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 |
|---|---|---|---|---|
| Ghs gastric intub aspiration lavage CPT 43753 | $186.20 | $503.25 | $24.85 – $713.79 | 28 |
| Ghs hcv amplificaiton CPT 87521 | $145.23 | $392.50 | $35.09 – $113.14 | 29 |
| Ghs heavy metals bld (ars,lead,merc) CPT 82715 | not published | not published | $18.24 – $108.04 | 29 |
| Ghs hepatitis c virus (hcv riba) CPT 86804 | not published | not published | $15.49 – $108.04 | 29 |
| Ghs hgb stability-thal CPT 83068 | not published | not published | $8.86 – $108.04 | 29 |
| Ghs histoplasma antigen CPT 87385 | $214.69 | $580.25 | $12.77 – $62.53 | 29 |
| Ghs HIV antibody CPT 86703 | $44.96 | $121.50 | $13.71 – $62.53 | 29 |
| Ghs hla-dr/dq, multiple antigens CPT 86817 | not published | not published | $49.47 – $238.81 | 29 |
| Ghs i and d abscess/hematoma scrotum CPT 54700 | $1,313.50 | $3,550.00 | $238.67 – $452.41 | 7 |
| Ghs i and d perirectal abscess 46040 CPT 46040 | $1,301.57 | $3,517.75 | $420.68 – $880.64 | 7 |
| Ghs i and d pilonidal cyst complex CPT 10081 | $1,468.35 | $3,968.50 | $181.85 – $1,612.78 | 29 |
| Ghs i and d pilonidal cyst simple CPT 10080 | $183.71 | $496.50 | $102.87 – $1,612.78 | 29 |
| Ghs immun0electrophoresis CPT 86320 | not published | not published | $14.92 – $108.04 | 29 |
| Ghs incision thrombosed ext hemorrhoid CPT 46083 | $186.48 | $504.00 | $113.63 – $557.48 | 29 |
| Ghs indirect laryngoscopy/w fb removal CPT 31511 | $238.65 | $645.00 | $144.62 – $445.00 | 29 |
| Ghs inf midline insertion CPT 36140 | $234.30 | $633.25 | $103.21 – $223.08 | 7 |
| Ghs inhibitor screen CPT 85335 | $122.66 | $331.50 | $12.87 – $100.82 | 29 |
| Ghs init tx 1st degree burn CPT 16000 | $86.58 | $234.00 | $51.78 – $455.47 | 29 |
| Ghs inj neurolytic intercostal nerve CPT 64620 | not published | not published | $188.60 – $2,040.73 | 29 |
| Ghs inj neurolytic other perph nerve CPT 64640 | $3,323.16 | $8,981.50 | $101.55 – $2,040.73 | 29 |
| Ghs inj tendon origin/insertion CPT 20551 | not published | not published | $47.50 – $676.64 | 29 |
| Ghs inj transforaminal cerv ea add bil CPT 64480 | not published | not published | $71.24 – $141.18 | 7 |
| Ghs inj transforaminal cerv single bil CPT 64479 | $1,285.20 | $3,473.50 | $140.95 – $2,040.73 | 29 |
| Ghs insertion of needle - bone CPT 36680 | $160.86 | $434.75 | $66.61 – $914.67 | 29 |
| Ghs intermed repair 12.6 - 20.0 cm-12035 CPT 12035 | $375.09 | $1,013.75 | $258.84 – $915.79 | 29 |
| Ghs intermed repair 20.1 - 30.0 cm-12036 CPT 12036 | $368.61 | $996.25 | $299.39 – $1,403.12 | 29 |
| Ghs intermed repair over 30 cm - 12037 CPT 12037 | $1,550.02 | $4,189.25 | $348.43 – $690.32 | 7 |
| Ghs intro needle/intracath vein - 36000 CPT 36000 | not published | not published | $10.58 – $17.68 | 7 |
| Ghs irrigate corpora cavernosa for priapism CPT 54220 | $224.59 | $607.00 | $151.25 – $557.48 | 29 |
| Ghs IV inf sq injection, on-body injector CPT 96377 | not published | not published | $47.01 – $105.77 | 22 |
| Ghs IV thrombolytics - cerebral CPT 37195 | $121.55 | $328.50 | $159.67 – $760.30 | 28 |
| Ghs lac repair mouth.ant tong 2.5cm/less CPT 41250 | $132.00 | $356.75 | $154.37 – $914.67 | 29 |
| Ghs layer closure 2.5 cm or less - 12031 CPT 12031 | $216.27 | $584.50 | $168.28 – $915.79 | 29 |
| Ghs layer closure 2.5 cm or less - 12041 CPT 12041 | $203.87 | $551.00 | $166.24 – $915.79 | 29 |
| Ghs layer closure 2.5cm or less - 12051 CPT 12051 | $176.95 | $478.25 | $188.93 – $915.79 | 29 |
| Ghs layer closure 2.6 - 5.0 cm - 12052 CPT 12052 | $176.95 | $478.25 | $225.72 – $915.79 | 29 |
| Ghs layer closure 2.6 - 7.5 cm - 12042 CPT 12042 | $215.62 | $582.75 | $214.11 – $915.79 | 29 |
| Ghs layer closure 5.1 - 7.5 cm - 12053 CPT 12053 | $159.93 | $432.25 | $234.49 – $915.79 | 29 |
| Ghs layer closure 7.6 - 12.5 cm - 12034 CPT 12034 | $292.58 | $790.75 | $220.52 – $915.79 | 29 |
| Ghs layer closure 7.6 - 12.5 cm - 12044 CPT 12044 | $262.79 | $710.25 | $231.82 – $1,403.12 | 29 |
| Ghs layer closure 7.6 - 12.5 cm - 12054 CPT 12054 | $138.38 | $374.00 | $247.51 – $915.79 | 29 |
| Ghs layered repair 12.6 - 20.0 cm -12045 CPT 12045 | $312.65 | $845.00 | $269.27 – $1,403.12 | 29 |
| Ghs layered repair 12.6 - 20.0 cm -12055 CPT 12055 | $236.25 | $638.50 | $306.29 – $915.79 | 29 |
| Ghs layered repair 20.1 - 30.0 cm -12046 CPT 12046 | not published | not published | $317.24 – $1,403.12 | 29 |
| Ghs layered repair 20.1 - 30.0 cm -12056 CPT 12056 | $203.41 | $549.75 | $373.10 – $915.79 | 29 |
| Ghs layered repair over 30.0 cm -12047 CPT 12047 | not published | not published | $347.13 – $797.96 | 7 |
| Ghs layered repair over 3.0 cm -12057 CPT 12057 | not published | not published | $407.02 – $915.79 | 29 |
| Ghs leukocyte alkaline phos (mayo) CPT 85540 | $57.81 | $156.25 | $8.60 – $51.91 | 29 |
| Ghs low level laser therapy CPT 97039 | not published | not published | $26.49 – $26.49 | 5 |
| Ghs mbp CPT 83873 | $74.19 | $200.50 | $17.20 – $41.87 | 29 |
| Ghs moderate sedation < 5 yr, 30 min CPT 99151 | $51.89 | $140.25 | $26.51 – $26.51 | 1 |
| Ghs moderate sedation < 5 yr, 30 min, other CPT 99155 | $39.31 | $106.25 | $103.75 – $103.75 | 1 |
| Ghs moderate sedation, > 5 yr, 30 min, other CPT 99156 | $48.01 | $129.75 | $85.28 – $85.28 | 1 |
| Ghs moderate sedation ea addtl 15 min CPT 99153 | $53.00 | $143.25 | $11.15 – $11.15 | 1 |
| Ghs moderate sedation ea addtl 15 min, other CPT 99157 | $38.30 | $103.50 | $64.65 – $64.65 | 1 |
| Ghs musc test done w/n test comp CPT 95886 | $130.98 | $354.00 | $45.26 – $173.94 | 6 |
| Ghs musc tst done w/nerv tst lim CPT 95885 | $118.22 | $319.50 | $40.24 – $124.03 | 6 |
| Ghs musc tst done w/n tst non ext CPT 95887 | not published | not published | $43.11 – $145.08 | 6 |
| Ghs nailbed repair/nail removal CPT 11760 | $193.60 | $523.25 | $125.81 – $1,403.12 | 29 |
| Ghs nerve blk intercostal, ea addtl level CPT 64421 | not published | not published | $102.66 – $2,040.73 | 29 |
| Ghs nerve blk intercostal, single level CPT 64420 | $750.55 | $2,028.50 | $75.45 – $1,587.40 | 29 |
| Ghs nerve block axillary nerve CPT 64417 | $1,090.39 | $2,947.00 | $79.22 – $2,040.73 | 29 |
| Ghs nerve block brachial plexus CPT 64415 | $1,165.69 | $3,150.50 | $74.02 – $2,040.73 | 29 |
| Ghs nerve block celiac plexus CPT 64530 | $342.71 | $926.25 | $101.82 – $2,040.73 | 29 |
| Ghs nerve block interscaline CPT 64510 | not published | not published | $77.59 – $2,040.73 | 29 |
| Ghs nerve block lumbar or thoracic symp CPT 64520 | $342.71 | $926.25 | $87.57 – $2,040.73 | 29 |
| Ghs nerve block sciatic nerve CPT 64445 | $1,709.77 | $4,621.00 | $81.60 – $1,587.40 | 29 |
| Ghs nerve block suprascapular CPT 64418 | $1,198.62 | $3,239.50 | $83.87 – $1,587.40 | 29 |
| Ghs ng placement w fluoro guidance CPT 43752 | $107.30 | $290.00 | $46.34 – $914.67 | 29 |
| Ghs o2 saturation CPT 82810 | not published | not published | $9.12 – $60.18 | 29 |
| Ghs o2 uptake rest & exercise CPT 94680 | not published | not published | $15.27 – $358.63 | 29 |
| Ghs o2 uptake rest & indirect CPT 94690 | $50.41 | $136.25 | $4.37 – $136.15 | 29 |
| Ghs ob unlisted IV or art inj or infusion CPT 96379 | not published | not published | $47.01 – $105.77 | 22 |
| Ghs opcc repair cvp without subq port CPT 36575 | $828.52 | $2,239.25 | $39.58 – $1,417.18 | 29 |
| Ghs opcc repair cvp w subq port CPT 36576 | $1,560.11 | $4,216.50 | $206.64 – $422.78 | 7 |
| Ghs optokenetic CPT 92544 | not published | not published | $2.17 – $358.63 | 29 |
| Ghs oscillating trac CPT 92545 | not published | not published | $2.17 – $713.79 | 29 |
| Ghs osteopathic manipulative tx, 1-2 regions CPT 98925 | $24.88 | $67.25 | $25.77 – $57.98 | 29 |
| Ghs osteopathic manipulative tx, 3-4 regions CPT 98926 | $31.73 | $85.75 | $25.77 – $75.66 | 29 |
| Ghs ot dds rom CPT 95851 | not published | not published | $8.68 – $48.55 | 29 |
| Ghs ot group caregiver training CPT 97552 | not published | not published | $20.38 – $45.85 | 22 |
| Ghs ot prosthetic training/15 min CPT 97761 | $28.77 | $77.75 | $34.44 – $84.96 | 29 |
| Ghs ot sensory integrative tech/15min CPT 97533 | $29.42 | $79.50 | $31.68 – $125.01 | 29 |
| Ghs ot work hardening-additional hours CPT 97546 | not published | not published | $54.05 – $149.64 | 6 |
| Ghs pacing - transcutaneous CPT 92953 | $479.43 | $1,295.75 | $1.14 – $1,499.96 | 29 |
| Ghs paravert facet/nerve cerv ea add bil CPT 64492 | not published | not published | $68.52 – $134.16 | 6 |
| Ghs paravert facet/nerve lumb ea add bil CPT 64495 | not published | not published | $59.12 – $114.66 | 6 |
| Ghs path - pap (papanicolau) smear - vagina CPT 88141 | not published | not published | $21.34 – $85.19 | 7 |
| Ghs peritonsillar abscess i andd CPT 42700 | $369.72 | $999.25 | $147.67 – $532.31 | 29 |
| Ghs phenylketonurid CPT 84030 | not published | not published | $3.57 – $60.18 | 29 |
| Ghs picc line insert < 5 CPT 36568 | $1,127.39 | $3,047.00 | $96.52 – $209.82 | 7 |
| Ghs plngl fx pm cl CPT 26725 | $141.53 | $382.50 | $244.38 – $641.18 | 29 |
| Ghs plt ct-manual CPT 85032 | not published | not published | $4.31 – $51.91 | 29 |
| Ghs polysom <6 yrs 4/> parameters CPT 95782 | not published | not published | $907.65 – $2,077.97 | 6 |
| Ghs pos nystagmus CPT 92542 | not published | not published | $2.17 – $295.47 | 29 |
| Ghs ppd (tb intradermal) CPT 86580 | $25.25 | $68.25 | $5.07 – $62.53 | 29 |
| Ghs prostatic acid phosphatase (mayo) CPT 84066 | $47.82 | $129.25 | $9.66 – $108.04 | 29 |
| Ghs protein, misc fluid CPT 84160 | not published | not published | $5.47 – $33.65 | 29 |
| Ghs protoporphyrins fract CPT 84202 | $53.00 | $143.25 | $14.35 – $34.91 | 29 |
| Ghs pr without cont pulse ox CPT 94625 | not published | not published | $60.51 – $136.15 | 22 |
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.