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 |
|---|---|---|---|---|
| Cryotherapy of acne 17340 CPT 17340 | not published | not published | $51.85 – $103.75 | 7 |
| Cryptococcus abs qn - sendout CPT 86641 | $52.63 | $142.25 | $15.11 – $79.86 | 7 |
| Cryptosporidium antigen CPT 87272 | not published | not published | $12.77 – $62.53 | 7 |
| Crystal identification light microscopy CPT 89060 | $23.50 | $63.50 | $7.56 – $17.40 | 7 |
| C-Section Delivery (full care) CPT 59510 | not published | not published | $2,269.84 – $4,333.20 | 7 |
| C-section delivery incl p/p care 59515 CPT 59515 | not published | not published | $1,250.16 – $1,421.75 | 2 |
| Csf leakage imaging CPT 78650 | not published | not published | $38.65 – $680.97 | 7 |
| Csf shunt reprogram 62252 CPT 62252 | $296.93 | $802.50 | $39.17 – $156.47 | 7 |
| Csf ventriculography CPT 78635 | not published | not published | $38.75 – $691.10 | 7 |
| CT 3d report other modality w/workstation CPT 76377 | $191.01 | $516.25 | $31.62 – $148.98 | 7 |
| Cta abdomen without & /or w/contrast CPT 74175 | $1,341.62 | $3,626.00 | $120.13 – $828.39 | 7 |
| Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast CPT 75635 | $1,528.75 | $4,131.75 | $153.62 – $919.65 | 7 |
| Cta lower extremity without & w/contrast (both sides) CPT 73706 | $2,658.27 | $7,184.50 | $120.93 – $827.60 | 7 |
| Cta neck without &/or w/contrast CPT 70498 | $1,315.72 | $3,556.00 | $111.11 – $1,049.91 | 7 |
| CT Angiogram of Abdomen and Pelvis CPT 74174 | $2,483.63 | $6,712.50 | $265.51 – $1,017.93 | 6 |
| CT Angiogram of the Chest (for blood clot) CPT 71275 | $1,499.24 | $4,052.00 | $121.36 – $824.48 | 7 |
| CT Angiogram of the Head CPT 70496 | $1,328.95 | $3,591.75 | $110.71 – $1,016.37 | 7 |
| CT angio hrt w/3d image CPT 75574 | $1,166.70 | $3,153.25 | $265.52 – $934.46 | 6 |
| CT angio pelvis CPT 72191 | $1,012.14 | $2,735.50 | $114.32 – $817.46 | 7 |
| Cta upper extremity w &/or without contrast left CPT 73206 | $1,229.70 | $3,323.50 | $115.11 – $748.82 | 7 |
| CT bone density axial CPT 77078 | not published | not published | $15.60 – $265.21 | 7 |
| CT colonography dx CPT 74261 | not published | not published | $112.82 – $1,089.69 | 6 |
| CT colonography dx w/dye CPT 74262 | not published | not published | $265.15 – $1,200.46 | 6 |
| CT colonography screening CPT 74263 | not published | not published | $648.14 – $1,568.62 | 6 |
| CT guidance for needle placement CPT 77012 | $584.14 | $1,578.75 | $67.56 – $487.52 | 7 |
| CT guidance for percutaneous drain w/catheter placement supervision & interpretation CPT 75989 | $562.49 | $1,520.25 | $63.24 – $542.92 | 7 |
| CT guid cryo ablat intramuscular CPT 20999 | $2,614.14 | $7,065.25 | $3,532.63 – $6,090.54 | 6 |
| CT guid parench tis ablat CPT 77013 | $325.51 | $879.75 | $252.95 – $487.52 | 6 |
| CT heart w/evaluation of calcium without contrast CPT 75571 | $277.50 | $750.00 | $60.01 – $230.89 | 6 |
| CT hrt c+ strux cgen hrt ds CPT 75573 | not published | not published | $265.16 – $868.17 | 6 |
| CT hrt w/3d image CPT 75572 | not published | not published | $199.06 – $634.94 | 6 |
| CT limited or localized follow-up study CPT 76380 | $275.00 | $743.25 | $60.01 – $340.10 | 7 |
| CT lower extremity w/contrast (both sides) CPT 73701 | $1,978.58 | $5,347.50 | $73.39 – $530.41 | 7 |
| CT lower extremity without contrast (both sides) CPT 73700 | $1,646.50 | $4,450.00 | $68.52 – $427.45 | 7 |
| CT lwr extremity w/o&w/dye CPT 73702 | $1,581.38 | $4,274.00 | $77.00 – $662.23 | 7 |
| CT neck soft tissue w/contrast CPT 70491 | $917.14 | $2,478.75 | $86.79 – $548.35 | 7 |
| CT neck soft tissue without contrast CPT 70490 | $725.29 | $1,960.25 | $80.91 – $456.32 | 7 |
| CT neck soft tissue without & w/contrast CPT 70492 | $1,042.01 | $2,816.25 | $90.87 – $652.10 | 7 |
| CT orbit/sella/fossa w/wo contrast CPT 70482 | $1,023.14 | $2,765.25 | $90.87 – $723.86 | 7 |
| CT orbit/sella/ or posterior outer inner or middle ear w/contrast CPT 70481 | $753.23 | $2,035.75 | $86.79 – $654.44 | 7 |
| CT orbit/sella/ or posterior outer inner or middle ear without contrast CPT 70480 | $790.88 | $2,137.50 | $80.51 – $565.52 | 7 |
| Ctrl nosebld postir subsq 30906 CPT 30906 | $239.30 | $646.75 | $153.22 – $282.37 | 7 |
| CT scan for therapy guide CPT 77014 | $360.75 | $975.00 | $52.59 – $487.52 | 7 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $1,216.01 | $3,286.50 | $255.45 – $825.26 | 6 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $1,187.61 | $3,209.75 | $222.39 – $705.92 | 6 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $920.93 | $2,489.00 | $114.61 – $474.26 | 6 |
| CT thoracic spine w/contrast CPT 72129 | $859.79 | $2,323.75 | $77.00 – $537.43 | 7 |
| CT thoracic spine without contrast CPT 72128 | $843.69 | $2,280.25 | $73.00 – $429.02 | 7 |
| CT thorax low dose for lung screening without contrast CPT 71271 | $952.66 | $2,574.75 | $97.66 – $97.66 | 1 |
| CT t-spine w /wo contrast CPT 72130 | $715.30 | $1,933.25 | $80.04 – $641.96 | 7 |
| CT upper extremity w/contrast (both sides) CPT 73201 | $1,771.19 | $4,787.00 | $73.00 – $523.40 | 7 |
| CT upper extremity without contrast (both sides) CPT 73200 | $1,587.30 | $4,290.00 | $68.52 – $426.66 | 7 |
| CT uppr extremity w/o&w/dye CPT 73202 | $1,476.49 | $3,990.50 | $76.61 – $663.03 | 7 |
| Cultr oocyte/embryo <4 days CPT 89250 | not published | not published | $195.81 – $1,530.91 | 6 |
| Cultr oocyte/embryo <4 days CPT 89251 | not published | not published | $195.81 – $1,592.41 | 6 |
| Cult skin graft fnhfg 15155 CPT 15155 | not published | not published | $732.78 – $1,500.75 | 7 |
| Cult skin grft t/arm/leg CPT 15150 | not published | not published | $691.59 – $1,340.07 | 7 |
| Culture aerobic additional method definitive id each CPT 87077 | $27.38 | $74.00 | $8.60 – $56.64 | 7 |
| Culture afb any source CPT 87116 | $51.34 | $138.75 | $11.47 – $26.28 | 7 |
| Culture anaerobic additional method definitive id each CPT 87076 | $35.34 | $95.50 | $8.60 – $56.64 | 7 |
| Culture anaerobic except blood CPT 87075 | $65.49 | $177.00 | $9.90 – $56.64 | 7 |
| Culture bact stool aero addl path ea CPT 87046 | $19.43 | $52.50 | $9.90 – $22.95 | 7 |
| Culture body fluid CPT 87070 | $60.22 | $162.75 | $9.12 – $56.64 | 7 |
| Culture fungi definitive id mold CPT 87107 | $27.10 | $73.25 | $10.94 – $25.11 | 7 |
| Culture fungi definitive id yeast CPT 87106 | $41.90 | $113.25 | $10.94 – $56.64 | 7 |
| Culture fungi other (except blood) CPT 87102 | $45.51 | $123.00 | $8.86 – $56.64 | 7 |
| Culture fungi skin/hair/nail CPT 87101 | $36.45 | $98.50 | $8.08 – $56.64 | 7 |
| Culture mycobacteria definitive id each isolate CPT 87118 | not published | not published | $11.47 – $113.14 | 7 |
| Culture mycoplasma any source CPT 87109 | $90.37 | $244.25 | $16.16 – $113.14 | 7 |
| Culture quantitative aerobic other source CPT 87071 | not published | not published | $9.90 – $56.64 | 7 |
| Culture screening strep group a CPT 87081 | $43.29 | $117.00 | $7.04 – $56.64 | 7 |
| Culture typing added method CPT 87158 | not published | not published | $5.47 – $113.14 | 7 |
| Culture typing immunologic CPT 87147 | $29.32 | $79.25 | $5.47 – $12.59 | 7 |
| Culture typing nucleic acid probe amplified per culture/isolate each organism CPT 87150 | not published | not published | $54.64 – $56.64 | 6 |
| Culture urine each isolate CPT 87088 | $17.48 | $47.25 | $7.62 – $14.96 | 7 |
| Culture virus isolation CPT 87250 | not published | not published | $20.59 – $113.14 | 7 |
| Curette/treat cornea CPT 65435 | $1,317.39 | $3,560.50 | $71.41 – $152.89 | 7 |
| Curette/treat cornea CPT 65436 | not published | not published | $370.95 – $813.56 | 7 |
| Cv line/pic reposition CPT 36597 | not published | not published | $69.50 – $114.96 | 7 |
| Cv stress test i&r only 93018 CPT 93018 | not published | not published | $16.54 – $27.21 | 7 |
| Cv stress test/supervision only 93016 CPT 93016 | not published | not published | $24.81 – $46.80 | 7 |
| Cyanocobalamin unsat binding capacity CPT 82608 | not published | not published | $15.11 – $108.04 | 7 |
| Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution HCPCS J3420 | $9.71 | $26.25 | $3.32 – $3.56 | 5 |
| Cyclic citrullinated peptide antibody CPT 86200 | $65.68 | $177.50 | $13.55 – $62.53 | 7 |
| Cyclophosphamide 25 mg capsule HCPCS J8530 | $22.40 | $60.55 | $1.58 – $1.70 | 5 |
| Cyclosporine 250 mg/5 ml intravenous solution HCPCS J7516 | $75.74 | $204.70 | $50.22 – $53.80 | 5 |
| Cyclosporine 2 hour CPT 80158 | $87.88 | $237.50 | $19.02 – $129.19 | 7 |
| Cyclosporine modified 25 mg capsule HCPCS J7515 | $1.30 | $3.50 | $1.34 – $1.44 | 5 |
| Cyclosporine oral 100 mg HCPCS J7502 | $263.81 | $713.00 | $5.00 – $5.36 | 5 |
| Cyp2c19 gene com variants CPT 81225 | $657.12 | $1,776.00 | $79.86 – $333.01 | 6 |
| Cyp2c9 gene com variants CPT 81227 | $318.85 | $861.75 | $79.86 – $199.79 | 6 |
| Cyp2d6 gene com variants CPT 81226 | not published | not published | $79.86 – $515.37 | 6 |
| Cyp3a4 gene common variants CPT 81230 | not published | not published | $198.41 – $283.19 | 6 |
| Cyp3a5 gene common variants CPT 81231 | not published | not published | $198.41 – $283.19 | 6 |
| Cystatin c CPT 82610 | $71.23 | $192.50 | $14.33 – $108.04 | 7 |
| Cystic fibrosis cftr CPT 81223 | $184.63 | $499.00 | $79.86 – $566.37 | 6 |
| Cystine urine quantitative CPT 82131 | $94.26 | $254.75 | $17.72 – $108.04 | 7 |
| Cysto cgen post urtl valves CPT 52400 | not published | not published | $538.99 – $1,011.69 | 7 |
| Cystogram >= 3 views supervision & interpretation CPT 74430 | $265.85 | $718.50 | $20.37 – $542.92 | 7 |
| Cystometrogram w/up 51727 CPT 51727 | not published | not published | $206.96 – $651.31 | 6 |
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.