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 |
|---|---|---|---|---|
| Methadone injection HCPCS J1230 | $45.23 | $122.25 | $11.72 – $12.55 | 5 |
| Methotrexate sodium 2.5 mg tablet HCPCS J8610 | $21.13 | $57.10 | $1.65 – $1.77 | 5 |
| Methotrexate sodium (pf) 1 gram solution for injection HCPCS J9260 | $52.04 | $140.65 | $4.02 – $4.30 | 5 |
| Methotrexate therapeutic drug level CPT 80204 | $101.75 | $275.00 | $43.78 – $43.78 | 1 |
| Methylene blue (antidote) 5 mg/ml intravenous solution HCPCS Q9968 | $344.73 | $931.70 | $0.80 – $0.85 | 5 |
| Methylergonovine 0.2 mg/ml (1 ml) injection solution HCPCS J2210 | $35.98 | $97.25 | $6.85 – $7.33 | 5 |
| Methylnaltrexone 12 mg/0.6 ml subcutaneous injection (wrapper) HCPCS J2212 | $0.39 | $1.06 | $0.71 – $0.77 | 5 |
| Methylprednisolone 4 mg tablet HCPCS J7509 | $2.39 | $6.45 | $0.80 – $0.85 | 5 |
| Metoclopramide in d5w IV syringe 0.2 mg/ml (neo/ped) - cnr HCPCS J2765 | $9.25 | $25.00 | $1.26 – $1.35 | 5 |
| Mgmt promoter methylation analysis CPT 81287 | $118.96 | $321.50 | $79.86 – $94.97 | 6 |
| Micafungin 100 mg intravenous solution HCPCS J2248 | $135.03 | $364.95 | $1.54 – $1.65 | 5 |
| Microalbumin urine screen CPT 82044 | not published | not published | $4.95 – $40.83 | 7 |
| Microbe susceptible mlc CPT 87187 | not published | not published | $10.04 – $56.64 | 7 |
| Microdissection laser CPT 88380 | $463.98 | $1,254.00 | $81.21 – $113.79 | 7 |
| Microdissection manual CPT 88381 | $42.74 | $115.50 | $47.23 – $113.79 | 7 |
| Microfluid analy tears CPT 83861 | not published | not published | $25.72 – $108.04 | 6 |
| Microsatellite instability CPT 81301 | $422.36 | $1,141.50 | $79.86 – $450.82 | 6 |
| Microsurg tehniq require use oper micro (add-on)69990 CPT 69990 | not published | not published | $246.58 – $395.22 | 7 |
| Microvolt t-wave assess CPT 93025 | not published | not published | $50.39 – $299.99 | 7 |
| Midazolam 1 mg/ml injection solution HCPCS J2250 | $22.29 | $60.25 | $0.22 – $0.24 | 5 |
| Middle cerebral artery echo CPT 76821 | $220.98 | $597.25 | $42.87 – $420.03 | 7 |
| Milrinone 20 mg/100 ml(200 mcg/ml) in 5 % dextrose intravenous piggybk HCPCS J2260 | $24.64 | $66.60 | $5.26 – $5.64 | 5 |
| Minocycline hydrochloride HCPCS J2265 | $34.97 | $94.50 | $0.84 – $0.90 | 5 |
| Mitomycin 40 mg intravenous solution HCPCS J9280 | $246.05 | $665.00 | $18.09 – $40.01 | 6 |
| Mitoxantrone 2 mg/ml concentrate,intravenous HCPCS J9293 | $78.44 | $212.00 | $53.42 – $57.24 | 5 |
| Mitral valve replacement w/bypass 33430 CPT 33430 | not published | not published | $3,170.49 – $6,058.41 | 7 |
| Mlh1 gene CPT 81288 | $118.96 | $321.50 | $182.46 – $182.46 | 1 |
| Mlh1 gene dup/delete variant CPT 81294 | not published | not published | $79.86 – $217.60 | 6 |
| Mlh1 gene full seq CPT 81292 | not published | not published | $79.86 – $737.50 | 6 |
| Mlh1 gene known variants CPT 81293 | not published | not published | $79.86 – $295.64 | 6 |
| Mlt osteot rlgnm imed rd hum CPT 24410 | not published | not published | $1,159.47 – $2,280.77 | 7 |
| Mnl appl strs jt radiography CPT 77071 | $45.70 | $123.50 | $45.70 – $93.19 | 7 |
| Mnpj anes sho jt fixj aprats CPT 23700 | not published | not published | $211.73 – $412.63 | 7 |
| Mnpj elbow under anes CPT 24300 | not published | not published | $410.52 – $868.94 | 7 |
| Mnpj of tmj w/anesth CPT 21073 | not published | not published | $261.63 – $543.67 | 7 |
| Mobilization of colon 44139 CPT 44139 | not published | not published | $137.90 – $258.19 | 7 |
| Modification of contact lens CPT 92325 | not published | not published | $28.99 – $74.14 | 7 |
| Modified maze/limited 33254 CPT 33254 | not published | not published | $1,540.40 – $2,964.08 | 7 |
| Modified maze/limited /w other op 33257 CPT 33257 | not published | not published | $653.96 – $678.94 | 2 |
| Mopath procedure level 1 CPT 81400 | $212.47 | $574.25 | $72.59 – $79.86 | 6 |
| Mopath procedure level 3 CPT 81402 | $212.01 | $573.00 | $79.86 – $170.62 | 6 |
| Mopath procedure level 5 CPT 81404 | $966.72 | $2,612.75 | $79.86 – $311.93 | 6 |
| Mopath procedure level 6 CPT 81405 | $1,126.65 | $3,045.00 | $79.86 – $342.03 | 6 |
| Mopath procedure level 7 CPT 81406 | $906.32 | $2,449.50 | $79.86 – $321.07 | 6 |
| Mopath procedure level 8 CPT 81407 | $710.68 | $1,920.75 | $79.86 – $960.52 | 6 |
| Mopath procedure level 9 CPT 81408 | $1,144.13 | $3,092.25 | $79.86 – $2,270.00 | 6 |
| Morphine 4 mg/ml injection (wrapper) HCPCS J2270 | $48.56 | $131.25 | $9.18 – $9.84 | 5 |
| Morphine (pf) 0.25 mg/0.5 ml injection (neo/ped) - cnr HCPCS J2274 | $210.23 | $568.20 | $14.70 – $15.75 | 5 |
| Morphometric analysis in situ hybridization computer-assisted per specimen each multiplex stain CPT 88374 | $281.94 | $762.00 | $297.48 – $348.29 | 6 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain computer-assisted CPT 88361 | not published | not published | $71.42 – $113.79 | 7 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain manual CPT 88360 | $153.18 | $414.00 | $66.49 – $113.79 | 7 |
| Motion analysis video/3d CPT 96000 | not published | not published | $106.10 – $210.61 | 7 |
| Motion test w/ft press meas CPT 96001 | not published | not published | $126.86 – $212.16 | 7 |
| Motor &/ sens nrve cndj test CPT 95905 | not published | not published | $69.70 – $139.63 | 6 |
| Mouth vestibule bx/w complex rpr 40814 CPT 40814 | not published | not published | $324.46 – $657.56 | 7 |
| M/phmtrc alys ishquant/semiq CPT 88373 | not published | not published | $51.37 – $103.39 | 6 |
| M/phmtrc alys ishquant/semiq CPT 88377 | $1,293.52 | $3,496.00 | $226.42 – $367.33 | 6 |
| M/phmtrc alysishquant/semiq CPT 88369 | not published | not published | $75.09 – $126.53 | 6 |
| M/phmtrc alys skeletal musc CPT 88355 | not published | not published | $60.01 – $113.79 | 7 |
| Mpl gene analysis common variants CPT 81338 | $174.83 | $472.50 | $170.62 – $170.62 | 1 |
| MRA abdomen post contrast CPT 74185 | not published | not published | $113.45 – $950.85 | 7 |
| MRA aorta thoracic w/wo contrast CPT 71555 | not published | not published | $114.72 – $943.04 | 7 |
| MRA chest w IV cont HCPCS C8909 | $595.98 | $1,610.75 | $943.04 – $943.04 | 5 |
| MRA chest wwo IV cont HCPCS C8911 | $843.69 | $2,280.25 | $943.04 – $943.04 | 5 |
| MRA ext low(run-off)pst cntrst CPT 73725 | not published | not published | $114.79 – $957.08 | 7 |
| MRA pelvis CPT 72198 | not published | not published | $113.45 – $951.62 | 7 |
| MRA spinal canal CPT 72159 | not published | not published | $112.44 – $964.89 | 7 |
| MRA upper extremity post contrast-bil CPT 73225 | not published | not published | $107.97 – $965.66 | 7 |
| MRA w/cont, abd HCPCS C8900 | $595.98 | $1,610.75 | $950.85 – $950.85 | 5 |
| MRA w/cont, lwr ext HCPCS C8912 | $1,191.96 | $3,221.50 | $805.38 – $957.08 | 6 |
| Mra, w/dye, upper extremity HCPCS C8934 | $887.26 | $2,398.00 | $2,149.97 – $2,149.97 | 5 |
| MRA without cont, abd HCPCS C8901 | $560.27 | $1,514.25 | $950.85 – $950.85 | 5 |
| MRA without cont, lwr ext HCPCS C8913 | $1,120.55 | $3,028.50 | $757.13 – $957.08 | 6 |
| MRA without fol w/cont, abd HCPCS C8902 | $980.13 | $2,649.00 | $950.85 – $950.85 | 5 |
| MRA without fol w/cont, lwr ext HCPCS C8914 | $1,907.17 | $5,154.50 | $957.08 – $1,288.63 | 6 |
| MRA without fol w/cont, pelvis HCPCS C8920 | $810.76 | $2,191.25 | $2,149.97 – $2,149.97 | 5 |
| Mra, w/o&w/dye, spinal canal HCPCS C8933 | $555.93 | $1,502.50 | $964.89 – $964.89 | 5 |
| Mra, w/o&w/dye, upper extr HCPCS C8936 | $1,085.03 | $2,932.50 | $2,149.97 – $2,149.97 | 5 |
| Mr elastography CPT 76391 | not published | not published | $179.61 – $297.12 | 4 |
| MRI brain w/dye CPT 70558 | not published | not published | $200.40 – $987.50 | 6 |
| MRI brain without dye CPT 70557 | not published | not published | $183.36 – $794.85 | 6 |
| MRI brain without & w/dye CPT 70559 | not published | not published | $203.38 – $1,173.93 | 6 |
| MRI breast c- unilateral CPT 77046 | $663.69 | $1,793.75 | $172.28 – $172.28 | 1 |
| MRI breast c-+ w/cad uni CPT 77048 | not published | not published | $283.93 – $477.50 | 4 |
| MRI breast without cont bi CPT 77047 | $869.96 | $2,351.25 | $171.59 – $287.94 | 4 |
| MRI breast w IV cont bi CPT 77049 | not published | not published | $282.54 – $475.52 | 4 |
| MRI cardiac morph & func wo IV cont CPT 75557 | $717.52 | $1,939.25 | $152.98 – $744.91 | 7 |
| MRI cardiac morph & func wwo IV cont CPT 75561 | $884.49 | $2,390.50 | $168.98 – $989.07 | 7 |
| MRI cardiac morph & func wwo IV cont w/stress img CPT 75563 | not published | not published | $201.28 – $1,167.69 | 7 |
| MRI chest without contrast CPT 71550 | $901.97 | $2,437.75 | $91.34 – $953.19 | 7 |
| MRI chest without & w/contrast CPT 71552 | $1,182.06 | $3,194.75 | $142.78 – $1,348.65 | 7 |
| MRI chest w IV cont CPT 71551 | $927.41 | $2,506.50 | $108.17 – $1,060.05 | 7 |
| MRI fetal ea addl gestation CPT 74713 | not published | not published | $141.21 – $413.93 | 6 |
| MRI fetal sngl/1st gestation CPT 74712 | not published | not published | $112.82 – $855.95 | 6 |
| MRI guid ndl plc s&i CPT 77021 | $388.78 | $1,050.75 | $95.29 – $682.97 | 7 |
| MRI guid parenchymal tiss ablation CPT 77022 | not published | not published | $265.24 – $1,492.39 | 6 |
| MRI loex nonjt w IV cont CPT 73719 | $1,953.60 | $5,280.00 | $101.53 – $957.87 | 7 |
| MRI lower extremity other than joint without contrast (both sides) CPT 73718 | $2,051.28 | $5,544.00 | $84.59 – $843.20 | 7 |
| MRI lower extremity other than joint without & w/contrast (both sides) CPT 73720 | $2,141.75 | $5,788.50 | $135.23 – $1,171.60 | 7 |
| MRI orbit/face/neck without contrast CPT 70540 | $932.86 | $2,521.25 | $84.59 – $826.82 | 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.