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 |
|---|---|---|---|---|
| Revision of ileostomy; simple 44312 CPT 44312 | not published | not published | $647.43 – $1,260.52 | 7 |
| Revision of infusion pump CPT 36261 | not published | not published | $365.41 – $858.80 | 7 |
| Revision of iris CPT 66761 | not published | not published | $254.93 – $1,257.50 | 29 |
| Revision of iris CPT 66762 | not published | not published | $421.90 – $1,257.50 | 29 |
| Revision of jaw muscle/bone CPT 21295 | not published | not published | $185.29 – $413.42 | 7 |
| Revision of jaw muscle/bone CPT 21296 | not published | not published | $451.74 – $939.14 | 7 |
| Revision of knee joint CPT 27440 | not published | not published | $848.42 – $1,683.28 | 7 |
| Revision of knee joint CPT 27441 | not published | not published | $876.76 – $1,738.66 | 7 |
| Revision of knee joint CPT 27442 | not published | not published | $959.76 – $1,839.28 | 7 |
| Revision of knee joint CPT 27443 | not published | not published | $896.87 – $1,723.06 | 7 |
| Revision of knee joint CPT 27446 | not published | not published | $1,247.11 – $2,342.40 | 7 |
| Revision of larynx CPT 31400 | not published | not published | $1,068.31 – $2,123.99 | 7 |
| Revision of leg vein 37780 CPT 37780 | not published | not published | $282.18 – $555.37 | 7 |
| Revision of neck muscle CPT 21700 | not published | not published | $414.32 – $799.52 | 7 |
| Revision of neck muscle CPT 21720 | not published | not published | $449.18 – $1,095.14 | 7 |
| Revision of neck muscle CPT 21725 | not published | not published | $581.28 – $1,612.78 | 29 |
| Revision of neck muscle/rib CPT 21705 | not published | not published | $621.70 – $1,194.21 | 7 |
| Revision of nose CPT 30120 | not published | not published | $477.40 – $934.46 | 7 |
| Revision of nose CPT 30430 | not published | not published | $912.06 – $1,872.05 | 7 |
| Revision of nose CPT 30435 | not published | not published | $1,268.42 – $2,372.03 | 7 |
| Revision of nose CPT 30450 | not published | not published | $1,617.30 – $3,194.97 | 7 |
| Revision of nose CPT 30460 | not published | not published | $831.62 – $1,731.64 | 7 |
| Revision of nose CPT 30462 | not published | not published | $1,538.53 – $3,069.37 | 7 |
| Revision of penis CPT 54300 | not published | not published | $721.55 – $1,354.12 | 7 |
| Revision of penis CPT 54304 | not published | not published | $841.26 – $1,584.22 | 7 |
| Revision of penis CPT 54420 | $1,609.22 | $4,349.25 | $790.58 – $1,489.06 | 7 |
| Revision of penis CPT 54430 | $1,609.22 | $4,349.25 | $717.27 – $1,351.78 | 7 |
| Revision of penis CPT 54435 | $4,367.48 | $11,804.00 | $465.85 – $877.53 | 7 |
| Revision of pharyngeal walls CPT 42892 | not published | not published | $2,003.51 – $4,049.09 | 7 |
| Revision of radius CPT 25350 | not published | not published | $738.64 – $1,417.30 | 7 |
| Revision of radius CPT 25355 | not published | not published | $837.45 – $1,613.86 | 7 |
| Revision of sciatic nerve CPT 64712 | not published | not published | $601.75 – $1,205.14 | 7 |
| Revision of scrotum CPT 55175 | not published | not published | $406.31 – $766.76 | 7 |
| Revision of scrotum CPT 55180 | not published | not published | $771.14 – $1,459.42 | 7 |
| Revision of spinal shunt CPT 63744 | not published | not published | $687.68 – $1,438.35 | 7 |
| Revision of testis CPT 54660 | not published | not published | $405.31 – $751.93 | 7 |
| Revision of thigh muscles CPT 27430 | not published | not published | $811.25 – $1,566.28 | 7 |
| Revision of toe CPT 28312 | not published | not published | $352.70 – $684.85 | 7 |
| Revision of tricuspid valve w/bypass 33460 CPT 33460 | not published | not published | $2,754.53 – $5,275.27 | 7 |
| Revision of ulna CPT 25360 | not published | not published | $716.12 – $1,378.29 | 7 |
| Revision of unstable kneecap CPT 27420 | not published | not published | $817.11 – $1,539.76 | 7 |
| Revision of unstable kneecap CPT 27422 | not published | not published | $816.28 – $1,571.74 | 7 |
| Revision of urethra CPT 53450 | not published | not published | $456.67 – $859.59 | 7 |
| Revision of urethra CPT 53460 | not published | not published | $512.83 – $964.11 | 7 |
| Revision of urethra CPT 57220 | not published | not published | $350.32 – $687.98 | 7 |
| Revision open av fistula without thromb CPT 36832 | not published | not published | $698.84 – $1,272.99 | 7 |
| Revision orbitofacial bones CPT 21275 | not published | not published | $887.84 – $1,793.27 | 7 |
| Revision/removal of kneecap CPT 27424 | not published | not published | $818.48 – $1,576.41 | 7 |
| Revision tips CPT 37183 | $5,034.59 | $13,607.00 | $433.26 – $858.02 | 7 |
| Revis reconst shoulder joint CPT 23473 | not published | not published | $1,807.95 – $3,457.05 | 6 |
| Revis reconst shoulder joint CPT 23474 | not published | not published | $1,953.97 – $3,736.30 | 6 |
| Revj fem anast autog vn grf CPT 35884 | not published | not published | $1,427.16 – $2,769.08 | 7 |
| Revj fem anast nonautog grf CPT 35883 | not published | not published | $1,388.77 – $2,693.42 | 7 |
| Revj mstdc rsltg compl mstdc CPT 69601 | not published | not published | $1,140.64 – $2,255.04 | 7 |
| Revj mstdc rsltg tympanplsty CPT 69604 | not published | not published | $1,212.23 – $2,398.56 | 7 |
| Revj prior hypspad repair CPT 54352 | not published | not published | $1,598.57 – $2,999.18 | 7 |
| Rev mastoidectomy rsltg modf rad mstdc 69602 CPT 69602 | not published | not published | $1,188.37 – $2,346.30 | 7 |
| Rev-rem impl neurostim gen-rec CPT 63688 | not published | not published | $393.87 – $786.26 | 7 |
| Rev/rmv perph nstim eltrd ra CPT 64585 | not published | not published | $158.36 – $308.10 | 7 |
| Rev/rmv prph sac/gstr npg/r CPT 64595 | not published | not published | $139.14 – $269.11 | 7 |
| Revsc opn/prq tib/pero stent CPT 37234 | $19,078.87 | $51,564.50 | $327.65 – $612.32 | 6 |
| Rheumatoid factor qualitative CPT 86430 | not published | not published | $5.99 – $62.53 | 29 |
| Rheumatoid factor quantitative CPT 86431 | $26.36 | $71.25 | $5.67 – $62.53 | 29 |
| Rhinp prim lat&alr crtlge&/elvtn nsl tip CPT 30400 | not published | not published | $1,081.94 – $2,150.52 | 7 |
| Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe HCPCS J2791 | $24.66 | $66.65 | $6.53 – $8.03 | 5 |
| Rho(d) immune globulin h, sd HCPCS J2792 | $633.74 | $1,712.80 | $21.29 – $32.09 | 5 |
| Rho(d) immune globulin (rhig) human full dose im CPT 90384 | not published | not published | $111.30 – $272.63 | 6 |
| Rib cartilage graft CPT 21230 | not published | not published | $825.95 – $1,571.74 | 7 |
| Right ventric recording CPT 93603 | $1,382.88 | $3,737.50 | $76.27 – $8,949.00 | 7 |
| Ring fx reform 11-13x17mm HCPCS L8610 | $1,059.07 | $2,862.35 | $568.44 – $1,106.93 | 6 |
| Risperidone microspheres 12.5 mg/2 ml inj HCPCS J2794 | $833.15 | $2,251.75 | $9.41 – $21.29 | 5 |
| Rituximab 10 mg/ml concentrate,intravenous HCPCS J9312 | $194.05 | $524.45 | $134.16 – $134.16 | 2 |
| Rmv anterior spine instrumentation 22855 CPT 22855 | not published | not published | $1,221.09 – $2,358.00 | 7 |
| Rmv implant contraceptive capsule 11976 CPT 11976 | not published | not published | $105.71 – $1,612.78 | 29 |
| Rmvl esophgl sphnctr dev CPT 43285 | not published | not published | $735.12 – $1,268.46 | 5 |
| Rmvl ext fixj sys under anes CPT 20694 | not published | not published | $365.25 – $713.71 | 7 |
| Rmvl fb upr arm/elbow deep CPT 24201 | $3,295.59 | $8,907.00 | $391.15 – $771.44 | 7 |
| Rmvl fecal impaction/fb spx under anes CPT 45915 | not published | not published | $238.68 – $483.61 | 7 |
| Rmvl foreign body upper arm/elbow subcutaneous CPT 24200 | $3,165.91 | $8,556.50 | $145.93 – $295.63 | 7 |
| Rmvl icd by tv extr CPT 33244 | $4,261.48 | $11,517.50 | $965.12 – $1,811.21 | 7 |
| Rmvl icd gen w/rplc icd gen dual lead sys CPT 33263 | $6,491.28 | $17,544.00 | $434.80 – $87,973.00 | 7 |
| Rmvl icd gen w/rplc icd gen mlt lead sys CPT 33264 | $6,491.28 | $17,544.00 | $453.39 – $87,973.00 | 7 |
| Rmvl icd gen w/rplc icd gen sgl lead sys CPT 33262 | $6,491.28 | $17,544.00 | $417.28 – $87,973.00 | 7 |
| Rmvl icd pulse gen only CPT 33241 | $1,575.09 | $4,257.00 | $238.95 – $471.13 | 7 |
| Rmvl left heart vent thor inscn ecmo CPT 33989 | not published | not published | $567.16 – $930.59 | 5 |
| Rmvl lung xcp tot pneumonectomy sleeve lob 32486 CPT 32486 | not published | not published | $2,660.74 – $5,069.36 | 7 |
| Rmvl ndwellg tun pleural cath CPT 32552 | $859.60 | $2,323.25 | $176.98 – $1,417.18 | 28 |
| Rmvl perm pm pulse gen CPT 33233 | $1,508.95 | $4,078.25 | $254.54 – $499.99 | 7 |
| Rmvl pm gen w/rplc pm gen mlt lead sys CPT 33229 | $5,171.86 | $13,978.00 | $418.62 – $31,789.00 | 7 |
| Rmvl pm gen w/rplc pm gen sgl lead sys CPT 33227 | $5,064.28 | $13,687.25 | $377.85 – $31,789.00 | 7 |
| Rmvl pq iabp CPT 33968 | $758.87 | $2,051.00 | $38.39 – $72.55 | 7 |
| Rmvl pq vad left hrt vein sep session CPT 33992 | $748.51 | $2,023.00 | $228.46 – $446.96 | 6 |
| Rmvl prosthhumrl&ulnar cmpnt CPT 24160 | not published | not published | $656.04 – $1,402.45 | 7 |
| Rmvl sq defib electrode CPT 33272 | $3,334.72 | $9,012.75 | $390.53 – $87,973.00 | 6 |
| Rmvl subq card rhythm mntr CPT 33286 | not published | not published | $716.79 – $1,612.78 | 22 |
| Rmvl tiss expndr without implant insrtn CPT 11971 | not published | not published | $316.14 – $678.63 | 7 |
| Rmvl tongs/halo anthr indiv CPT 20665 | $348.36 | $941.50 | $100.02 – $914.67 | 29 |
| Rmvl tv pm lead dual CPT 33235 | $4,340.38 | $11,730.75 | $713.55 – $1,347.09 | 7 |
| Rmvl tv pm lead sgl CPT 33234 | $4,340.38 | $11,730.75 | $543.61 – $1,032.74 | 7 |
| Rmv prosth mat/mesh/abd wall/infec 11008 CPT 11008 | not published | not published | $311.21 – $585.02 | 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.