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 |
|---|---|---|---|---|
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $33.23 | $89.80 | $9.03 – $9.68 | 5 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | $32.38 | $87.50 | $6.31 – $6.76 | 5 |
| Dolasetron mesylate HCPCS J1260 | $33.30 | $90.00 | $8.53 – $9.13 | 5 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $31.45 | $85.00 | $0.87 – $0.93 | 5 |
| Doppler echo complete CPT 93320 | not published | not published | $25.28 – $92.04 | 7 |
| Doppler intravascular pressure flow initial vessel CPT 93571 | not published | not published | $121.63 – $191.11 | 6 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $280.46 | $758.00 | $28.25 – $254.41 | 7 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $194.71 | $526.25 | $15.50 – $163.26 | 7 |
| Doripenem 50 mg/ml inj 10 ml HCPCS J1267 | $70.91 | $191.65 | $0.94 – $1.00 | 5 |
| Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 | $87.26 | $235.85 | $4.91 – $5.26 | 5 |
| Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension HCPCS Q2050 | $2,469.31 | $6,673.80 | $813.82 – $871.95 | 5 |
| Dpyd gene common variants CPT 81232 | not published | not published | $198.41 – $283.19 | 6 |
| Drainage absc/cyst/hmtma/vestibule mouth smpl CPT 40800 | $579.70 | $1,566.75 | $133.74 – $283.92 | 7 |
| Drainage ext aud canal abscess 69020 CPT 69020 | not published | not published | $151.97 – $306.56 | 7 |
| Drainage external ear complex 69005 CPT 69005 | not published | not published | $171.57 – $338.53 | 7 |
| Drainage external ear simple 69000 CPT 69000 | $579.70 | $1,566.75 | $126.25 – $258.19 | 7 |
| Drainage lymph node lesion 38300 CPT 38300 | $1,062.27 | $2,871.00 | $196.35 – $397.03 | 7 |
| Drainage lymph node lesion 38305 CPT 38305 | not published | not published | $503.55 – $987.50 | 7 |
| Drainage mouth roof lesion CPT 42000 | $315.33 | $852.25 | $111.16 – $248.04 | 7 |
| Drainage of arm bursa 23931 CPT 23931 | $228.48 | $617.50 | $167.62 – $336.97 | 7 |
| Drainage of bladder abscess CPT 51080 | not published | not published | $458.19 – $861.14 | 7 |
| Drainage of eye CPT 65800 | $1,095.20 | $2,960.00 | $100.84 – $200.47 | 7 |
| Drainage of eye CPT 65810 | $3,667.81 | $9,913.00 | $464.60 – $1,004.67 | 7 |
| Drainage of eye CPT 65815 | not published | not published | $471.74 – $1,044.45 | 7 |
| Drainage of forearm bursa CPT 25031 | not published | not published | $394.38 – $733.99 | 7 |
| Drainage of kidney lesion CPT 50390 | $685.43 | $1,852.50 | $109.78 – $208.26 | 7 |
| Drainage of mouth lesion CPT 41005 | not published | not published | $134.88 – $273.79 | 7 |
| Drainage of mouth lesion CPT 41006 | not published | not published | $280.85 – $568.63 | 7 |
| Drainage of mouth lesion CPT 41007 | not published | not published | $272.31 – $531.19 | 7 |
| Drainage of mouth lesion CPT 41008 | not published | not published | $291.32 – $577.21 | 7 |
| Drainage of mouth lesion CPT 41009 | not published | not published | $315.93 – $627.92 | 7 |
| Drainage of mouth lesion CPT 41015 | not published | not published | $361.28 – $744.14 | 7 |
| Drainage of mouth lesion CPT 41016 | not published | not published | $374.87 – $756.63 | 7 |
| Drainage of mouth lesion CPT 41017 | not published | not published | $376.47 – $755.06 | 7 |
| Drainage of mouth lesion CPT 41018 | not published | not published | $442.72 – $890.00 | 7 |
| Drainage of nose lesion int 30000 CPT 30000 | $326.80 | $883.25 | $126.51 – $254.28 | 7 |
| Drainage of nose lesion sept 30020 CPT 30020 | $425.59 | $1,150.25 | $127.31 – $255.06 | 7 |
| Drainage of pelvis bursa CPT 26991 | not published | not published | $564.68 – $1,107.63 | 7 |
| Drainage of pelvis lesion 26990 CPT 26990 | not published | not published | $665.69 – $1,319.02 | 7 |
| Drainage of prostate abscess CPT 52700 | not published | not published | $495.03 – $929.01 | 7 |
| Drainage of prostate abscess CPT 55720 | not published | not published | $506.63 – $953.19 | 7 |
| Drainage of prostate abscess CPT 55725 | not published | not published | $728.47 – $1,251.94 | 7 |
| Drainage of rectal abscess CPT 45005 | $1,318.50 | $3,563.50 | $164.09 – $338.53 | 7 |
| Drainage of rectal abscess 45020 CPT 45020 | not published | not published | $583.59 – $1,216.83 | 7 |
| Drainage of salivary gland CPT 42305 | not published | not published | $478.87 – $927.44 | 7 |
| Drainage of salivary gland CPT 42320 | not published | not published | $192.86 – $382.22 | 7 |
| Drainage of throat abscess CPT 42725 | not published | not published | $908.20 – $1,752.70 | 7 |
| Drainage of urethra abscess CPT 53040 | $2,186.61 | $5,909.75 | $439.06 – $827.60 | 7 |
| Drainage of urethra abscess 53060 CPT 53060 | not published | not published | $183.42 – $348.66 | 7 |
| Drainage of urinary leakage CPT 53080 | not published | not published | $469.25 – $885.32 | 7 |
| Drainage of urinary leakage CPT 53085 | not published | not published | $738.14 – $1,390.77 | 7 |
| Drain bladder by trocar/cath CPT 51101 | not published | not published | $58.87 – $97.95 | 7 |
| Drain blood from under nail 11740 CPT 11740 | $64.29 | $173.75 | $34.47 – $68.65 | 7 |
| Drain cath image guided peri/retroperitoneal transvag/transrectal CPT 49407 | not published | not published | $241.31 – $472.69 | 6 |
| Drain cath image guided visceral pq CPT 49405 | $817.05 | $2,208.25 | $226.78 – $443.05 | 6 |
| Drain cerebro spinal fluid 62272 CPT 62272 | $735.84 | $1,988.75 | $94.01 – $179.41 | 7 |
| Drain chest lesion CPT 21502 | not published | not published | $562.42 – $1,071.75 | 7 |
| Drain chst dry seal exp thorastat HCPCS A7041 | $58.28 | $157.50 | $148.45 – $148.45 | 1 |
| Drain finger abscess;simple 26010 CPT 26010 | $211.36 | $571.25 | $140.21 – $293.29 | 7 |
| Drain lower leg bursa CPT 27604 | not published | not published | $371.23 – $721.52 | 7 |
| Drain lower leg lesion 27603 CPT 27603 | not published | not published | $421.23 – $833.06 | 7 |
| Drain neck/chest lesion 21501 CPT 21501 | not published | not published | $338.36 – $686.42 | 7 |
| Drain open lung lesion 32200 CPT 32200 | not published | not published | $1,265.75 – $2,436.00 | 7 |
| Drain ovarn cyst abd CPT 58805 | not published | not published | $444.93 – $869.72 | 7 |
| Drain ovary abscess open CPT 58820 | not published | not published | $354.25 – $672.38 | 7 |
| Drain pancreatic pseudocyst 48510 CPT 48510 | not published | not published | $1,160.16 – $2,300.28 | 7 |
| Drain penis lesion CPT 54015 | $294.89 | $797.00 | $345.61 – $652.10 | 7 |
| Drain shoulder bone lesion CPT 23035 | not published | not published | $746.44 – $1,436.80 | 7 |
| Drain shoulder bursa 23031 CPT 23031 | not published | not published | $231.40 – $461.77 | 7 |
| Drain shoulder lesion CPT 23030 | not published | not published | $280.07 – $541.34 | 7 |
| Drain thigh/knee lesion 27301 CPT 27301 | not published | not published | $537.79 – $1,060.83 | 7 |
| Drain thyroid/tongue cyst CPT 60000 | not published | not published | $155.80 – $331.51 | 7 |
| Drain to peritoneal cavity CPT 49062 | not published | not published | $824.34 – $1,571.74 | 7 |
| Dress/debride pt-tck burn/5-10% bs 16025 CPT 16025 | $162.15 | $438.25 | $123.51 – $208.16 | 7 |
| Dress/debride pt-thick burn/<5% bs 16020 CPT 16020 | $148.93 | $402.50 | $59.17 – $100.68 | 7 |
| Dress/debrid prtl-thick burn l 16030 CPT 16030 | $220.61 | $596.25 | $146.03 – $247.60 | 7 |
| Dressing change not for burn w/anes 15852 CPT 15852 | not published | not published | $52.74 – $99.85 | 7 |
| Drill hole evac+/drg subdural hematoma 61108 CPT 61108 | not published | not published | $937.30 – $1,908.70 | 7 |
| Drill hole implt ventricular cath/device 61107 CPT 61107 | $1,577.31 | $4,263.00 | $355.18 – $659.12 | 7 |
| Drng appendix abscess open 44900 CPT 44900 | not published | not published | $826.82 – $1,648.96 | 7 |
| Drng hand tendon sheath 26020 CPT 26020 | $1,334.22 | $3,606.00 | $451.76 – $795.21 | 7 |
| Drng of eyelid abscess 67700 CPT 67700 | $529.10 | $1,430.00 | $114.91 – $251.95 | 7 |
| Drng of finger abscess comp 26011 CPT 26011 | $1,468.35 | $3,968.50 | $196.22 – $389.24 | 7 |
| Drng of hydrocele 55000 CPT 55000 | not published | not published | $95.37 – $179.41 | 7 |
| Drng of mouth lesion 40801 CPT 40801 | not published | not published | $236.02 – $477.37 | 7 |
| Drng of ovarian cyst(s) 58800 CPT 58800 | not published | not published | $325.48 – $641.96 | 7 |
| Drng of palm multi bursas 26030 CPT 26030 | not published | not published | $524.70 – $1,035.08 | 7 |
| Drng of palm single bursa 26025 CPT 26025 | not published | not published | $442.42 – $888.45 | 7 |
| Drng of pelvic abscess transrectal 45000 CPT 45000 | not published | not published | $445.87 – $905.60 | 7 |
| Drng of salivary cyst 42409 CPT 42409 | not published | not published | $244.94 – $482.84 | 7 |
| Drng of scrotum abscess 55100 CPT 55100 | $1,468.35 | $3,968.50 | $183.73 – $352.57 | 7 |
| Drng open retroperitoneal abscess 49060 CPT 49060 | not published | not published | $1,215.59 – $2,340.06 | 7 |
| Drng open subdiaphragmatic/subphrenic absc 49040 CPT 49040 | not published | not published | $1,086.01 – $2,137.25 | 7 |
| Drng ovary abscess perqt 58822 CPT 58822 | not published | not published | $769.85 – $1,597.48 | 7 |
| Drng peritoneal abscess open 49020 CPT 49020 | not published | not published | $1,734.89 – $3,384.51 | 7 |
| Drng salivary gland simple 42300 CPT 42300 | $957.38 | $2,587.50 | $166.27 – $331.51 | 7 |
| Drng salivary gland submax/subling 42310 CPT 42310 | not published | not published | $135.69 – $274.56 | 7 |
| Droperidol 2.5 mg/ml injection solution HCPCS J1790 | $19.15 | $51.75 | $3.39 – $3.63 | 5 |
| Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm HCPCS Q4102 | $22.68 | $61.30 | $4.78 – $16.45 | 6 |
| Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm HCPCS Q4124 | $31.39 | $84.85 | $16.97 – $18.18 | 5 |
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.