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 |
|---|---|---|---|---|
| Infectious agent nucleic acid amplified probe CPT 87798 | $366.60 | $564.00 | $31.21 – $160.20 | 86 |
| Infectious agent nucleic acid amplified probe chlamydia trachomatis CPT 87491 | $221.00 | $340.00 | $31.21 – $160.20 | 86 |
| Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s) CPT 87493 | $100.75 | $155.00 | $33.15 – $160.20 | 86 |
| Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets CPT 87483 | $856.70 | $1,318.00 | $375.10 – $1,297.80 | 80 |
| Infectious agent nucleic acid amplified probe hsv-1 CPT 87529 | $100.75 | $155.00 | $31.21 – $160.20 | 86 |
| Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus CPT 87641 | $100.75 | $155.00 | $31.21 – $160.20 | 86 |
| Infectious agent nucleic acid amplified probe mycobacteria tuberculosis CPT 87556 | $238.55 | $367.00 | $37.07 – $160.20 | 86 |
| Infectious agent nucleic acid amplified probe neisseria gonorrhoeae CPT 87591 | $104.65 | $161.00 | $31.21 – $160.20 | 86 |
| Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 CPT 87635 | $130.00 | $200.00 | $45.64 – $83.06 | 69 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b CPT 87636 | $178.75 | $275.00 | $126.87 – $230.88 | 69 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv CPT 87637 | $256.75 | $395.00 | $126.87 – $230.88 | 69 |
| Infectious agent nucleic acid amplified probe streptococcus group a CPT 87651 | $65.00 | $100.00 | $31.58 – $160.20 | 83 |
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | $153.40 | $236.00 | $31.21 – $160.20 | 86 |
| Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae CPT 87494 | $178.10 | $274.00 | $68.85 – $113.60 | 62 |
| Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance CPT 87564 | $143.00 | $220.00 | $68.28 – $124.27 | 60 |
| Infectious agent nucleic acid joint space pathogens multiplex amplified probe >= 26 targets CPT 87627 | $358.80 | $552.00 | $666.85 – $1,100.34 | 62 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | $718.25 | $1,105.00 | $375.10 – $2,456.85 | 79 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | $478.40 | $736.00 | $38.11 – $195.58 | 86 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | $123.50 | $190.00 | $38.11 – $195.58 | 86 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $154.70 | $238.00 | $38.11 – $195.58 | 86 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $224.90 | $346.00 | $75.70 – $388.49 | 86 |
| Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets CPT 87631 | $399.75 | $615.00 | $92.72 – $585.72 | 79 |
| Infliximab 100 mg intravenous solution HCPCS J1745 | $2,663.29 | $4,097.37 | $31.81 – $1,491.39 | 79 |
| Infliximab-axxq 100 mg intravenous solution HCPCS Q5121 | $1,144.00 | $1,760.00 | $23.36 – $1,206.00 | 70 |
| Infliximab-dyyb 100 mg intravenous solution HCPCS Q5103 | $2,159.29 | $3,321.98 | $23.76 – $1,300.26 | 79 |
| Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis CPT 94642 | $204.10 | $314.00 | $4.61 – $391.51 | 73 |
| Initiation & management bipap/cpap initial day CPT 94660 | $817.05 | $1,257.00 | $121.06 – $391.51 | 62 |
| Inj anifrolumab-fnia 1mg HCPCS J0491 | $12,569.62 | $19,337.88 | $17.99 – $20,466.00 | 70 |
| Inj, aspara, rylaze, 0.1 mg HCPCS J9021 | $12,678.25 | $19,505.00 | $55.11 – $10,971.00 | 69 |
| Inj., benralizumab, 1 mg HCPCS J0517 | $13,707.62 | $21,088.65 | $160.85 – $18,298.20 | 79 |
| Inj, bezlotoxumab, 10 mg HCPCS J0565 | $8,651.50 | $13,310.00 | $39.07 – $14,814.00 | 79 |
| Inj brixadi, more than 7 day HCPCS J0578 | $3,578.65 | $5,505.61 | $1,648.29 – $6,250.38 | 70 |
| Inj calcitriol per 0.1 mcg HCPCS J0636 | $9.25 | $14.23 | $4.50 – $16.10 | 17 |
| Inj cefazolin sodium, hikma HCPCS J0688 | $27.10 | $41.69 | $5.82 – $19.56 | 12 |
| Inj, cefiderocol, 10 mg HCPCS J0699 | $762.03 | $1,172.35 | $2.37 – $900.00 | 70 |
| Inj ceftolozane tazobactam HCPCS J0695 | $591.66 | $910.25 | $8.78 – $665.60 | 79 |
| Inj crotalidae im f(ab')2 eq HCPCS J0841 | $2,659.80 | $4,092.00 | $1,027.17 – $18,321.60 | 62 |
| Inj cyclophosphamd (ingenus) HCPCS J9073 | $2,672.80 | $4,112.00 | $0.68 – $876.00 | 69 |
| Inj. denosumab-bbdz, 1 mg HCPCS Q5136 | $7,305.30 | $11,238.92 | $27.69 – $6,301.20 | 63 |
| Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides) CPT 64454 | $1,175.12 | $1,807.88 | $2.40 – $1,225.99 | 63 |
| Injection during cath supravalvular aortography CPT 93567 | $1,175.20 | $1,808.00 | $32.54 – $735.00 | 9 |
| Injection, edaravone, 1 mg HCPCS J1301 | $1,307.53 | $2,011.59 | $17.14 – $1,949.40 | 63 |
| Injection epidural blood patch or clot CPT 62273 | $1,748.58 | $2,690.13 | $93.93 – $1,225.99 | 75 |
| Injection for bladder x-ray CPT 51600 | $1,855.75 | $2,855.00 | $34.66 – $735.00 | 76 |
| Injection for ureter x-ray CPT 50690 | $434.20 | $668.00 | $56.50 – $735.00 | 15 |
| Injection, fulvestrant HCPCS J9395 | $461.50 | $710.00 | $112.60 – $3,661.96 | 20 |
| Injection glatiramer acetate HCPCS J1595 | $732.15 | $1,126.39 | $63.25 – $237.13 | 11 |
| Injection, inclisiran, 1 mg HCPCS J1306 | $7,518.45 | $11,566.85 | $12.45 – $13,404.80 | 70 |
| Injection,onabotulinumtoxina HCPCS J0585 | $1,311.76 | $2,018.10 | $6.39 – $2,422.00 | 79 |
| Injection(s) anesthetic agent(s) and/or steroid femoral nerve left CPT 64447 | $16,567.29 | $25,488.14 | $90.58 – $21,873.59 | 79 |
| Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides) CPT 64450 | $9,161.06 | $14,093.94 | $35.13 – $5,515.84 | 79 |
| Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides) CPT 64483 | $1,447.44 | $2,226.83 | $90.96 – $1,536.17 | 77 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level CPT 64491 | $1,185.83 | $1,824.35 | $47.00 – $1,536.17 | 76 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level CPT 64490 | $1,185.83 | $1,824.35 | $86.06 – $1,536.17 | 76 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance CPT 64494 | $1,197.24 | $1,841.91 | $40.70 – $1,536.17 | 76 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level CPT 64493 | $1,197.24 | $1,841.91 | $74.30 – $1,536.17 | 76 |
| Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance CPT 62321 | $1,459.13 | $2,244.82 | $87.68 – $1,225.99 | 70 |
| Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance CPT 62323 | $1,476.03 | $2,270.82 | $81.78 – $1,225.99 | 70 |
| Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 | $37.05 | $57.00 | $50.62 – $735.00 | 63 |
| Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s) CPT 20552 | $140.40 | $216.00 | $32.44 – $735.00 | 64 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug CPT 96375 | $136.50 | $210.00 | $39.33 – $74.15 | 65 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 | $136.50 | $210.00 | $32.55 – $40.93 | 5 |
| Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug CPT 96374 | $136.50 | $210.00 | $164.56 – $336.83 | 65 |
| Injection therapeutic/prophylactic/diagnostic subcutaneous/im CPT 96372 | $104.00 | $160.00 | $60.68 – $114.02 | 65 |
| Inj fluphenazine hcl 1.25 mg HCPCS J2679 | $29.65 | $45.62 | $7.69 – $27.50 | 12 |
| Inj for ext venography CPT 36005 | $4,658.54 | $7,166.98 | $37.87 – $2,640.85 | 76 |
| Inj., guselkumab, 1 mg HCPCS J1628 | $34,802.08 | $53,541.66 | $71.55 – $54,264.00 | 78 |
| Inj heparin, pfizer, 1000u HCPCS J1643 | $18.49 | $28.45 | $1.31 – $7.82 | 12 |
| Inj hrt cath w/s&i nonsel p-art angrp CPT 93568 | $1,235.00 | $1,900.00 | $40.32 – $735.00 | 9 |
| Inj hrt cath w/s&i sel hrt ang CPT 93563 | $1,425.45 | $2,193.00 | $44.94 – $735.00 | 9 |
| Inj hrt cath w/s&i sel hrt art CPT 93564 | $1,053.65 | $1,621.00 | $47.90 – $735.00 | 9 |
| Inj hrt cath w/s&i sel left vent CPT 93565 | $1,407.25 | $2,165.00 | $23.35 – $735.00 | 9 |
| Inj hrt cath w/s&i sel right vent CPT 93566 | $1,407.25 | $2,165.00 | $22.59 – $735.00 | 9 |
| Inj levocarnitine per 1 gm HCPCS J1955 | $110.14 | $169.44 | $25.56 – $86.56 | 21 |
| Inj, levothyroxine, freskabi HCPCS J0651 | $743.22 | $1,143.42 | $6.80 – $129.00 | 70 |
| Inj lwr xtr fscl pln blk uni w/wo image CPT 64473 | $16,778.04 | $25,812.37 | $51.11 – $21,873.59 | 79 |
| Inj mepivacaine hcl/10 ml HCPCS J0670 | $43.54 | $66.98 | $3.55 – $18.73 | 21 |
| Inj meropenem (wg crit care) HCPCS J2183 | $92.62 | $142.50 | $16.50 – $58.40 | 12 |
| Inj multihance HCPCS A9577 | $91.53 | $140.82 | $10.20 – $32.35 | 15 |
| Inj. mycophenolate mofetil HCPCS J7519 | $223.85 | $344.38 | $17.50 – $68.00 | 12 |
| Inj nephrosto/ureterogram w/img exstng access CPT 50431 | $1,996.15 | $3,071.00 | $53.68 – $1,093.24 | 74 |
| Inj ogivri 10 mg HCPCS Q5114 | $5,978.49 | $9,197.68 | $36.99 – $1,104.75 | 69 |
| Inj proc lumbr disk ea lvl CPT 62290 | $8,853.16 | $13,620.25 | $131.44 – $5,546.12 | 79 |
| Inj, releuko 1 mcg HCPCS Q5125 | $785.46 | $1,208.40 | $0.33 – $378.00 | 63 |
| Inj sulf hexa lipid microsph HCPCS Q9950 | $448.46 | $689.94 | $103.30 – $337.90 | 8 |
| Inj, sutimlimab-jome, 10 mg HCPCS J1302 | $4,759.65 | $7,322.54 | $18.67 – $7,785.80 | 70 |
| Inj testosterone cypionate HCPCS J1071 | $55.44 | $85.29 | $4.00 – $20.00 | 21 |
| Inj thrc fascial pln blk uni w/wo image CPT 64466 | $1,252.02 | $1,926.19 | $20.43 – $167.98 | 18 |
| Inj, tofidence, 1 mg HCPCS Q5133 | $4,397.25 | $6,765.00 | $5.48 – $1,662.40 | 69 |
| Inj, tyenne, 1 mg HCPCS Q5135 | $4,461.86 | $6,864.40 | $4.11 – $1,248.00 | 70 |
| Inj w/fluor eval cv device CPT 36598 | $405.60 | $624.00 | $28.29 – $735.00 | 77 |
| Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln HCPCS J9229 | $55,503.47 | $85,389.95 | $2,763.25 – $49,510.35 | 71 |
| Ins cath ren art 1st bi CPT 36252 | $10,673.91 | $16,421.40 | $275.96 – $5,350.75 | 79 |
| Ins cath ren art 1st uni CPT 36251 | $16,123.82 | $24,805.88 | $202.40 – $18,099.34 | 78 |
| Ins cerv dilator (sep proc) CPT 59200 | $237.25 | $365.00 | $51.98 – $1,577.00 | 66 |
| Insert cath pleura with image CPT 32557 | $1,784.25 | $2,745.00 | $119.85 – $2,640.85 | 79 |
| Insert intrauterine device iud CPT 58300 | $3,913.09 | $6,020.14 | $95.11 – $5,075.27 | 78 |
| Insertion catheter bladder non indwelling CPT 51701 | $19,823.47 | $30,497.65 | $20.15 – $11,367.77 | 79 |
| Insertion catheter bladder temporary simple CPT 51702 | $17,576.54 | $27,040.83 | $20.72 – $11,367.77 | 79 |
| Insertion catheter pleural indwelling tunneled with cuff CPT 32550 | $4,535.89 | $6,978.29 | $165.55 – $5,999.40 | 79 |
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.