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 |
|---|---|---|---|---|
| Mcp joint arthroscopysurg 29902 CPT 29902 | not published | not published | $536.66 – $1,262.86 | 7 |
| Meas lung vol thru 2 yrs CPT 94013 | not published | not published | $22.47 – $1,216.24 | 28 |
| Measure kidney pressure CPT 50396 | not published | not published | $131.97 – $1,529.98 | 29 |
| Measurement post void urine by ultrasound CPT 51798 | $95.92 | $259.25 | $19.77 – $136.15 | 29 |
| Measure ureter pressure CPT 50686 | not published | not published | $100.44 – $358.63 | 29 |
| Mechlorethamine hcl inj HCPCS J9230 | $231.27 | $625.05 | $199.53 – $262.69 | 5 |
| Mecp2 gene dup/delet variant CPT 81304 | not published | not published | $79.86 – $337.50 | 28 |
| Mecp2 gene full seq CPT 81302 | not published | not published | $79.86 – $1,187.71 | 28 |
| Mecp2 gene known variant CPT 81303 | not published | not published | $79.86 – $270.00 | 28 |
| Medial canthopexy CPT 21280 | not published | not published | $568.35 – $1,249.60 | 7 |
| Mediastinoscpy w/lmph nod bx CPT 39402 | not published | not published | $459.32 – $789.20 | 5 |
| Mediastinoscpy w/medstnl bx 39401 CPT 39401 | not published | not published | $351.15 – $604.37 | 5 |
| Medical testimony CPT 99075 | not published | not published | not published | 0 |
| Med physic dos eval rad exps CPT 76145 | not published | not published | $540.55 – $1,216.24 | 23 |
| Medroxyprogesterone 150 mg/ml im injection (wrapper) HCPCS J1050 | $9.25 | $25.00 | $0.37 – $0.41 | 5 |
| Meg evoked single CPT 95966 | not published | not published | $250.05 – $425.89 | 6 |
| Meg spontaneous CPT 95965 | not published | not published | $502.13 – $922.76 | 6 |
| Meniscal trnspl knee w/scpe CPT 29868 | not published | not published | $1,831.16 – $3,544.40 | 7 |
| Meperidine (pf) 25 mg/ml injection (wrapper) HCPCS J2175 | $23.53 | $63.60 | $4.38 – $21.29 | 5 |
| Mepolizumab 100 mg/ml subcutaneous auto-injector HCPCS J2182 | $64.75 | $175.00 | $36.78 – $39.41 | 4 |
| Meropenem 1 gram intravenous solution HCPCS J2185 | $9.79 | $26.46 | $1.42 – $1.74 | 5 |
| Mesh/prosth/ pelvic floor rpr/vag 57267 CPT 57267 | not published | not published | $286.50 – $553.82 | 7 |
| Mesna 100 mg/ml intravenous solution HCPCS J9209 | $35.39 | $95.65 | $4.05 – $4.98 | 5 |
| Metabolic Blood Panel (Basic) CPT 80048 | $31.73 | $85.75 | $8.46 – $20.58 | 29 |
| Metabolic Blood Panel (Comprehensive) CPT 80053 | $40.79 | $110.25 | $10.56 – $109.05 | 29 |
| Metabolic panel ionized ca CPT 80047 | $76.78 | $207.50 | $8.86 – $109.05 | 29 |
| Methacholine chloride 0.0625 mg/ml nebulization soln HCPCS J7674 | $0.97 | $2.63 | $0.68 – $0.84 | 5 |
| Methadone injection HCPCS J1230 | $45.23 | $122.25 | $11.72 – $21.29 | 5 |
| Methotrexate sodium 2.5 mg tablet HCPCS J8610 | $21.13 | $57.10 | $1.65 – $21.29 | 5 |
| Methotrexate sodium (pf) 1 gram solution for injection HCPCS J9260 | $52.04 | $140.65 | $4.02 – $21.29 | 5 |
| Methotrexate therapeutic drug level CPT 80204 | $101.75 | $275.00 | $38.57 – $86.78 | 23 |
| Methylene blue (antidote) 5 mg/ml intravenous solution HCPCS Q9968 | $344.73 | $931.70 | $0.70 – $0.85 | 5 |
| Methylergonovine 0.2 mg/ml (1 ml) injection solution HCPCS J2210 | $35.98 | $97.25 | $6.85 – $21.29 | 5 |
| Methylnaltrexone 12 mg/0.6 ml subcutaneous injection (wrapper) HCPCS J2212 | $0.39 | $1.06 | $0.37 – $0.77 | 5 |
| Methylprednisolone 4 mg tablet HCPCS J7509 | $2.39 | $6.45 | $0.78 – $0.85 | 5 |
| Metoclopramide in d5w IV syringe 0.2 mg/ml (neo/ped) - cnr HCPCS J2765 | $9.25 | $25.00 | $1.26 – $21.29 | 5 |
| Mgmt promoter methylation analysis CPT 81287 | $118.96 | $321.50 | $79.86 – $280.44 | 28 |
| Micafungin 100 mg intravenous solution HCPCS J2248 | $135.03 | $364.95 | $1.54 – $9.29 | 5 |
| Microalbumin urine screen CPT 82044 | not published | not published | $4.95 – $40.83 | 29 |
| Microbe susceptible mlc CPT 87187 | not published | not published | $10.04 – $90.38 | 29 |
| Microdissection laser CPT 88380 | $463.98 | $1,254.00 | $81.21 – $113.79 | 7 |
| Microdissection manual CPT 88381 | $42.74 | $115.50 | $47.23 – $113.79 | 7 |
| Microfluid analy tears CPT 83861 | not published | not published | $22.48 – $108.04 | 28 |
| Microsatellite instability CPT 81301 | $422.36 | $1,141.50 | $79.86 – $784.26 | 28 |
| Microsurg tehniq require use oper micro (add-on)69990 CPT 69990 | not published | not published | $246.58 – $395.22 | 7 |
| Microvolt t-wave assess CPT 93025 | not published | not published | $50.39 – $358.63 | 29 |
| Midazolam 1 mg/ml injection solution HCPCS J2250 | $22.29 | $60.25 | $0.20 – $0.24 | 5 |
| Middle cerebral artery echo CPT 76821 | $220.98 | $597.25 | $42.87 – $420.03 | 29 |
| Milrinone 20 mg/100 ml(200 mcg/ml) in 5 % dextrose intravenous piggybk HCPCS J2260 | $24.64 | $66.60 | $4.59 – $5.64 | 5 |
| Minocycline hydrochloride HCPCS J2265 | $34.97 | $94.50 | $0.37 – $0.90 | 5 |
| Mitomycin 40 mg intravenous solution HCPCS J9280 | $246.05 | $665.00 | $18.09 – $50.53 | 6 |
| Mitoxantrone 2 mg/ml concentrate,intravenous HCPCS J9293 | $78.44 | $212.00 | $50.53 – $57.24 | 5 |
| Mitral valve replacement w/bypass 33430 CPT 33430 | not published | not published | $3,170.49 – $6,058.41 | 7 |
| Mlh1 gene CPT 81288 | $118.96 | $321.50 | $182.46 – $432.72 | 23 |
| Mlh1 gene dup/delete variant CPT 81294 | not published | not published | $79.86 – $455.40 | 28 |
| Mlh1 gene full seq CPT 81292 | not published | not published | $79.86 – $1,519.65 | 28 |
| Mlh1 gene known variants CPT 81293 | not published | not published | $79.86 – $744.75 | 28 |
| Mlt osteot rlgnm imed rd hum CPT 24410 | not published | not published | $1,159.47 – $2,280.77 | 7 |
| Mnl appl strs jt radiography CPT 77071 | $45.70 | $123.50 | $45.70 – $201.83 | 29 |
| Mnpj anes sho jt fixj aprats CPT 23700 | $1,854.53 | $5,012.25 | $211.73 – $412.63 | 7 |
| Mnpj elbow under anes CPT 24300 | not published | not published | $410.52 – $868.94 | 7 |
| Mnpj of tmj w/anesth CPT 21073 | not published | not published | $261.63 – $543.67 | 7 |
| Mnt subs tx for change dx HCPCS G0270 | $24.14 | $65.25 | $30.20 – $59.29 | 6 |
| Mobilization of colon 44139 CPT 44139 | not published | not published | $137.90 – $258.19 | 7 |
| Modification of contact lens CPT 92325 | not published | not published | $28.99 – $295.47 | 29 |
| Modified maze/limited 33254 CPT 33254 | not published | not published | $1,540.40 – $2,964.08 | 7 |
| Modified maze/limited /w other op 33257 CPT 33257 | not published | not published | $653.96 – $678.94 | 2 |
| Mog-igg1 antb flo cytmtry ea CPT 86363 | not published | not published | $37.73 – $84.89 | 22 |
| Mopath procedure level 1 CPT 81400 | $212.47 | $574.25 | $63.96 – $143.91 | 28 |
| Mopath procedure level 3 CPT 81402 | $212.01 | $573.00 | $79.86 – $338.24 | 28 |
| Mopath procedure level 5 CPT 81404 | $966.72 | $2,612.75 | $79.86 – $618.37 | 28 |
| Mopath procedure level 6 CPT 81405 | $1,126.65 | $3,045.00 | $79.86 – $678.04 | 28 |
| Mopath procedure level 7 CPT 81406 | $906.32 | $2,449.50 | $79.86 – $636.48 | 28 |
| Mopath procedure level 8 CPT 81407 | $710.68 | $1,920.75 | $79.86 – $1,904.11 | 28 |
| Mopath procedure level 9 CPT 81408 | $1,144.13 | $3,092.25 | $79.86 – $2,270.00 | 6 |
| Morphine 4 mg/ml injection (wrapper) HCPCS J2270 | $48.56 | $131.25 | $8.00 – $9.84 | 5 |
| Morphine (pf) 0.25 mg/0.5 ml injection (neo/ped) - cnr HCPCS J2274 | $210.23 | $568.20 | $14.70 – $15.75 | 4 |
| Morphometric analysis in situ hybridization computer-assisted per specimen each multiplex stain CPT 88374 | $281.94 | $762.00 | $174.57 – $392.78 | 28 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain computer-assisted CPT 88361 | not published | not published | $71.42 – $824.56 | 29 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain manual CPT 88360 | $153.18 | $414.00 | $66.49 – $392.78 | 29 |
| Motion analysis video/3d CPT 96000 | not published | not published | $106.10 – $1,216.24 | 29 |
| Motion test w/ft press meas CPT 96001 | not published | not published | $126.86 – $212.16 | 7 |
| Motor &/ sens nrve cndj test CPT 95905 | not published | not published | $69.70 – $914.67 | 28 |
| Mouth vestibule bx/w complex rpr 40814 CPT 40814 | not published | not published | $324.46 – $657.56 | 7 |
| M/phmtrc alys ishquant/semiq CPT 88373 | not published | not published | $51.37 – $103.39 | 6 |
| M/phmtrc alys ishquant/semiq CPT 88377 | $1,293.52 | $3,496.00 | $174.57 – $392.78 | 28 |
| M/phmtrc alysishquant/semiq CPT 88369 | not published | not published | $74.18 – $126.53 | 6 |
| M/phmtrc alys skeletal musc CPT 88355 | not published | not published | $60.01 – $392.78 | 29 |
| Mpl gene analysis common variants CPT 81338 | $174.83 | $472.50 | $150.33 – $338.24 | 23 |
| MRA abdomen post contrast CPT 74185 | not published | not published | $113.45 – $950.85 | 7 |
| MRA aorta thoracic w/wo contrast CPT 71555 | not published | not published | $114.72 – $943.04 | 7 |
| MRA chest w IV cont HCPCS C8909 | $595.98 | $1,610.75 | $943.04 – $943.04 | 5 |
| MRA chest wwo IV cont HCPCS C8911 | $843.69 | $2,280.25 | $943.04 – $943.04 | 5 |
| MRA ext low(run-off)pst cntrst CPT 73725 | not published | not published | $114.79 – $957.08 | 7 |
| MRA pelvis CPT 72198 | not published | not published | $113.45 – $951.62 | 7 |
| MRA spinal canal CPT 72159 | not published | not published | $112.44 – $964.89 | 7 |
| MRA upper extremity post contrast-bil CPT 73225 | not published | not published | $107.97 – $965.66 | 7 |
| MRA w/cont, abd HCPCS C8900 | $595.98 | $1,610.75 | $950.85 – $950.85 | 5 |
| MRA w/cont, lwr ext HCPCS C8912 | $1,191.96 | $3,221.50 | $805.38 – $957.08 | 6 |
| Mra, w/dye, upper extremity HCPCS C8934 | $887.26 | $2,398.00 | $2,149.97 – $2,149.97 | 5 |
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.