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 |
|---|---|---|---|---|
| Inst fibrinolysis agent sbsq d CPT 32562 | $891.15 | $2,408.50 | $70.03 – $1,417.18 | 28 |
| Instillation anticarcinogenic agent bladder CPT 51720 | $481.56 | $1,301.50 | $71.07 – $1,529.98 | 29 |
| Instll rx agnt into rnal tub CPT 50391 | not published | not published | $111.23 – $557.48 | 29 |
| Ins tun cvad 2 cath w/subq port(s) CPT 36566 | not published | not published | $420.26 – $829.93 | 7 |
| Ins tun cv cath wo subq prt/pm CPT 36557 | not published | not published | $350.52 – $656.78 | 7 |
| Ins tun cv cath wo subq prt/pm CPT 36558 | $1,773.69 | $4,793.75 | $296.64 – $602.96 | 7 |
| Ins tun intraperit dia cath CPT 49421 | not published | not published | $260.56 – $491.42 | 7 |
| Inst via cath agent pleurds CPT 32560 | $524.57 | $1,417.75 | $88.78 – $1,417.18 | 29 |
| Insulin total CPT 83525 | $48.66 | $131.50 | $11.43 – $85.28 | 29 |
| Ins vag brachytx device CPT 57156 | not published | not published | $164.33 – $697.27 | 28 |
| Integra meshed bil wound mat HCPCS C9363 | $9,955.85 | $26,907.70 | $29.95 – $36.83 | 5 |
| Interdental fixation CPT 21110 | not published | not published | $665.34 – $1,418.86 | 7 |
| Interdental wirg oth/thn fx CPT 21497 | $810.12 | $2,189.50 | $580.83 – $1,306.53 | 7 |
| Interdiscal perq aspir dx CPT 62267 | $633.07 | $1,711.00 | $179.89 – $1,612.78 | 29 |
| Interferon alfa-2b inj HCPCS J9214 | $473.03 | $1,278.45 | $12.64 – $50.53 | 6 |
| Intermediate visual field xm CPT 92082 | not published | not published | $26.96 – $136.15 | 29 |
| Internal nerve revision 64727 CPT 64727 | not published | not published | $207.59 – $390.01 | 7 |
| Interrogate subq defib CPT 93261 | not published | not published | $21.57 – $106.80 | 28 |
| Interrogation vad in person CPT 93750 | not published | not published | $51.91 – $210.40 | 28 |
| Interrog dev eval icpms ip CPT 93290 | not published | not published | $9.70 – $85.48 | 29 |
| Interrog dev eval scrms ip CPT 93291 | $16.28 | $44.00 | $15.10 – $64.62 | 29 |
| Interrog device eval heart CPT 93289 | $41.44 | $112.00 | $20.12 – $111.10 | 29 |
| Interrog evl pm/ldls pm ip CPT 93288 | $39.59 | $107.00 | $16.17 – $85.48 | 29 |
| Interrog&prgrmg ipnss CPT 93151 | not published | not published | $93.51 – $210.40 | 22 |
| Interrog without prgrmg ipnss CPT 93153 | not published | not published | $93.51 – $210.40 | 22 |
| Interstitial brachy inter CPT 77799 | not published | not published | $111.55 – $1,214.25 | 27 |
| Intestinal stricturoplasty CPT 44615 | not published | not published | $1,180.36 – $2,293.26 | 7 |
| Int hrhc lig 1 hroid without img CPT 46945 | not published | not published | $217.84 – $481.27 | 7 |
| Int hrhc lig 2+hroid without img CPT 46946 | not published | not published | $232.66 – $479.71 | 7 |
| Intra-atrial pacing CPT 93610 | $1,575.65 | $4,258.50 | $61.34 – $8,949.00 | 7 |
| Intra-atrial recording CPT 93602 | $1,575.65 | $4,258.50 | $50.39 – $8,949.00 | 7 |
| Intracard echo interv w/s&i CPT 93662 | $857.66 | $2,318.00 | $55.86 – $303.43 | 6 |
| Intracran angioplsty w/stent CPT 61635 | $2,921.89 | $7,897.00 | $1,622.39 – $2,942.23 | 7 |
| Intracranial angioplasty CPT 61630 | $2,131.20 | $5,760.00 | $1,485.13 – $2,700.43 | 7 |
| Intracranial complete study CPT 93886 | $336.61 | $909.75 | $58.19 – $757.40 | 29 |
| Intracranial limited study CPT 93888 | $238.37 | $644.25 | $39.31 – $440.72 | 29 |
| Intranasal biopsy 30100 CPT 30100 | not published | not published | $75.03 – $148.21 | 7 |
| Intranasal reconstruction CPT 30620 | not published | not published | $649.07 – $1,337.73 | 7 |
| Intraop epicard/endocard/pace/map/ 93631 CPT 93631 | not published | not published | $148.26 – $8,949.00 | 7 |
| Intraoral i+d tongue/floor lingual 41000 CPT 41000 | not published | not published | $119.62 – $1,167.30 | 29 |
| Intrapul surf admin endo tube CPT 94610 | $100.64 | $272.00 | $62.75 – $466.20 | 29 |
| Intrauterine transfusion ftl CPT 36460 | not published | not published | $389.66 – $1,002.11 | 29 |
| Intraventricular pacing CPT 93612 | $6,938.89 | $18,753.75 | $71.59 – $8,949.00 | 7 |
| Intrinsic factor antibody CPT 86340 | $59.66 | $161.25 | $15.08 – $111.67 | 29 |
| Intrm oph exam est patient CPT 92012 | not published | not published | $56.88 – $295.40 | 29 |
| Intro cath dialysis circuit CPT 36901 | $1,034.15 | $2,795.00 | $165.15 – $284.61 | 5 |
| Intro cath dialysis circuit w/pta CPT 36902 | $7,292.70 | $19,710.00 | $246.16 – $424.45 | 5 |
| Intro cath dialysis circuit w/stent plcmnt CPT 36903 | $12,700.44 | $34,325.50 | $337.07 – $581.88 | 5 |
| Intro catheter aorta CPT 36200 | $230.05 | $621.75 | $160.69 – $332.29 | 7 |
| Intro cath svc/ivc CPT 36010 | $234.30 | $633.25 | $125.35 – $263.64 | 7 |
| Intro long gi tube CPT 44500 | $481.00 | $1,300.00 | $22.02 – $2,149.09 | 29 |
| Intro long gi tube w/mult fluo CPT 74340 | not published | not published | $33.88 – $542.92 | 6 |
| Intro windpipe wire/tube CPT 31730 | not published | not published | $169.30 – $316.69 | 7 |
| Intrvasc Ultrasound noncoronary 1st vessel CPT 37252 | $915.47 | $2,474.25 | $105.59 – $180.60 | 5 |
| Intrvasc Ultrasound noncoronary addl vessel CPT 37253 | $610.41 | $1,649.75 | $85.13 – $144.76 | 5 |
| Intubation endotracheal emergency procedure CPT 31500 | $263.53 | $712.25 | $132.58 – $532.31 | 29 |
| Io anal gast n-stim subsq CPT 95981 | not published | not published | $19.44 – $136.15 | 29 |
| Io ga n-stim subsq w/reprog CPT 95982 | not published | not published | $37.99 – $85.48 | 29 |
| Ionm in operatng room 15 min CPT 95940 | $82.79 | $223.75 | $36.33 – $69.42 | 6 |
| Ionm remote/>1 pt or per hr CPT 95941 | not published | not published | $144.81 – $144.81 | 5 |
| Iopamidol 250 mg iodine/ml (51 %) intravenous solution HCPCS Q9966 | $11.99 | $32.40 | $0.29 – $0.36 | 5 |
| Iopamidol 300 mg iodine/ml (61 %) intravenous solution HCPCS Q9967 | $153.98 | $416.15 | $0.24 – $0.30 | 5 |
| Io rad tx deliver by elctrns CPT 77425 | not published | not published | $767.92 – $767.92 | 5 |
| Io rad tx delivery by x-ray CPT 77424 | not published | not published | $767.92 – $767.92 | 5 |
| Ipilimumab 5 mg/ml intravenous solution (wrapper) HCPCS J9228 | $230.57 | $623.15 | $199.53 – $219.00 | 5 |
| Irinotecan 20 mg/ml intravenous solution (wrapper) HCPCS J9206 | $25.55 | $69.05 | $6.27 – $7.71 | 5 |
| Iron CPT 83540 | $70.67 | $191.00 | $6.47 – $60.18 | 29 |
| Iron binding capacity CPT 83550 | $24.14 | $65.25 | $8.74 – $60.18 | 29 |
| Iron dextran 50 mg/ml injection solution HCPCS J1750 | $62.12 | $167.90 | $19.08 – $21.29 | 5 |
| Iron stain peripheral blood CPT 85536 | not published | not published | $6.78 – $51.91 | 29 |
| Iron sucrose 20 mg iron/ml intravenous solution (wrapper) HCPCS J1756 | $53.50 | $144.60 | $0.43 – $1.98 | 5 |
| Irradiation of blood product each unit reference CPT 86945 | $71.04 | $192.00 | $15.37 – $89.98 | 28 |
| Irrigation implantable venous access device for drug delivery systems CPT 96523 | $100.36 | $271.25 | $25.34 – $136.15 | 29 |
| Irrigation sphenoid sinus CPT 31002 | not published | not published | $203.60 – $427.45 | 7 |
| Irrigation vagina and/or appl medicament tx disease CPT 57150 | $255.21 | $689.75 | $32.51 – $136.15 | 29 |
| Island pedicle flap graft CPT 15740 | not published | not published | $934.03 – $1,819.79 | 7 |
| Ivc venogram s&i CPT 75825 | $1,395.64 | $3,772.00 | $71.85 – $542.92 | 7 |
| IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour CPT 96367 | $75.94 | $205.25 | $32.19 – $163.13 | 29 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $71.87 | $194.25 | $21.67 – $38.22 | 7 |
| IV infusion therapy/prophylaxis/diagnosis each additional 1 hour CPT 96366 | $67.62 | $182.75 | $19.92 – $105.77 | 29 |
| IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour CPT 96365 | $229.40 | $620.00 | $71.10 – $482.94 | 29 |
| IV inj ra drug dx study CPT 78808 | $145.60 | $393.50 | $46.88 – $921.08 | 29 |
| IV njx tst vasc flo flap/grf CPT 15860 | not published | not published | $123.52 – $914.67 | 29 |
| Ivp w/nephrotomography CPT 74415 | $322.92 | $872.75 | $30.74 – $408.06 | 29 |
| Ivp w/wo kub w/wo tomography CPT 74400 | $330.32 | $892.75 | $30.74 – $408.06 | 29 |
| Ixabepilone 15 mg intravenous solution HCPCS J9207 | $139.88 | $378.05 | $99.67 – $116.56 | 5 |
| Jak2 targeted sequence analysis CPT 81279 | $215.62 | $582.75 | $185.20 – $416.70 | 23 |
| Jaw arthroscopy/surgery CPT 29800 | not published | not published | $563.45 – $1,086.58 | 7 |
| Jaw arthroscopy/surgery CPT 29804 | not published | not published | $702.42 – $1,377.51 | 7 |
| Jejunstmy tube plcmt CPT 44372 | not published | not published | $275.12 – $554.60 | 7 |
| John cunningham antibody CPT 86711 | not published | not published | $16.89 – $62.53 | 28 |
| J-tube placement CPT 44015 | not published | not published | $161.78 – $303.43 | 7 |
| Keratoprosthesis CPT 65770 | not published | not published | $1,435.01 – $3,297.93 | 7 |
| Ketogenic steroids fract CPT 83582 | not published | not published | $14.85 – $85.28 | 29 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $64.10 | $173.25 | $8.17 – $60.18 | 29 |
| Ketorolac 15 mg/ml injection (wrapper) HCPCS J1885 | $9.71 | $26.25 | $0.62 – $9.29 | 5 |
| Kidney endoscopy CPT 50551 | not published | not published | $333.78 – $625.58 | 7 |
| Kidney endoscopy CPT 50553 | not published | not published | $354.71 – $670.04 | 7 |
| Kidney endoscopy CPT 50570 | not published | not published | $560.01 – $1,042.89 | 7 |
| Kidney endoscopy CPT 50575 | not published | not published | $812.30 – $1,518.69 | 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.