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 |
|---|---|---|---|---|
| Sex transformation m to f CPT 55970 | not published | not published | $8,061.72 – $8,061.72 | 5 |
| Sgmdsc w/band ligation CPT 45350 | not published | not published | $114.59 – $114.59 | 1 |
| Shave sgl skin lsn f/e/e/n/l/m 0.5cm/< CPT 11310 | not published | not published | $48.55 – $455.47 | 29 |
| Shave sgl skin lsn f/e/e/n/l/m 0.6-1.0cm CPT 11311 | not published | not published | $71.03 – $455.47 | 29 |
| Shave sgl skin lsn f/e/e/n/l/m 1.1-2cm CPT 11312 | not published | not published | $81.54 – $915.79 | 29 |
| Shave sgl skin lsn f/e/e/n/l/m >2cm CPT 11313 | not published | not published | $109.18 – $915.79 | 29 |
| Shave sgl skin lsn s/n/h/f/g 0.5cm/< CPT 11305 | not published | not published | $42.64 – $455.47 | 29 |
| Shave sgl skin lsn s/n/h/f/g 0.6-1.0 cm CPT 11306 | not published | not published | $58.59 – $455.47 | 29 |
| Shave sgl skin lsn s/n/h/f/g 1.1-2cm CPT 11307 | not published | not published | $75.22 – $455.47 | 29 |
| Shave sgl skin lsn s/n/h/f/g >2cm CPT 11308 | not published | not published | $83.29 – $915.79 | 29 |
| Shave sgl skin lsn t/a/l 0.5cm/< CPT 11300 | not published | not published | $33.56 – $915.79 | 29 |
| Shave sgl skin lsn t/a/l 0.6-1.0cm CPT 11301 | not published | not published | $56.97 – $455.47 | 29 |
| Shave sgl skin lsn t/a/l 1.1-2.0cm CPT 11302 | not published | not published | $70.54 – $455.47 | 29 |
| Shigella antibody CPT 86771 | not published | not published | $13.81 – $79.86 | 29 |
| Sho arthrs dx +- synovial bx CPT 29805 | not published | not published | $509.35 – $997.65 | 7 |
| Sho arthrs srg bicp tenodsis CPT 29828 | not published | not published | $1,006.18 – $1,957.86 | 7 |
| Sho arthrs srg capsulorraphy CPT 29806 | not published | not published | $1,173.66 – $2,247.23 | 7 |
| Sho arthrs srg compl synvct CPT 29821 | not published | not published | $641.41 – $1,246.47 | 7 |
| Sho arthrs srg lmtd dbrdmt CPT 29822 | not published | not published | $622.72 – $1,216.83 | 7 |
| Sho arthrs srg lss&rescj ads CPT 29825 | not published | not published | $634.08 – $1,239.45 | 7 |
| Sho arthrs srg prtl synvct CPT 29820 | not published | not published | $587.06 – $1,142.73 | 7 |
| Sho arthrs srg rmvl loose/fb CPT 29819 | not published | not published | $640.41 – $1,240.24 | 7 |
| Sho arthrs srg rpr slap les CPT 29807 | not published | not published | $1,144.02 – $2,190.30 | 7 |
| Sho arthrs srg xtnsv dbrdmt CPT 29823 | not published | not published | $679.63 – $1,328.37 | 7 |
| Shortening of hand tendon CPT 26479 | not published | not published | $648.11 – $1,276.89 | 7 |
| Shorten radius or ulna CPT 25390 | not published | not published | $847.20 – $1,619.33 | 7 |
| Shorten radius & ulna CPT 25392 | not published | not published | $1,126.07 – $2,139.59 | 7 |
| Shoulder Arthroscopy (Rotator Cuff Repair) CPT 29827 | not published | not published | $1,167.55 – $2,277.66 | 7 |
| Shoulder MRI (with and without contrast) CPT 73223 | $1,070.87 | $2,894.25 | $134.83 – $1,098.27 | 29 |
| Shoulder MRI (with contrast) CPT 73222 | $1,025.64 | $2,772.00 | $101.53 – $1,810.98 | 29 |
| Shoulder MRI (without contrast) CPT 73221 | $2,051.28 | $5,544.00 | $84.59 – $567.86 | 29 |
| Shoulder prosthesis removal CPT 23334 | not published | not published | $1,190.52 – $2,165.34 | 6 |
| Shoulder prosthesis removal CPT 23335 | not published | not published | $1,419.81 – $2,584.99 | 6 |
| Shoulder X-ray CPT 73030 | $263.81 | $713.00 | $11.52 – $259.34 | 29 |
| Shrinker prosth above knee HCPCS L8460 | $157.49 | $425.65 | $128.24 – $128.24 | 1 |
| Shrinker prosth below knee HCPCS L8440 | $90.54 | $244.70 | $73.73 – $73.73 | 1 |
| Shuntogram nonvascular supervision & interpretation CPT 75809 | $99.25 | $268.25 | $29.40 – $243.74 | 29 |
| Sialidase enzyme assay CPT 87905 | not published | not published | $12.22 – $113.14 | 29 |
| Sialography s&i CPT 70390 | $168.72 | $456.00 | $23.98 – $554.06 | 29 |
| Sialolithotomy 42330 CPT 42330 | $1,805.60 | $4,880.00 | $181.48 – $358.04 | 7 |
| Sickling rbc CPT 85660 | $25.81 | $69.75 | $5.51 – $51.91 | 29 |
| Sigmoidoscopy and biopsy CPT 45331 | not published | not published | $81.39 – $2,089.82 | 29 |
| Sigmoidoscopy flex decompression 45337 CPT 45337 | not published | not published | $132.11 – $2,089.82 | 29 |
| Sigmoidoscopy for bleeding CPT 45334 | not published | not published | $134.11 – $353.36 | 7 |
| Sigmoidoscopy/submucosal injection 45335 CPT 45335 | not published | not published | $75.17 – $2,089.82 | 29 |
| Sigmoidoscopy w/ablation CPT 45346 | not published | not published | $183.36 – $351.01 | 5 |
| Sigmoidoscopy w/fb removal 45332 CPT 45332 | not published | not published | $119.66 – $240.25 | 7 |
| Sigmoidoscopy w/plcmt stent CPT 45347 | not published | not published | $176.45 – $329.24 | 5 |
| Sigmoidoscopy w/resection CPT 45349 | not published | not published | $226.72 – $226.72 | 1 |
| Sigmoidoscopy w/tumr remove CPT 45338 | not published | not published | $137.24 – $304.99 | 7 |
| Sigmoidoscopy w/ultrasound CPT 45341 | not published | not published | $141.16 – $2,089.82 | 29 |
| Sigmoidoscopy w/us guide bx CPT 45342 | not published | not published | $193.88 – $515.59 | 7 |
| Sigmoid/rmv tumor/polyp/hot bx for 45333 CPT 45333 | not published | not published | $106.78 – $2,089.82 | 29 |
| Signal avg ecg w or without ecg 93278 CPT 93278 | not published | not published | $16.00 – $136.15 | 29 |
| Sig w/tndsc balloon dilation CPT 45340 | not published | not published | $88.05 – $251.17 | 7 |
| Simple cystometrogram 51725 CPT 51725 | not published | not published | $97.04 – $557.48 | 29 |
| Sincalide 5 mcg solution for injection HCPCS J2805 | $204.98 | $554.00 | $99.67 – $140.40 | 5 |
| Sinus CT scan (with and without contrast) CPT 70488 | $786.90 | $2,126.75 | $89.07 – $673.16 | 29 |
| Sinus CT scan (with contrast) CPT 70487 | $741.48 | $2,004.00 | $82.24 – $560.84 | 29 |
| Sinus CT scan (without contrast) CPT 70486 | $756.00 | $2,043.25 | $71.66 – $466.45 | 29 |
| Sinus/juglr venogram s&i CPT 75860 | $2,517.48 | $6,804.00 | $73.36 – $542.92 | 7 |
| Sinusotomy maxillary sinus 31020 CPT 31020 | not published | not published | $365.52 – $762.85 | 7 |
| Sinusotomy sinus remove polyps 31032 CPT 31032 | not published | not published | $610.62 – $1,217.61 | 7 |
| Sinusotomy sphenoid w/wo bx 31050 CPT 31050 | not published | not published | $518.93 – $1,030.40 | 7 |
| Sirolimus, oral HCPCS J7520 | $22.20 | $60.00 | $21.29 – $24.64 | 5 |
| Skin and muscle repair face CPT 15845 | not published | not published | $1,037.99 – $2,175.47 | 7 |
| Skin Biopsy CPT 11102 | not published | not published | $202.43 – $455.47 | 22 |
| Skin full graft 20sq cm less 15200 CPT 15200 | not published | not published | $710.42 – $1,432.12 | 7 |
| Skin full graft add-on 15241 CPT 15241 | not published | not published | $124.85 – $238.68 | 7 |
| Skin pedicle flap arms/legs CPT 15572 | not published | not published | $785.88 – $1,573.30 | 7 |
| Skin pedicle flap trunk CPT 15570 | not published | not published | $777.67 – $1,572.53 | 7 |
| Skin split graft addl 100sq cm 15101 CPT 15101 | not published | not published | $123.86 – $235.57 | 7 |
| Skin test unlisted antigen ea CPT 86486 | $26.09 | $70.50 | $3.51 – $56.64 | 29 |
| Sleep study attended CPT 95807 | $697.17 | $1,884.25 | $99.31 – $1,216.24 | 29 |
| Sleep Study (Polysomnography) CPT 95810 | $2,163.85 | $5,848.25 | $209.89 – $1,293.27 | 7 |
| Sleep study unattended CPT 95806 | not published | not published | $100.11 – $372.84 | 29 |
| Sling arm deluxe w/pad xs HCPCS A4565 | $103.58 | $279.95 | $14.95 – $14.95 | 1 |
| Slitting of prepuce CPT 54000 | not published | not published | $119.87 – $226.21 | 7 |
| Slitting of prepuce CPT 54001 | not published | not published | $154.66 – $292.50 | 7 |
| Slp eval for nonspeech dev ea addl 30 mins CPT 92618 | not published | not published | $36.92 – $69.42 | 6 |
| Slp eval non-spch gen comm dev CPT 92605 | not published | not published | $99.02 – $188.77 | 6 |
| Slp pure tone screening CPT 92551 | not published | not published | $11.45 – $24.96 | 7 |
| Slp stdy unatnd w/anal CPT 95801 | not published | not published | $42.04 – $197.35 | 28 |
| Slp ther svc non-spch gen CPT 92606 | not published | not published | $79.36 – $151.33 | 6 |
| Sm-153 lexidron ther HCPCS A9604 | $15,695.96 | $42,421.50 | $6,909.77 – $11,546.10 | 5 |
| Small bowel endoscopy CPT 44360 | not published | not published | $164.18 – $338.53 | 7 |
| Small bowel endoscopy CPT 44364 | not published | not published | $233.71 – $475.03 | 7 |
| Small bowel endoscopy CPT 44366 | not published | not published | $274.70 – $559.28 | 7 |
| Small bowel endoscopy CPT 44369 | not published | not published | $281.72 – $571.76 | 7 |
| Small bowel endoscopy CPT 44376 | not published | not published | $325.60 – $653.65 | 7 |
| Small bowel endoscopy CPT 44378 | not published | not published | $441.08 – $887.66 | 7 |
| Small bowel endoscopy CPT 44382 | not published | not published | $82.98 – $2,149.09 | 29 |
| Small bowel endoscopy CPT 44384 | not published | not published | $174.89 – $304.06 | 5 |
| Small bowel endoscopy >2nd w/remove 44363 CPT 44363 | not published | not published | $219.26 – $444.62 | 7 |
| Small bowel endoscopy 44365 CPT 44365 | not published | not published | $206.10 – $422.78 | 7 |
| Small bowel endoscopy/biopsy CPT 44361 | not published | not published | $181.35 – $372.07 | 7 |
| Small bowel endoscopy/biopsy CPT 44377 | not published | not published | $343.09 – $691.87 | 7 |
| Small bowel endoscopy br/wa CPT 44380 | not published | not published | $63.54 – $2,149.09 | 29 |
| Small bowel endoscopy br/wa CPT 44381 | not published | not published | $96.23 – $96.23 | 1 |
| Small bowel endoscopy/stent 44370 CPT 44370 | not published | not published | $304.68 – $617.77 | 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.