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 |
|---|---|---|---|---|
| Excise anal ext tag/papilla CPT 46220 | not published | not published | $122.12 – $254.28 | 7 |
| Excise epiphyseal bar CPT 20150 | not published | not published | $1,050.02 – $2,132.58 | 7 |
| Excise foot tendon sheath CPT 28086 | not published | not published | $396.35 – $769.87 | 7 |
| Excise foot tendon sheath CPT 28088 | not published | not published | $311.18 – $646.63 | 7 |
| Excise inferior turbinate CPT 30130 | not published | not published | $392.97 – $807.32 | 7 |
| Excise intestine lesion(s) 44110 CPT 44110 | not published | not published | $922.09 – $1,810.42 | 7 |
| Excise intraspinl lesion crv CPT 63265 | not published | not published | $1,798.62 – $3,510.09 | 7 |
| Excise intrspinl lesion lmbr CPT 63267 | not published | not published | $1,487.35 – $2,899.34 | 7 |
| Excise intrspinl lesion scrl CPT 63268 | not published | not published | $1,494.48 – $3,049.10 | 7 |
| Excise lesion testis CPT 54512 | not published | not published | $606.12 – $1,138.83 | 7 |
| Excise lip or cheek fold CPT 40819 | $1,028.05 | $2,778.50 | $247.74 – $507.02 | 7 |
| Excise lwr jaw cyst w/repair CPT 21047 | not published | not published | $1,447.51 – $2,779.98 | 7 |
| Excise mandible lesion CPT 21040 | not published | not published | $429.84 – $887.66 | 7 |
| Excise max/zygoma b9 tumor CPT 21030 | not published | not published | $432.23 – $886.88 | 7 |
| Excise max/zygoma mal tumor CPT 21034 | not published | not published | $1,288.01 – $2,492.16 | 7 |
| Excise oral mucosa for graft 40818 CPT 40818 | not published | not published | $287.54 – $1,167.30 | 29 |
| Excise parotid gland/lesion CPT 42410 | not published | not published | $691.28 – $1,346.31 | 7 |
| Excise parotid gland/lesion CPT 42415 | not published | not published | $1,178.31 – $2,285.47 | 7 |
| Excise parotid gland/lesion CPT 42420 | not published | not published | $1,323.60 – $2,567.05 | 7 |
| Excise parotid gland/lesion CPT 42425 | not published | not published | $931.80 – $1,810.42 | 7 |
| Excise pharynx lesion CPT 42808 | not published | not published | $179.68 – $351.79 | 7 |
| Excise/repair mouth lesion CPT 40812 | not published | not published | $210.73 – $424.32 | 7 |
| Excise sacral spine tumor CPT 49215 | not published | not published | $2,435.32 – $4,695.72 | 7 |
| Excise sublingual gland CPT 42450 | not published | not published | $394.24 – $778.45 | 7 |
| Excise submaxillary gland CPT 42440 | not published | not published | $456.63 – $892.34 | 7 |
| Excise subq tumor/abd wall <3 cm 22902 CPT 22902 | not published | not published | $363.64 – $689.53 | 6 |
| Excise tendon forearm/wrist CPT 25109 | not published | not published | $564.72 – $1,129.47 | 7 |
| Excise wrist tendon sheath CPT 25118 | not published | not published | $409.76 – $799.52 | 7 |
| Excision addl breast lesion 19126 CPT 19126 | not published | not published | $182.42 – $342.43 | 7 |
| Excision aural polyp CPT 69540 | not published | not published | $135.07 – $273.79 | 7 |
| Excision benign lesion face/ears/eyelids/nose/lips/muc memb 0.6 - 1.0 cm CPT 11441 | not published | not published | $135.92 – $1,612.78 | 29 |
| Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm CPT 11422 | $940.45 | $2,541.75 | $141.45 – $287.82 | 7 |
| Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm CPT 11402 | $463.33 | $1,252.25 | $118.22 – $1,612.78 | 29 |
| Excision benign lesion trunk/arms/legs > 4.0 cm CPT 11406 | not published | not published | $253.01 – $520.27 | 7 |
| Excision breast lesion CPT 19125 | not published | not published | $476.37 – $969.56 | 7 |
| Excision floor mouth lesion 41116 CPT 41116 | not published | not published | $234.56 – $478.16 | 7 |
| Excision graft extremity CPT 35903 | not published | not published | $639.84 – $1,255.05 | 7 |
| Excision graft thorax 35905 CPT 35905 | not published | not published | $2,030.61 – $3,749.55 | 7 |
| Excision gum each quadrant CPT 41820 | not published | not published | $269.10 – $404.20 | 6 |
| Excision hand/finger tendon CPT 26415 | not published | not published | $731.48 – $1,662.23 | 7 |
| Excision lesion mouth roof CPT 42106 | not published | not published | $194.03 – $384.56 | 7 |
| Excision lesion mouth roof CPT 42107 | not published | not published | $376.02 – $749.59 | 7 |
| Excision nasal polyp(s) simple 30110 CPT 30110 | not published | not published | $141.18 – $279.24 | 7 |
| Excision of anal lesion(s) CPT 46922 | not published | not published | $141.64 – $290.16 | 7 |
| Excision of gum flap CPT 41821 | not published | not published | $60.70 – $120.40 | 6 |
| Excision of gum lesion CPT 41822 | not published | not published | $191.43 – $392.35 | 7 |
| Excision of gum lesion CPT 41823 | not published | not published | $341.44 – $694.23 | 7 |
| Excision of gum lesion CPT 41826 | not published | not published | $218.24 – $456.32 | 7 |
| Excision of gum lesion CPT 41827 | not published | not published | $324.99 – $660.67 | 7 |
| Excision of gum lesion CPT 41828 | not published | not published | $238.86 – $457.09 | 7 |
| Excision of gum lesion 41825 CPT 41825 | not published | not published | $134.66 – $263.64 | 7 |
| Excision of lesion of mesentery 44820 CPT 44820 | not published | not published | $914.17 – $1,788.59 | 7 |
| Excision of lingual tonsil CPT 42870 | not published | not published | $613.53 – $1,250.37 | 7 |
| Excision of meckels diverticulum 44800 CPT 44800 | not published | not published | $825.42 – $1,626.35 | 7 |
| Excision of mouth lesion complex 40816 CPT 40816 | not published | not published | $339.87 – $684.85 | 7 |
| Excision of neck cyst CPT 42815 | not published | not published | $610.39 – $1,210.59 | 7 |
| Excision of neck cyst confined 42810 CPT 42810 | not published | not published | $309.12 – $628.69 | 7 |
| Excision of penis lesion(s) 54060 CPT 54060 | not published | not published | $144.77 – $274.56 | 7 |
| Excision of rectal lesion CPT 45160 | not published | not published | $1,079.35 – $2,173.13 | 7 |
| Excision of rectal stricture CPT 45150 | not published | not published | $402.96 – $845.53 | 7 |
| Excision of salivary cyst CPT 42408 | not published | not published | $362.41 – $708.26 | 7 |
| Excision of skull tumor CPT 61563 | not published | not published | $2,088.19 – $4,142.69 | 7 |
| Excision of stomach lesion CPT 43610 | not published | not published | $1,068.89 – $2,085.78 | 7 |
| Excision of tongue lesion CPT 41112 | not published | not published | $267.63 – $546.01 | 7 |
| Excision of tongue lesion CPT 41114 | not published | not published | $699.00 – $1,366.59 | 7 |
| Excision of tongue lesion w/closure 41113 CPT 41113 | not published | not published | $298.54 – $603.74 | 7 |
| Excision of tonsil tags CPT 42860 | not published | not published | $204.44 – $408.72 | 7 |
| Excision of umbilicus 49250 CPT 49250 | not published | not published | $627.40 – $1,241.79 | 7 |
| Excision of uvula CPT 42140 | not published | not published | $165.28 – $338.53 | 7 |
| Excision of vaginal septum 57130 CPT 57130 | not published | not published | $174.06 – $343.21 | 7 |
| Excision olecranon bursa CPT 24105 | not published | not published | $355.40 – $736.33 | 7 |
| Excision radial head CPT 24130 | not published | not published | $543.23 – $1,067.84 | 7 |
| Excision tongue lesion without closure 41110 CPT 41110 | $1,245.05 | $3,365.00 | $141.32 – $287.05 | 7 |
| Excision tumor soft tissue back/flank subcutaneous >= 3 cm CPT 21931 | not published | not published | $521.03 – $997.65 | 6 |
| Excis partial tal calc CPT 28120 | not published | not published | $448.88 – $1,068.64 | 7 |
| Excis uppr jaw cyst w/repair CPT 21049 | not published | not published | $1,344.44 – $2,613.85 | 7 |
| Exc leg/ankle tum dep 5 cm/ > 27634 CPT 27634 | not published | not published | $759.01 – $1,450.84 | 6 |
| Exc leg/ankle tum subfasc<5cm 27619 CPT 27619 | not published | not published | $516.87 – $1,017.14 | 7 |
| Exc les conjunctiva <1 cm CPT 68110 | not published | not published | $148.74 – $326.83 | 7 |
| Exc les conjunctiva >1 cm CPT 68115 | not published | not published | $186.46 – $397.03 | 7 |
| Exc les conjunctiva adj scl CPT 68130 | not published | not published | $411.99 – $868.94 | 7 |
| Exc les/mucos/sub/ves mouth/no rpr 40810 CPT 40810 | not published | not published | $134.33 – $276.90 | 7 |
| Exc malig feenl <0.5cm 11640 CPT 11640 | not published | not published | $129.41 – $1,612.78 | 29 |
| Exc malig feenl 1.1-2 11642 CPT 11642 | $513.38 | $1,387.50 | $199.81 – $1,612.78 | 29 |
| Exc malig feenl 3.1-4.0 11644 CPT 11644 | not published | not published | $312.85 – $609.19 | 7 |
| Exc malig feenl >4cm 11646 CPT 11646 | not published | not published | $441.14 – $843.99 | 7 |
| Exc malig snhfg 0.5cm or less 11620 CPT 11620 | not published | not published | $123.03 – $258.19 | 7 |
| Exc malig snhfg 0.6-1.0 cm 11621 CPT 11621 | not published | not published | $158.49 – $1,612.78 | 29 |
| Exc malig snhfg 2.1-3 cm 11623 CPT 11623 | $1,006.31 | $2,719.75 | $226.27 – $452.41 | 7 |
| Exc malig tal <0.5cm 11600 CPT 11600 | not published | not published | $121.26 – $1,612.78 | 29 |
| Exc malig tal 0.6-1.0cm 11601 CPT 11601 | not published | not published | $156.82 – $1,612.78 | 29 |
| Exc mal+marg tal 1.1-2 cm 11602 CPT 11602 | not published | not published | $172.58 – $915.79 | 29 |
| Exc mal+marg tal 2.1-3 cm 11603 CPT 11603 | $1,394.16 | $3,768.00 | $205.92 – $1,612.78 | 29 |
| Exc mal+marg tal 3.1-4 cm 11604 CPT 11604 | $1,394.16 | $3,768.00 | $226.69 – $1,612.78 | 29 |
| Exc mandible 21025 CPT 21025 | not published | not published | $815.62 – $1,594.35 | 7 |
| Exc neck tum deep < 5 cm CPT 21556 | not published | not published | $449.67 – $1,135.72 | 7 |
| Exc neck tum deep 5 cm/> CPT 21554 | not published | not published | $812.19 – $1,549.89 | 6 |
| Exc of facial bones/osteomy/abcess 21026 CPT 21026 | not published | not published | $518.50 – $1,060.05 | 7 |
| Exc of rectal prlpse 45130 CPT 45130 | not published | not published | $1,189.61 – $2,350.21 | 7 |
| Exc of residual cervix 57540 CPT 57540 | not published | not published | $895.78 – $1,686.41 | 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.