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 |
|---|---|---|---|---|
| Rmv suture/anesthesia/not local 15850 CPT 15850 | not published | not published | $46.58 – $85.02 | 7 |
| Ropivacaine 0.2 % epidural pca - 1 hour dose limit HCPCS J2795 | $229.40 | $620.00 | $0.07 – $0.18 | 6 |
| Rotavirus antibody CPT 86759 | not published | not published | $13.81 – $79.86 | 29 |
| Routine footcare pt w lops HCPCS G0247 | $116.27 | $314.25 | $26.14 – $44.22 | 6 |
| Rplcmt oi implt skl prq esp CPT 69717 | not published | not published | $1,241.32 – $2,434.44 | 7 |
| Rpl non-tun cvc wo sbq prt/pmp CPT 36580 | $1,063.20 | $2,873.50 | $75.75 – $145.08 | 7 |
| Rp loclzj tum 2+area 1+d img CPT 78801 | $627.52 | $1,696.00 | $50.07 – $921.08 | 29 |
| Rp loclzj tum spect w/ct 1 CPT 78830 | not published | not published | $434.19 – $434.19 | 1 |
| Rp loclzj tum spect w/ct 2 CPT 78832 | not published | not published | $847.80 – $847.80 | 1 |
| Rpl picc wo subq port/pump incl image guidnc w/s&i CPT 36584 | $877.73 | $2,372.25 | $74.83 – $124.48 | 7 |
| Rpl tun-cvad w subq port CPT 36582 | $1,638.82 | $4,429.25 | $328.19 – $662.23 | 7 |
| Rpl tun-cvad w subq pump CPT 36583 | not published | not published | $355.83 – $722.30 | 7 |
| Rpl tun cvc wo subq port CPT 36581 | $1,773.69 | $4,793.75 | $206.58 – $427.45 | 7 |
| Rpr blood ves w/vein graft/up ext 35236 CPT 35236 | not published | not published | $1,123.57 – $2,171.57 | 7 |
| Rpr blood vsl grf oth vein lo ex CPT 35286 | $6,067.72 | $16,399.25 | $1,067.40 – $2,064.71 | 7 |
| Rpr choanal atresia ntranasl CPT 30540 | not published | not published | $718.66 – $1,466.44 | 7 |
| Rpr choanal atresia trsnpltn CPT 30545 | not published | not published | $961.65 – $1,814.32 | 7 |
| Rpr csf leak/pseudomeng/laminectomy63709 CPT 63709 | not published | not published | $1,189.85 – $2,327.57 | 7 |
| Rpr diaphragm hernia/chronic/not neonate 39541 CPT 39541 | not published | not published | $1,048.11 – $2,007.77 | 7 |
| Rpr diaphragm lac/any approach 39501 CPT 39501 | not published | not published | $949.08 – $1,815.10 | 7 |
| Rpr fem hernia init blocked CPT 49553 | not published | not published | $677.56 – $1,340.07 | 7 |
| Rpr hern preemie reduc CPT 49491 | not published | not published | $841.09 – $1,684.07 | 7 |
| Rpr hypspad comp dsj & urtp CPT 54348 | not published | not published | $1,142.21 – $2,116.20 | 7 |
| Rpr hypspad comp simple CPT 54340 | not published | not published | $634.42 – $1,202.00 | 7 |
| Rpr ing hernia baby blocked CPT 49496 | not published | not published | $609.02 – $1,216.06 | 7 |
| Rpr ing hernia baby reduc CPT 49495 | not published | not published | $423.11 – $837.74 | 7 |
| Rpr ing hernia init blocked CPT 49501 | not published | not published | $642.99 – $1,284.69 | 7 |
| Rpr ing hernia init reduce CPT 49500 | not published | not published | $422.46 – $794.06 | 7 |
| Rpr ing hern premie blocked CPT 49492 | not published | not published | $1,028.57 – $1,981.25 | 7 |
| Rpr&refit spct prsth aphakia CPT 92371 | not published | not published | $11.86 – $136.15 | 29 |
| Rpr rem hernia init reduce CPT 49550 | not published | not published | $618.66 – $1,223.07 | 7 |
| Rpr xtnsr tndn leg prim without grft ea tndn CPT 27664 | not published | not published | $396.91 – $773.00 | 7 |
| Rp therapy unlisted px CPT 79999 | not published | not published | $228.33 – $852.61 | 27 |
| Rrp hypspad comp moblj&urtp CPT 54344 | not published | not published | $1,067.43 – $2,003.87 | 7 |
| Rsv assay w/optic CPT 87807 | $53.00 | $143.25 | $12.77 – $56.64 | 29 |
| Rtm 1st set-up&pt educaj eqp CPT 98975 | not published | not published | $131.29 – $295.40 | 22 |
| Rtm dev sply mscskl 16-30 d CPT 98977 | not published | not published | $37.99 – $85.48 | 22 |
| Rtm dev sply resp sys 16-30d CPT 98976 | not published | not published | $37.99 – $85.48 | 22 |
| Rubella antibody igg CPT 86762 | $60.40 | $163.25 | $14.39 – $62.53 | 29 |
| Rubeola antibody igg CPT 86765 | $50.23 | $135.75 | $12.88 – $31.35 | 29 |
| Russell viper venom diluted CPT 85613 | $60.22 | $162.75 | $9.58 – $100.82 | 29 |
| Rx metab gen seq alys pnl 6 CPT 81418 | not published | not published | $917.08 – $2,063.43 | 22 |
| Salivary gland function exam CPT 78232 | not published | not published | $29.80 – $921.08 | 29 |
| Salivary gland imaging CPT 78230 | $272.41 | $736.25 | $28.06 – $921.08 | 29 |
| Salivary glnd img serial img CPT 78231 | not published | not published | $32.54 – $921.08 | 29 |
| Salmonella antibody CPT 86768 | $22.20 | $60.00 | $11.38 – $29.68 | 29 |
| Salpingostomy 58770 CPT 58770 | not published | not published | $964.59 – $1,845.53 | 7 |
| Same day nb discharge 99463 CPT 99463 | not published | not published | $93.22 – $295.40 | 24 |
| Sargramostim injection HCPCS J2820 | $451.34 | $1,219.85 | $23.75 – $99.67 | 6 |
| Sars-cov-2 antb quantitative CPT 86413 | not published | not published | $51.43 – $115.72 | 22 |
| Sarscov coronavirus ag ia CPT 87426 | not published | not published | $35.33 – $79.49 | 22 |
| Sarscov & inf vir a&b ag ia CPT 87428 | not published | not published | $70.29 – $158.15 | 22 |
| S bowel endoscope w/stent CPT 44379 | not published | not published | $469.36 – $945.38 | 7 |
| Sbsq nurs facil care/day unstabl/new prob 35 min 99310 CPT 99310 | not published | not published | $146.81 – $149.38 | 2 |
| Sbsq nursing facil care/day minor complj 15 min CPT 99308 | not published | not published | $74.69 – $75.69 | 2 |
| Sbsq nursing facil care/day new problem 25 min CPT 99309 | not published | not published | $99.15 – $100.22 | 2 |
| Sbsq nursing facility care/day e/m stable 10 min CPT 99307 | not published | not published | $48.87 – $48.95 | 2 |
| Scan duplex abd/pelvis/retroperitoneal complete CPT 93975 | $444.65 | $1,201.75 | $114.12 – $743.37 | 29 |
| Scan duplex abd/pelvis/retroperitoneal limited CPT 93976 | $348.91 | $943.00 | $75.74 – $433.70 | 29 |
| Scan duplex aorta/ivc/iliac or bypass grafts complete CPT 93978 | $188.52 | $509.50 | $41.01 – $554.06 | 29 |
| Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 | $163.45 | $441.75 | $27.49 – $326.04 | 29 |
| Scan duplex extracranial arteries unilateral/limited study CPT 93882 | $251.05 | $678.50 | $25.11 – $349.45 | 29 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $385.36 | $1,041.50 | $28.36 – $243.74 | 29 |
| Scan duplex lower extremity arteries complete bilateral CPT 93925 | $395.99 | $1,070.25 | $36.34 – $554.06 | 29 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $294.43 | $795.75 | $24.64 – $294.84 | 29 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $280.83 | $759.00 | $19.40 – $325.27 | 29 |
| Scan proc cranial extra CPT 61782 | not published | not published | $197.80 – $352.37 | 6 |
| Scan proc cranial intra 61781 CPT 61781 | not published | not published | $269.15 – $427.88 | 6 |
| Scan proc spinal CPT 61783 | not published | not published | $264.36 – $428.56 | 6 |
| Sclerotherapy fluid collection pq w/img CPT 49185 | $1,261.42 | $3,409.25 | $138.64 – $239.64 | 5 |
| Scope plantar fasciotomy CPT 29893 | not published | not published | $472.26 – $917.31 | 7 |
| Screening Mammogram CPT 77067 | $140.60 | $380.00 | $79.81 – $245.26 | 27 |
| Screen/visual acuity/bilat/quant 99173 CPT 99173 | not published | not published | $2.69 – $5.45 | 7 |
| Sc ther infusion reset pump CPT 96371 | $49.58 | $134.00 | $69.34 – $198.90 | 29 |
| Sec abd wall suture evisceration/dehsn 49900 CPT 49900 | not published | not published | $877.92 – $1,734.76 | 7 |
| Sec art mech thrmbc non-intracranial add-on CPT 37186 | $1,855.27 | $5,014.25 | $283.75 – $549.13 | 7 |
| Sedation moderate same physician performing a gastrointestinal endoscopic service >= 5 years initial 15 minutes intra-service time HCPCS G0500 | $66.51 | $179.75 | $6.24 – $6.24 | 1 |
| Sedimentation rate erythrocyte automated CPT 85652 | $20.81 | $56.25 | $2.70 – $51.91 | 29 |
| Segmentectomy 32484 CPT 32484 | not published | not published | $1,619.40 – $3,097.46 | 7 |
| Select picture audiometry CPT 92583 | not published | not published | $35.43 – $136.15 | 29 |
| Self-meas bp pt educaj/train CPT 99473 | not published | not published | $24.95 – $56.14 | 22 |
| Self-mgmt educ/train 2-4 pt 30min CPT 98961 | not published | not published | $12.65 – $23.80 | 7 |
| Self-mgmt educ/train 5-8 pt 30min CPT 98962 | not published | not published | $9.46 – $17.68 | 7 |
| Semen analysis presence/motility CPT 89321 | not published | not published | $12.05 – $113.79 | 29 |
| Semen analysis w/count CPT 89310 | not published | not published | $8.61 – $113.79 | 29 |
| Sensorimotor examination CPT 92060 | not published | not published | $20.62 – $136.15 | 29 |
| Sensorineural acuity lvl tst CPT 92575 | not published | not published | $37.65 – $155.23 | 29 |
| Separate eyelid adhesions CPT 68340 | not published | not published | $393.71 – $879.07 | 7 |
| Sept9 promoter methylation analysis CPT 81327 | not published | not published | $90.36 – $432.00 | 28 |
| Sequestrectomy olecrn proces CPT 24138 | not published | not published | $714.11 – $1,420.41 | 7 |
| Sequestrectomy radial h/n CPT 24136 | not published | not published | $651.64 – $1,328.37 | 7 |
| Sequestrectomy shft/dstl hum CPT 24134 | not published | not published | $821.47 – $1,574.87 | 7 |
| Serial casting application 97139app CPT 97139 | not published | not published | $35.95 – $35.95 | 5 |
| Serpina1 gene CPT 81332 | $216.27 | $584.50 | $43.65 – $98.21 | 28 |
| Set radiation therapy field CPT 77280 | $350.76 | $948.00 | $43.56 – $857.53 | 29 |
| Set radiation therapy field CPT 77285 | $474.62 | $1,282.75 | $65.05 – $839.12 | 29 |
| Set radiation therapy field CPT 77290 | $647.59 | $1,750.25 | $96.62 – $1,384.03 | 29 |
| Set-up cardiovert-defibrill CPT 93745 | not published | not published | $256.00 – $687.47 | 27 |
| Sever cranial nerve CPT 64771 | not published | not published | $644.14 – $1,226.98 | 7 |
| Sex transformation f to m CPT 55980 | not published | not published | $7,759.15 – $7,759.15 | 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.