |
| Esoph scope w/submucous inj CPT 43201 | not published | not published | $116.95 – $275.35 | 7 |
| Essure 58565 CPT 58565 | not published | not published | $477.46 – $937.59 | 7 |
| Establish access to aorta CPT 36160 | $200.17 | $541.00 | $141.66 – $278.47 | 7 |
| Establish access to artery CPT 36100 | not published | not published | $175.58 – $347.11 | 7 |
| Establish brain cavity shunt CPT 62223 | not published | not published | $1,109.09 – $2,217.60 | 7 |
| Established Patient Office Visit (level 1) CPT 99211 | $92.87 | $251.00 | $10.21 – $15.51 | 7 |
| Established Patient Office Visit (level 2) CPT 99212 | $131.07 | $354.25 | $28.12 – $42.18 | 7 |
| Established Patient Office Visit (level 3) CPT 99213 | $165.39 | $447.00 | $55.58 – $85.59 | 7 |
| Established Patient Office Visit (level 4) CPT 99214 | $213.21 | $576.25 | $85.98 – $132.12 | 7 |
| Established Patient Office Visit (level 5) CPT 99215 | $264.46 | $714.75 | $122.03 – $186.07 | 7 |
| Estradiol total CPT 82670 | $88.43 | $239.00 | $27.94 – $111.67 | 29 |
| Estradiol valerate 10 mg inj HCPCS J1380 | $137.64 | $372.00 | $13.38 – $21.29 | 5 |
| Estrogens total-sendout CPT 82672 | $83.71 | $226.25 | $21.70 – $111.67 | 29 |
| Etanercept injection HCPCS J1438 | $2,306.67 | $6,234.25 | $199.53 – $454.98 | 5 |
| Ethmoidectomy extranasal total 31205 CPT 31205 | not published | not published | $922.29 – $1,928.21 | 7 |
| Ethylene glycol -sendout CPT 82693 | $64.75 | $175.00 | $14.90 – $112.27 | 29 |
| Etoposide 20 mg/ml intravenous solution HCPCS J9181 | $20.35 | $55.00 | $1.16 – $21.29 | 5 |
| Etoposide 50 mg cap HCPCS J8560 | $110.87 | $299.65 | $0.46 – $99.84 | 6 |
| Euglobulin lysis CPT 85360 | $84.92 | $229.50 | $8.41 – $89.93 | 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.