Mercy Orthopedic Hospital Fort Smith
3601 S. 79th St, Fort Smith, AR · Mercy · · NPI 1568433480
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 |
|---|---|---|---|---|
| 11-desoxycortisol - sendout CPT 82634 | $70.85 | $109.00 | $26.04 – $133.67 | 86 |
| 17-hydroxypregnenolone CPT 84143 | $100.10 | $154.00 | $20.29 – $104.19 | 86 |
| 2d tee w or without fol w/con,in HCPCS C8925 | $2,342.60 | $3,604.00 | $467.42 – $1,361.53 | 58 |
| 2d tte w or without fol w/con,co HCPCS C8923 | $1,468.35 | $2,259.00 | $206.06 – $1,361.53 | 51 |
| 2nd order venous cath CPT 36012 | $6,009.65 | $9,245.62 | $49.95 – $2,640.85 | 76 |
| 3-d radiotherapy plan CPT 77295 | $27,452.10 | $42,234.00 | $214.21 – $2,828.22 | 80 |
| 5' nucleotidase - sendout CPT 83915 | $40.30 | $62.00 | $9.92 – $50.90 | 86 |
| 88334 ap bill cytologic exam each additional site CPT 88334 | $72.80 | $112.00 | $11.83 – $74.31 | 27 |
| Abatacept (with maltose) 250 mg intravenous solution HCPCS J0129 | $3,232.57 | $4,973.18 | $43.92 – $2,185.75 | 78 |
| #a/b/c/c/h pnl-candida albicans ab CPT 86628 | $57.85 | $89.00 | $10.68 – $54.84 | 86 |
| Abd aorta w/runoff s&i CPT 75630 | $2,061.15 | $3,171.00 | $53.83 – $6,235.38 | 72 |
| Abd exp/postop hem/throm/infec 35840 CPT 35840 | $5,370.08 | $8,261.66 | $59.20 – $1,630.82 | 75 |
| Abd/low ext cath 1st CPT 36245 | $19,061.46 | $29,325.32 | $186.66 – $18,099.34 | 75 |
| Abd/low ext cath 2nd CPT 36246 | $13,500.62 | $20,770.19 | $198.35 – $28,740.90 | 75 |
| Abd/low ext cath 3rd CPT 36247 | $13,577.78 | $20,888.90 | $6.60 – $18,099.34 | 78 |
| Abd/low ext cath addl CPT 36248 | $16,381.78 | $25,202.74 | $4.52 – $18,099.34 | 76 |
| Abdominal CT scan (with and without contrast) CPT 74170 | $1,758.25 | $2,705.00 | $143.16 – $1,411.22 | 77 |
| Abdominal CT scan (with contrast) CPT 74160 | $1,397.50 | $2,150.00 | $151.76 – $1,200.46 | 77 |
| Abdominal CT scan (without contrast) CPT 74150 | $982.15 | $1,511.00 | $70.23 – $669.29 | 77 |
| Abdominal MRI (with and without contrast) CPT 74183 | $2,334.15 | $3,591.00 | $204.04 – $2,772.61 | 77 |
| Abdominal MRI (with contrast) CPT 74182 | $1,963.00 | $3,020.00 | $191.82 – $2,573.97 | 77 |
| Abdominal MRI (without contrast) CPT 74181 | $1,806.35 | $2,779.00 | $110.75 – $1,798.80 | 77 |
| Abdominal paracentesis w/image guidance CPT 49083 | $2,795.65 | $4,301.00 | $85.31 – $1,575.27 | 74 |
| Abdominal Ultrasound (complete) CPT 76700 | $703.30 | $1,082.00 | $56.00 – $294.37 | 81 |
| Abdominal Ultrasound (limited) CPT 76705 | $482.30 | $742.00 | $20.00 – $252.18 | 81 |
| Ablate arrhythmia add on CPT 93655 | $6,509.75 | $10,015.00 | $198.89 – $451.48 | 13 |
| Ablate heart dysrhythm focus CPT 93650 | $9,898.85 | $15,229.00 | $435.41 – $12,899.77 | 77 |
| Ablate inf turbinate submuc 30802 CPT 30802 | $3,618.89 | $5,567.52 | $161.43 – $5,513.22 | 80 |
| Ablation cardiac vagal inputs atrium CPT 93799 | $5,671.25 | $8,725.00 | $122.26 – $735.00 | 65 |
| Ablation cryo pq liver tumor(s) CPT 47383 | $7,742.47 | $11,911.49 | $42.71 – $17,699.07 | 76 |
| Ablation of upper extremity nerves rf CPT 64999 | $7,179.90 | $11,046.00 | $251.65 – $3,319.71 | 79 |
| Abscess drain retroperitoneal surg code CPT 49406 | $3,794.76 | $5,838.09 | $154.50 – $2,589.43 | 78 |
| Acetaminophen level CPT 80143 | $150.80 | $232.00 | $16.58 – $30.17 | 67 |
| Acetazolamide 500 mg solution for injection HCPCS J1120 | $97.26 | $149.63 | $21.62 – $95.20 | 21 |
| Acetone qualitative CPT 82009 | $33.80 | $52.00 | $4.02 – $20.63 | 86 |
| Acetylcholine receptor modulating antibody CPT 86043 | $196.30 | $302.00 | $10.72 – $19.51 | 67 |
| Acetylcholinesterase assay CPT 82013 | $219.05 | $337.00 | $10.93 – $51.00 | 80 |
| Acetylcysteine 200 mg/ml (20 %) intravenous solution HCPCS J0132 | $339.66 | $522.55 | $30.60 – $235.63 | 21 |
| Aco med nutria tx/group, ea 30 min 97804aco CPT 97804 | $52.00 | $80.00 | $11.52 – $48.20 | 64 |
| Actinotherapy uv light CPT 96900 | $118.95 | $183.00 | $19.97 – $66.78 | 65 |
| Acute hepatitis panel CPT 80074 | $250.90 | $386.00 | $42.37 – $217.48 | 86 |
| Acute venous thrombus image CPT 78456 | $775.45 | $1,193.00 | $159.39 – $2,862.43 | 75 |
| Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr HCPCS J0133 | $34.74 | $53.44 | $2.00 – $44.00 | 21 |
| #acylcarnitineprfl CPT 82017 | $133.90 | $206.00 | $15.01 – $76.98 | 86 |
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | $148.20 | $228.00 | $0.96 – $5.88 | 21 |
| Adh-sendout CPT 84588 | $108.55 | $167.00 | $30.19 – $154.97 | 80 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $78.90 | $121.39 | $12.60 – $146.64 | 20 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $235.30 | $362.00 | $60.68 – $114.02 | 68 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | $256.10 | $394.00 | $60.68 – $243.64 | 68 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $258.70 | $398.00 | $282.76 – $523.06 | 68 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | $263.90 | $406.00 | $196.08 – $523.06 | 68 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | $157.95 | $243.00 | $60.68 – $131.78 | 68 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $200.20 | $308.00 | $60.68 – $274.44 | 68 |
| Administration immunization 1 vaccine CPT 90471 | $20.80 | $32.00 | $19.35 – $128.73 | 65 |
| Administration immunization each additional component CPT 90461 | $0.65 | $1.00 | $8.07 – $38.30 | 50 |
| Administration immunization each additional vaccine CPT 90472 | $0.65 | $1.00 | $12.70 – $38.30 | 6 |
| Administration immunization first component each vaccine CPT 90460 | $20.80 | $32.00 | $18.34 – $74.98 | 62 |
| Administration vaccine hepatitis b HCPCS G0010 | $9.75 | $15.00 | $40.23 – $73.41 | 59 |
| Administration vaccine influenza virus HCPCS G0008 | $11.05 | $17.00 | $2.46 – $73.41 | 63 |
| Administration vaccine pneumococcal HCPCS G0009 | $11.05 | $17.00 | $2.46 – $73.41 | 63 |
| Ado-trastuzumab emtansine 100 mg intravenous solution HCPCS J9354 | $15,109.63 | $23,245.59 | $41.39 – $8,240.00 | 78 |
| Adrenal cortex & medulla img CPT 78075 | $1,214.85 | $1,869.00 | $37.00 – $2,862.43 | 75 |
| Aep hearing status deter i&r CPT 92651 | $254.15 | $391.00 | $71.99 – $386.05 | 64 |
| Aep neurodiagnostic i&r CPT 92653 | $254.15 | $391.00 | $72.05 – $386.05 | 64 |
| Aep thrshld est mlt freq i&r CPT 92652 | $328.90 | $506.00 | $97.35 – $386.05 | 64 |
| _afb id by dna probe rflx ast CPT 87149 | $68.25 | $105.00 | $17.83 – $91.55 | 80 |
| _afb org id by sequencing rflx ast-sendout CPT 87153 | $353.60 | $544.00 | $70.73 – $526.69 | 86 |
| Aflibercept injection HCPCS J0178 | $4,557.86 | $7,012.10 | $749.39 – $5,683.44 | 79 |
| Albumin body fluid quantitative each specimen CPT 82042 | $15.60 | $24.00 | $6.92 – $23.63 | 86 |
| Albumin (human), 25%, 50ml HCPCS P9047 | $277.87 | $427.50 | $49.70 – $197.44 | 78 |
| Albumin (human), 5%, 250 ml HCPCS P9045 | $144.35 | $222.07 | $49.70 – $197.44 | 78 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $99.45 | $153.00 | $5.14 – $26.41 | 86 |
| Albumin serum plasma or whole blood CPT 82040 | $17.55 | $27.00 | $4.40 – $22.59 | 86 |
| Alcohol (ethanol) any specimen except urine/breath CPT 82077 | $109.85 | $169.00 | $15.54 – $27.95 | 64 |
| Alkaline phosphatase CPT 84075 | $71.50 | $110.00 | $4.61 – $23.63 | 86 |
| Allergen alpha lactalbumin ige CPT 86008 | $55.25 | $85.00 | $15.95 – $50.26 | 78 |
| Allergen egg white ige CPT 86003 | $52.00 | $80.00 | $4.64 – $23.83 | 86 |
| Allergen specific ige qual multi scrn ea CPT 86005 | $58.50 | $90.00 | $7.17 – $36.41 | 77 |
| Allograft epieffect 2x3cm-q4186-cost per sq cm HCPCS Q4186 | $1,721.20 | $2,648.00 | $124.72 – $362.88 | 70 |
| Allograft graftjacket 2x12cm-q4107-cost per sq cm HCPCS Q4107 | $2,471.30 | $3,802.00 | $86.69 – $239.88 | 71 |
| Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution HCPCS J0256 | $1,329.90 | $2,046.00 | $5.27 – $1,998.00 | 79 |
| Alpha-fetoprotein amniotic CPT 82106 | $121.55 | $187.00 | $15.12 – $76.60 | 80 |
| Alpha-fetoprotein tumor marker CPT 82105 | $140.40 | $216.00 | $14.92 – $76.60 | 86 |
| Alprostadil for injection HCPCS J0270 | $522.85 | $804.39 | $2,888.00 – $13,320.00 | 7 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | $17,732.73 | $27,281.12 | $71.26 – $698.12 | 79 |
| Alt/sgpt CPT 84460 | $14.30 | $22.00 | $4.71 – $24.16 | 86 |
| Aluminum - quest CPT 82108 | $88.40 | $136.00 | $11.92 – $64.65 | 86 |
| Amantadine (symmetrel)-sendout CPT 80375 | $183.30 | $282.00 | $21.35 – $48.46 | 11 |
| Amikacin 4 mg/ml intravitreal injection - cnr HCPCS J0278 | $49.40 | $76.00 | $2.70 – $14.76 | 21 |
| Amino acids quant 2-5 CPT 82136 | $174.85 | $269.00 | $17.44 – $76.98 | 86 |
| Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr HCPCS J0281 | $33.47 | $51.49 | $7.45 – $29.60 | 8 |
| Aminolevulinic acid delta CPT 82135 | $100.75 | $155.00 | $14.63 – $75.12 | 86 |
| Aminophylline 25 mg/ml intravenous solution (wrapper) HCPCS J0280 | $67.90 | $104.46 | $5.17 – $38.72 | 21 |
| Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV HCPCS J0283 | $142.64 | $219.45 | $12.60 – $47.00 | 11 |
| Amiodarone 50 mg/ml intravenous solution HCPCS J0282 | $7.15 | $11.00 | $1.85 – $62.54 | 21 |
| Amitriptyline (elavil) -sendout CPT 80335 | $68.25 | $105.00 | $27.18 – $61.70 | 11 |
| Amivantamab-vmjw 50 mg/ml intravenous solution HCPCS J9061 | $27,156.23 | $41,778.81 | $22.13 – $23,126.25 | 69 |
| Ammonia CPT 82140 | $124.15 | $191.00 | $11.93 – $39.93 | 86 |
| Amphetamine confirm urine -sendout CPT 80324 | $87.75 | $135.00 | $23.60 – $53.57 | 11 |
| Amphetamines 5 or more CPT 80326 | $85.15 | $131.00 | $23.60 – $60.75 | 11 |
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.