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 |
|---|---|---|---|---|
| Ftl cgen abnor four anal CPT 81511 | $163.80 | $252.00 | $98.97 – $295.53 | 67 |
| Furosemide 10 mg/ml injection solution HCPCS J1938 | $7.15 | $11.00 | $0.40 – $1.60 | 8 |
| G0180 home health certification HCPCS G0180 | $87.75 | $135.00 | $46.86 – $92.58 | 61 |
| Ga-67 gallium 0.1 mci HCPCS A9556 | $78.00 | $120.00 | $14.68 – $169.31 | 14 |
| Ga-68 gallium 68 dotatate HCPCS A9587 | $118.95 | $183.00 | $45.98 – $162.94 | 73 |
| Gadobutrol 1 mmol/ml intravenous solution (wrapper) HCPCS A9585 | $274.79 | $422.75 | $22.50 – $43.50 | 5 |
| Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution HCPCS A9581 | $438.30 | $674.31 | $135.00 – $306.45 | 15 |
| Galac-1-phosphate uridyltran - sendout CPT 82775 | $370.50 | $570.00 | $18.74 – $96.18 | 86 |
| Galactose transferase test CPT 82776 | $14.30 | $22.00 | $8.75 – $29.29 | 86 |
| Gallbladder Removal (Laparoscopic) CPT 47562 | $7,005.15 | $10,777.15 | $363.00 – $9,918.41 | 79 |
| Gallium illuccix 1 millicure HCPCS A9596 | $731.25 | $1,125.00 | $469.43 – $1,295.64 | 67 |
| Gammaglobulin iga CPT 82784 | $123.50 | $190.00 | $7.87 – $26.34 | 86 |
| Gammaglobulin ige CPT 82785 | $44.20 | $68.00 | $14.64 – $73.92 | 86 |
| Gamma glutamyltransferase CPT 82977 | $65.00 | $100.00 | $6.40 – $32.88 | 86 |
| Gamunex-c/gammaked HCPCS J1561 | $12,347.92 | $18,996.80 | $48.14 – $1,825.60 | 79 |
| Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr HCPCS J1570 | $185.25 | $285.00 | $28.74 – $124.70 | 21 |
| Gardner vag dna quant CPT 87512 | $113.75 | $175.00 | $22.47 – $105.97 | 82 |
| Gastric emptying imag study CPT 78265 | $1,291.55 | $1,987.00 | $255.88 – $828.29 | 69 |
| Gastric emptying imag study CPT 78266 | $1,714.70 | $2,638.00 | $293.39 – $1,109.46 | 69 |
| Gastroesophageal reflux study CPT 78262 | $802.75 | $1,235.00 | $64.00 – $828.29 | 75 |
| Gastroesophageal reflux test CPT 91034 | $1,244.75 | $1,915.00 | $159.60 – $1,153.00 | 78 |
| Gated heart multiple CPT 78473 | $1,649.05 | $2,537.00 | $61.00 – $828.29 | 75 |
| Gba gene CPT 81251 | $313.30 | $482.00 | $42.03 – $491.82 | 72 |
| Gemcitabine 1 gram intravenous solution HCPCS J9201 | $109.54 | $168.52 | $2.87 – $242.25 | 20 |
| Gentamicin 10 mg/ml liquid compound - enteral use only HCPCS J1580 | $21.71 | $33.40 | $2.20 – $11.46 | 21 |
| Gentamicin peak therapeutic drug level CPT 80170 | $87.10 | $134.00 | $14.57 – $74.82 | 86 |
| G-esoph reflx tst w/electrod CPT 91035 | $1,290.25 | $1,985.00 | $330.48 – $1,535.35 | 78 |
| Ghs acetylcholinesterase, rbc CPT 82482 | $55.25 | $85.00 | $8.73 – $35.09 | 80 |
| Ghs alpha thalasemia, 7 deletions CPT 81257 | $262.60 | $404.00 | $90.96 – $418.29 | 79 |
| Ghs analysis neurostim without reprogramming CPT 95970 | $85.80 | $132.00 | $9.90 – $210.69 | 74 |
| Ghs antibodies (torch) igm CPT 86694 | $52.00 | $80.00 | $12.80 – $65.72 | 86 |
| Ghs aspiration bladder - needle CPT 51100 | $13,967.65 | $21,488.69 | $31.08 – $8,642.15 | 79 |
| Ghs bladder cath - complex-foley CPT 51703 | $169.00 | $260.00 | $61.63 – $735.00 | 73 |
| Ghs bleeding time (ivy) CPT 85002 | $53.95 | $83.00 | $4.29 – $20.58 | 80 |
| Ghs block ilioinguinal/gentitofemoral CPT 64425 | $893.21 | $1,374.17 | $45.68 – $1,225.99 | 77 |
| Ghs change cysto/gastrost CPT 43762 | $172.25 | $265.00 | $30.82 – $433.94 | 62 |
| Ghs chemo >8 hrs CPT 96416 | $442.65 | $681.00 | $113.05 – $523.06 | 68 |
| Ghs chemo IV push, ea addtl CPT 96411 | $256.75 | $395.00 | $60.68 – $209.94 | 68 |
| Ghs chlamydia pneumoniae by pcr (arup) (306630) CPT 87486 | $98.15 | $151.00 | $31.21 – $160.20 | 79 |
| Ghs closure surg wound/dehiscence-13160 CPT 13160 | $4,084.88 | $6,284.43 | $250.00 – $6,154.82 | 77 |
| Ghs community re-entry 15 minutes CPT 97537 | $59.80 | $92.00 | $29.27 – $95.02 | 57 |
| Ghs diphtheria toxoid ab igg CPT 86648 | $102.05 | $157.00 | $13.53 – $69.44 | 86 |
| Ghs eeg cont rec w/video by tec min 8 chnls CPT 95700 | $340.60 | $524.00 | $133.38 – $386.05 | 64 |
| Ghs febrile agglutinns(mayo) CPT 86000 | $74.75 | $115.00 | $2.15 – $18.00 | 86 |
| Ghs fish cytogen CPT 88271 | $228.15 | $351.00 | $19.05 – $97.79 | 86 |
| Ghs fish hybrid in situ 100-300 CPT 88275 | $98.80 | $152.00 | $45.53 – $183.35 | 86 |
| Ghs flow volume loop CPT 94375 | $245.05 | $377.00 | $13.00 – $386.05 | 74 |
| Ghs gastric intub aspiration lavage CPT 43753 | $2,282.91 | $3,512.17 | $18.39 – $735.00 | 75 |
| Ghs hcv amplificaiton CPT 87521 | $196.30 | $302.00 | $31.58 – $160.20 | 77 |
| Ghs hgb stability-thal CPT 83068 | $79.95 | $123.00 | $8.42 – $38.63 | 86 |
| Ghs histoplasma antigen CPT 87385 | $163.15 | $251.00 | $11.79 – $41.12 | 86 |
| Ghs HIV antibody CPT 86703 | $130.65 | $201.00 | $7.91 – $62.58 | 86 |
| Ghs immun0electrophoresis CPT 86320 | $59.15 | $91.00 | $26.61 – $102.34 | 80 |
| Ghs inf midline insertion CPT 36140 | $16,059.08 | $24,706.28 | $70.55 – $5,467.90 | 79 |
| Ghs inhibitor screen CPT 85335 | $263.25 | $405.00 | $11.45 – $58.76 | 86 |
| Ghs inj transforaminal cerv single bil CPT 64479 | $1,440.93 | $2,216.82 | $106.81 – $1,536.17 | 77 |
| Ghs intermed repair 12.6 - 20.0 cm-12035 CPT 12035 | $3,686.15 | $5,671.00 | $172.57 – $4,865.49 | 80 |
| Ghs IV inf sq injection, on-body injector CPT 96377 | $105.30 | $162.00 | $15.83 – $910.11 | 72 |
| Ghs layer closure 2.5 cm or less - 12031 CPT 12031 | $4,347.44 | $6,688.37 | $119.31 – $2,589.43 | 78 |
| Ghs layer closure 2.5 cm or less - 12041 CPT 12041 | $3,853.13 | $5,927.89 | $116.16 – $2,589.43 | 78 |
| Ghs layer closure 2.6 - 5.0 cm - 12052 CPT 12052 | $3,832.50 | $5,896.16 | $4.52 – $2,589.43 | 79 |
| Ghs layer closure 2.6 - 7.5 cm - 12042 CPT 12042 | $4,150.89 | $6,385.99 | $151.80 – $2,589.43 | 78 |
| Ghs layer closure 7.6 - 12.5 cm - 12034 CPT 12034 | $6,135.22 | $9,438.80 | $161.51 – $6,509.78 | 80 |
| Ghs mbp CPT 83873 | $61.75 | $95.00 | $15.30 – $78.56 | 86 |
| Ghs moderate sedation < 5 yr, 30 min CPT 99151 | $104.65 | $161.00 | $19.81 – $88.58 | 6 |
| Ghs moderate sedation < 5 yr, 30 min, other CPT 99155 | $256.10 | $394.00 | $73.98 – $121.89 | 5 |
| Ghs moderate sedation, > 5 yr, 30 min, other CPT 99156 | $202.80 | $312.00 | $65.76 – $106.47 | 6 |
| Ghs moderate sedation ea addtl 15 min CPT 99153 | $143.65 | $221.00 | $9.67 – $17.45 | 5 |
| Ghs moderate sedation ea addtl 15 min, other CPT 99157 | $117.65 | $181.00 | $50.04 – $80.97 | 6 |
| Ghs musc test done w/n test comp CPT 95886 | $98.80 | $152.00 | $42.76 – $143.17 | 18 |
| Ghs musc tst done w/nerv tst lim CPT 95885 | $87.75 | $135.00 | $39.03 – $114.78 | 18 |
| Ghs nerve blk intercostal, ea addtl level CPT 64421 | $1,465.78 | $2,255.04 | $20.09 – $1,536.17 | 77 |
| Ghs nerve blk intercostal, single level CPT 64420 | $1,461.18 | $2,247.97 | $48.27 – $1,225.99 | 77 |
| Ghs nerve block axillary nerve CPT 64417 | $4,065.20 | $6,254.15 | $56.52 – $12,144.34 | 80 |
| Ghs nerve block brachial plexus CPT 64415 | $7,863.07 | $12,097.03 | $61.71 – $12,144.34 | 80 |
| Ghs nerve block celiac plexus CPT 64530 | $1,532.77 | $2,358.11 | $77.86 – $1,536.17 | 77 |
| Ghs nerve block interscaline CPT 64510 | $2,107.48 | $3,242.27 | $63.40 – $1,536.17 | 77 |
| Ghs nerve block lumbar or thoracic symp CPT 64520 | $2,123.86 | $3,267.48 | $69.83 – $1,536.17 | 77 |
| Ghs nerve block sciatic nerve CPT 64445 | $10,210.30 | $15,708.15 | $60.63 – $12,144.34 | 79 |
| Ghs o2 saturation CPT 82810 | $63.70 | $98.00 | $8.69 – $39.86 | 86 |
| Ghs ot dds rom CPT 95851 | $49.40 | $76.00 | $6.29 – $36.89 | 65 |
| Ghs ot prosthetic training/15 min CPT 97761 | $62.40 | $96.00 | $35.35 – $103.47 | 65 |
| Ghs ot sensory integrative tech/15min CPT 97533 | $52.65 | $81.00 | $52.51 – $91.76 | 63 |
| Ghs ot work hardening-additional hours CPT 97546 | $102.70 | $158.00 | $160.43 – $160.43 | 1 |
| Ghs pacing - transcutaneous CPT 92953 | $761.15 | $1,171.00 | $35.42 – $1,147.94 | 76 |
| Ghs paravert facet/nerve cerv ea add bil CPT 64492 | $1,175.32 | $1,808.18 | $47.51 – $1,536.17 | 76 |
| Ghs paravert facet/nerve lumb ea add bil CPT 64495 | $1,197.24 | $1,841.91 | $41.83 – $1,536.17 | 76 |
| Ghs peritonsillar abscess i andd CPT 42700 | $6,089.90 | $9,369.07 | $39.60 – $2,518.18 | 80 |
| Ghs phenylketonurid CPT 84030 | $63.05 | $97.00 | $4.89 – $25.00 | 86 |
| Ghs picc line insert < 5 CPT 36568 | $1,257.75 | $1,935.00 | $77.62 – $2,640.85 | 78 |
| Ghs polysom <6 yrs 4/> parameters CPT 95782 | $2,546.70 | $3,918.00 | $675.41 – $2,582.18 | 77 |
| Ghs ppd (tb intradermal) CPT 86580 | $38.35 | $59.00 | $6.69 – $45.35 | 81 |
| Ghs prostatic acid phosphatase (mayo) CPT 84066 | $43.55 | $67.00 | $8.59 – $44.12 | 80 |
| Ghs protein, misc fluid CPT 84160 | $31.20 | $48.00 | $4.99 – $23.63 | 80 |
| Ghs protoporphyrins fract CPT 84202 | $83.20 | $128.00 | $12.76 – $65.48 | 80 |
| Ghs pr without cont pulse ox CPT 94625 | $252.85 | $389.00 | $50.63 – $105.47 | 61 |
| Ghs pt - work hardening/int 2hrs CPT 97545 | $219.70 | $338.00 | $401.68 – $401.68 | 1 |
| Ghs quinidine CPT 80194 | $68.25 | $105.00 | $12.99 – $66.67 | 80 |
| Ghs reticulocyte count CPT 85044 | $26.65 | $41.00 | $3.83 – $19.66 | 86 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | $155.35 | $239.00 | $12.29 – $41.12 | 86 |
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.