Ascension St. John Nowata (Jane Phillips Nowata Hospital, Inc.)
237 S Locust St, Nowata, OK · Ascension · · NPI 1548247489
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 |
|---|---|---|---|---|
| Chromosome karyotype study CPT 88280 | not published | not published | $26.58 – $195.81 | 7 |
| Chromosome study additional CPT 88289 | $144.12 | $389.50 | $36.22 – $113.79 | 7 |
| Chronic urticaria - sendout CPT 86343 | not published | not published | $13.03 – $79.86 | 7 |
| Chylomicron screen, bf - sendout CPT 82664 | $59.57 | $161.00 | $36.22 – $60.18 | 7 |
| Cidofovir injection HCPCS J0740 | $1,060.92 | $2,867.35 | $1,035.24 – $1,109.19 | 5 |
| Cilastatin sodium injection HCPCS J0743 | $43.44 | $117.40 | $7.21 – $7.72 | 5 |
| Ciliary transsleral therapy CPT 66710 | not published | not published | $394.65 – $867.38 | 7 |
| Cine/video x-rays CPT 76120 | not published | not published | $23.59 – $259.34 | 7 |
| Cine/video x-rays add-on CPT 76125 | not published | not published | $17.74 – $259.34 | 6 |
| Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback HCPCS J0744 | $43.80 | $118.39 | $1.75 – $1.88 | 5 |
| Circum 28 days or older CPT 54161 | not published | not published | $220.30 – $415.76 | 7 |
| Circumcise/surg/28 days or < 54160 CPT 54160 | not published | not published | $161.83 – $304.22 | 7 |
| Circumcision (newborn) CPT 54150 | $176.49 | $477.00 | $110.98 – $209.82 | 7 |
| Cisplatin 1 mg/ml desensitization HCPCS J9060 | $52.43 | $141.70 | $3.29 – $3.52 | 5 |
| C-kit mutation liquid tumor - sendout CPT 81272 | $365.76 | $988.53 | $376.62 – $533.80 | 6 |
| Cladribine 10 mg/10 ml intravenous solution HCPCS J9065 | $347.10 | $938.10 | $35.28 – $37.80 | 5 |
| Claviculectomy partial CPT 23120 | not published | not published | $620.65 – $1,235.54 | 7 |
| Claviculectomy total CPT 23125 | not published | not published | $764.52 – $1,493.73 | 7 |
| Clean out mastoid cavity CPT 69222 | not published | not published | $147.24 – $294.07 | 7 |
| Clearance of airways CPT 31720 | $80.94 | $218.75 | $59.07 – $95.23 | 7 |
| Clearance of tear duct CPT 68530 | $656.38 | $1,774.00 | $269.43 – $568.63 | 7 |
| C-lens fitg corneosclrl lens CPT 92313 | not published | not published | $52.58 – $107.64 | 7 |
| C-lens fitg tech aphakia 1 CPT 92315 | not published | not published | $24.81 – $53.04 | 7 |
| C-lens fitg tech aphakia ou CPT 92316 | not published | not published | $37.06 – $85.81 | 7 |
| C-lens fitg tech corneosclrl CPT 92317 | not published | not published | $25.54 – $46.80 | 7 |
| Clitoroplasty intersex state CPT 56805 | not published | not published | $1,323.59 – $2,482.80 | 7 |
| Clofarabine 1 mg/ml intravenous solution HCPCS J9027 | $3,993.47 | $10,793.15 | $205.44 – $220.11 | 5 |
| Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution HCPCS J0735 | $387.33 | $1,046.85 | $32.87 – $35.22 | 5 |
| Close bronchial fistula 32815 CPT 32815 | not published | not published | $3,129.14 – $6,049.05 | 7 |
| Closed carpo/metacarpal disl thumb w/manip CPT 26641 | $444.09 | $1,200.25 | $340.96 – $619.03 | 7 |
| Closed carpo/metacarpal fx disl thumb w/manip CPT 26645 | $2,628.48 | $7,104.00 | $392.68 – $822.14 | 7 |
| Closed treatment of femoral fracture proximal end neck; wi CPT 27232 | $1,505.99 | $4,070.25 | $831.41 – $1,410.84 | 7 |
| Closed tx/acetabululm without manip 27220 CPT 27220 | $812.52 | $2,196.00 | $560.95 – $967.32 | 7 |
| Closed tx humerus fx with manip 23605 CPT 23605 | $3,388.46 | $9,158.00 | $446.02 – $897.81 | 7 |
| Closed tx humerus fx without manip 23600 CPT 23600 | $393.96 | $1,064.75 | $299.44 – $648.20 | 7 |
| Closed tx humerus fx w/manip 24505 CPT 24505 | $2,628.48 | $7,104.00 | $473.18 – $954.74 | 7 |
| Closed tx metatarsophalangeal jnt disl without anes CPT 28630 | $258.82 | $699.50 | $123.19 – $235.57 | 7 |
| Closed tx nose/jaw fx CPT 21345 | not published | not published | $712.79 – $1,428.22 | 7 |
| Closed tx orbit without manipulj CPT 21400 | $920.38 | $2,487.50 | $152.03 – $334.63 | 7 |
| Closed tx orbit w/manipulj CPT 21401 | not published | not published | $316.05 – $629.47 | 7 |
| Closed tx post hip arthroplasty disloc w/anes 27266 CPT 27266 | $2,569.28 | $6,944.00 | $630.29 – $1,226.98 | 7 |
| Closed tx septal&nose fx CPT 21337 | $1,861.19 | $5,030.25 | $303.76 – $632.60 | 7 |
| Closed tx sesamoid fx 28530 CPT 28530 | not published | not published | $108.56 – $216.07 | 7 |
| Closed tx/talus fracture without manip 28430 CPT 28430 | $376.11 | $1,016.50 | $210.28 – $444.62 | 7 |
| Closed tx vert fx w/manj CPT 22315 | not published | not published | $817.03 – $1,624.78 | 7 |
| Close lac/mouth vest/2.5 cm or < 40830 CPT 40830 | $315.52 | $852.75 | $169.55 – $361.92 | 7 |
| Close mastoid fistula CPT 69700 | not published | not published | $751.85 – $1,478.13 | 7 |
| Close median sternotomy separation 21750 CPT 21750 | not published | not published | $765.90 – $1,476.59 | 7 |
| Close tear duct opening CPT 68760 | not published | not published | $146.07 – $320.59 | 7 |
| Close tear duct opening CPT 68761 | not published | not published | $118.28 – $258.96 | 7 |
| Close tear system fistula CPT 68770 | not published | not published | $598.83 – $1,386.87 | 7 |
| Clostridium toxin a w/optic CPT 87803 | not published | not published | $12.77 – $56.64 | 7 |
| Clos txnose fx without stablz 21315 CPT 21315 | $916.49 | $2,477.00 | $158.91 – $326.83 | 7 |
| Closure enterostomy lg/sm intestine 44620 CPT 44620 | not published | not published | $941.59 – $1,854.11 | 7 |
| Closure enterostomy lg/sm intestine anast 44626 CPT 44626 | not published | not published | $1,779.12 – $3,425.07 | 7 |
| Closure enterostomy lg/sm intestine oth/thn 44625 CPT 44625 | not published | not published | $1,116.59 – $2,183.28 | 7 |
| Closure intestinal cutaneous fistula 44640 CPT 44640 | not published | not published | $1,550.99 – $2,993.71 | 7 |
| Closure laceration vestibule mouth > 2.5 cm cmplx CPT 40831 | $730.75 | $1,975.00 | $238.42 – $487.52 | 7 |
| Closure of eyelid by suture CPT 67875 | not published | not published | $100.82 – $213.73 | 7 |
| Closure of salivary fistula CPT 42600 | not published | not published | $380.27 – $755.84 | 7 |
| Closure of windpipe lesion 31820 CPT 31820 | not published | not published | $359.09 – $707.47 | 7 |
| Closure paravalvlr leak pq CPT 33999 | not published | not published | $2,820.93 – $2,820.93 | 5 |
| Clot factor fletcher fact CPT 85292 | not published | not published | $20.06 – $100.82 | 7 |
| Clot factor viii reltd antgn CPT 85244 | not published | not published | $21.63 – $100.82 | 7 |
| Clot factor wght kininogen CPT 85293 | not published | not published | $20.06 – $100.82 | 7 |
| Clot factor xii hageman CPT 85280 | $95.74 | $258.75 | $20.33 – $100.82 | 7 |
| Clot factor xiii fibrin scrn CPT 85291 | not published | not published | $9.38 – $100.82 | 7 |
| Clot factor xiii fibrin stab CPT 85290 | $84.27 | $227.75 | $17.20 – $100.82 | 7 |
| Clotting assay whole blood CPT 85396 | $59.39 | $160.50 | $15.24 – $37.41 | 7 |
| Clsd/shoulder dislo/manip/no anest 23650 CPT 23650 | $381.75 | $1,031.75 | $280.11 – $613.09 | 7 |
| Clsd tx bimalleol ank fx without manip 27808 CPT 27808 | $512.82 | $1,386.00 | $297.42 – $635.71 | 7 |
| Clsd tx carpo/metacarpl disl thmb manip ea without anes CPT 26670 | $450.48 | $1,217.50 | $305.19 – $555.09 | 7 |
| Clsd tx clav dislc without manip 23520 CPT 23520 | $2,628.48 | $7,104.00 | $225.20 – $491.42 | 7 |
| Clsd tx clavicle dislocation without manip 23540 CPT 23540 | $271.03 | $732.50 | $219.05 – $481.27 | 7 |
| Clsd tx clavicle fracture w/manip 23505 CPT 23505 | $1,321.64 | $3,572.00 | $340.75 – $701.24 | 7 |
| Clsd tx/clavicular fx without manip 23500 CPT 23500 | $264.55 | $715.00 | $214.70 – $468.79 | 7 |
| Clsd tx coccygeal fracture 27200 CPT 27200 | $188.05 | $508.25 | $183.19 – $343.53 | 7 |
| Clsd tx/dis phalan fx without manip/ea 26750 CPT 26750 | $148.37 | $401.00 | $174.93 – $340.13 | 7 |
| Clsd tx dist fib fx w/manip 27788 CPT 27788 | $511.06 | $1,381.25 | $407.44 – $712.90 | 7 |
| Clsd tx/dis tib/wt bear no manip 27824 CPT 27824 | $377.03 | $1,019.00 | $304.75 – $641.18 | 7 |
| Clsd tx elbow dislocation child 24640 CPT 24640 | $292.49 | $790.50 | $92.21 – $203.58 | 7 |
| Clsd tx/fem shaft fx/manipulation 27502 CPT 27502 | $2,587.60 | $6,993.50 | $840.79 – $1,634.93 | 7 |
| Clsd tx finger tendon w/wo perq pin 26432 CPT 26432 | not published | not published | $514.12 – $1,031.97 | 7 |
| Clsd tx fracture of radius 25500 CPT 25500 | $415.88 | $1,124.00 | $240.76 – $525.74 | 7 |
| Clsd tx/fx grt toe/phalanx/phalang 28490 CPT 28490 | $376.11 | $1,016.50 | $121.99 – $266.77 | 7 |
| Clsd tx/fx/phalanx/phalang/manip 28515 CPT 28515 | $130.89 | $353.75 | $147.76 – $303.43 | 7 |
| Clsd tx fx radius/ulna dist without manip 25600 CPT 25600 | $393.96 | $1,064.75 | $263.21 – $652.88 | 7 |
| Clsd tx fx radius/ulna dist w/manip 25605 CPT 25605 | $975.88 | $2,637.50 | $554.67 – $1,089.69 | 7 |
| Clsd tx fx radius/ulna without manip 25560 CPT 25560 | $335.68 | $907.25 | $239.49 – $530.41 | 7 |
| Clsd tx fx radius/ulna w/manip 25565 CPT 25565 | $882.64 | $2,385.50 | $499.51 – $997.65 | 7 |
| Clsd tx/grt hum tube fx without manip 23620 CPT 23620 | $482.85 | $1,305.00 | $251.04 – $540.56 | 7 |
| Clsd tx hip disloc without anes 27265 CPT 27265 | $489.51 | $1,323.00 | $421.18 – $745.56 | 7 |
| Clsd tx humeral fract without manip 24530 CPT 24530 | $456.86 | $1,234.75 | $344.75 – $631.27 | 7 |
| Clsd tx humerus fract without manip 24500 CPT 24500 | $546.86 | $1,478.00 | $320.00 – $685.64 | 7 |
| Clsd tx iphal jnt disl w/manip req anes CPT 26775 | $1,233.58 | $3,334.00 | $347.74 – $733.99 | 7 |
| Clsd tx mandibular fx without manip 21450 CPT 21450 | $483.22 | $1,306.00 | $475.45 – $1,044.45 | 7 |
| Clsd tx/metacar/interphal artic fx 26740 CPT 26740 | $376.11 | $1,016.50 | $209.62 – $450.85 | 7 |
| Clsd tx/metacarpal fx/sg without manip 26600 CPT 26600 | $353.72 | $956.00 | $255.82 – $582.67 | 7 |
| Clsd tx/metacarpal fx/sng/w manip 26605 CPT 26605 | $257.98 | $697.25 | $292.79 – $617.00 | 7 |
| Clsd tx metacarp fx w/manip&ext fix ea bone 26607 CPT 26607 | not published | not published | $466.08 – $958.64 | 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.