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 |
|---|---|---|---|---|
| Prepare embryo for transfer CPT 89255 | not published | not published | $54.43 – $122.47 | 27 |
| Prepare penis study CPT 54230 | not published | not published | $89.19 – $168.49 | 7 |
| Prep skin to 100cm2 other CPT 15004 | $892.44 | $2,412.00 | $301.99 – $1,403.12 | 29 |
| Prep skin to 100cm2 trk/ext CPT 15002 | $937.12 | $2,532.75 | $253.33 – $487.52 | 7 |
| Prep skn trk/ext adl 100cm2 CPT 15003 | not published | not published | $51.38 – $97.51 | 7 |
| Pressure max expiratory/inspiratory CPT 94799 | $232.27 | $627.75 | $5.50 – $358.63 | 28 |
| Pressure velocity wire add ves CPT 93572 | $173.07 | $467.75 | $95.79 – $153.66 | 6 |
| Pretreatment serum by diff red cell adsorption patient rbc/known phenotype each adsorption ref CPT 86977 | not published | not published | $14.59 – $392.78 | 28 |
| Pretreat rbc absorption reference CPT 86978 | $19.61 | $53.00 | $14.59 – $136.15 | 28 |
| Pretreat rbc density gradient separation reference CPT 86972 | $119.51 | $323.00 | $17.46 – $392.78 | 28 |
| Pretreat rbc w chem/drugs reference CPT 86970 | $207.39 | $560.50 | $10.94 – $136.15 | 28 |
| Pretreat rbc w enzyme reference CPT 86971 | not published | not published | $10.94 – $392.78 | 28 |
| Pr evaluation psychiatric diagnostic w/medical services CPT 90792 | not published | not published | $159.80 – $368.28 | 28 |
| Pr excision benign lesion scalp/neck/hands/feet/genitalia <= 0.5 cm CPT 11420 | $1,907.07 | $5,154.25 | $86.60 – $173.17 | 7 |
| Pr excision benign lesion trunk/arms/legs 3.1 - 4.0 cm CPT 11404 | not published | not published | $167.86 – $343.21 | 7 |
| Pr excision nail/nail matrix partial/complete permanent removal CPT 11750 | $503.29 | $1,360.25 | $124.09 – $915.79 | 29 |
| Pr gastrorrhaphy suture perforated duodenal or gastric ulcer/wound/ injury CPT 43840 | not published | not published | $1,447.30 – $2,889.19 | 7 |
| Prgrmg dev eval impltbl sys CPT 93260 | not published | not published | $21.57 – $117.00 | 28 |
| Prgrmg dev eval pm/ldls pm CPT 93279 | $39.59 | $107.00 | $17.97 – $91.16 | 29 |
| Prgrmg dev eval scrms ip CPT 93285 | not published | not published | $16.17 – $85.48 | 29 |
| Prgrmg eval implantable dfb CPT 93282 | $41.44 | $112.00 | $20.85 – $106.67 | 29 |
| Prgrmg eval implantable dfb CPT 93283 | $41.44 | $112.00 | $24.07 – $104.00 | 29 |
| Prgrmg eval implantable dfb CPT 93284 | $41.44 | $112.00 | $27.67 – $107.93 | 29 |
| Prgr stim/pace a/iv drug CPT 93623 | $1,267.53 | $3,425.75 | $58.65 – $8,949.00 | 7 |
| Pr hospital ip/obs care initial high level per day CPT 99223 | not published | not published | $224.49 – $224.63 | 2 |
| Pr hospital ip/obs care initial moderate level per day CPT 99222 | not published | not published | $151.74 – $152.46 | 2 |
| Pr hospital ip/obs care initial straightforward or low level per day CPT 99221 | not published | not published | $111.73 – $112.48 | 2 |
| Pr hospital ip/obs care subsequent high level per day CPT 99233 | not published | not published | $115.70 – $119.05 | 2 |
| Pr hospital ip/obs care subsequent moderate level per day CPT 99232 | not published | not published | $80.04 – $83.09 | 2 |
| Pr hospital ip/obs care subsequent straightforward or low level per day CPT 99231 | not published | not published | $43.57 – $46.08 | 2 |
| Prim art mech thrmbc non-intracranial CPT 37184 | $4,659.97 | $12,594.50 | $514.14 – $988.28 | 7 |
| Prim art mech thrmbc non-intracranial add-on CPT 37185 | $2,329.98 | $6,297.25 | $193.03 – $362.71 | 7 |
| Pr incision & drainage abscess complicated/multiple CPT 10061 | $313.30 | $846.75 | $180.89 – $915.79 | 29 |
| Pr incision & drainage abscess simple/single CPT 10060 | $238.65 | $645.00 | $100.77 – $455.47 | 29 |
| Pr incision & drainage abscess vulva/perineal CPT 56405 | $168.72 | $456.00 | $118.31 – $697.27 | 29 |
| Pr incision & removal foreign body subcutaneous tissues simple CPT 10120 | $429.94 | $1,162.00 | $99.06 – $915.79 | 29 |
| Pr management transitional care high w/in 7 days of discharge CPT 99496 | $149.11 | $403.00 | $131.29 – $334.32 | 28 |
| Pr management transitional care moderate w/in 14 days of discharge CPT 99495 | $149.11 | $403.00 | $122.33 – $295.40 | 28 |
| Pr moderate sedation same physician >= 5 years initial 15 minutes CPT 99152 | $66.51 | $179.75 | $13.79 – $13.79 | 1 |
| Pr neuroplasty and/or transposition ulnar nerve at elbow CPT 64718 | not published | not published | $610.17 – $1,250.37 | 7 |
| Probe nasolacrimal duct CPT 68810 | not published | not published | $137.54 – $685.22 | 29 |
| Probe nasolacrimal duct CPT 68811 | not published | not published | $147.50 – $452.41 | 7 |
| Probe nasolacrimal duct CPT 68815 | not published | not published | $239.11 – $563.18 | 7 |
| Probe nl duct w/balloon CPT 68816 | not published | not published | $176.55 – $549.92 | 7 |
| Procainamide 100 mg/ml injection (wrapper) HCPCS J2690 | $9.25 | $25.00 | $4.93 – $21.29 | 6 |
| Procalcitonin CPT 84145 | $101.10 | $273.25 | $27.22 – $111.67 | 28 |
| Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution HCPCS J0780 | $12.52 | $33.84 | $6.51 – $9.29 | 5 |
| Proctectomy combined abd pull-thru px 45112 CPT 45112 | not published | not published | $2,095.60 – $4,051.43 | 7 |
| Proctectomy complete abd w/clst 45110 CPT 45110 | not published | not published | $2,023.89 – $3,970.31 | 7 |
| Proctosigmoidoscopy ablate CPT 45320 | not published | not published | $117.22 – $230.89 | 7 |
| Proctosigmoidoscopy control bleed 45317 CPT 45317 | not published | not published | $126.48 – $256.62 | 7 |
| Proctosigmoidoscopy dilate 45303 CPT 45303 | not published | not published | $95.31 – $198.90 | 7 |
| Proctosigmoidoscopy dx 45300 CPT 45300 | $346.88 | $937.50 | $55.42 – $2,089.82 | 29 |
| Proctosigmoidoscopy removal CPT 45308 | not published | not published | $91.80 – $188.77 | 7 |
| Proctosigmoidoscopy removal CPT 45309 | not published | not published | $100.39 – $200.47 | 7 |
| Proctosigmoidoscopy tumor removal 45315 CPT 45315 | not published | not published | $118.39 – $237.12 | 7 |
| Proctosigmoidoscopy volvul CPT 45321 | not published | not published | $114.16 – $233.23 | 7 |
| Proctosigmoidoscopy w/bx 45305 CPT 45305 | not published | not published | $82.21 – $171.60 | 7 |
| Proctosigmoidoscopy w/fb remove 45307 CPT 45307 | $2,773.89 | $7,497.00 | $108.45 – $223.86 | 7 |
| Proctosigmoidoscopy w/stent CPT 45327 | not published | not published | $127.88 – $275.35 | 7 |
| Progesterone CPT 84144 | $66.14 | $178.75 | $20.86 – $85.28 | 29 |
| Prolactin CPT 84146 | $101.75 | $275.00 | $19.38 – $111.67 | 29 |
| Promethazine hcl injection HCPCS J2550 | $10.51 | $28.40 | $2.56 – $21.29 | 5 |
| Proph rta dtchmnt crtx dthrm CPT 67141 | not published | not published | $304.54 – $1,066.28 | 29 |
| Proph rta dtchmnt pc CPT 67145 | not published | not published | $492.91 – $1,257.50 | 29 |
| Proph tx w/wo mthylmthcrylt CPT 24498 | not published | not published | $953.22 – $1,832.26 | 7 |
| Prophylactic tx radius CPT 25490 | not published | not published | $790.12 – $1,476.59 | 7 |
| Prophylactic tx radius&ulna CPT 25492 | not published | not published | $996.86 – $1,684.84 | 7 |
| Prophylactic tx ulna CPT 25491 | not published | not published | $813.76 – $1,557.70 | 7 |
| Propranolol in ns IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J1800 | $20.85 | $56.35 | $2.04 – $9.29 | 5 |
| Prostate biopsy, any mthd HCPCS G0416 | $599.68 | $1,620.75 | $113.79 – $492.64 | 7 |
| Prostatectomy (turp) CPT 52601 | not published | not published | $952.29 – $1,788.59 | 7 |
| Prostate laser enucleation CPT 52649 | not published | not published | $925.15 – $1,723.06 | 7 |
| Prostatic microwave thermotx CPT 53850 | not published | not published | $678.34 – $1,280.01 | 7 |
| Prostatic rf thermotx CPT 53852 | not published | not published | $698.55 – $1,315.11 | 7 |
| Protamine 10 mg/ml intravenous solution HCPCS J2720 | $27.48 | $74.27 | $0.78 – $1.57 | 5 |
| Protector nerve neurawrap 4cm HCPCS C9353 | $2,931.49 | $7,922.95 | $642.29 – $789.71 | 5 |
| Protein c activity CPT 85303 | $91.85 | $248.25 | $13.84 – $100.82 | 29 |
| Protein electrophoretic fractionation & quantitation serum CPT 84165 | $47.82 | $129.25 | $10.74 – $60.18 | 29 |
| Protein s total CPT 85305 | $85.10 | $230.00 | $11.61 – $100.82 | 29 |
| Protein total 24 hour urine CPT 84156 | $32.10 | $86.75 | $3.67 – $60.18 | 29 |
| Protein total body fluid CPT 84157 | $27.94 | $75.50 | $3.91 – $9.00 | 29 |
| Protein total serum plasma whole blood CPT 84155 | $40.70 | $110.00 | $3.67 – $33.65 | 29 |
| Prothrombin time substitution plasma fractions each CPT 85611 | $17.48 | $47.25 | $3.94 – $38.30 | 29 |
| Proton treatment complex CPT 77525 | not published | not published | $2,985.92 – $2,985.92 | 5 |
| Proton trmt intermediate CPT 77523 | not published | not published | $12,812.28 – $12,812.28 | 5 |
| Proton trmt simple w/comp CPT 77522 | not published | not published | $12,378.84 – $12,378.84 | 5 |
| Proton trmt simple without comp CPT 77520 | not published | not published | $589.32 – $5,851.44 | 27 |
| Protoporphyrin rbc screen CPT 84203 | not published | not published | $9.12 – $108.04 | 29 |
| Prp i/hern init block >5 yr CPT 49507 | not published | not published | $652.78 – $1,243.35 | 7 |
| Pr planning advance care 1st 30 minutes CPT 99497 | not published | not published | $85.24 – $212.02 | 23 |
| Prq cardiac angio addl art CPT 92921 | not published | not published | $15,412.38 – $19,696.00 | 6 |
| Prq card revasc chronic addl CPT 92944 | $7,990.52 | $21,596.00 | $15,412.38 – $21,711.00 | 6 |
| Prq card revasc mi 1 vsl CPT 92941 | $8,878.24 | $23,995.25 | $757.51 – $21,711.00 | 7 |
| Prq card revasc mi 1 vsl drug-eluting HCPCS C9606 | $12,467.24 | $33,695.25 | $15,412.38 – $29,049.00 | 6 |
| Prq card stent w/angio addl CPT 92929 | $7,990.52 | $21,596.00 | $15,412.38 – $21,711.00 | 6 |
| Prq revasc byp graft 1 art and/or branches CPT 92937 | $8,878.24 | $23,995.25 | $673.50 – $21,711.00 | 7 |
| Prq revasc byp graft addl CPT 92938 | $7,990.52 | $21,596.00 | $15,412.38 – $21,711.00 | 6 |
| Prq skel fix clcnl fx w/mnpj CPT 28406 | not published | not published | $568.75 – $1,114.65 | 7 |
| Prq skel fix epcndylr hum fx CPT 24566 | not published | not published | $754.93 – $1,511.67 | 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.