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 |
|---|---|---|---|---|
| Trnsfr/rearrngmnt adjcnt tiss eye/nose/ear/lip 10.1-30sqcm CPT 14061 | not published | not published | $919.78 – $1,775.33 | 7 |
| Trnsfr/rearrngmnt adjcnt tiss sclp/arm/lg 10.1-30sqcm CPT 14021 | not published | not published | $791.89 – $1,535.08 | 7 |
| Trnsfr/rearrngmnt adjcnt tiss trnk 10.1-30sqcm CPT 14001 | not published | not published | $714.14 – $1,394.68 | 7 |
| Trnsfr/rearrngmnt adjcnt tiss trnk 10sqcm/< CPT 14000 | not published | not published | $536.33 – $1,072.52 | 7 |
| Troponin quantitative CPT 84484 | $119.05 | $321.75 | $10.42 – $108.04 | 29 |
| Tr retinal les preterm inf CPT 67229 | not published | not published | $558.89 – $2,464.09 | 29 |
| Tte w or without fol w/con,stres HCPCS C8928 | $458.06 | $1,238.00 | $408.72 – $408.72 | 5 |
| Tte w or without fol w/cont, f/u HCPCS C8922 | $941.56 | $2,544.75 | $1,489.08 – $1,489.08 | 5 |
| Tubal Ligation (Laparoscopic) CPT 58670 | not published | not published | $400.77 – $789.38 | 7 |
| Tube trach disp innr can 5 xlt HCPCS A7521 | $114.81 | $310.30 | $91.37 – $91.37 | 1 |
| Tube trach fen sz 6 uncuffed HCPCS A7520 | $1,120.18 | $3,027.50 | $92.23 – $92.23 | 1 |
| Tumor cell deplete of harvst CPT 38211 | not published | not published | $84.57 – $1,002.11 | 29 |
| Tvh >250 gms 58290 CPT 58290 | not published | not published | $1,273.33 – $2,483.58 | 7 |
| Tvh w/mmk 58267 CPT 58267 | not published | not published | $1,160.06 – $2,283.90 | 7 |
| Tx atrial fib pulm vein isol CPT 93656 | $17,899.12 | $48,376.00 | $1,273.90 – $11,285.00 | 7 |
| Tx closed distal humerus fx CPT 24999 | $135.14 | $365.25 | $182.63 – $2,247.03 | 28 |
| Tx closed hip disl traumatic without anes CPT 27250 | $294.34 | $795.50 | $205.25 – $549.86 | 29 |
| Tx closed tib fx proximal w/w/o manip w/skel trac CPT 27532 | not published | not published | $622.14 – $1,217.61 | 7 |
| Tx closed tib shaft fx without manip CPT 27750 | $256.97 | $694.50 | $244.38 – $670.82 | 29 |
| Tx contour defects >10.0 cc CPT 11954 | not published | not published | $128.04 – $1,403.12 | 29 |
| Tx contour defects 1.1-5.0cc 11951 CPT 11951 | not published | not published | $79.75 – $1,403.12 | 29 |
| Tx ectopic pregnancy abdl pregnancy 59130 CPT 59130 | not published | not published | $1,041.03 – $1,811.21 | 7 |
| Tx ectopic pregnancy ntrstl prtl rescj uter 59136 CPT 59136 | not published | not published | $985.51 – $1,960.97 | 7 |
| Tx l/r atrial fib addl CPT 93657 | $16,109.25 | $43,538.50 | $482.10 – $11,285.00 | 7 |
| Tx open art fx mcp/iphlngl jnt incl int fixtn ea CPT 26746 | $1,679.52 | $4,539.25 | $752.58 – $1,558.47 | 7 |
| Tx open dstl phlngl fx f/t internal fixation ea CPT 26765 | $2,930.49 | $7,920.25 | $495.49 – $1,053.81 | 7 |
| Tx open iphlngl jt disl internal fixation sngl CPT 26785 | $3,238.80 | $8,753.50 | $541.93 – $1,148.98 | 7 |
| Tx open nsl fx uncomp CPT 21325 | not published | not published | $490.47 – $992.97 | 7 |
| Tx open nsl sptl fx CPT 21336 | not published | not published | $678.04 – $1,375.95 | 7 |
| Tx phalangeal shaft fx open prox/middle ea CPT 26735 | $1,391.29 | $3,760.25 | $611.43 – $1,255.05 | 7 |
| Tx septic abortion surgical 59830 CPT 59830 | not published | not published | $486.31 – $936.02 | 7 |
| Tx tarsal bone fx without manip 28450 CPT 28450 | $376.11 | $1,016.50 | $195.31 – $549.86 | 29 |
| Tympanic membrane repair CPT 69610 | not published | not published | $321.59 – $627.13 | 7 |
| Tympanolysis transcanal 69450 CPT 69450 | not published | not published | $574.77 – $1,173.93 | 7 |
| Tympanometry & reflex thresh CPT 92550 | not published | not published | $23.26 – $358.63 | 28 |
| Tympanostomy/ven tube/loc/top anes 69433 CPT 69433 | not published | not published | $140.19 – $1,167.30 | 29 |
| Tympp antrt/mastoidotomy prosthesis torp 69637 CPT 69637 | not published | not published | $1,484.50 – $2,963.30 | 7 |
| Tympp antrt/mastoid without ossic chain recnst 69635 CPT 69635 | not published | not published | $1,315.55 – $2,634.13 | 7 |
| Ua w/micro/comp poc CPT 81000 | not published | not published | $3.39 – $40.83 | 29 |
| Ugt1a1 gene analy common variants CPT 81350 | not published | not published | $79.86 – $526.50 | 28 |
| Ultrasound abdomen aorta screening study aaa CPT 76706 | not published | not published | $67.19 – $243.74 | 27 |
| Ultrasound bone density measure CPT 76977 | not published | not published | $3.44 – $243.74 | 29 |
| Ultrasound breast complete CPT 76641 | $695.23 | $1,879.00 | $72.22 – $243.74 | 27 |
| Ultrasound breast unilateral limited (both sides) CPT 76642 | $695.23 | $1,879.00 | $55.33 – $201.83 | 27 |
| Ultrasound chest CPT 76604 | $263.90 | $713.25 | $34.35 – $243.74 | 29 |
| Ultrasound doppler velocimetry fetal umbilical artery CPT 76820 | $340.03 | $919.00 | $23.00 – $420.03 | 29 |
| Ultrasound dx ophth b-scan CPT 76512 | $256.50 | $693.25 | $40.25 – $243.74 | 29 |
| Ultrasound elastography ea l target les CPT 76983 | $114.33 | $309.00 | $38.73 – $38.73 | 1 |
| Ultrasound elastography parenchyma CPT 76981 | $114.33 | $309.00 | $80.21 – $243.74 | 23 |
| Ultrasound encephalogram CPT 76506 | $226.26 | $611.50 | $40.47 – $258.19 | 29 |
| Ultrasound exam k transpl w/doppler CPT 76776 | $398.49 | $1,077.00 | $47.67 – $315.12 | 29 |
| Ultrasound fetal biophysical profile without non-stress testing CPT 76819 | $294.06 | $794.75 | $47.35 – $420.03 | 29 |
| Ultrasound guidance for vascular access CPT 76937 | $155.49 | $420.25 | $17.24 – $64.62 | 7 |
| Ultrasound guided needle placement supervision & interpretation CPT 76942 | $289.99 | $783.75 | $28.39 – $426.10 | 7 |
| Ultrasound guide intraoperative CPT 76998 | $193.42 | $522.75 | $75.63 – $426.10 | 6 |
| Ultrasound guide tissue ablation CPT 76940 | not published | not published | $72.39 – $426.10 | 6 |
| Ultrasound hips infant dynamic CPT 76885 | $175.75 | $475.00 | $46.34 – $306.56 | 29 |
| Ultrasound infant hips ltd without stress CPT 76886 | $93.80 | $253.50 | $38.32 – $217.63 | 29 |
| Ultrasound joint complete left CPT 76881 | $205.63 | $555.75 | $88.38 – $251.17 | 28 |
| Ultrasound joint/nonvascular extremity limited left CPT 76882 | $154.75 | $418.25 | $11.51 – $243.74 | 28 |
| Ultrasound nrv&acc strux 1xtr compre CPT 76883 | not published | not published | $108.33 – $243.74 | 22 |
| Ultrasound ob >=14wks ea addl gest CPT 76810 | $192.22 | $519.50 | $44.19 – $420.03 | 7 |
| Ultrasound pregnant uterus < 14 weeks each additional gestation CPT 76802 | $125.34 | $338.75 | $22.63 – $122.44 | 7 |
| Ultrasound pregnant uterus detailed fetal exam single/1st gestation CPT 76811 | $479.89 | $1,297.00 | $87.32 – $554.06 | 29 |
| Ultrasound pregnant uterus follow up per fetus CPT 76816 | $446.22 | $1,206.00 | $52.19 – $420.03 | 29 |
| Ultrasound pregnant uterus limited >= 1 fetuses CPT 76815 | $350.02 | $946.00 | $40.13 – $420.03 | 29 |
| Ultrasound pregnant uterus transvaginal CPT 76817 | $272.04 | $735.25 | $46.01 – $420.03 | 29 |
| Ultrasound prostate/transrectal CPT 76872 | $295.45 | $798.50 | $44.69 – $243.74 | 29 |
| Ultrasound retroperitoneal limited CPT 76775 | $277.13 | $749.00 | $30.19 – $243.74 | 29 |
| Ultrasound scrotum and contents CPT 76870 | $299.15 | $808.50 | $36.65 – $255.85 | 29 |
| Ultrasound spinal canal and contents CPT 76800 | $175.01 | $473.00 | $60.01 – $273.79 | 29 |
| Ultrasound transabd ea addl gest CPT 76812 | $137.55 | $371.75 | $108.53 – $420.03 | 7 |
| Ultrasound transvaginal non obstetric CPT 76830 | $378.88 | $1,024.00 | $42.80 – $243.74 | 29 |
| Ultrasound trgt dyn mbubb 1st les CPT 76978 | not published | not published | $181.36 – $408.06 | 25 |
| Ultraviolet therapy CPT 97028 | not published | not published | $7.23 – $16.79 | 29 |
| Umbilical artery cath newborn 36660 CPT 36660 | $293.78 | $794.00 | $82.11 – $158.34 | 7 |
| Umbilical cord occlud w/us CPT 59072 | not published | not published | $309.90 – $1,123.23 | 29 |
| Umbilicoplasty 15847 CPT 15847 | not published | not published | $518.35 – $1,785.36 | 6 |
| Unlistd noninvas vasc dx std CPT 93998 | not published | not published | $24.95 – $319.48 | 27 |
| Unlisted all/immlg svc/px CPT 95199 | not published | not published | $24.95 – $485.04 | 27 |
| Unlisted chemotherapy px CPT 96549 | not published | not published | $47.01 – $159.67 | 27 |
| Unlisted cranfcl&maxlfcl px CPT 21299 | not published | not published | $236.58 – $4,162.07 | 28 |
| Unlisted CT procedure CPT 76497 | not published | not published | $89.70 – $201.83 | 27 |
| Unlisted cv px dx nuc med CPT 78499 | not published | not published | $49.14 – $921.08 | 27 |
| Unlisted cytogenetic study CPT 88299 | not published | not published | $54.43 – $195.81 | 27 |
| Unlisted cytopathology px CPT 88199 | not published | not published | $54.43 – $122.47 | 27 |
| Unlisted dx gi procedure CPT 91299 | not published | not published | $159.39 – $1,595.15 | 27 |
| Unlisted endocrine px dx nuc CPT 78099 | not published | not published | $409.37 – $1,279.16 | 27 |
| Unlisted fetal invas px w/us CPT 59897 | not published | not published | $204.94 – $461.12 | 27 |
| Unlisted fluoroscopic px CPT 76496 | not published | not published | $89.70 – $259.34 | 27 |
| Unlisted gi px dx nuc med CPT 78299 | not published | not published | $409.37 – $1,279.16 | 27 |
| Unlisted gu px dx nuc med CPT 78799 | not published | not published | $409.37 – $1,279.16 | 27 |
| Unlisted hystsc px uterus CPT 58579 | not published | not published | $204.94 – $8,183.00 | 27 |
| Unlisted laparoscopic liver biopy 47379 CPT 47379 | not published | not published | $8,183.00 – $8,183.00 | 5 |
| Unlisted laparoscopic procedure 49659 CPT 49659 | not published | not published | $8,183.00 – $8,183.00 | 5 |
| Unlisted laparoscopic reduction intestine 44238 CPT 44238 | not published | not published | $11,888.86 – $11,888.86 | 5 |
| Unlisted laparoscopy procedure biliary tract 47579 CPT 47579 | not published | not published | $569.42 – $569.42 | 5 |
| Unlisted laps px appendix CPT 44979 | not published | not published | $1,276.89 – $1,276.89 | 5 |
| Unlisted laps px bladder CPT 51999 | not published | not published | $1,619.33 – $1,619.33 | 5 |
| Unlisted laps px endoc sys CPT 60659 | not published | not published | $8,183.00 – $8,183.00 | 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.