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 |
|---|---|---|---|---|
| Opn tx nasomax fx multple CPT 21347 | not published | not published | $1,190.97 – $2,363.47 | 7 |
| Opn tx nasomax fx w/fixj CPT 21346 | not published | not published | $991.09 – $1,948.48 | 7 |
| Opn tx orbit fx combined CPT 21387 | not published | not published | $780.77 – $1,569.40 | 7 |
| Opn tx orbit fx periorbital CPT 21386 | not published | not published | $727.92 – $1,491.39 | 7 |
| Opn tx orbit fx transantral CPT 21385 | not published | not published | $746.13 – $1,466.44 | 7 |
| Opn tx orbit fx w/bone grft CPT 21408 | not published | not published | $961.99 – $1,901.68 | 7 |
| Opn tx orbit fx w/implant CPT 21407 | not published | not published | $697.27 – $1,398.58 | 7 |
| Opn tx orbit fx without impl 21406 CPT 21406 | not published | not published | $587.38 – $1,196.55 | 7 |
| Opn tx orbit periorbtl implt CPT 21390 | not published | not published | $842.40 – $1,720.72 | 7 |
| Opn tx orbit periorbt w/grft CPT 21395 | not published | not published | $1,067.37 – $2,106.05 | 7 |
| Oprelvekin injection HCPCS J2355 | $353.44 | $955.25 | $199.53 – $469.81 | 5 |
| Opscpy extnd on/mac draw CPT 92202 | not published | not published | $60.51 – $136.15 | 22 |
| Opscpy extnd rta draw uni/bi CPT 92201 | not published | not published | $60.51 – $136.15 | 22 |
| Optx acrclv dslc aq/chrn grf CPT 23552 | not published | not published | $716.26 – $1,387.66 | 7 |
| Optx acromclv dislc aqt/chrn CPT 23550 | not published | not published | $614.85 – $1,202.80 | 7 |
| Optx acute shoulder dislc CPT 23660 | not published | not published | $629.84 – $1,232.43 | 7 |
| Optx carpl scphd fx int fixj CPT 25628 | not published | not published | $776.30 – $1,513.24 | 7 |
| Optx clavicular fx w/int fix CPT 23515 | not published | not published | $765.82 – $1,523.39 | 7 |
| Optx complicated mndblr fx CPT 21470 | not published | not published | $1,305.43 – $2,575.63 | 7 |
| Optx crpl fx oth/thn scph ea CPT 25645 | not published | not published | $611.56 – $1,198.12 | 7 |
| Optx gr hmrl tbrs fx int fix CPT 23630 | not published | not published | $818.21 – $1,655.21 | 7 |
| Optx lunate dislocation CPT 25695 | not published | not published | $686.92 – $1,332.28 | 7 |
| Optx medial ankle fx CPT 27766 | not published | not published | $663.42 – $1,290.15 | 7 |
| Optx mndblr cndylr fx CPT 21465 | not published | not published | $998.31 – $2,000.76 | 7 |
| Optx mndblr fx wo ntrdntl CPT 21461 | not published | not published | $966.59 – $2,004.66 | 7 |
| Optx mndblr fx xtrnl fixj CPT 21454 | not published | not published | $598.21 – $1,155.99 | 7 |
| Optx mndblr/max alv ridge fx CPT 21445 | not published | not published | $649.66 – $1,320.58 | 7 |
| Optx palatal/max fracture CPT 21422 | not published | not published | $725.79 – $1,418.07 | 7 |
| Optx partclr fx&/dslc elbw w CPT 24587 | not published | not published | $1,198.45 – $2,292.48 | 7 |
| Optx post ankle fx CPT 27769 | not published | not published | $764.16 – $1,552.25 | 7 |
| Optx prox humrl fx w/int fix CPT 23615 | not published | not published | $953.45 – $1,872.82 | 7 |
| Optx prx hmrl fx fix rpr rpl CPT 23616 | not published | not published | $1,375.68 – $2,631.02 | 7 |
| Optx radial shaft fracture CPT 25515 | not published | not published | $725.64 – $1,411.84 | 7 |
| Optx rad/uln dislc aqt/chrnc CPT 25676 | not published | not published | $683.50 – $1,326.03 | 7 |
| Optx rdcrpl/ntrcrpl dislc 1+ CPT 25670 | not published | not published | $660.47 – $1,271.44 | 7 |
| Optx rdl shft fx&cltx rad/ul CPT 25525 | not published | not published | $861.65 – $1,648.19 | 7 |
| Optx rdl shft fx&dstl rad/ul CPT 25526 | not published | not published | $1,046.96 – $2,014.02 | 7 |
| Optx rdl&uln shft fx rds&uln CPT 25575 | not published | not published | $973.93 – $1,899.34 | 7 |
| Optx rdl&uln shft fx rds/uln CPT 25574 | not published | not published | $713.67 – $1,420.41 | 7 |
| Optx scapular fx w/int fixj CPT 23585 | not published | not published | $1,046.11 – $2,081.10 | 7 |
| Optx sho dislc fx CPT 23670 | not published | not published | $921.89 – $1,858.01 | 7 |
| Optx sho dislc neck fx fixj CPT 23680 | not published | not published | $998.36 – $1,964.88 | 7 |
| Optx strclv dslc aq/chrn grf CPT 23532 | not published | not published | $673.68 – $1,314.34 | 7 |
| Optx strnclav dislc aqt/chrn CPT 23530 | not published | not published | $587.67 – $1,205.91 | 7 |
| Optx tmprmand dislocation CPT 21490 | not published | not published | $1,010.93 – $1,975.01 | 7 |
| Optx trns-scphprlnr fx dislc CPT 25685 | not published | not published | $798.25 – $1,549.12 | 7 |
| Optx ulnar shft fx int fixj CPT 25545 | not published | not published | $677.17 – $1,312.00 | 7 |
| Optx ulnar styloid fracture CPT 25652 | not published | not published | $665.96 – $1,308.09 | 7 |
| Oral aprepitant HCPCS J8501 | $91.24 | $246.60 | $9.98 – $11.51 | 5 |
| Oral busulfan HCPCS J8510 | $232.30 | $627.85 | $9.98 – $18.51 | 5 |
| Orchiectomy partial CPT 54522 | not published | not published | $664.09 – $1,274.55 | 7 |
| Orchiopexy (fowler-stephens) CPT 54650 | not published | not published | $814.59 – $1,503.09 | 7 |
| Orchiopexy ingun/scrot appr CPT 54640 | not published | not published | $533.63 – $1,015.59 | 7 |
| Organic acids total quant ea spec CPT 83918 | $147.17 | $397.75 | $17.46 – $112.27 | 29 |
| Oritavancin 400 mg intravenous solution HCPCS J2407 | $1,212.12 | $3,276.00 | $34.51 – $36.98 | 4 |
| Oropharyngeal biopsy 42800 CPT 42800 | not published | not published | $122.35 – $244.15 | 7 |
| Orphenadrine citrate 30 mg/ml injection solution HCPCS J2360 | $12.47 | $33.71 | $9.60 – $21.29 | 5 |
| Ortho ewhf rigd without jnt cstm w HCPCS L3765 | $782.70 | $2,115.40 | $1,965.08 – $1,965.08 | 1 |
| Orthopantogram CPT 70355 | not published | not published | $9.70 – $259.34 | 29 |
| Orthop traing supvj phys/qhp CPT 92066 | not published | not published | $60.51 – $136.15 | 22 |
| Orthosis lso rigd frm hyperex HCPCS L0472 | $813.61 | $2,198.95 | $697.01 – $697.01 | 1 |
| Oscillation chest wall mechanical per session CPT 94669 | $110.08 | $297.50 | $33.43 – $466.20 | 28 |
| Osmolality blood CPT 83930 | $53.56 | $144.75 | $6.61 – $60.18 | 29 |
| Osmolality urine CPT 83935 | $39.22 | $106.00 | $6.82 – $60.18 | 29 |
| Ostectomy complete 1st metatarsal head 28111 CPT 28111 | not published | not published | $362.52 – $712.94 | 7 |
| Ostectomy scapula partial CPT 23190 | not published | not published | $604.65 – $1,201.23 | 7 |
| Osteochondral knee allograft CPT 27415 | not published | not published | $1,522.53 – $2,905.58 | 7 |
| Osteochondral knee autograft CPT 27416 | not published | not published | $1,070.15 – $2,070.95 | 7 |
| Osteochondral talus autogrft CPT 28446 | not published | not published | $1,316.98 – $2,588.89 | 7 |
| Osteopath manip tx/5-6 body region 98927 CPT 98927 | not published | not published | $25.77 – $101.41 | 29 |
| Osteopath manip tx/7-8 body region 98928 CPT 98928 | not published | not published | $25.77 – $128.71 | 29 |
| Osteopath manip tx/9-10 body region98929 CPT 98929 | not published | not published | $25.77 – $153.66 | 29 |
| Osteoplasty humerus CPT 24420 | not published | not published | $1,085.00 – $2,095.13 | 7 |
| Osteot humerus w/wo int fixj CPT 24400 | not published | not published | $901.08 – $1,735.55 | 7 |
| Osteotomy/graft tarsal/calcaneus/talus 28305 CPT 28305 | not published | not published | $741.78 – $1,404.04 | 7 |
| Ot evaluation high complexity patient/family CPT 97167 | $74.56 | $201.50 | $85.24 – $213.66 | 27 |
| Ot evaluation low complexity patient/family CPT 97165 | $74.56 | $201.50 | $85.24 – $213.66 | 27 |
| Ot evaluation moderate complexity patient/family CPT 97166 | $74.56 | $201.50 | $85.24 – $213.66 | 27 |
| Other immunoelectrophoresis CPT 86325 | not published | not published | $14.66 – $108.04 | 29 |
| Oth resp proc, group HCPCS G0239 | $61.88 | $167.25 | $13.30 – $24.96 | 6 |
| Oth resp proc, indiv HCPCS G0238 | $20.54 | $55.50 | $10.43 – $22.62 | 6 |
| Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes CPT 97763 | not published | not published | $46.34 – $104.27 | 26 |
| Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes CPT 97760 | $34.50 | $93.25 | $38.32 – $95.98 | 29 |
| Ot manual therpy techniques >=1 region each 15 minutes CPT 97140 | $33.95 | $91.75 | $25.70 – $63.18 | 29 |
| Otolaryngo binocular microscopy 92504 CPT 92504 | not published | not published | $10.58 – $17.68 | 7 |
| Otoplasty 69300 CPT 69300 | not published | not published | $505.17 – $1,023.38 | 7 |
| Ot re-evaluation patient/family CPT 97168 | $38.30 | $103.50 | $56.10 – $146.86 | 27 |
| Ot therapeutic activities direct patient contact each 15 minutes CPT 97530 | $34.50 | $93.25 | $32.36 – $73.32 | 29 |
| Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes CPT 97130 | not published | not published | $20.11 – $45.25 | 22 |
| Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes CPT 97129 | not published | not published | $21.05 – $47.36 | 22 |
| Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes CPT 97110 | $33.02 | $89.25 | $27.21 – $67.85 | 29 |
| Ot therapeutic procedure neuromuscular reeducate each 15 minutes CPT 97112 | $31.17 | $84.25 | $30.27 – $70.21 | 29 |
| Ot training self care/home management direct contact each 15 minutes CPT 97535 | $42.55 | $115.00 | $30.09 – $73.32 | 29 |
| Outflow tarct agmntj heart chamber 33478 CPT 33478 | not published | not published | $1,782.61 – $3,416.49 | 7 |
| Ovarian cystectomy 58925 CPT 58925 | not published | not published | $826.40 – $1,599.05 | 7 |
| Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr HCPCS J2700 | $26.95 | $72.85 | $3.26 – $9.29 | 5 |
| Oxaliplatin 5 mg/ml desensitization HCPCS J9263 | $33.86 | $91.50 | $0.42 – $21.29 | 5 |
| Oxytocin 10 unit/ml injection solution HCPCS J2590 | $58.28 | $157.50 | $0.59 – $0.72 | 5 |
| Paclitaxel 6 mg/ml concentrate,intravenous HCPCS J9267 | $1.05 | $2.85 | $0.25 – $0.27 | 4 |
| Paclitaxel protein-bound 100 mg intravenous suspension HCPCS J9264 | $38.81 | $104.90 | $15.09 – $21.29 | 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.