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 |
|---|---|---|---|---|
| Bladder irrigate/lavage/instill 51700 CPT 51700 | $188.15 | $508.50 | $40.29 – $94.38 | 7 |
| Bld exchange truj oth thn nb CPT 36455 | not published | not published | $145.33 – $248.04 | 7 |
| Bld prd mix CPT 86965 | $61.98 | $167.50 | $13.55 – $49.47 | 6 |
| Bld push tfuj 2 yr/< CPT 36440 | not published | not published | $61.46 – $125.58 | 7 |
| Bleomycin 15 unit solution for injection HCPCS J9040 | $176.86 | $478.00 | $29.76 – $31.89 | 5 |
| Blepharoplasty lower 15820 CPT 15820 | not published | not published | $513.70 – $1,119.32 | 7 |
| Blepharoplasty upper 15822 CPT 15822 | not published | not published | $392.51 – $844.76 | 7 |
| Blepharoplasty upper eyelid 15823 CPT 15823 | not published | not published | $588.21 – $1,190.31 | 7 |
| Blepharp lwr eyelid fat pad CPT 15821 | not published | not published | $545.88 – $1,181.73 | 7 |
| Blinatumomab 35 mcg intravenous solution HCPCS J9039 | $211.38 | $571.30 | $136.07 – $145.78 | 5 |
| Blink reflex test CPT 95933 | not published | not published | $36.44 – $187.20 | 7 |
| Blm gene CPT 81209 | not published | not published | $44.62 – $79.86 | 6 |
| Block brachial plexus w/cath plmt w/img CPT 64416 | not published | not published | $89.99 – $172.38 | 7 |
| Block femoral nerve cont infusion cath w/img CPT 64448 | not published | not published | $81.22 – $155.23 | 7 |
| Block paracervical nrv CPT 64435 | not published | not published | $92.60 – $180.96 | 7 |
| Block plantar digital nerve CPT 64455 | not published | not published | $39.58 – $76.44 | 7 |
| Block tap inj(s) w/wo img bi CPT 64488 | not published | not published | $83.97 – $268.02 | 6 |
| Block tap inj(s) w/wo img uni CPT 64486 | not published | not published | $70.52 – $217.68 | 6 |
| Blood Clotting (PT/INR) Test CPT 85610 | $29.60 | $80.00 | $4.17 – $9.55 | 7 |
| Blood Clotting (PTT) Test CPT 85730 | $22.11 | $59.75 | $6.25 – $38.30 | 7 |
| Blood Count (CBC) Test CPT 85025 | $45.33 | $122.50 | $8.08 – $51.91 | 7 |
| Blood Count (CBC) Test (without differential) CPT 85027 | $29.60 | $80.00 | $6.78 – $51.91 | 7 |
| Blood count spun microhematocrit CPT 85013 | not published | not published | $2.61 – $51.91 | 7 |
| Blood Culture Test CPT 87040 | $61.70 | $166.75 | $10.94 – $113.14 | 7 |
| Blood draw capillary 36416 CPT 36416 | $7.68 | $20.75 | $5.17 – $6.08 | 6 |
| Blood gases o2 saturation direct measurement CPT 82805 | not published | not published | $29.97 – $60.18 | 7 |
| Blood gases ph venous CPT 82800 | $32.93 | $89.00 | $8.86 – $60.18 | 7 |
| Blood occult fecal hemoglobin immunoassay qualitative 1-3 simultaneous determinations diagnostic CPT 82274 | $58.28 | $157.50 | $16.68 – $33.65 | 7 |
| Blood occult feces 1-3 determinations other than neoplasm screening qualitative CPT 82272 | $20.17 | $54.50 | $3.39 – $33.65 | 7 |
| Blood occult feces colorectal neoplasm screening qualitative CPT 82270 | not published | not published | $3.39 – $60.18 | 7 |
| Blood occult peroxidase activity qualitative gastric CPT 82271 | $24.98 | $67.50 | $3.39 – $33.65 | 7 |
| Blood smear interpretation CPT 85060 | not published | not published | $18.09 – $45.57 | 7 |
| Blood smear microscopic w manual differential wbc count CPT 85007 | $32.47 | $87.75 | $3.65 – $51.91 | 7 |
| Blood typing abo CPT 86900 | $37.56 | $101.50 | $3.13 – $49.47 | 7 |
| Blood typing ag donor ea ag CPT 86902 | $64.29 | $173.75 | $5.96 – $49.47 | 6 |
| Blood typing patient serum CPT 86904 | not published | not published | $9.90 – $49.47 | 7 |
| Blood typing rbc ag non abo/rh ea CPT 86905 | $37.56 | $101.50 | $3.91 – $49.47 | 7 |
| Blood typing rh (d) CPT 86901 | $35.98 | $97.25 | $3.13 – $7.26 | 7 |
| Blood typing rh phenotype complete reference CPT 86906 | $42.09 | $113.75 | $8.08 – $49.47 | 7 |
| Blood volume CPT 78122 | not published | not published | $28.46 – $202.81 | 7 |
| Bone biopsy open superficial CPT 20240 | $1,491.19 | $4,030.25 | $171.26 – $472.69 | 7 |
| Bone Density Scan (DEXA) CPT 77080 | $109.34 | $295.50 | $12.46 – $100.62 | 7 |
| Bone imaging multiple areas CPT 78305 | not published | not published | $52.05 – $487.52 | 7 |
| Bone/joint imaging ltd area CPT 78300 | not published | not published | $39.12 – $370.51 | 7 |
| Bone marrow;aspiration only 38220 CPT 38220 | $817.05 | $2,208.25 | $69.25 – $128.71 | 7 |
| Bone marrow biopsyneedle/trocar 38221 CPT 38221 | $593.30 | $1,603.50 | $83.90 – $159.91 | 7 |
| Bone marrow harvest allogen CPT 38230 | not published | not published | $222.98 – $440.72 | 7 |
| Bone marrow harvest autolog CPT 38232 | not published | not published | $220.14 – $440.72 | 6 |
| Bone marrow imaging body CPT 78104 | not published | not published | $50.75 – $510.13 | 7 |
| Bone marrow imaging ltd CPT 78102 | not published | not published | $34.74 – $347.89 | 7 |
| Bone marrow imaging mult CPT 78103 | not published | not published | $47.21 – $445.39 | 7 |
| Bone marrow interpretation CPT 85097 | not published | not published | $37.66 – $113.79 | 7 |
| Bone/skin graft great toe CPT 20973 | not published | not published | $2,794.49 – $6,053.73 | 7 |
| Bone/skin graft metatarsal CPT 20972 | not published | not published | $2,717.81 – $4,754.22 | 7 |
| Bone survey-lead poisoning CPT 77074 | $240.22 | $649.25 | $28.46 – $259.34 | 7 |
| Boot mlti podous univ xlg HCPCS L4396 | $129.59 | $350.25 | $282.66 – $282.66 | 1 |
| Borrelia antibody CPT 86619 | not published | not published | $14.07 – $79.86 | 7 |
| Borrelia burgdorferi (lyme disease) antibody nonspecific CPT 86618 | $64.75 | $175.00 | $17.98 – $41.43 | 7 |
| Bortezomib 3.5 mg (2.5 mg/ml) solution for subcutaneous injection HCPCS J9041 | $103.66 | $280.15 | $37.24 – $77.39 | 6 |
| (both sides) smear without diff wbc count CPT 85008 | not published | not published | $3.65 – $51.91 | 7 |
| Bowel imaging CPT 78290 | not published | not published | $43.13 – $684.85 | 7 |
| Brace ank air stirrup univ HCPCS L4350 | $56.65 | $153.10 | $143.99 – $143.99 | 1 |
| Brace ortho tlso 2xl 19in strnl y bar wst belt pd shldr HCPCS L0456 | $1,975.62 | $5,339.50 | $1,674.82 – $1,674.82 | 1 |
| Brachioplasty 15836 CPT 15836 | not published | not published | $803.67 – $1,684.84 | 7 |
| Brach/thor cath 1st CPT 36215 | not published | not published | $267.61 – $524.96 | 7 |
| Brach/thor cath 2nd CPT 36216 | not published | not published | $309.88 – $596.72 | 7 |
| Brach/thor cath 3rd CPT 36217 | not published | not published | $368.82 – $714.51 | 7 |
| Brach/thor cath addl CPT 36218 | not published | not published | $59.24 – $113.88 | 7 |
| Brachytx isodose complex CPT 77318 | not published | not published | $208.78 – $604.07 | 6 |
| Brachytx isodose intermed CPT 77317 | not published | not published | $153.79 – $417.68 | 6 |
| Brachytx isodose plan simple CPT 77316 | not published | not published | $118.22 – $319.04 | 6 |
| Braf gene CPT 81210 | $407.56 | $1,101.50 | $79.86 – $204.56 | 6 |
| Brain biopsy w/ct/mr guide CPT 61751 | $946.37 | $2,557.75 | $1,464.74 – $2,511.48 | 7 |
| Brain cavity shunt w/scope CPT 62201 | not published | not published | $1,259.72 – $2,521.02 | 7 |
| Brain flow imaging only CPT 78610 | not published | not published | $19.54 – $360.37 | 7 |
| Brain image < 4 views CPT 78600 | not published | not published | $27.99 – $375.18 | 7 |
| Brain image 4+ views CPT 78605 | not published | not published | $33.81 – $404.84 | 7 |
| Brain image w/flow < 4 views CPT 78601 | not published | not published | $32.07 – $442.26 | 7 |
| Brain image w/flow 4 + views CPT 78606 | not published | not published | $40.45 – $679.40 | 7 |
| Brain MRA (blood vessel MRI, with and without contrast) CPT 70546 | $838.98 | $2,267.50 | $113.05 – $1,402.47 | 7 |
| Brain MRA (blood vessel MRI, with contrast) CPT 70545 | $686.07 | $1,854.25 | $75.27 – $913.41 | 7 |
| Brain MRA (blood vessel MRI, without contrast) CPT 70544 | $599.59 | $1,620.50 | $75.27 – $928.23 | 7 |
| Brain MRI (with and without contrast) CPT 70553 | $1,278.91 | $3,456.50 | $148.26 – $1,147.41 | 7 |
| Brain MRI (with contrast) CPT 70552 | $985.40 | $2,663.25 | $112.11 – $977.37 | 7 |
| Brain MRI (without contrast) CPT 70551 | $870.98 | $2,354.00 | $92.97 – $873.62 | 7 |
| Brca1&2 gene full seq alys CPT 81163 | $1,491.93 | $4,032.25 | $491.40 – $531.18 | 4 |
| Brca1&2 gen ful dup/del alys CPT 81164 | not published | not published | $613.44 – $663.10 | 4 |
| Brca1 dna gene analy known fam var CPT 81215 | not published | not published | $79.86 – $106.41 | 6 |
| Brca1 gene full dup/del alys CPT 81166 | not published | not published | $316.41 – $342.03 | 4 |
| Brca1 gene full seq alys CPT 81165 | not published | not published | $297.02 – $321.07 | 4 |
| Brca2 dna gene analy full seq analy CPT 81216 | not published | not published | $79.86 – $210.11 | 6 |
| Brca2 dna gene analy known fam var CPT 81217 | not published | not published | $79.86 – $106.41 | 6 |
| Brca2 gene full dup/del alys CPT 81167 | not published | not published | $297.02 – $321.07 | 4 |
| Brcassure ashkenazi panel-sendout CPT 81212 | not published | not published | $79.86 – $201.67 | 6 |
| Brcassure comprehensive panel-sendout CPT 81162 | $929.26 | $2,511.50 | $2,071.24 – $4,027.09 | 6 |
| Breast augmentation 19325 CPT 19325 | not published | not published | $698.42 – $1,375.95 | 7 |
| Breast Biopsy (ultrasound-guided, percutaneous) CPT 19083 | $3,598.62 | $9,726.00 | $180.42 – $348.66 | 6 |
| Breast punct aspir cyst, bil CPT 19000 | $305.62 | $826.00 | $49.38 – $92.83 | 7 |
| Breast reconstruction 19357 CPT 19357 | not published | not published | $1,645.80 – $3,210.57 | 7 |
| Breast reconstruction tram flap 19367 CPT 19367 | not published | not published | $1,983.11 – $3,835.36 | 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.