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 |
|---|---|---|---|---|
| Leukocyte phagocytosis CPT 86344 | not published | not published | $8.34 – $79.86 | 7 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | $8,124.05 | $21,956.90 | $214.57 – $355.05 | 6 |
| Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 | $4,175.52 | $11,285.20 | $1,186.33 – $1,271.07 | 5 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $0.11 | $0.31 | $0.21 – $0.23 | 5 |
| Levetiracetam therapeutic drug level CPT 80177 | $70.39 | $190.25 | $20.63 – $129.19 | 6 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $34.00 | $91.90 | $4.19 – $4.49 | 5 |
| Lidocaine therapeutic drug level CPT 80176 | $59.29 | $160.25 | $15.37 – $129.19 | 7 |
| Ligate leg veins open CPT 37761 | not published | not published | $620.58 – $1,200.46 | 6 |
| Ligate leg veins radical 37760 CPT 37760 | not published | not published | $696.71 – $1,332.28 | 7 |
| Ligate oviduct(s) add-on 58611 CPT 58611 | not published | not published | $85.77 – $168.49 | 7 |
| Ligate/strip long leg vein CPT 37722 | not published | not published | $540.00 – $1,056.92 | 7 |
| Ligate/strip short leg vein CPT 37718 | not published | not published | $484.52 – $962.55 | 7 |
| Ligate/transect fallopian tubes 58600 CPT 58600 | not published | not published | $398.92 – $787.83 | 7 |
| Ligation/biopsy of temporal artery 37609 CPT 37609 | $1,044.33 | $2,822.50 | $227.50 – $451.64 | 7 |
| Ligation/divis of long saph vein 37700 CPT 37700 | not published | not published | $278.76 – $549.92 | 7 |
| Ligation external carotid artery 37600 CPT 37600 | not published | not published | $803.28 – $1,539.76 | 7 |
| Ligation internal/common carotid artery 37605 CPT 37605 | not published | not published | $897.34 – $1,767.52 | 7 |
| Ligation internal jugular vein 37565 CPT 37565 | not published | not published | $817.14 – $1,653.64 | 7 |
| Ligation/major artery/extremity 37618 CPT 37618 | $1,044.42 | $2,822.75 | $430.20 – $843.20 | 7 |
| Ligation major artery neck CPT 37615 | not published | not published | $548.94 – $1,111.53 | 7 |
| Ligation nasal sinus artery CPT 30915 | not published | not published | $622.50 – $1,232.43 | 7 |
| Ligation of abdomen artery 37617 CPT 37617 | not published | not published | $1,518.64 – $2,903.24 | 7 |
| Ligation of femoral vein CPT 37650 | not published | not published | $527.21 – $1,017.93 | 7 |
| Ligation of inf vena cava CPT 37619 | not published | not published | $1,873.07 – $3,666.09 | 6 |
| Ligation of neck artery CPT 37606 | not published | not published | $585.65 – $1,238.68 | 7 |
| Ligation of salivary duct CPT 42665 | not published | not published | $226.50 – $450.07 | 7 |
| Ligation upper jaw artery CPT 30920 | not published | not published | $901.35 – $1,785.46 | 7 |
| Ligation vericose vein cluster(s) 1 leg CPT 37785 | $3,071.93 | $8,302.50 | $293.67 – $573.31 | 7 |
| Lig/band angioaccess av fistula CPT 37607 | not published | not published | $424.85 – $828.39 | 7 |
| Lig&div&compl strpg saph vn CPT 37735 | not published | not published | $666.43 – $1,402.47 | 7 |
| Limb exercise test CPT 95875 | not published | not published | $40.42 – $263.64 | 7 |
| Limited visual field xm CPT 92081 | not published | not published | $17.97 – $62.58 | 7 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $64.58 | $174.54 | $64.36 – $68.95 | 5 |
| Lipase CPT 83690 | $44.68 | $120.75 | $7.30 – $16.75 | 7 |
| Lip exc/transverse wedge/w closure 40510 CPT 40510 | not published | not published | $388.09 – $764.42 | 7 |
| Lipoprotein blood high res frac & quant CPT 83701 | not published | not published | $26.06 – $108.04 | 7 |
| Lipoprotein blood quant CPT 83704 | $40.05 | $108.25 | $33.35 – $108.04 | 7 |
| Lipoprotein direct measurement hdl CPT 83718 | $36.72 | $99.25 | $8.60 – $60.18 | 7 |
| Lipoprotein direct measurement ldl CPT 83721 | $29.79 | $80.50 | $10.16 – $60.18 | 7 |
| Lipoprtn dir meas sd ldl chl CPT 83722 | not published | not published | $36.82 – $38.81 | 4 |
| Lip surgery procedure CPT 40799 | not published | not published | $4,162.07 – $4,162.07 | 5 |
| Listeria monocytogenes CPT 86723 | not published | not published | $13.81 – $79.86 | 7 |
| Lithium therapeutic drug level CPT 80178 | $45.51 | $123.00 | $7.04 – $16.09 | 7 |
| Liver abs/cyst dr opn 1-2 stge CPT 47010 | not published | not published | $1,297.06 – $2,556.90 | 7 |
| Liver elastography 91200 CPT 91200 | not published | not published | $25.15 – $63.27 | 6 |
| Liver Function Test CPT 80076 | $44.31 | $119.75 | $8.60 – $109.05 | 7 |
| Liver hem/re-expl wnd/remove pack 47362 CPT 47362 | not published | not published | $1,546.03 – $3,075.62 | 7 |
| Liver imaging CPT 78201 | not published | not published | $27.20 – $380.65 | 7 |
| Liver imag w/vasclr flow CPT 78202 | not published | not published | $31.67 – $418.87 | 7 |
| Liver/spleen imag static only CPT 78215 | not published | not published | $30.74 – $399.37 | 7 |
| Liver/spleen imag w/vasclr flow CPT 78216 | not published | not published | $35.68 – $254.28 | 7 |
| Lmtd oph exam general anes CPT 92019 | not published | not published | $79.04 – $150.55 | 7 |
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | not published | not published | $511.34 – $989.84 | 7 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $1.55 | $4.20 | $1.74 – $1.86 | 5 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $13.56 | $36.65 | $1.16 – $1.25 | 5 |
| Loudness balance test CPT 92562 | not published | not published | $24.29 – $95.94 | 7 |
| Low back disk surgery CPT 63030 | not published | not published | $1,045.75 – $2,035.86 | 7 |
| Low cost skin substitute app HCPCS C5273 | $2,147.57 | $5,804.25 | $4,252.27 – $4,252.27 | 5 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $715.30 | $1,933.25 | $80.04 – $638.84 | 7 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $902.80 | $2,440.00 | $77.00 – $535.87 | 7 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $843.69 | $2,280.25 | $73.00 – $428.23 | 7 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $1,396.84 | $3,775.25 | $147.87 – $1,124.00 | 7 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $1,054.87 | $2,851.00 | $112.11 – $963.32 | 7 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $924.82 | $2,499.50 | $92.97 – $765.19 | 7 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $148.46 | $401.25 | $13.80 – $259.34 | 7 |
| Lower jaw bone graft CPT 21215 | not published | not published | $941.97 – $1,943.03 | 7 |
| Low frequency non-thermal Ultrasound CPT 97610 | $182.78 | $494.00 | $17.85 – $808.98 | 6 |
| Lsh uterus 250 g or less CPT 58541 | not published | not published | $791.97 – $1,869.71 | 7 |
| Lsh uterus above 250 g CPT 58543 | not published | not published | $914.31 – $2,123.22 | 7 |
| Lsh w/t/o ut 250 g or less CPT 58542 | not published | not published | $905.34 – $2,089.68 | 7 |
| Lsh w/t/o uterus above 250 g CPT 58544 | not published | not published | $997.27 – $2,300.28 | 7 |
| L/s ratio fetal lung CPT 83661 | not published | not published | $23.19 – $108.04 | 7 |
| Lumbar diskogram s&i CPT 72295 | not published | not published | $51.04 – $542.92 | 7 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $1,758.47 – $3,367.35 | 7 |
| Lung function test (mbc/mvv) CPT 94200 | $69.75 | $188.50 | $6.65 – $45.57 | 7 |
| Lung Function Test (Spirometry) CPT 94010 | $99.16 | $268.00 | $10.26 – $244.04 | 7 |
| Lung perfusion imaging CPT 78580 | not published | not published | $46.74 – $487.52 | 7 |
| Lung volume reduction 32491 CPT 32491 | not published | not published | $1,656.82 – $3,166.11 | 7 |
| Lw ntsty Ultrasound stimj bone healg CPT 20979 | not published | not published | $36.46 – $69.42 | 7 |
| Lymphadenect/stage/pelv/paraaortic 38562 CPT 38562 | not published | not published | $783.21 – $1,487.49 | 7 |
| Lymphatics/lymph node imaging CPT 78195 | not published | not published | $75.96 – $733.99 | 7 |
| Lymphocyte culture mixed CPT 86821 | not published | not published | $49.47 – $87.91 | 7 |
| Lymphocyte transformation mitogen CPT 86353 | $95.55 | $258.25 | $51.60 – $79.86 | 7 |
| Lymphocytotoxicity assay CPT 86805 | not published | not published | $49.47 – $81.41 | 7 |
| Lymph vessel x-ray arm/leg CPT 75801 | not published | not published | $50.29 – $542.92 | 6 |
| Lymph vessel x-ray arms/legs CPT 75803 | not published | not published | $74.26 – $542.92 | 6 |
| Lymph vessel x-ray trunk CPT 75805 | not published | not published | $51.80 – $542.92 | 6 |
| Lymph vessel x-ray trunk CPT 75807 | not published | not published | $74.26 – $542.92 | 6 |
| Lysis intranasal synechia 30560 CPT 30560 | not published | not published | $144.65 – $294.07 | 7 |
| Lysis of labial adhesions CPT 56441 | not published | not published | $151.79 – $294.84 | 7 |
| Lysis penil circumic lesion CPT 54162 | not published | not published | $222.10 – $420.44 | 7 |
| Macro exam dissect molec study ea CPT 88387 | $36.54 | $98.75 | $7.55 – $63.27 | 6 |
| Macroscopic exam arthropod CPT 87168 | $49.03 | $132.50 | $4.43 – $56.64 | 7 |
| Macroscopic exam parasite CPT 87169 | $30.43 | $82.25 | $4.43 – $56.64 | 7 |
| Magnesium CPT 83735 | $51.06 | $138.00 | $7.04 – $16.30 | 7 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $31.45 | $85.00 | $0.35 – $0.38 | 5 |
| Magnetic image bone marrow CPT 77084 | not published | not published | $100.99 – $893.90 | 7 |
| Malaria antibody CPT 86750 | not published | not published | $11.38 – $79.86 | 7 |
| Male sling procedure CPT 53440 | not published | not published | $846.35 – $1,592.01 | 7 |
| Management of liver hemorrhage 47361 CPT 47361 | not published | not published | $3,346.88 – $6,431.27 | 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.