Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution at Mercy Orthopedic Hospital Fort Smith
3601 S. 79th St, Fort Smith, AR · Mercy · · NPI 1568433480
$438.30
Cash price Discounted cash price What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge. Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.
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What you pay up front if you don't use insurance.
$674.31
Gross charge Gross charge (chargemaster price) The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this. Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.
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The hospital's undiscounted list price — almost no one pays this.
$134.86 with MEDICAID [20240] vs $573.16 with MULTIPLAN CONTRACTED [320270] — same scan, same building. Share
Negotiated rates by payer
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →Payer ?Payer The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on. Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509. Full explanation → |
Plan ?Plan The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates. Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible. Full explanation → |
Negotiated rate | vs. cash |
|---|---|---|---|
| MEDICAID [20240] | HB FTSM MO MEDICAID | $134.86 | ↓ -69% |
| HOME STATE MEDICAID CONTRACTED [320189] | HB FTSM MANAGED MO MCD | $134.86 | ↓ -69% |
| SUMMIT COMMUNITY CARE CONTRACTED [320368] | HB FTSM SUMMIT | $135.00 | ↓ -69% |
| SUMMIT COMMUNITY CARE [20368] | HB FTSM ARK MEDICAID | $135.00 | ↓ -69% |
| MEDICAID [20240] | HB FTSM ARK MEDICAID | $135.00 | ↓ -69% |
| ARKANSAS DEPARTMENT OF HEALTH [20036] | HB FTSM ARK MEDICAID | $135.00 | ↓ -69% |
| CARESOURCE MEDICAID CONTRACTED [320460] | HB FTSM CARESOURCE MEDICAID | $137.70 | ↓ -69% |
| CARESOURCE MEDICAID [20460] | HB FTSM CARESOURCE MEDICAID | $137.70 | ↓ -69% |
| MERCY INTERFACILITY [20513] | HB FTSM Inter-Facility CCR New 6.1.25 | $148.48 | ↓ -66% |
| HEALTH CHOICE CONTRACTED [320166] | HB FTSM OKLAHOMA STATE AND EDUCATION EMPLOYEES | $167.90 | ↓ -62% |
| USABLE CONTRACTED [320409] | HB FTSM BLUE CROSS | $168.00 | ↓ -62% |
| MC ANTHEM [20455] | HB FTSM BLUE CROSS | $168.00 | ↓ -62% |
| BLUE CROSS AND BLUE SHIELD [20053] | HB FTSM BCBS EXCHANGE | $168.00 | ↓ -62% |
| BLUE CROSS AND BLUE SHIELD [20053] | HB FTSM BLUE CROSS | $168.00 | ↓ -62% |
| AETNA MEDICAID CONTRACTED [320009] | HB FTSM OK MANAGED MEDICAID | $168.58 | ↓ -62% |
| OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] | HB FTSM OK MANAGED MEDICAID | $168.58 | ↓ -62% |
| HUMANA MEDICAID CONTRACTED [320486] | HB FTSM OK MANAGED MEDICAID | $168.58 | ↓ -62% |
| EMPOWER HEALTHCARE SOLUTIONS MEDICAID CONTRACTED [320118] | HB FTSM PASSE EMPOWER | $171.45 | ↓ -61% |
| EMPOWER HEALTHCARE SOLUTIONS MEDICAID [20118] | HB FTSM PASSE EMPOWER | $171.45 | ↓ -61% |
| MERCY BENEFIT ADMIN CONTRACTED [320251] | HB FTSM DEC SCHAEFER QCG | $236.01 | ↓ -46% |
| AITHER HEALTH CONTRACTED [320449] | HB FTSM DEC LACLEDE - NEW 07.01.25 | $236.01 | ↓ -46% |
| MERCY BENEFIT ADMIN CONTRACTED [320251] | HB FTSM DEC TALL TREE | $236.01 | ↓ -46% |
| YUZU HEALTH CONTRACTED [320521] | HB FTSM DEC LEVEL HEALTH - NEW 01.01.26 | $236.01 | ↓ -46% |
| AITHER HEALTH CONTRACTED [320449] | HB FTSM DEC WOODARD | $236.01 | ↓ -46% |
| MERCY BENEFIT ADMIN CONTRACTED [320251] | HB FTSM DEC BARTEL | $236.01 | ↓ -46% |
| EDISON HEALTH SOLUTIONS CONTRACTED [320502] | HB FTSM DEC WOODARD | $236.01 | ↓ -46% |
| QUAL CHOICE CONTRACTED [320324] | HB FTSM,WLDAR,OZKAR,PRSAR, BNVAR QUAL CHOICE | $269.72 | ↓ -38% |
| CIGNA HEALTHCARE CONTRACTED [320071] | HB FTSM CIGNA | $277.80 | ↓ -37% |
| ARKANSAS TOTAL CARE CONTRACTED [320039] | HB FTSM PASSE AR TOTAL CARE | $306.45 | ↓ -30% |
| ARKANSAS TOTAL CARE [20039] | HB FTSM PASSE AR TOTAL CARE | $306.45 | ↓ -30% |
| SHOW-ME HEALTH ADMINISTRATORS CONTRACTED [320483] | HB FTSM ROGR DEC ASI | $337.16 | ↓ -23% |
| 90 DEGREE BENEFITS CONTRACTED [320436] | HB FTSM DEC SHOW ME | $337.16 | ↓ -23% |
| MERCY BENEFIT ADMIN CONTRACTED [320251] | HB FTSM DEC SHOW ME | $337.16 | ↓ -23% |
| MERCY BENEFIT ADMIN CONTRACTED [320251] | HB FTSM DEC TOWN AND COUNTRY | $337.16 | ↓ -23% |
| MERCY BENEFIT ADMIN CONTRACTED [320251] | HB FTSM DEC HERMAN | $404.59 | ↓ -8% |
| MERCY BENEFIT ADMIN CONTRACTED [320251] | HB FTSM ROGR CAH DEC SAPAUGH | $404.59 | ↓ -8% |
| MERCY BENEFIT ADMIN CONTRACTED [320251] | HB FTSM ROGR DEC CITY OF JACKSON | $404.59 | ↓ -8% |
| MERCY BENEFIT ADMIN CONTRACTED [320251] | HB FTSM ROGR DEC EASTER SEALS | $404.59 | ↓ -8% |
| IMAGINE 360 CONTRACTED [320494] | HB FTSM ROGR DEC ROBINSON CONSTRUCTION | $404.59 | ↓ -8% |
| MERCY BENEFIT ADMIN CONTRACTED [320251] | HB FTSM DEC QUIKTRIP CO | $404.59 | ↓ -8% |
| REFLECT HEALTH CONTRACTED [320492] | HB FTSM DEC WWWood Products | $404.59 | ↓ -8% |
| HEALTHLINK CONTRACTED [320179] | HB FTSM ROGR CAH DEC SAPAUGH | $404.59 | ↓ -8% |
| EBMS CONTRACTED [320493] | HB FTSM CRADER | $404.59 | ↓ -8% |
| EBMS [20493] | HB FTSM CRADER | $404.59 | ↓ -8% |
| AUXIANT CONTRACTED [320462] | HB FTSM ROGR DEC CITY OF JACKSON | $404.59 | ↓ -8% |
| AUXIANT CONTRACTED [320462] | HB FTSM ROGR DEC BUCHHEIT | $404.59 | ↓ -8% |
| MUNICIPAL HEALTH PLAN CONTRACTED [320271] | HB FTSM MUNICIPAL HEALTH | $404.59 | ↓ -8% |
| HEALTHLINK CONTRACTED [320179] | HB FTSM NET AFFILIATION | $438.30 | ↑ +0% |
| INSURANCE SYSTEM INC CONTRACTED [320465] | HB FTSM NET AFFILIATION | $438.30 | ↑ +0% |
| AUXIANT CONTRACTED [320462] | HB FTSM NET AFFILIATION | $438.30 | ↑ +0% |
| WORKERS COMP [20426] | HB FTSM WORK COMP AETNA/COVENTRY | $438.30 | ↑ +0% |
| PREFERRED HEALTH PLAN CONTRACTED [320522] | HB FTSM NET AFFILIATION | $438.30 | ↑ +0% |
| PERSONIFY HEALTH CONTRACTED [320051] | HB FTSM NET AFFILIATION | $438.30 | ↑ +0% |
| PPO PLUS CONTRACTED [320310] | HB FTSM PPO PLUS | $505.73 | ↑ +15% |
| HUMANA CONTRACTED [320193] | HB FTSM HUMANA | $505.73 | ↑ +15% |
| EMPLOYERS HEALTH COALITION CONTRACTED [320116] | HB FTSM EHC NON EXCLUSIVE | $529.33 | ↑ +21% |
| PRIVATE HEALTH CARE SYSTEMS [20320] | HB FTSM PHCS | $539.45 | ↑ +23% |
| PRIVATE HEALTH CARE SYSTEMS CONTRACTED [320320] | HB FTSM PHCS | $539.45 | ↑ +23% |
| MULTIPLAN [20270] | HB FTSM,WLDAR,OZKAR,PRSAR MULTI PLAN | $573.16 | ↑ +31% |
| MULTIPLAN CONTRACTED [320270] | HB FTSM,WLDAR,OZKAR,PRSAR MULTI PLAN | $573.16 | ↑ +31% |