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 |
|---|---|---|---|---|
| Cystorrhaphy wound comp 51865 CPT 51865 | not published | not published | $1,006.89 – $1,903.25 | 7 |
| Cystorrhaphy wound simple 51860 CPT 51860 | not published | not published | $835.81 – $1,585.79 | 7 |
| Cystoscopy and biopsy CPT 52007 | not published | not published | $187.22 – $351.79 | 7 |
| Cystoscopy and radiotracer CPT 52250 | not published | not published | $270.92 – $514.81 | 7 |
| Cystoscopy and treatment CPT 52214 | not published | not published | $200.70 – $374.41 | 7 |
| Cystoscopy and treatment CPT 52224 | not published | not published | $216.26 – $433.70 | 7 |
| Cystoscopy and treatment CPT 52234 | not published | not published | $278.74 – $521.06 | 7 |
| Cystoscopy and treatment CPT 52235 | not published | not published | $326.95 – $612.32 | 7 |
| Cystoscopy and treatment CPT 52240 | not published | not published | $444.43 – $832.27 | 7 |
| Cystoscopy and treatment CPT 52260 | not published | not published | $237.91 – $446.96 | 7 |
| Cystoscopy and treatment CPT 52265 | not published | not published | $183.23 – $348.66 | 7 |
| Cystoscopy and treatment CPT 52276 | not published | not published | $299.96 – $563.18 | 7 |
| Cystoscopy and treatment CPT 52277 | not published | not published | $366.39 – $692.66 | 7 |
| Cystoscopy and treatment CPT 52283 | not published | not published | $227.69 – $427.45 | 7 |
| Cystoscopy and treatment CPT 52285 | not published | not published | $221.31 – $416.53 | 7 |
| Cystoscopy and treatment CPT 52290 | not published | not published | $276.03 – $518.72 | 7 |
| Cystoscopy and treatment CPT 52300 | not published | not published | $317.64 – $606.08 | 7 |
| Cystoscopy and treatment CPT 52301 | not published | not published | $328.67 – $620.90 | 7 |
| Cystoscopy and treatment CPT 52305 | not published | not published | $316.21 – $591.25 | 7 |
| Cystoscopy and treatment CPT 52310 | not published | not published | $171.46 – $322.16 | 7 |
| Cystoscopy and treatment CPT 52315 | not published | not published | $311.04 – $581.89 | 7 |
| Cystoscopy and treatment CPT 52320 | not published | not published | $279.81 – $523.40 | 7 |
| Cystoscopy and treatment CPT 52330 | not published | not published | $299.07 – $560.05 | 7 |
| Cystoscopy (Bladder Scope) CPT 52000 | $605.78 | $1,637.25 | $113.10 – $267.55 | 7 |
| Cystoscopy chemodenervation CPT 52287 | not published | not published | $191.69 – $358.81 | 6 |
| Cystoscopy & duct catheter CPT 52010 | not published | not published | $187.22 – $351.02 | 7 |
| Cystoscopy implant stent CPT 52282 | not published | not published | $381.54 – $715.28 | 7 |
| Cystoscopy inject material CPT 52327 | not published | not published | $298.01 – $558.50 | 7 |
| Cystoscopy removal of clots CPT 52001 | $1,528.84 | $4,132.00 | $325.51 – $609.19 | 7 |
| Cystoscopy & revise urethra CPT 52270 | not published | not published | $205.75 – $386.11 | 7 |
| Cystoscopy & revise urethra CPT 52275 | not published | not published | $281.60 – $527.30 | 7 |
| Cystoscopy stone removal CPT 52325 | not published | not published | $364.19 – $681.74 | 7 |
| Cystoscopy & ureter catheter CPT 52005 | $1,757.59 | $4,750.25 | $150.26 – $282.37 | 7 |
| Cystostomy cystotomy w/drainage 51040 CPT 51040 | $976.15 | $2,638.25 | $321.94 – $608.42 | 7 |
| Cystotomy/cystostomy fulg+/insj radact matrl 51020 CPT 51020 | not published | not published | $524.04 – $989.07 | 7 |
| Cystotomy excise/incise/repair 51535 CPT 51535 | not published | not published | $878.12 – $1,645.85 | 7 |
| Cystouretero & or pyeloscope CPT 52351 | not published | not published | $343.19 – $655.22 | 7 |
| Cysto/uretero stricture tx CPT 52344 | not published | not published | $418.88 – $804.98 | 7 |
| Cystouretero w/biopsy CPT 52354 | not published | not published | $473.10 – $902.48 | 7 |
| Cystouretero w/excise tumor CPT 52355 | not published | not published | $530.44 – $1,010.12 | 7 |
| Cysto/uretero w/lithotripsy CPT 52356 | not published | not published | $471.66 – $851.00 | 6 |
| Cystouretero w/lithotripsy CPT 52353 | not published | not published | $444.43 – $848.67 | 7 |
| Cystouretero w/renal strict CPT 52346 | not published | not published | $506.11 – $970.34 | 7 |
| Cystouretero w/stone remove CPT 52352 | not published | not published | $401.25 – $769.10 | 7 |
| Cysto/uretero w/up stricture CPT 52345 | not published | not published | $447.19 – $858.80 | 7 |
| Cystourethro cut ejacul duct CPT 52402 | not published | not published | $303.48 – $566.29 | 7 |
| Cystourethroscop/calib/dilat stric 52281 CPT 52281 | $999.19 | $2,700.50 | $171.88 – $322.93 | 7 |
| Cystourethroscopy w/biopsy(s) 52204 CPT 52204 | not published | not published | $159.97 – $300.31 | 7 |
| Cystourethro w/addl implant 52442 CPT 52442 | not published | not published | $68.74 – $1,628.52 | 6 |
| Cystourethro w/implant CPT 52441 | not published | not published | $257.68 – $2,122.38 | 6 |
| Cysto w/renal stricture tx CPT 52343 | not published | not published | $389.85 – $741.03 | 7 |
| Cysto w/up stricture tx CPT 52342 | not published | not published | $350.51 – $666.14 | 7 |
| Cysto w/ureter stricture tx CPT 52341 | $2,708.31 | $7,319.75 | $321.84 – $612.32 | 7 |
| Cytarabine 20 mg/ml injection solution HCPCS J9100 | $28.25 | $76.35 | $1.50 – $1.60 | 5 |
| Cytogenetics 25-99 CPT 88274 | not published | not published | $36.74 – $79.86 | 7 |
| Cytogenetics 3-5 CPT 88272 | not published | not published | $28.14 – $79.86 | 7 |
| Cytogenomic neo microra alys CPT 81277 | not published | not published | $1,316.60 – $1,316.60 | 1 |
| Cytogenom microarray copy nmbr var CPT 81228 | $629.65 | $1,701.75 | $79.86 – $1,021.50 | 6 |
| Cytomegalovirus (cmv) antibody igg CPT 86644 | $49.03 | $132.50 | $15.11 – $79.86 | 7 |
| Cytomegalovirus (cmv) antibody igm CPT 86645 | $49.40 | $133.50 | $17.72 – $79.86 | 7 |
| Cytomegalovirus dfa CPT 87271 | not published | not published | $12.77 – $62.53 | 7 |
| Cytomegalovirus imm IV /vial HCPCS J0850 | $941.58 | $2,544.80 | $1,606.89 – $1,721.67 | 5 |
| Cyto/molecular report CPT 88291 | $235.90 | $637.57 | $22.84 – $79.86 | 7 |
| Cytopath c/v auto in fluid CPT 88174 | not published | not published | $18.11 – $85.19 | 7 |
| Cytopath c/v index add-on CPT 88155 | not published | not published | $6.25 – $85.19 | 7 |
| Cytopath fl nongyn filter CPT 88106 | not published | not published | $22.24 – $113.79 | 7 |
| Cytopathology cellular enhancement technique non-gyn CPT 88112 | $47.64 | $128.75 | $32.18 – $113.79 | 7 |
| Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review CPT 88175 | not published | not published | $22.83 – $85.19 | 7 |
| Cytopathology cervical/vaginal thin layer manual screening CPT 88142 | not published | not published | $18.74 – $85.19 | 7 |
| Cytopathology concentration technique smears & interpretation CPT 88108 | $48.56 | $131.25 | $22.24 – $113.79 | 7 |
| Cytopathology fluids/washings/brushings smears with interpretation CPT 88104 | $40.70 | $110.00 | $22.24 – $113.79 | 7 |
| Cytopathology fna adequacy evaluation each separate additional episode same site CPT 88177 | $27.29 | $73.75 | $7.55 – $54.42 | 6 |
| Cytopathology fna adequacy evaluation first episode each site CPT 88172 | $26.92 | $72.75 | $16.02 – $113.79 | 7 |
| Cytopathology fna adequacy evaluation first episode each site interp/rpt CPT 88173 | $73.26 | $198.00 | $45.73 – $113.79 | 7 |
| Cytopath smear other source CPT 88160 | $41.07 | $111.00 | $19.15 – $113.79 | 7 |
| Cytopath smear other source CPT 88162 | $55.50 | $150.00 | $28.53 – $113.79 | 7 |
| Cytopath smear oth prep screen & interp CPT 88161 | $32.75 | $88.50 | $19.62 – $113.79 | 7 |
| Cytopath tbs c/v manual CPT 88164 | not published | not published | $11.20 – $85.19 | 7 |
| Cytotoxic antibody screening CPT 86807 | $184.63 | $499.00 | $41.69 – $61.62 | 7 |
| Cytotoxic antibody screening CPT 86808 | not published | not published | $31.27 – $49.47 | 7 |
| Cytp urine 3-5 probes cmptr CPT 88121 | not published | not published | $195.81 – $502.27 | 6 |
| Dacarbazine 100 mg intravenous solution HCPCS J9130 | $29.80 | $80.55 | $6.34 – $6.79 | 5 |
| Dactinomycin 0.5 mg intravenous solution HCPCS J9120 | $803.44 | $2,171.45 | $1,023.46 – $1,096.56 | 5 |
| Dalbavancin 500 mg intravenous solution HCPCS J0875 | $2,077.81 | $5,615.70 | $21.28 – $22.80 | 5 |
| Dalteparin sodium HCPCS J1645 | $55.19 | $149.15 | $20.86 – $22.35 | 5 |
| Daptomycin 500 mg/10 ml intravenous solution HCPCS J0878 | $0.58 | $1.57 | $0.88 – $0.88 | 5 |
| Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe HCPCS J0881 | $556.33 | $1,503.60 | $5.82 – $6.24 | 5 |
| Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution HCPCS J9153 | $11,312.75 | $30,575.00 | $259.07 – $259.07 | 3 |
| Daunorubicin 5 mg/ml intravenous solution HCPCS J9150 | $130.13 | $351.70 | $15.24 – $44.35 | 6 |
| D&c after delivery 59160 CPT 59160 | not published | not published | $193.77 – $371.30 | 7 |
| D&c/diagnostic/therapeutic/non ob 58120 CPT 58120 | not published | not published | $241.79 – $471.13 | 7 |
| Dch glucoscan CPT 82948 | not published | not published | $3.39 – $20.23 | 7 |
| Dch pulmonary stress test CPT 94621 | $246.61 | $666.50 | $87.07 – $343.98 | 7 |
| Dch validity tests CPT 81002 | $18.59 | $50.25 | $2.61 – $20.23 | 7 |
| Dcm pq ndl dsk sgl/mlt lv lmbr w/guide CPT 62287 | not published | not published | $620.72 – $1,213.72 | 7 |
| Dcmprn orbit only transcrnl CPT 61330 | not published | not published | $1,755.28 – $3,860.32 | 7 |
| Dcmprn plantar digital nerve CPT 64726 | not published | not published | $302.10 – $585.80 | 7 |
| D&c of cervical stump CPT 57558 | not published | not published | $124.10 – $244.93 | 7 |
| Debr g/per/abd wall 11006 CPT 11006 | not published | not published | $798.10 – $1,503.88 | 7 |
| Debrid ecz/inf skin up tp 10% body 11000 CPT 11000 | $555.65 | $1,501.75 | $32.38 – $61.63 | 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.