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 |
|---|---|---|---|---|
| Fundus photography with i&r 92250 CPT 92250 | not published | not published | $27.30 – $143.53 | 7 |
| Fuse bile ducts and bowel 47785 CPT 47785 | not published | not published | $3,438.51 – $6,885.23 | 7 |
| Fuse pancreas cyst and bowel 48520 CPT 48520 | not published | not published | $1,188.77 – $2,325.23 | 7 |
| Fusion/graft of finger joint CPT 26862 | not published | not published | $764.17 – $1,499.98 | 7 |
| Fusion/graft of hand joint CPT 26844 | not published | not published | $866.20 – $1,690.30 | 7 |
| Fusion of ankle joint open CPT 27870 | not published | not published | $1,140.92 – $2,202.77 | 7 |
| Fusion of big toe joint CPT 28750 | not published | not published | $651.35 – $1,275.33 | 7 |
| Fusion of big toe joint CPT 28755 | not published | not published | $365.49 – $706.70 | 7 |
| Fusion of finger joint CPT 26860 | not published | not published | $581.00 – $1,163.79 | 7 |
| Fusion of finger tendons CPT 26471 | not published | not published | $640.88 – $1,271.44 | 7 |
| Fusion of finger tendons CPT 26474 | not published | not published | $613.35 – $1,222.28 | 7 |
| Fusion of foot bones CPT 28730 | not published | not published | $809.95 – $1,567.06 | 7 |
| Fusion of foot bones CPT 28735 | not published | not published | $870.18 – $1,675.49 | 7 |
| Fusion of foot bones CPT 28740 | not published | not published | $689.73 – $1,336.96 | 7 |
| Fusion of hand joint CPT 26843 | not published | not published | $774.43 – $1,533.52 | 7 |
| Fusion of knuckle CPT 26850 | not published | not published | $732.21 – $1,431.33 | 7 |
| Fusion of knuckle joint CPT 26516 | not published | not published | $740.63 – $1,452.40 | 7 |
| Fusion of knuckle joints CPT 26517 | not published | not published | $838.52 – $1,703.56 | 7 |
| Fusion of knuckle joints CPT 26518 | not published | not published | $882.71 – $1,738.66 | 7 |
| Fusion of knuckle with graft CPT 26852 | not published | not published | $843.14 – $1,643.49 | 7 |
| Fusion of spermatic ducts CPT 54900 | not published | not published | $938.38 – $1,670.81 | 7 |
| Fusion of spermatic ducts CPT 54901 | not published | not published | $1,189.12 – $2,205.11 | 7 |
| Fusion of tendons at wrist CPT 25300 | not published | not published | $741.14 – $1,450.06 | 7 |
| Fusion of tendons at wrist CPT 25301 | not published | not published | $704.94 – $1,354.12 | 7 |
| Fusion of thumb CPT 26841 | not published | not published | $767.29 – $1,511.67 | 7 |
| Fusion of tibiofibular joint CPT 27871 | not published | not published | $753.82 – $1,458.65 | 7 |
| Fusion of toes CPT 28280 | not published | not published | $387.44 – $755.84 | 7 |
| G6pc gene CPT 81250 | $314.78 | $850.75 | $66.39 – $79.86 | 6 |
| G6pd full gene sequence CPT 81249 | not published | not published | $681.00 – $972.00 | 6 |
| G6pd gene alys cmn variant CPT 81247 | not published | not published | $198.41 – $283.19 | 6 |
| G6pd known familial variant CPT 81248 | not published | not published | $425.91 – $607.90 | 6 |
| Gadobutrol 1 mmol/ml intravenous solution (wrapper) HCPCS A9585 | $0.74 | $2.00 | $0.66 – $0.70 | 5 |
| Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper) HCPCS A9579 | $9.25 | $25.00 | $3.12 – $3.35 | 5 |
| Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution HCPCS A9575 | $2.16 | $5.85 | $0.67 – $0.72 | 5 |
| Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution HCPCS A9581 | $31.52 | $85.20 | $21.46 – $23.00 | 5 |
| Galac-1-phosphate uridyltran - sendout CPT 82775 | $96.94 | $262.00 | $22.15 – $108.04 | 7 |
| Galactokinase - sendout CPT 82759 | not published | not published | $22.67 – $108.04 | 7 |
| Galactose transferase test CPT 82776 | not published | not published | $8.86 – $108.04 | 7 |
| Galectin-3 CPT 82777 | not published | not published | $34.24 – $108.04 | 6 |
| Gallbladder Removal (Laparoscopic) CPT 47562 | not published | not published | $735.82 – $1,397.79 | 7 |
| Gamma globulin 1 cc inj HCPCS J1460 | $29.56 | $79.90 | $38.01 – $40.73 | 5 |
| Gammaglobulin iga CPT 82784 | $72.15 | $195.00 | $9.90 – $22.62 | 7 |
| Gammaglobulin ige CPT 82785 | $58.18 | $157.25 | $17.46 – $40.08 | 7 |
| Gamma glutamyltransferase CPT 82977 | $49.03 | $132.50 | $7.56 – $33.65 | 7 |
| Gamunex-c/gammaked HCPCS J1561 | $140.60 | $380.00 | $63.03 – $67.53 | 5 |
| Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr HCPCS J1570 | $131.15 | $354.45 | $114.27 – $122.43 | 5 |
| Gardner vag dna quant CPT 87512 | $63.27 | $171.00 | $19.90 – $113.14 | 7 |
| Gastric analy w/ph ea spec CPT 82930 | not published | not published | $8.48 – $108.04 | 6 |
| Gastric emptying imag study CPT 78265 | not published | not published | $333.80 – $719.61 | 6 |
| Gastric emptying imag study CPT 78266 | not published | not published | $429.72 – $852.43 | 6 |
| Gastric motility studies CPT 91020 | not published | not published | $93.89 – $510.91 | 7 |
| Gastric mucosa imaging CPT 78261 | not published | not published | $43.60 – $517.93 | 7 |
| Gastrin test CPT 82938 | not published | not published | $18.76 – $111.67 | 7 |
| Gastroesophageal reflux study CPT 78262 | not published | not published | $42.33 – $514.04 | 7 |
| Gastroesophageal reflux test CPT 91034 | not published | not published | $63.58 – $406.38 | 7 |
| Gastrojejunostomy;w/o vagotomy 43820 CPT 43820 | not published | not published | $1,427.07 – $2,850.19 | 7 |
| Gastrostomy open neonatal CPT 43831 | not published | not published | $622.06 – $1,265.97 | 7 |
| Gated heart multiple CPT 78473 | not published | not published | $96.59 – $609.19 | 7 |
| Gba gene CPT 81251 | not published | not published | $53.63 – $79.86 | 6 |
| Gemcitabine 1 gram intravenous solution HCPCS J9201 | $184.50 | $498.65 | $11.73 – $12.57 | 5 |
| Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln HCPCS J9203 | $10,030.70 | $27,110.00 | $260.22 – $278.81 | 5 |
| General health panel CPT 80050 | $161.14 | $435.50 | $29.19 – $109.05 | 6 |
| Genetic tstg severe inh cond CPT 81443 | $1,358.64 | $3,672.00 | $2,779.12 – $2,779.12 | 1 |
| Genioplasty augmentation CPT 21120 | not published | not published | $518.75 – $1,055.37 | 7 |
| Geniop sldg augmentation CPT 21123 | not published | not published | $933.88 – $1,861.13 | 7 |
| Geniop sldg osteot 1 CPT 21121 | not published | not published | $702.73 – $1,357.23 | 7 |
| Geniop sldg osteot 2/> CPT 21122 | not published | not published | $725.34 – $1,489.85 | 7 |
| Genome sequence analysis CPT 81425 | not published | not published | $5,710.41 – $5,710.41 | 1 |
| Gentamicin 10 mg/ml liquid compound - enteral use only HCPCS J1580 | $10.93 | $29.55 | $2.13 – $2.28 | 5 |
| Gentamicin peak therapeutic drug level CPT 80170 | $88.43 | $239.00 | $17.20 – $39.88 | 7 |
| G-esoph reflx tst w/electrod CPT 91035 | not published | not published | $103.81 – $1,048.34 | 7 |
| Ghs abscess perianal iandd CPT 46050 | $1,410.90 | $3,813.25 | $98.31 – $209.82 | 7 |
| Ghs abscess postoperative iandd complex CPT 10180 | $1,244.68 | $3,364.00 | $190.85 – $378.31 | 7 |
| Ghs acetylcholinesterase, rbc CPT 82482 | $44.12 | $119.25 | $8.08 – $108.04 | 7 |
| Ghs alcohol, methyl (methanol)-medtox CPT 84600 | $103.14 | $278.75 | $16.94 – $108.04 | 7 |
| Ghs alpha thalasemia, 7 deletions CPT 81257 | $213.03 | $575.75 | $79.86 – $116.07 | 6 |
| Ghs analysis neurostim without reprogramming CPT 95970 | $62.72 | $169.50 | $26.98 – $44.90 | 7 |
| Ghs antibodies (torch) igm CPT 86694 | $49.03 | $132.50 | $15.11 – $35.02 | 7 |
| Ghs aspiration bladder - needle CPT 51100 | not published | not published | $44.41 – $72.11 | 7 |
| Ghs bladder cath - complex-foley CPT 51703 | $190.55 | $515.00 | $86.94 – $150.33 | 7 |
| Ghs bleeding time (ivy) CPT 85002 | not published | not published | $4.69 – $38.30 | 7 |
| Ghs block ilioinguinal/gentitofemoral CPT 64425 | not published | not published | $104.82 – $206.71 | 7 |
| Ghs central line insert < age 5, failed CPT 36555 | $1,030.45 | $2,785.00 | $122.11 – $258.96 | 7 |
| Ghs change cysto/gastrost CPT 43762 | $413.29 | $1,117.00 | $374.51 – $374.51 | 3 |
| Ghs chemo >8 hrs CPT 96416 | $187.13 | $505.75 | $142.25 – $281.58 | 7 |
| Ghs chemo infusion >8 hrs CPT 96425 | $156.60 | $423.25 | $186.65 – $365.05 | 7 |
| Ghs chemo IV push, ea addtl CPT 96411 | $76.87 | $207.75 | $64.22 – $124.80 | 7 |
| Ghs chlamydia pneumoniae by pcr (arup) (306630) CPT 87486 | $164.84 | $445.50 | $37.00 – $113.14 | 7 |
| Ghs closd tx interphalang jt disloc w/ma CPT 26770 | $223.76 | $604.75 | $250.32 – $544.45 | 7 |
| Ghs closed reduction ankle dislocation CPT 27840 | $541.96 | $1,464.75 | $375.42 – $794.85 | 7 |
| Ghs closed tx bimalleolar fracture w/manip CPT 27810 | $2,628.48 | $7,104.00 | $456.82 – $906.39 | 7 |
| Ghs closed tx radiocarpal disloc w manip CPT 25660 | not published | not published | $420.53 – $865.04 | 7 |
| Ghs closed tx tibial fracture w/manip CPT 27752 | $2,856.96 | $7,721.50 | $529.67 – $1,048.34 | 7 |
| Ghs closure surg wound/dehiscence-13160 CPT 13160 | $2,433.40 | $6,576.75 | $886.96 – $1,721.50 | 7 |
| Ghs clsd red med malleolus fx without manip CPT 27760 | $404.41 | $1,093.00 | $304.06 – $645.07 | 7 |
| Ghs clsd red med malleolus fx w manip CPT 27762 | $3,066.01 | $8,286.50 | $466.35 – $921.20 | 7 |
| Ghs clsd tx frac distal tibia w/manipulation CPT 27825 | $3,347.95 | $9,048.50 | $539.50 – $1,042.89 | 7 |
| Ghs cl tx knee disl; wo anesth CPT 27550 | $603.19 | $1,630.25 | $483.87 – $978.15 | 7 |
| Ghs cl tx metacarpophal disloc without anes CPT 26700 | $393.40 | $1,063.25 | $300.82 – $563.25 | 7 |
| Ghs community re-entry 15 minutes CPT 97537 | $42.55 | $115.00 | $32.55 – $63.97 | 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.