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 |
|---|---|---|---|---|
| Urinalysis qual/semiquant excpt ia CPT 81005 | not published | not published | $2.17 – $40.83 | 29 |
| Urinalysis (with microscopy) CPT 81001 | $33.02 | $89.25 | $3.17 – $40.83 | 29 |
| Urinalysis (without microscopy) CPT 81003 | $21.46 | $58.00 | $2.25 – $20.23 | 29 |
| Urinary bldr retent nuc study CPT 78730 | not published | not published | $10.81 – $134.95 | 7 |
| Urinary reflex study CPT 51792 | not published | not published | $60.51 – $379.57 | 29 |
| Urine Culture Test CPT 87086 | $47.82 | $129.25 | $8.07 – $56.64 | 29 |
| Urine flow measurement 51736 CPT 51736 | not published | not published | $7.20 – $295.47 | 29 |
| Urine pregnancy test CPT 81025 | $27.01 | $73.00 | $6.78 – $40.83 | 29 |
| Urography, antegrade CPT 74425 | $297.67 | $804.50 | $23.05 – $818.62 | 29 |
| Urography inf drip &/or bolus CPT 74410 | $292.12 | $789.50 | $31.13 – $408.06 | 29 |
| Use 1st target lesion CPT 76982 | $114.33 | $309.00 | $72.19 – $243.74 | 23 |
| Ustekinumab 130 mg/26 ml intravenous solution HCPCS J3358 | $133.50 | $360.80 | $17.57 – $18.82 | 4 |
| Vaccine dtap < 7 years im CPT 90700 | $51.45 | $139.05 | $22.15 – $35.20 | 6 |
| Vaccine dtap-hep b-ipv im CPT 90723 | $128.52 | $347.35 | $75.19 – $119.86 | 6 |
| Vaccine dtap-ipv 4-6 years im CPT 90696 | not published | not published | $66.06 – $81.22 | 5 |
| Vaccine dtap-ipv/hib im CPT 90698 | not published | not published | $72.91 – $136.46 | 6 |
| Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im CPT 90647 | not published | not published | $23.34 – $38.72 | 6 |
| Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im CPT 90648 | $50.17 | $135.60 | $22.83 – $44.61 | 6 |
| Vaccine hepatitis a (hepa) adult im CPT 90632 | not published | not published | $45.55 – $97.31 | 6 |
| Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im CPT 90636 | $166.00 | $448.65 | $86.54 – $157.75 | 6 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im CPT 90633 | not published | not published | $23.94 – $48.93 | 6 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 3 dose im CPT 90634 | not published | not published | $77.00 – $115.50 | 5 |
| Vaccine hepatitis b (hepb) adolescent 2 dose im CPT 90743 | not published | not published | $50.44 – $90.22 | 6 |
| Vaccine hepatitis b (hepb) adult 3 dose im CPT 90746 | $88.52 | $239.25 | $51.79 – $80.13 | 6 |
| Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 | $35.61 | $96.25 | $26.64 – $36.33 | 6 |
| Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im CPT 90649 | not published | not published | $143.59 – $240.48 | 6 |
| Vaccine influenza (iiv) preservative free antigen content im CPT 90662 | not published | not published | $34.75 – $42.72 | 5 |
| Vaccine influenza nos 0.5ml dose im CPT 90658 | not published | not published | $12.51 – $18.07 | 6 |
| Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im CPT 90656 | not published | not published | $12.54 – $16.02 | 6 |
| Vaccine influenza quadrivalent (iiv4) 0.5ml dose im CPT 90688 | not published | not published | $18.39 – $22.61 | 5 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.25ml dose im CPT 90685 | not published | not published | $25.35 – $31.17 | 5 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im CPT 90686 | $37.06 | $100.15 | $19.63 – $24.14 | 5 |
| Vaccine influenza quadrivalent live (laiv4) intranasal CPT 90672 | not published | not published | $26.85 – $33.02 | 5 |
| Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im CPT 90661 | not published | not published | $22.56 – $27.73 | 5 |
| Vaccine influenza trivalent (iiv3) 0.25ml dose im CPT 90657 | not published | not published | $5.68 – $9.03 | 6 |
| Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im CPT 90734 | $160.73 | $434.40 | $114.68 – $192.90 | 6 |
| Vaccine mmr live subcutaneous CPT 90707 | $115.29 | $311.60 | $51.74 – $95.36 | 6 |
| Vaccine mmrv live subcutaneous CPT 90710 | not published | not published | $141.78 – $264.44 | 6 |
| Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im CPT 90732 | $150.79 | $407.55 | $41.37 – $116.76 | 6 |
| Vaccine pneumococcal conjugate 13 valent (pcv13) im CPT 90670 | $270.03 | $729.80 | $187.84 – $364.90 | 6 |
| Vaccine polio (ipv) subcutaneous/im CPT 90713 | $54.70 | $147.85 | $30.48 – $46.71 | 6 |
| Vaccine rabies im CPT 90675 | $595.40 | $1,609.20 | $154.89 – $720.38 | 28 |
| Vaccine rotavirus attenuated (rv1) live 2 dose oral CPT 90681 | not published | not published | $148.03 – $182.01 | 5 |
| Vaccine rotavirus pentavalent (rv5) live 3 dose oral CPT 90680 | not published | not published | $76.54 – $128.38 | 6 |
| Vaccine tdap >=7 years im CPT 90715 | $61.66 | $166.65 | $37.03 – $63.57 | 6 |
| Vaccine td preservative free >= 7 years im CPT 90714 | $53.22 | $143.85 | $20.04 – $31.83 | 6 |
| Vaccine typhoid vicps im CPT 90691 | not published | not published | $43.61 – $80.66 | 6 |
| Vaccine varicella live subcutaneous CPT 90716 | not published | not published | $89.79 – $160.77 | 6 |
| Vaccine yellow fever live subcutaneous CPT 90717 | not published | not published | $59.49 – $272.63 | 6 |
| Vaccinia vrs vac 0.3 ml perq CPT 90622 | not published | not published | $0.01 – $0.02 | 22 |
| Vag hys/<250g/rmv tube/rpr entero 58263 CPT 58263 | not published | not published | $1,093.52 – $2,144.27 | 7 |
| Vag hyst incl t/o complex CPT 58291 | not published | not published | $1,374.34 – $2,701.98 | 7 |
| Vag hyst including t/o CPT 58262 | not published | not published | $1,018.61 – $1,996.08 | 7 |
| Vag hyst t/o & repair compl CPT 58292 | not published | not published | $1,449.61 – $2,849.42 | 7 |
| Vag hyst w/enterocele compl 58294 CPT 58294 | not published | not published | $1,344.54 – $2,642.71 | 7 |
| Vag hyst w/enterocele repair CPT 58270 | not published | not published | $974.87 – $1,907.15 | 7 |
| Vag hyst w/uro repair compl 58293 CPT 58293 | not published | not published | $1,509.04 – $2,964.08 | 7 |
| Vaginal bx CPT 58999 | not published | not published | $204.94 – $6,415.67 | 27 |
| Vaginal delivery after cesarean delivery 59612 CPT 59612 | not published | not published | $1,005.20 – $1,978.91 | 7 |
| Vaginal Delivery (full care) CPT 59400 | not published | not published | $2,004.50 – $3,921.64 | 7 |
| Vaginal hysterectomy CPT 58260 | not published | not published | $912.10 – $1,789.37 | 7 |
| Vaginectomy partial w/nodes CPT 57109 | not published | not published | $1,849.63 – $3,566.25 | 7 |
| Vagotomy pfrmd w/prtl dstl gstrct 43635 CPT 43635 | not published | not published | $128.04 – $238.68 | 7 |
| Vagotomy & pylorus repair 43640 CPT 43640 | not published | not published | $1,277.94 – $2,506.99 | 7 |
| Valproic acid total therapeutic drug level CPT 80164 | $53.00 | $143.25 | $13.54 – $32.97 | 29 |
| Valvuloplasty aortic CPT 92986 | $7,020.01 | $18,973.00 | $1,491.31 – $2,835.37 | 7 |
| Valvuloplasty mitral CPT 92987 | $6,699.13 | $18,105.75 | $1,539.36 – $2,933.65 | 7 |
| Valvuloplasty pulmonary CPT 92990 | not published | not published | $1,225.87 – $2,298.71 | 7 |
| Valvuloplasty/tv without ring insert 33463 CPT 33463 | not published | not published | $3,506.73 – $6,711.29 | 7 |
| Valvuloplasty/tv w/ring insertion 33464 CPT 33464 | not published | not published | $2,768.26 – $5,317.40 | 7 |
| Vancomycin peak therapeutic drug level CPT 80202 | $90.84 | $245.50 | $13.54 – $129.19 | 29 |
| Vanomycin dna amp probe CPT 87500 | not published | not published | $35.09 – $79.86 | 29 |
| Varicella zoster antibody igg CPT 86787 | $128.11 | $346.25 | $12.88 – $31.35 | 29 |
| Varicella-zoster immue globin im CPT 90396 | not published | not published | $808.86 – $994.50 | 5 |
| Vasc graft into carpal bone CPT 25430 | not published | not published | $773.78 – $1,500.75 | 7 |
| Vasectomy CPT 55250 | not published | not published | $252.89 – $477.37 | 7 |
| Vbac delivery 59610 CPT 59610 | not published | not published | $2,110.97 – $4,711.32 | 7 |
| Vbac/include postpartum care 59614 CPT 59614 | not published | not published | $1,124.15 – $2,460.18 | 7 |
| Vedolizumab 300 mg intravenous solution HCPCS J3380 | $50.88 | $137.50 | $22.95 – $24.59 | 4 |
| Veeg cont 2-12 hrs CPT 95713 | not published | not published | $540.55 – $1,216.24 | 22 |
| Veeg intrmnt 2-12 hrs CPT 95712 | not published | not published | $317.24 – $713.79 | 22 |
| Veeg unmon 12-26 hrs CPT 95714 | not published | not published | $540.55 – $1,216.24 | 22 |
| Veeg unmon 2-12 hrs CPT 95711 | not published | not published | $317.24 – $713.79 | 22 |
| Vein bypass grft fem-popliteal 35583 CPT 35583 | not published | not published | $1,664.57 – $3,215.25 | 7 |
| Vein byp fem-tibial peroneal 35585 CPT 35585 | not published | not published | $1,930.69 – $3,738.64 | 7 |
| Vein gft fem a/p tib/pero/dis art 35566 CPT 35566 | not published | not published | $1,922.77 – $3,727.72 | 7 |
| Vein x-ray adrenal gland CPT 75840 | $1,190.85 | $3,218.50 | $71.05 – $542.92 | 7 |
| Vein x-ray adrenal glands CPT 75842 | $4,171.01 | $11,273.00 | $94.24 – $542.92 | 7 |
| Vein x-ray eye socket CPT 75880 | $815.39 | $2,203.75 | $43.27 – $1,417.18 | 29 |
| Vein x-ray kidney CPT 75831 | $1,190.85 | $3,218.50 | $71.95 – $542.92 | 7 |
| Vein x-ray liver CPT 75891 | $1,396.01 | $3,773.00 | $72.46 – $542.92 | 7 |
| Vein x-ray liver w/hemodynam CPT 75885 | $1,213.60 | $3,280.00 | $89.11 – $542.92 | 7 |
| Vein x-ray liver w/hemodynam CPT 75889 | $1,274.28 | $3,444.00 | $72.46 – $542.92 | 7 |
| Vein x-ray liver without hemodyn CPT 75887 | $766.36 | $2,071.25 | $90.19 – $542.92 | 7 |
| Vein x-ray skull CPT 75870 | $348.82 | $942.75 | $71.66 – $542.92 | 7 |
| Vein x-ray skull epidural CPT 75872 | not published | not published | $75.50 – $1,417.18 | 29 |
| Vein x-ray spleen/liver CPT 75810 | not published | not published | $72.85 – $542.92 | 6 |
| Vemp test i&r cervical CPT 92517 | not published | not published | $159.39 – $358.63 | 22 |
| Vemp test i&r ocular CPT 92518 | not published | not published | $159.39 – $358.63 | 22 |
| Vemp tst i&r cervical&ocular CPT 92519 | not published | not published | $317.24 – $713.79 | 22 |
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.