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 |
|---|---|---|---|---|
| Incision of tibia & fibula CPT 27709 | not published | not published | $1,250.60 – $2,482.03 | 7 |
| Incision of toe tendons 28011 CPT 28011 | not published | not published | $316.90 – $624.02 | 7 |
| Incision of tongue fold CPT 41010 | $1,021.85 | $2,761.75 | $115.66 – $237.12 | 7 |
| Incision of tongue nerve CPT 64740 | not published | not published | $496.86 – $982.05 | 7 |
| Incision of urethra CPT 53000 | not published | not published | $164.44 – $312.01 | 7 |
| Incision of urethra CPT 53010 | not published | not published | $327.14 – $617.77 | 7 |
| Incision of urethra CPT 53020 | not published | not published | $109.61 – $205.92 | 7 |
| Incision of urethra CPT 53025 | not published | not published | $79.92 – $156.78 | 7 |
| Incision of windpipe CPT 31601 | not published | not published | $240.74 – $558.50 | 7 |
| Incision of windpipe CPT 31610 | not published | not published | $775.24 – $1,530.40 | 7 |
| Incision of wrist capsule CPT 25085 | not published | not published | $488.82 – $948.51 | 7 |
| Incision secondary cataract CPT 66820 | not published | not published | $389.12 – $848.67 | 7 |
| Incision tendon sheath CPT 26055 | not published | not published | $307.53 – $649.76 | 7 |
| Incisn of toe tndn CPT 28010 | not published | not published | $230.02 – $448.51 | 7 |
| Incisn windpipe CPT 31600 | $3,093.57 | $8,361.00 | $447.18 – $853.34 | 7 |
| Induced ab 1+vag supp d&c CPT 59856 | not published | not published | $546.20 – $1,047.57 | 7 |
| Induced ab 1+ vag sup w/dlv fetus CPT 59855 | not published | not published | $463.60 – $891.56 | 7 |
| Induced abortion d&c CPT 59840 | not published | not published | $230.22 – $443.05 | 7 |
| Induced abortion dilat&evac CPT 59841 | not published | not published | $403.30 – $774.57 | 7 |
| Inf agt nucleic acid human papillomavirus separately reported high-risk types pooled result(s) CPT 87626 | not published | not published | $70.20 – $157.95 | 22 |
| Infect ag drug suscept pheno predict CPT 87900 | $158.55 | $428.50 | $82.44 – $293.29 | 29 |
| Infect ag eia chlamydia trachomatis CPT 87320 | not published | not published | $12.77 – $62.53 | 29 |
| Infect ag eia influenza a or b ea CPT 87400 | not published | not published | $12.77 – $79.86 | 29 |
| Infect ag genotype na cytomegalovirus CPT 87910 | $358.99 | $970.25 | $79.86 – $579.26 | 28 |
| Infect ag genotype na dna hepatitis b CPT 87912 | $202.30 | $546.75 | $79.86 – $579.26 | 28 |
| Infect ag genotype na hiv-1 other region CPT 87906 | $310.41 | $838.95 | $79.86 – $289.64 | 28 |
| Infect ag genotype na hiv-1 revr trn/prt CPT 87901 | $367.32 | $992.75 | $49.47 – $579.26 | 29 |
| Infect ag ia direct hiv-1 antgn CPT 87806 | not published | not published | $32.77 – $73.73 | 28 |
| Infect ag ia optc obs chlamydia trach CPT 87810 | not published | not published | $12.77 – $79.40 | 29 |
| Infect ag ia optc obs influenza CPT 87804 | $65.58 | $177.25 | $12.77 – $56.64 | 29 |
| Infect ag if ea plyvlnt antsrm CPT 87300 | $18.78 | $50.75 | $11.98 – $29.19 | 29 |
| Infect ag if hep delta agent CPT 87380 | $78.26 | $211.50 | $17.20 – $62.53 | 29 |
| Infect ag if influenza a CPT 87276 | $40.61 | $109.75 | $12.77 – $62.53 | 29 |
| Infect ag if influenza b CPT 87275 | $43.38 | $117.25 | $12.25 – $62.53 | 29 |
| Infect ag if legionella pneumophila CPT 87278 | $64.75 | $175.00 | $12.77 – $62.53 | 29 |
| Infect ag if nos ea CPT 87299 | $60.40 | $163.25 | $12.77 – $62.53 | 29 |
| Infect ag if pneumocystis carinii CPT 87281 | $56.15 | $151.75 | $11.98 – $62.53 | 29 |
| Infect ag if varicella zoster CPT 87290 | not published | not published | $12.77 – $62.53 | 29 |
| Infect ag na chlamydia trachomatis qnt CPT 87492 | not published | not published | $19.90 – $120.31 | 29 |
| Infect ag na hep b amp CPT 87516 | not published | not published | $35.09 – $113.14 | 29 |
| Infect ag na herpes simplex quant CPT 87530 | $190.46 | $514.75 | $42.84 – $113.14 | 29 |
| Infect ag na hpv high-risk types CPT 87624 | $136.25 | $368.25 | $35.09 – $78.95 | 28 |
| Infect ag na influenza r/amp 1st 2 types CPT 87502 | $294.06 | $794.75 | $79.86 – $215.55 | 28 |
| Infect ag na influenza revr/amp ea type CPT 87501 | $121.55 | $328.50 | $51.31 – $115.45 | 28 |
| Infect ag na orthopoxvirus amp prb each CPT 87593 | not published | not published | $51.31 – $115.45 | 22 |
| Infect ag na resp virus 12-25 targets CPT 87633 | $336.15 | $908.50 | $113.14 – $937.75 | 28 |
| Infect ag phenotype na hiv-1 1-10 drugs CPT 87903 | not published | not published | $49.47 – $1,099.49 | 29 |
| Infect ag phenotype na hiv-1 ea addl drg CPT 87904 | not published | not published | $26.07 – $58.66 | 29 |
| Infectious agent antigen immunoassay direct optical observation sars-cov-2 CPT 87811 | not published | not published | $41.38 – $93.11 | 22 |
| Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin CPT 87324 | $40.70 | $110.00 | $11.98 – $29.19 | 29 |
| Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans CPT 87327 | $51.15 | $138.25 | $12.77 – $62.53 | 29 |
| Infectious agent antigen immunoassay ql/sq multi step cryptosporidium CPT 87328 | $43.38 | $117.25 | $12.77 – $62.53 | 29 |
| Infectious agent antigen immunoassay ql/sq multi step giardia CPT 87329 | $44.77 | $121.00 | $11.98 – $62.53 | 29 |
| Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool CPT 87338 | $112.85 | $305.00 | $11.90 – $62.53 | 29 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn CPT 87340 | $35.80 | $96.75 | $10.33 – $62.53 | 29 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization CPT 87341 | $21.46 | $58.00 | $10.33 – $25.14 | 29 |
| Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies CPT 87389 | $32.28 | $87.25 | $24.08 – $62.53 | 28 |
| Infectious agent antigen immunoassay ql/sq multi step legionella urine CPT 87449 | $98.51 | $266.25 | $11.98 – $62.53 | 29 |
| Infectious agent antigen immunoassay ql/sq multi step rotavirus CPT 87425 | $71.41 | $193.00 | $11.98 – $62.53 | 29 |
| Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin CPT 87427 | not published | not published | $11.98 – $62.53 | 29 |
| Infectious agent nucleic acid amplified probe CPT 87798 | $386.17 | $1,043.70 | $25.85 – $85.38 | 29 |
| Infectious agent nucleic acid amplified probe chlamydia trachomatis CPT 87491 | $92.04 | $248.75 | $35.09 – $78.95 | 29 |
| Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s) CPT 87493 | $77.42 | $209.25 | $37.27 – $83.86 | 28 |
| Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets CPT 87483 | $372.96 | $1,008.00 | $416.78 – $937.75 | 28 |
| Infectious agent nucleic acid amplified probe hsv-1 CPT 87529 | $157.62 | $426.00 | $35.09 – $113.14 | 29 |
| Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus CPT 87641 | $13.60 | $36.75 | $18.38 – $113.14 | 29 |
| Infectious agent nucleic acid amplified probe mycobacteria tuberculosis CPT 87556 | $165.58 | $447.50 | $37.00 – $113.14 | 29 |
| Infectious agent nucleic acid amplified probe neisseria gonorrhoeae CPT 87591 | $92.04 | $248.75 | $35.09 – $113.14 | 29 |
| Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 CPT 87635 | $37.46 | $101.25 | $51.31 – $115.45 | 23 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b CPT 87636 | not published | not published | $142.63 – $320.92 | 22 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv CPT 87637 | not published | not published | $142.63 – $320.92 | 22 |
| Infectious agent nucleic acid amplified probe streptococcus group a CPT 87651 | not published | not published | $35.09 – $113.14 | 29 |
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | $58.74 | $158.75 | $35.09 – $113.14 | 28 |
| Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance CPT 87564 | not published | not published | $76.77 – $172.73 | 22 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | $462.63 | $1,250.34 | $416.78 – $978.39 | 28 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets CPT 87505 | not published | not published | $128.29 – $301.15 | 28 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets CPT 87506 | not published | not published | $262.99 – $591.73 | 28 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | $197.40 | $533.50 | $42.84 – $113.14 | 29 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | $203.50 | $550.00 | $42.84 – $113.14 | 29 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $222.28 | $600.75 | $42.84 – $113.14 | 29 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $200.08 | $540.75 | $85.10 – $191.47 | 29 |
| Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets CPT 87631 | $443.35 | $1,198.25 | $113.14 – $320.92 | 28 |
| Infliximab 100 mg intravenous solution HCPCS J1745 | $178.95 | $483.65 | $111.12 – $199.53 | 5 |
| Infliximab-dyyb 100 mg intravenous solution HCPCS Q5103 | $96.50 | $260.80 | $135.13 – $135.13 | 3 |
| Influenza dna amp prob addl CPT 87503 | $75.80 | $204.87 | $29.22 – $79.86 | 28 |
| Influenza virus vaccine, inact hemagglutinin tiv pf inj CPT 90673 | not published | not published | $40.60 – $49.92 | 5 |
| Influenza virus vaccine, live trivalent intranasal CPT 90660 | not published | not published | $24.55 – $35.19 | 6 |
| Infratemporal approach/skull CPT 61591 | not published | not published | $3,435.80 – $6,605.21 | 7 |
| Infuse radioactive materials CPT 77750 | not published | not published | $100.10 – $761.31 | 29 |
| Ingest challenge ea addl 60 min CPT 95079 | not published | not published | $74.93 – $144.31 | 6 |
| Ingest challenge ini 120 min CPT 95076 | not published | not published | $81.98 – $1,216.24 | 28 |
| Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis CPT 94642 | not published | not published | $46.96 – $466.20 | 28 |
| Initial foot exam pt lops HCPCS G0245 | $142.17 | $384.25 | $48.10 – $79.59 | 6 |
| Initial hosp neonate 28 d/less than not critically ill 99477 CPT 99477 | not published | not published | $393.24 – $419.31 | 2 |
| Initial nursing facility care/day 35 minutes CPT 99305 | not published | not published | $138.99 – $143.61 | 2 |
| Initial nursing facility care/day 45 minutes CPT 99306 | not published | not published | $178.78 – $184.06 | 2 |
| Initial nursing facility care/day low severity 99304 CPT 99304 | not published | not published | $99.28 – $100.65 | 2 |
| Initiation & management bipap/cpap initial day CPT 94660 | $103.69 | $280.25 | $42.86 – $466.20 | 29 |
| Inj, abilify maintena, 1 mg HCPCS J0401 | $2,488.27 | $6,725.05 | $4.64 – $5.55 | 5 |
| Inj, bezlotoxumab, 10 mg HCPCS J0565 | $46.58 | $125.90 | $54.26 – $58.14 | 4 |
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.