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 |
|---|---|---|---|---|
| X-ray thoracic spine 2 views CPT 72070 | $148.46 | $401.25 | $13.80 – $259.34 | 7 |
| X-ray thoracic spine 3 views CPT 72072 | $172.24 | $465.50 | $13.80 – $259.34 | 7 |
| X-ray thoracolumbar spine >=2 views CPT 72080 | $141.43 | $382.25 | $13.80 – $259.34 | 7 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | $143.38 | $387.50 | $25.88 – $68.86 | 6 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views CPT 72082 | $148.46 | $401.25 | $46.72 – $109.64 | 6 |
| X-ray tibia/fibula 2 views (both sides) CPT 73590 | $232.18 | $627.50 | $10.66 – $259.34 | 7 |
| X-ray toe(s) > 2 views (both sides) CPT 73660 | $200.91 | $543.00 | $7.98 – $259.34 | 7 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast CPT 74246 | $321.62 | $869.25 | $43.60 – $265.98 | 7 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study CPT 74240 | $299.98 | $810.75 | $43.60 – $237.12 | 7 |
| X-ray wrist 2 views (both sides) CPT 73100 | $246.42 | $666.00 | $10.19 – $259.34 | 7 |
| X-ray xm phrnx&/crv esoph c+ CPT 74210 | not published | not published | $23.05 – $259.34 | 7 |
| Xylose absorption test blood &/or urine CPT 84620 | not published | not published | $12.51 – $108.04 | 7 |
| Yersinia antibody CPT 86793 | not published | not published | $13.81 – $79.86 | 7 |
| Ziconotide injection HCPCS J2278 | $2,571.72 | $6,950.60 | $6.78 – $11.21 | 6 |
| Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr HCPCS J3485 | $54.54 | $147.40 | $2.38 – $2.55 | 5 |
| Zika virus dna/rna amp probe CPT 87662 | not published | not published | $58.24 – $58.24 | 1 |
| Zika virus igm antibody CPT 86794 | not published | not published | $19.12 – $19.12 | 1 |
| Ziprasidone 20 mg/ml (final concentration) intramuscular solution HCPCS J3486 | $30.75 | $83.10 | $16.45 – $17.63 | 5 |
| Ziv-aflibercept 25 mg/ml intravenous solution (wrapper) HCPCS J9400 | $36.26 | $98.00 | $14.85 – $15.91 | 5 |
| Zoster vaccine-live inj CPT 90736 | not published | not published | $161.60 – $253.51 | 6 |
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.