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 |
|---|---|---|---|---|
| Warde sex hormone binding globulin CPT 84270 | $43.20 | $116.75 | $21.73 – $108.04 | 29 |
| Warde somatomedin CPT 84305 | $106.75 | $288.50 | $21.26 – $111.67 | 29 |
| Warde sugars single qualitative each specimen stool CPT 84376 | $32.19 | $87.00 | $5.50 – $60.18 | 29 |
| Warde t3 (triiodothyronine) reverse CPT 84482 | $115.44 | $312.00 | $15.76 – $85.28 | 29 |
| Warde thyroid stimulating immunoglobulins CPT 84445 | $180.01 | $486.50 | $50.86 – $114.44 | 29 |
| Warde topiramate therapeutic drug level CPT 80201 | $76.04 | $205.50 | $11.92 – $129.19 | 29 |
| Warde virus isolation tissue culture innoculation presumptive id herpes simplex CPT 87252 | $123.51 | $333.80 | $26.07 – $113.14 | 29 |
| Warde viscosity CPT 85810 | $42.92 | $116.00 | $11.67 – $89.93 | 29 |
| Warde vitamin a CPT 84590 | $59.66 | $161.25 | $11.61 – $108.04 | 29 |
| Warde vitamin b-1 (thiamine) CPT 84425 | $83.99 | $227.00 | $21.23 – $108.04 | 29 |
| Warde vitamin b6 (pyridoxine) CPT 84207 | $126.82 | $342.75 | $28.10 – $108.04 | 29 |
| Warde vitamin c (ascorbic acid) CPT 82180 | $98.98 | $267.50 | $9.89 – $60.18 | 29 |
| Warde vitamin d (1 25 dihydroxy) CPT 82652 | $140.32 | $379.25 | $38.50 – $108.04 | 29 |
| Warde vitamin e (alpha-tocopherol) CPT 84446 | $46.90 | $126.75 | $14.18 – $108.04 | 29 |
| Warde zinc CPT 84630 | $57.81 | $156.25 | $11.39 – $112.27 | 29 |
| Wash harvest stem cells CPT 38209 | not published | not published | $14.11 – $1,002.11 | 29 |
| Wbc automated CPT 85048 | not published | not published | $2.54 – $51.91 | 29 |
| Wedge biopsy of liver 47100 CPT 47100 | not published | not published | $898.46 – $1,796.39 | 7 |
| Wedge rescj/bisctj ovary uni/bi 58920 CPT 58920 | not published | not published | $806.22 – $1,514.80 | 7 |
| Wedge resect of lung add-on 32506 CPT 32506 | not published | not published | $178.02 – $356.47 | 6 |
| Wedge resect of lung diag 32507 CPT 32507 | not published | not published | $178.02 – $356.47 | 6 |
| Wedge resect of lung initial 32505 CPT 32505 | not published | not published | $1,046.58 – $2,059.25 | 6 |
| Wedging of cast CPT 29740 | not published | not published | $76.93 – $608.76 | 29 |
| Wedging of clubfoot cast CPT 29750 | not published | not published | $77.27 – $608.76 | 29 |
| Western blot test CPT 84181 | $235.78 | $637.25 | $14.66 – $62.53 | 29 |
| Whole mitochondrial genome CPT 81460 | not published | not published | $1,460.74 – $1,460.74 | 1 |
| Wnd prep f/n/hf/g addl cm CPT 15005 | not published | not published | $102.75 – $195.01 | 7 |
| Wound therapy negative pressure per session <= 50 sq cm CPT 97607 | not published | not published | $407.02 – $915.79 | 22 |
| Wound therapy negative pressure per session > 50 sq cm CPT 97608 | not published | not published | $407.02 – $915.79 | 22 |
| Wound therapy negative pressure per session <= 50 sq cm dme CPT 97605 | $206.46 | $558.00 | $28.17 – $455.47 | 29 |
| Wound therapy negative pressure per session > 50 sq cm dme CPT 97606 | $249.66 | $674.75 | $30.57 – $915.79 | 29 |
| Wrist arthroscopy CPT 29840 | not published | not published | $481.28 – $954.74 | 7 |
| Wrist arthroscopy/surgery CPT 29843 | not published | not published | $517.62 – $1,021.04 | 7 |
| Wrist arthroscopy/surgery CPT 29844 | not published | not published | $538.82 – $1,050.68 | 7 |
| Wrist arthroscopy/surgery CPT 29845 | not published | not published | $616.45 – $1,222.28 | 7 |
| Wrist arthroscopy/surgery CPT 29846 | not published | not published | $567.09 – $1,098.27 | 7 |
| Wrist arthroscopy/surgery CPT 29847 | not published | not published | $589.23 – $1,147.41 | 7 |
| Wrist endoscopy/surgery CPT 29848 | not published | not published | $534.66 – $1,075.65 | 7 |
| Wrist X-ray CPT 73110 | $263.81 | $713.00 | $10.66 – $259.34 | 29 |
| Xcapsl ctrc rmvl cplx wo ecp CPT 66982 | not published | not published | $863.63 – $1,733.98 | 7 |
| Xfer tis f/c/c/m/n/a/g/h/f 10sq cm/< CPT 14040 | $2,004.20 | $5,416.75 | $696.52 – $1,354.90 | 7 |
| Xfer tis s/a/l 10 sq cm/< CPT 14020 | not published | not published | $613.38 – $1,212.93 | 7 |
| Xm archive tissue molec anal CPT 88363 | not published | not published | $22.27 – $113.79 | 28 |
| Xpos opn fmrl eprst aor uni add-on CPT 34812 | not published | not published | $388.49 – $744.91 | 7 |
| X-ray abdomen 1 view CPT 74018 | $116.83 | $315.75 | $21.25 – $201.83 | 28 |
| X-ray abdomen 2 views CPT 74019 | $158.73 | $429.00 | $25.30 – $243.74 | 28 |
| X-ray abdomen >=3 views CPT 74021 | $158.73 | $429.00 | $29.52 – $243.74 | 28 |
| X-ray abdomen complete acute series including spine erect and/or decubitus single view chest CPT 74022 | $199.80 | $540.00 | $20.08 – $259.34 | 29 |
| X-ray acromioclavicular joints without or w/weighted distraction bilateral CPT 73050 | $117.94 | $318.75 | $12.86 – $259.34 | 29 |
| X-ray ankle 2 views (both sides) CPT 73600 | $230.51 | $623.00 | $9.79 – $259.34 | 29 |
| X-ray arthrogram shoulder supervision & interpretation (both sides) CPT 73040 | $267.14 | $722.00 | $33.88 – $818.62 | 29 |
| X-ray bone age studies CPT 77072 | $170.57 | $461.00 | $11.99 – $259.34 | 29 |
| X-ray bone length studies CPT 77073 | $150.41 | $406.50 | $16.94 – $259.34 | 29 |
| X-ray bone survey complete CPT 77075 | $330.04 | $892.00 | $33.88 – $259.34 | 29 |
| X-ray bone survey infant CPT 77076 | $158.36 | $428.00 | $42.47 – $259.34 | 29 |
| X-ray cervical spine 2-3 views CPT 72040 | $148.46 | $401.25 | $13.80 – $259.34 | 29 |
| X-ray cervical spine 4-5 views CPT 72050 | $184.82 | $499.50 | $19.21 – $259.34 | 29 |
| X-ray cervical spine >= 6 views CPT 72052 | $217.93 | $589.00 | $22.65 – $259.34 | 29 |
| X-ray clavicle complete (both sides) CPT 73000 | $242.35 | $655.00 | $10.19 – $259.34 | 29 |
| X-ray colon abdominal radiograph(s) & delayed images single contrast study CPT 74270 | $287.68 | $777.50 | $43.60 – $408.06 | 29 |
| X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study CPT 74280 | $340.40 | $920.00 | $62.34 – $454.75 | 29 |
| X-ray elbow 2 views (both sides) CPT 73070 | $225.89 | $610.50 | $9.32 – $259.34 | 29 |
| X-ray elbow >= 3 views (both sides) CPT 73080 | $238.28 | $644.00 | $10.66 – $259.34 | 29 |
| X-ray esophogram chest radiograph(s) & delayed images single contrast study CPT 74220 | $221.54 | $598.75 | $28.93 – $408.06 | 29 |
| X-ray exam entire spi 4/5 vw CPT 72083 | $195.36 | $528.00 | $50.67 – $243.74 | 28 |
| X-ray exam entire spi 6/> vw CPT 72084 | not published | not published | $60.72 – $243.74 | 28 |
| X-ray exam of arm infant CPT 73092 | $167.06 | $451.50 | $9.79 – $243.74 | 29 |
| X-ray exam of eye sockets CPT 70200 | $74.93 | $202.50 | $17.41 – $243.74 | 29 |
| X-ray exam of femur 1 CPT 73551 | $110.54 | $298.75 | $19.77 – $201.83 | 28 |
| X-ray exam of jaw joint CPT 70328 | $57.44 | $155.25 | $11.12 – $201.83 | 29 |
| X-ray exam of jaw joint CPT 70332 | not published | not published | $33.08 – $554.06 | 29 |
| X-ray exam of mastoids CPT 70120 | $48.01 | $129.75 | $11.12 – $243.74 | 29 |
| X-ray exam of middle ear CPT 70134 | not published | not published | $21.31 – $1,256.81 | 29 |
| X-ray exam of penis CPT 74445 | not published | not published | $49.19 – $542.92 | 28 |
| X-ray exam of perineum CPT 74775 | $160.95 | $435.00 | $39.12 – $554.06 | 28 |
| X-ray exam of salivary gland CPT 70380 | $53.47 | $144.50 | $10.66 – $201.83 | 29 |
| X-ray exam of sinuses CPT 70210 | $70.67 | $191.00 | $10.66 – $201.83 | 29 |
| X-ray exam of tear duct CPT 70170 | not published | not published | $18.74 – $554.06 | 28 |
| X-ray exam of teeth CPT 70300 | not published | not published | $6.58 – $259.34 | 29 |
| X-ray exam of teeth CPT 70310 | not published | not published | $10.19 – $554.06 | 29 |
| X-ray exam si joints CPT 72200 | $120.71 | $326.25 | $10.66 – $259.34 | 29 |
| X-ray exam thorac spine4/>vw CPT 72074 | $175.01 | $473.00 | $13.80 – $259.34 | 29 |
| X-ray eye detection foreign body (both sides) CPT 70030 | $45.70 | $123.50 | $10.66 – $201.83 | 29 |
| X-ray facial bones complete > 3 views CPT 70150 | $95.18 | $257.25 | $16.07 – $243.74 | 29 |
| X-ray fallopian tube CPT 74742 | not published | not published | $38.25 – $542.92 | 6 |
| X-ray femur >=2 views (both sides) CPT 73552 | $232.18 | $627.50 | $23.36 – $201.83 | 28 |
| X-ray finger(s) >= 2 views (both sides) CPT 73140 | $240.32 | $649.50 | $8.38 – $259.34 | 29 |
| X-ray foot 2 views (both sides) CPT 73620 | $232.18 | $627.50 | $9.79 – $259.34 | 29 |
| X-ray forearm 2 views (both sides) CPT 73090 | $235.32 | $636.00 | $9.79 – $259.34 | 29 |
| X-ray hand 2 views (both sides) CPT 73120 | $240.32 | $649.50 | $9.79 – $259.34 | 29 |
| X-ray head for orthodontia CPT 70350 | not published | not published | $9.70 – $259.34 | 29 |
| X-ray heel/calcaneus > 2 views (both sides) CPT 73650 | $220.15 | $595.00 | $9.79 – $259.34 | 29 |
| X-ray hip uni w/wo pelvis min 4 views CPT 73503 | $161.69 | $437.00 | $37.73 – $243.74 | 28 |
| X-ray hip with pelvis when performed bilateral 2 views CPT 73521 | $107.67 | $291.00 | $28.39 – $243.74 | 28 |
| X-ray hip with pelvis when performed bilateral 3-4 views CPT 73522 | $159.19 | $430.25 | $34.14 – $243.74 | 28 |
| X-ray hip with pelvis when performed bilateral >= 5 views CPT 73523 | not published | not published | $40.96 – $243.74 | 28 |
| X-ray hip with pelvis when performed unilateral 1 view left CPT 73501 | $100.27 | $271.00 | $20.49 – $201.83 | 28 |
| X-ray humerus >= 2 views left CPT 73060 | $124.23 | $335.75 | $10.66 – $259.34 | 29 |
| X-ray joint survey 1 view CPT 77077 | $284.16 | $768.00 | $19.51 – $259.34 | 29 |
| X-ray knee 1-2 views (both sides) CPT 73560 | $207.20 | $560.00 | $10.66 – $259.34 | 29 |
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.