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 |
|---|---|---|---|---|
| Ghs sedimentation rate CPT 85651 | $57.85 | $89.00 | $3.80 – $16.21 | 86 |
| Ghs semen analysis fert CPT 89320 | $124.15 | $191.00 | $11.08 – $55.02 | 77 |
| Ghs sensitivity (per antimicro) CPT 87184 | $53.30 | $82.00 | $6.65 – $31.48 | 86 |
| Ghs sleep study unattended CPT 95800 | $430.30 | $662.00 | $86.61 – $386.05 | 68 |
| Ghs somatosensory testing lower extremit CPT 95926 | $917.80 | $1,412.00 | $31.85 – $386.05 | 74 |
| Ghs sp train/fitting sp device - kx CPT 92609 | $260.65 | $401.00 | $88.61 – $346.92 | 61 |
| Ghs st - re-eval for alt comm CPT 92597 | $271.05 | $417.00 | $62.78 – $229.93 | 63 |
| Ghs subcutaneous infus, for therapy ea. add. hr CPT 96370 | $122.20 | $188.00 | $15.15 – $74.15 | 65 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $3,829.08 | $5,890.89 | $158.54 – $1,283.64 | 75 |
| Ghs urine, porphyrins quant CPT 84120 | $86.45 | $133.00 | $13.08 – $61.04 | 86 |
| Ghs vaginal delivery only CPT 59409 | $204.75 | $315.00 | $706.07 – $5,075.27 | 58 |
| Gi inhouse confirmation CPT 87045 | $33.80 | $52.00 | $8.40 – $43.10 | 86 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | $2,098.85 | $3,229.00 | $615.58 – $3,089.68 | 78 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $864.50 | $1,330.00 | $38.55 – $613.30 | 79 |
| Glucagon plasma - sendout CPT 82943 | $76.70 | $118.00 | $12.71 – $65.23 | 80 |
| Glucose 1 hr post dose CPT 82950 | $53.30 | $82.00 | $4.23 – $21.68 | 86 |
| Glucose-6-phosphate dhydrogenase screen CPT 82960 | $51.35 | $79.00 | $5.38 – $27.63 | 80 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $31.20 | $48.00 | $2.92 – $10.71 | 80 |
| Glucose blood quantitative CPT 82947 | $14.30 | $22.00 | $3.50 – $17.93 | 86 |
| Glucose body fluid CPT 82945 | $59.15 | $91.00 | $3.50 – $17.93 | 86 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $97.50 | $150.00 | $11.45 – $58.76 | 86 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $40.95 | $63.00 | $3.49 – $17.90 | 86 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | $7.41 | $11.40 | $0.42 – $1.40 | 12 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $4,554.67 | $7,007.18 | $11.41 – $3,096.28 | 79 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $66.30 | $102.00 | $16.53 – $84.83 | 86 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $130.65 | $201.00 | $16.47 – $84.54 | 86 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | $7,315.87 | $11,255.19 | $318.75 – $1,518.46 | 74 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $37.70 | $58.00 | $28.53 – $205.80 | 69 |
| Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm HCPCS Q4113 | $2,516.80 | $3,872.00 | $311.36 – $1,041.00 | 11 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | $150.80 | $232.00 | $34.27 – $205.80 | 67 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $585.00 | $900.00 | $124.72 – $239.88 | 56 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $323.05 | $497.00 | $124.72 – $205.80 | 60 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | $1,550.90 | $2,386.00 | $23.13 – $239.88 | 68 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | $323.05 | $497.00 | $124.72 – $205.80 | 53 |
| Granisetron hcl injection HCPCS J1626 | $578.57 | $890.11 | $1.80 – $418.82 | 21 |
| Gu dilat ureter/urethra s&i CPT 74485 | $1,214.85 | $1,869.00 | $67.46 – $3,985.99 | 66 |
| Guid loc target vol rad tx CPT 77387 | $19,784.70 | $30,438.00 | $33.65 – $2,295.24 | 74 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | $86.70 | $133.38 | $5.27 – $67.08 | 21 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $7.15 | $11.00 | $0.89 – $15.39 | 21 |
| Hand X-ray CPT 73130 | $323.70 | $498.00 | $24.14 – $179.57 | 81 |
| Haptoglobin quantitative CPT 83010 | $123.50 | $190.00 | $11.19 – $57.41 | 86 |
| Hba1/hba2 full gene sequence CPT 81259 | $533.00 | $820.00 | $533.69 – $1,362.00 | 78 |
| Hba1/hba2 gene dup/del vrnts CPT 81269 | $393.25 | $605.00 | $180.03 – $459.45 | 78 |
| Hbb full gene sequence CPT 81364 | $502.45 | $773.00 | $288.71 – $736.80 | 79 |
| Hbb gene dup/del variants CPT 81363 | $538.85 | $829.00 | $180.03 – $459.45 | 72 |
| Hbot, full body chamber, 30m HCPCS G0277 | $564.20 | $868.00 | $117.56 – $215.75 | 65 |
| Hc fl sm bowel enteroclss tube w kub double contrast CPT 74251 | $545.35 | $839.00 | $35.00 – $1,125.98 | 75 |
| Hcg qualitative CPT 84703 | $36.40 | $56.00 | $6.69 – $34.35 | 86 |
| Hcg quantitative CPT 84702 | $53.95 | $83.00 | $11.03 – $37.99 | 86 |
| Hc i-131 sodium iodide cap dx per mci HCPCS A9528 | $106.60 | $164.00 | $12.04 – $27.33 | 10 |
| Hc nm cardiac blood pool planar 1 stdy wal motn eject fract CPT 78481 | $545.35 | $839.00 | $46.00 – $1,109.46 | 75 |
| Hc nm kidney imaging with flow CPT 78701 | $499.20 | $768.00 | $46.00 – $828.29 | 75 |
| Hc nm myocard infarct avid plnr tomo spect w/wo quant CPT 78469 | $1,160.90 | $1,786.00 | $44.00 – $2,862.43 | 83 |
| Hc pet myocardial imaging metabolic eval single study CPT 78459 | $3,610.75 | $5,555.00 | $50.27 – $2,862.43 | 80 |
| Hc transcatheter placement and sbsq removal cepd perq CPT 33370 | $2,430.35 | $3,739.00 | not published | 0 |
| Hdr rdncl ntrstl/icav brchtx CPT 77770 | $2,863.90 | $4,406.00 | $205.35 – $1,457.61 | 75 |
| Hdr rdncl ntrstl/icav brchtx CPT 77771 | $3,645.85 | $5,609.00 | $339.36 – $1,457.61 | 75 |
| Hdr rdncl ntrstl/icav brchtx CPT 77772 | $4,440.15 | $6,831.00 | $519.97 – $1,622.35 | 68 |
| Head CT scan (with and without contrast) CPT 70470 | $1,688.70 | $2,598.00 | $98.54 – $948.54 | 77 |
| Head CT scan (with contrast) CPT 70460 | $1,402.70 | $2,158.00 | $81.24 – $766.85 | 77 |
| Head CT scan (without contrast) CPT 70450 | $1,075.10 | $1,654.00 | $57.46 – $669.29 | 77 |
| Heart infarct image CPT 78466 | $1,160.90 | $1,786.00 | $38.00 – $828.29 | 83 |
| Helicobacter pylori antibody igm CPT 86677 | $90.35 | $139.00 | $14.99 – $66.27 | 80 |
| Hematocrit CPT 85014 | $28.60 | $44.00 | $2.11 – $10.80 | 86 |
| Hemin 350 mg intravenous powder for solution HCPCS J1640 | $23,025.73 | $35,424.20 | $34.64 – $45,969.00 | 72 |
| Hemodialysis one evaluation CPT 90935 | $1,400.10 | $2,154.00 | $57.83 – $1,227.07 | 63 |
| Hemoglobin CPT 85018 | $10.40 | $16.00 | $2.11 – $10.80 | 86 |
| Hemoglobin fetal qualitative CPT 83033 | $21.45 | $33.00 | $7.12 – $25.93 | 80 |
| Hemoglobin methemoglobin quantitative CPT 83050 | $30.55 | $47.00 | $7.29 – $26.41 | 86 |
| Hemoglobin plasma CPT 83051 | $43.55 | $67.00 | $6.50 – $33.40 | 86 |
| Hemophilus influenza antibdy CPT 86684 | $114.40 | $176.00 | $14.09 – $67.01 | 86 |
| Hemorrhoidectomy intrnl lig rbbr band ligations CPT 46221 | $4,664.19 | $7,175.68 | $173.49 – $1,615.17 | 76 |
| Heparin assay CPT 85520 | $107.90 | $166.00 | $10.64 – $35.60 | 86 |
| Heparin bolus from bag HCPCS J1644 | $50.95 | $78.38 | $0.20 – $5.27 | 21 |
| Heparin neutralization CPT 85525 | $70.20 | $108.00 | $10.53 – $52.27 | 86 |
| Heparin, porcine (pf) 10 unit/ml flush (wrapper) HCPCS J1642 | $27.79 | $42.75 | $0.02 – $2.29 | 18 |
| Hepatitis a antibody igm CPT 86709 | $78.00 | $120.00 | $10.02 – $51.41 | 86 |
| Hepatitis b core antibody igm CPT 86705 | $50.05 | $77.00 | $10.47 – $53.77 | 86 |
| Hepatitis b core antibody total CPT 86704 | $42.90 | $66.00 | $10.72 – $55.02 | 86 |
| Hepatitis b immune globulin greater than 1,560 units/5 ml im solution CPT 90371 | $2,440.27 | $3,754.26 | $60.48 – $413.48 | 72 |
| Hepatitis b surface antibody CPT 86706 | $60.45 | $93.00 | $9.55 – $49.03 | 86 |
| Hepatitis c antibody CPT 86803 | $50.70 | $78.00 | $12.69 – $65.17 | 86 |
| Hepatobiliary system imaging CPT 78226 | $1,192.10 | $1,834.00 | $212.15 – $871.76 | 83 |
| Hereditary colon ca dsordrs CPT 81435 | $2,748.85 | $4,229.00 | $584.90 – $2,110.70 | 74 |
| Hernia Repair (Inguinal) CPT 49505 | $6,739.98 | $10,369.20 | $363.00 – $5,999.40 | 80 |
| Herpes simplex 1 ag if CPT 87274 | $74.75 | $115.00 | $10.66 – $41.12 | 80 |
| Herpes simplex 2 ag if CPT 87273 | $68.90 | $106.00 | $10.66 – $41.12 | 80 |
| Herpes simplex type 1 antibody igg CPT 86695 | $139.10 | $214.00 | $11.73 – $43.24 | 86 |
| Herpes simplex type 2 antibody igg CPT 86696 | $139.10 | $214.00 | $17.21 – $88.36 | 86 |
| Herpes simplex virus isolation CPT 87255 | $110.50 | $170.00 | $30.12 – $154.61 | 86 |
| Heterophile antibodies screening CPT 86308 | $18.20 | $28.00 | $4.61 – $23.63 | 86 |
| Hexa gene CPT 81255 | $345.80 | $532.00 | $45.76 – $291.49 | 72 |
| Hip arthroscopy dx CPT 29860 | $6,554.19 | $10,083.37 | $297.00 – $12,144.34 | 80 |
| Hip X-ray CPT 73502 | $199.55 | $307.00 | $27.84 – $179.57 | 78 |
| Histamine CPT 83088 | $168.35 | $259.00 | $26.27 – $127.40 | 86 |
| Histochemical stains add-on CPT 88314 | $12,407.23 | $19,088.05 | $40.00 – $9,749.60 | 87 |
| Hla i typing high res 1 allele grp ea CPT 81381 | $364.65 | $561.00 | $96.72 – $431.80 | 86 |
| Hla typing dr/dq CPT 86816 | $275.60 | $424.00 | $26.84 – $127.21 | 80 |
| Hocm 250-299mg/ml iodine,1ml HCPCS Q9961 | $7.72 | $11.88 | $3.00 – $5.00 | 5 |
| Hocm 350-399mg/ml iodine,1ml HCPCS Q9963 | $140.44 | $216.06 | $30.00 – $50.40 | 5 |
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.