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 |
|---|---|---|---|---|
| Mayo factor x CPT 85260 | $103.69 | $280.25 | $17.90 – $100.82 | 29 |
| Mayo factor xi CPT 85270 | $97.68 | $264.00 | $17.90 – $100.82 | 29 |
| Mayo fat/lipids feces quantitative CPT 82710 | $70.67 | $191.00 | $16.80 – $40.89 | 29 |
| Mayo fbl culture fungi blood CPT 87103 | $45.70 | $123.50 | $9.64 – $113.14 | 29 |
| Mayo fdp/fsp paracoagulation CPT 85366 | not published | not published | $9.12 – $181.03 | 29 |
| Mayo ffspg allergen clam igg CPT 86001 | $22.66 | $61.25 | $5.47 – $17.59 | 29 |
| Mayo fibrinogen antigen CPT 85385 | $71.87 | $194.25 | $8.86 – $38.30 | 29 |
| Mayo gabapentin bld/srm/plasma therapeutic drug level CPT 80171 | $70.39 | $190.25 | $20.63 – $129.19 | 28 |
| Mayo gamma-globin full gene sequencing CPT 81479 | $1,460.30 | $3,946.75 | $79.86 – $79.86 | 5 |
| Mayo hemosiderin qualitative urine CPT 83070 | $27.01 | $73.00 | $4.75 – $11.56 | 29 |
| Mayo hip12 infectious agent nucleic acid amplified probe hiv-1 rna qualitative CPT 87535 | $170.57 | $461.00 | $35.09 – $113.14 | 29 |
| Mayo hip12 infectious agent nucleic acid amplified probe hiv-2 CPT 87538 | $158.64 | $428.75 | $35.09 – $113.14 | 29 |
| Mayo hiser histoplasma antibodies immunodiffusion CPT 86698 | $36.82 | $99.50 | $13.29 – $31.03 | 29 |
| Mayo hla typing a/b/c single antigen CPT 86812 | not published | not published | $25.81 – $58.07 | 29 |
| Mayo hvdip HIV 1 antibody CPT 86701 | $16.28 | $44.00 | $8.89 – $21.61 | 29 |
| Mayo hvdip HIV 2 antibody CPT 86702 | $22.02 | $59.50 | $13.52 – $32.88 | 29 |
| Mayo hydroxyprogesterone 17-d CPT 83498 | $106.65 | $288.25 | $27.17 – $111.67 | 29 |
| Mayo immunoassay c1 esterase inhibitor antibody quantitative CPT 83520 | $229.31 | $619.75 | $13.55 – $62.53 | 29 |
| Mayo immunoassay infectious agent antibody quantitative diptheria igg CPT 86317 | $95.46 | $258.00 | $14.99 – $36.48 | 29 |
| Mayo immunoassay tumor antigen quantitative ca 27.29 CPT 86300 | $71.87 | $194.25 | $20.81 – $113.14 | 29 |
| Mayo immunoassay tumor antigen quantitative chromogranin a CPT 86316 | $172.70 | $466.75 | $20.81 – $108.04 | 29 |
| Mayo inf agt nucleic acid amp prb helicobacter pylori clarithromycin resistance CPT 87513 | not published | not published | $35.09 – $78.95 | 22 |
| Mayo infectious agent antigen immunoassay direct optical observation cryptococcus CPT 87899 | $28.21 | $76.25 | $12.77 – $36.16 | 29 |
| Mayo infectious agent antigen immunoassay ql/sq multi step aspergillus bal CPT 87305 | $150.13 | $405.75 | $11.98 – $56.64 | 29 |
| Mayo infectious agent nucleic acid amplified probe enterovirus CPT 87498 | $219.13 | $592.25 | $35.09 – $113.14 | 29 |
| Mayo infectious agent nucleic acid amplified probe mycoplasma genitalium urine CPT 87563 | $44.81 | $121.10 | $35.09 – $78.95 | 23 |
| Mayo infectious agent nucleic acid amplified probe mycoplasma pneumoniae CPT 87581 | $225.15 | $608.50 | $35.09 – $113.14 | 29 |
| Mayo infectious agent nucleic acid amplified probe pneumocystis jirovecii CPT 87594 | not published | not published | $35.09 – $78.95 | 22 |
| Mayo infectious agent nucleic acid quantification cytomegalovirus CPT 87497 | $197.58 | $534.00 | $42.84 – $113.14 | 29 |
| Mayo infectious disease hepatitis c chronic six biochemical assays CPT 81596 | $146.89 | $397.00 | $72.19 – $162.43 | 23 |
| Mayo infliximab therapeutic drug level CPT 80230 | $167.06 | $451.50 | $38.57 – $86.78 | 23 |
| Mayo inhab inhibin a CPT 86336 | $103.23 | $279.00 | $15.59 – $37.92 | 29 |
| Mayo insft insulin free CPT 83527 | $37.74 | $102.00 | $12.95 – $31.50 | 29 |
| Mayo insulin antibodies CPT 86337 | $93.24 | $252.00 | $21.41 – $111.67 | 29 |
| Mayo iodine CPT 83789 | $113.50 | $306.75 | $19.02 – $108.04 | 29 |
| Mayo itraconazole therapeutic drug level CPT 80189 | $77.70 | $210.00 | $27.11 – $61.00 | 23 |
| Mayo lacosamide therapeutic drug level CPT 80235 | $79.27 | $214.25 | $27.11 – $61.00 | 23 |
| Mayo lamotrigine therapeutic drug level CPT 80175 | $73.91 | $199.75 | $13.25 – $129.19 | 28 |
| Mayo ld_i lactate dehydrogenase isoenzymes CPT 83625 | $44.03 | $119.00 | $12.79 – $108.04 | 29 |
| Mayo legionella antibody CPT 86713 | $72.89 | $197.00 | $15.30 – $79.86 | 29 |
| Mayo leptospira antibody igm CPT 86720 | $79.64 | $215.25 | $13.81 – $79.86 | 29 |
| Mayo lipoprotein electrophoresis CPT 83700 | $27.10 | $73.25 | $11.26 – $27.38 | 29 |
| Mayo lywb borrelia burgdorferi (lyme disease) antibody igg confirmatory CPT 86617 | $88.10 | $238.10 | $15.49 – $79.86 | 29 |
| Mayo manganese CPT 83785 | $64.57 | $174.50 | $26.06 – $112.27 | 29 |
| Mayo metanephrines plasma CPT 83835 | $139.31 | $376.50 | $16.94 – $41.22 | 29 |
| Mayo mgle voltage-gated calcium channel antibody each CPT 86596 | not published | not published | $12.05 – $27.11 | 22 |
| Mayo mgrm acetylcholine receptor binding antibody CPT 86041 | not published | not published | $18.40 – $41.40 | 22 |
| Mayo microsomal antibody liver-kidney CPT 86376 | $82.33 | $222.50 | $14.55 – $111.67 | 29 |
| Mayo mitotane (lysodren) therapeutic drug level CPT 80299 | $167.61 | $453.00 | $14.33 – $41.94 | 29 |
| Mayo molecular pathology procedure level 2 apoe genotype CPT 81401 | $990.03 | $2,675.75 | $79.86 – $308.25 | 28 |
| Mayo mpl sequence analysis exon 10 CPT 81339 | not published | not published | $185.20 – $416.70 | 23 |
| Mayo muramidase CPT 85549 | $64.38 | $174.00 | $18.75 – $108.04 | 29 |
| Mayo muscle-specific kinase (musk) antibody CPT 86366 | not published | not published | $18.40 – $41.40 | 22 |
| Mayo mycophenolic acid therapeutic drug level CPT 80180 | $70.39 | $190.25 | $18.05 – $129.19 | 28 |
| Mayo myoglobin CPT 83874 | $59.11 | $159.75 | $12.92 – $108.04 | 29 |
| Mayo nickel CPT 83885 | not published | not published | $24.51 – $112.27 | 29 |
| Mayo organic acid methylmalonic single quantitative CPT 83921 | $222.74 | $602.00 | $17.46 – $108.04 | 29 |
| Mayo organic acids qualitative each specimen CPT 83919 | $96.02 | $259.50 | $16.45 – $108.04 | 29 |
| Mayo oxalate 24 hour urine CPT 83945 | $48.31 | $130.58 | $13.55 – $32.51 | 29 |
| Mayo pancreatic elastase fecal qualitative or semi quantitative CPT 82656 | not published | not published | $11.53 – $108.04 | 29 |
| Mayo parvs parvovirus b19 antibody igg CPT 86747 | $43.48 | $117.50 | $15.03 – $79.86 | 29 |
| Mayo paval fluorescent antibody screen agna type 1 CPT 86255 | $377.68 | $1,020.75 | $12.05 – $29.32 | 29 |
| Mayo pborb infectious agent nucleic acid amplified probe borrelia burgdorferi (lyme) CPT 87476 | $184.17 | $497.75 | $35.09 – $113.14 | 29 |
| Mayo phospholipid neutralization hexagonal lupus anticoagulant CPT 85598 | not published | not published | $17.98 – $100.82 | 28 |
| Mayo pntft phenytoin free therapeutic drug level CPT 80186 | $46.62 | $126.00 | $13.76 – $33.49 | 29 |
| Mayo pqnu porphobilinogen urine quantitative 24 hour urine CPT 84110 | $62.53 | $169.00 | $8.44 – $20.54 | 29 |
| Mayo pregnenolone CPT 84140 | not published | not published | $20.67 – $111.67 | 29 |
| Mayo prmb primidone therapeutic drug level CPT 80188 | $66.32 | $179.25 | $16.59 – $129.19 | 29 |
| Mayo proinsulin CPT 84206 | $102.49 | $277.00 | $18.76 – $111.67 | 29 |
| Mayo psaft prostate specific antigen free CPT 84154 | $100.64 | $272.00 | $18.39 – $60.18 | 29 |
| Mayo radioimmunoassay procollagen i intact n-terminal antibody quantitative CPT 83519 | $211.64 | $572.00 | $14.33 – $62.53 | 29 |
| Mayo rbcme osmotic fragility rbc incubated CPT 85557 | not published | not published | $13.36 – $89.93 | 29 |
| Mayo receptor assay transferrin soluble CPT 84238 | $125.34 | $338.75 | $36.57 – $108.04 | 29 |
| Mayo renin CPT 84244 | $80.38 | $217.25 | $21.99 – $53.52 | 29 |
| Mayo repu protein electrophoresis urine CPT 84166 | $75.11 | $203.00 | $14.66 – $43.40 | 29 |
| Mayo selenium CPT 84255 | $103.60 | $280.00 | $25.53 – $108.04 | 29 |
| Mayo semb semen analysis volume/count/motility/differential strict morphologic criteria CPT 89322 | not published | not published | $15.50 – $60.18 | 29 |
| Mayo serotonin CPT 84260 | $181.30 | $490.00 | $25.28 – $111.67 | 29 |
| Mayo sfgp rickettsia rickettsii antibody igg CPT 86757 | $79.25 | $214.20 | $19.35 – $79.86 | 29 |
| Mayo sirolimus therapeutic drug level CPT 80195 | $94.72 | $256.00 | $13.73 – $129.19 | 29 |
| Mayo syphilis test non-treponemal antibody qualitative vdrl CPT 86592 | $25.62 | $69.25 | $4.27 – $62.53 | 29 |
| Mayo tcgr analysis gene rearrangement trb@ abnormal clonal population(s) amplification CPT 81340 | not published | not published | $79.86 – $470.07 | 28 |
| Mayo tgrp testosterone free CPT 84402 | $83.81 | $226.50 | $25.47 – $111.67 | 29 |
| Mayo tgrp testosterone total CPT 84403 | $93.70 | $253.25 | $25.81 – $111.67 | 29 |
| Mayo thiopurine s-methyltransferase CPT 84433 | not published | not published | $22.17 – $49.88 | 22 |
| Mayo thyroglobulin CPT 84432 | $77.24 | $208.75 | $16.06 – $111.67 | 29 |
| Mayo ticks anaplasma phagocytophilum antibody igg CPT 86666 | $42.46 | $114.75 | $10.18 – $79.86 | 29 |
| Mayo ticks babesia microti antibody igg CPT 86753 | $64.84 | $175.25 | $12.39 – $62.53 | 29 |
| Mayo ttfb testosterone bioavailable direct CPT 84410 | not published | not published | $51.28 – $117.53 | 28 |
| Mayo tulab francisella tularensis antibody igg CPT 86668 | $26.46 | $71.50 | $10.94 – $31.86 | 29 |
| Mayo valpg valproic acid free therapeutic drug level CPT 80165 | $35.80 | $96.75 | $13.54 – $31.82 | 28 |
| Mayo vasoactive intestinal peptide CPT 84586 | $130.15 | $351.75 | $35.33 – $111.67 | 29 |
| Mayo vitamin b-2 (riboflavin) CPT 84252 | $102.58 | $277.25 | $20.24 – $108.04 | 29 |
| Mayo vitamin b3 (niacin) CPT 84591 | $61.98 | $167.50 | $12.25 – $38.38 | 29 |
| Mayo vitamin k CPT 84597 | $148.93 | $402.50 | $13.72 – $108.04 | 29 |
| Mayo zonisamide therapeutic drug level CPT 80203 | $66.05 | $178.50 | $13.25 – $129.19 | 28 |
| Maze/extensive/w/card/pulm bypass 33259 CPT 33259 | not published | not published | $949.80 – $1,001.45 | 2 |
| Mcoln1 gene CPT 81290 | not published | not published | $39.31 – $88.45 | 28 |
| Mcp joint arthroscopy dx CPT 29900 | not published | not published | $462.19 – $957.08 | 7 |
| Mcp joint arthroscopy surg CPT 29901 | not published | not published | $543.61 – $1,124.79 | 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.