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 |
|---|---|---|---|---|
| Streptomycin injection HCPCS J3000 | $231.56 | $356.25 | $1.99 – $126.02 | 21 |
| Stress tte complete CPT 93351 | $1,452.75 | $2,235.00 | $198.98 – $1,242.60 | 74 |
| Str markers specimen anal CPT 81265 | $679.25 | $1,045.00 | $207.31 – $981.81 | 85 |
| St treatment speech individual CPT 92507 | $267.15 | $411.00 | $21.76 – $251.33 | 69 |
| St treatment swallow dysfunction/oral CPT 92526 | $292.50 | $450.00 | $72.86 – $272.73 | 60 |
| Subtalar arthro w/fb rmvl CPT 29904 | $8,068.61 | $12,413.25 | $250.00 – $12,144.34 | 79 |
| Succinylcholine chloride 20 mg/ml injection solution (wrapper) HCPCS J0330 | $7.15 | $11.00 | $0.63 – $5.43 | 20 |
| Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution HCPCS J2865 | $37.54 | $57.76 | $1.60 – $4.48 | 8 |
| Sulfonylurea screen qn-sendout CPT 80377 | $67.60 | $104.00 | $21.35 – $48.46 | 11 |
| Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 | $151.29 | $232.75 | $6.42 – $119.88 | 20 |
| Support clav 29.6-40.5in med HCPCS L3650 | $5.85 | $9.00 | $66.09 – $118.29 | 49 |
| Surgical pathology level 1 gross examination only CPT 88300 | $7,011.87 | $10,787.49 | $8.55 – $45.35 | 87 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $13,436.36 | $20,671.32 | $18.00 – $66.00 | 87 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $5,878.05 | $9,043.15 | $22.00 – $91.95 | 87 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $2,974.53 | $4,576.20 | $27.79 – $92.99 | 87 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $8,168.42 | $12,566.80 | $53.00 – $591.30 | 87 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $16,052.93 | $24,696.82 | $46.00 – $1,263.17 | 87 |
| Susceptibility agar dilution per agent CPT 87181 | $35.10 | $54.00 | $4.23 – $21.68 | 86 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $40.95 | $63.00 | $4.23 – $21.68 | 86 |
| Susceptibility mic per plate CPT 87186 | $88.40 | $136.00 | $7.69 – $26.34 | 86 |
| Suscept studies macrobroth dilution ea CPT 87188 | $99.45 | $153.00 | $5.91 – $21.25 | 86 |
| Svc venogram s&i CPT 75827 | $1,251.25 | $1,925.00 | $54.96 – $2,640.85 | 72 |
| Sweat collection by iontophoresis CPT 89230 | $63.05 | $97.00 | $2.47 – $81.70 | 75 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $58.50 | $90.00 | $3.91 – $20.08 | 86 |
| T3 (triiodothyronine) free CPT 84481 | $60.45 | $93.00 | $15.07 – $77.34 | 86 |
| T3 (triiodothyronine) total CPT 84480 | $43.55 | $67.00 | $12.61 – $64.71 | 86 |
| T4 (thyroxine) free CPT 84439 | $48.10 | $74.00 | $8.02 – $41.17 | 86 |
| T4 (thyroxine) total CPT 84436 | $20.80 | $32.00 | $6.11 – $28.45 | 86 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | $4.87 | $7.50 | $0.18 – $6.04 | 21 |
| Tacrolimus 5 mg/ml intravenous solution HCPCS J7525 | $811.02 | $1,247.73 | $106.29 – $976.32 | 72 |
| Tacrolimus therapeutic drug level CPT 80197 | $122.20 | $188.00 | $12.21 – $62.68 | 86 |
| Tafasitamab-cxix 200 mg intravenous solution HCPCS J9349 | $3,246.10 | $4,994.00 | $13.97 – $2,781.00 | 69 |
| Talquetamab-tgvs 2 mg/ml subcutaneous solution HCPCS J3055 | $27,262.12 | $41,941.72 | $73.49 – $23,409.60 | 69 |
| Tamoxifen 10 mg tabs 60 each bottle HCPCS S0187 | $35.75 | $55.00 | $0.21 – $3.16 | 16 |
| Target gsa panel hmtlmph neop CPT 81450 | $1,740.05 | $2,677.00 | $652.94 – $1,253.22 | 74 |
| Target gsa panel organ neop CPT 81445 | $1,842.75 | $2,835.00 | $531.83 – $997.91 | 67 |
| Tarlatamab-dlle 10 mg intravenous solution HCPCS J9026 | $35,155.25 | $54,085.00 | $1,500.00 – $5,827.70 | 70 |
| Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe HCPCS J1447 | $805.77 | $1,239.65 | $0.24 – $524.37 | 78 |
| Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells CPT 86481 | $159.90 | $246.00 | $87.22 – $342.10 | 86 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $81.90 | $126.00 | $55.13 – $282.98 | 86 |
| Tc-99m bicisate HCPCS A9557 | $794.30 | $1,222.00 | $32.00 – $1,255.33 | 66 |
| Tc-99m exame autol wbc diag per dose HCPCS A9569 | $2,614.95 | $4,023.00 | $916.38 – $2,149.31 | 67 |
| Tc-99m exametazime diag HCPCS A9521 | $1,477.45 | $2,273.00 | $347.61 – $2,149.31 | 66 |
| Tc-99m labeled rbc HCPCS A9560 | $185.25 | $285.00 | $53.92 – $122.40 | 13 |
| Tc-99m maa HCPCS A9540 | $108.55 | $167.00 | $18.14 – $41.18 | 14 |
| Tc-99m mebrofenin HCPCS A9537 | $105.30 | $162.00 | $38.20 – $86.71 | 14 |
| Tc-99m medronate HCPCS A9503 | $38.35 | $59.00 | $13.65 – $145.28 | 17 |
| Tc-99m mertiatide HCPCS A9562 | $362.05 | $557.00 | $31.27 – $971.56 | 13 |
| Tc-99m oxidronate HCPCS A9561 | $105.30 | $162.00 | $23.04 – $55.18 | 13 |
| Tc-99m pentetate dtpa HCPCS A9539 | $91.65 | $141.00 | $13.68 – $39.29 | 13 |
| Tc-99m pertechnetate per mci HCPCS A9512 | $37.05 | $57.00 | $0.20 – $2.12 | 14 |
| Tc-99m pyroph diag per dose up to 25 mci HCPCS A9538 | $100.75 | $155.00 | $20.80 – $80.32 | 14 |
| Tc-99m sestamibi p study dose HCPCS A9500 | $230.10 | $354.00 | $70.66 – $160.40 | 14 |
| Tc-99m succimer (dmsa) HCPCS A9551 | $390.65 | $601.00 | $88.87 – $1,068.23 | 65 |
| Tc-99m sulfur colloid HCPCS A9541 | $265.20 | $408.00 | $52.88 – $335.28 | 17 |
| Tc-99m tetrofosmin p study dose HCPCS A9502 | $199.55 | $307.00 | $89.53 – $363.20 | 17 |
| Tc-99m tilmanocept diag HCPCS A9520 | $694.85 | $1,069.00 | $258.12 – $829.62 | 14 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $110.50 | $170.00 | $41.79 – $183.79 | 86 |
| T cells absolute cd 4 count CPT 86361 | $145.60 | $224.00 | $23.82 – $91.94 | 80 |
| T cells total count CPT 86359 | $110.50 | $170.00 | $33.56 – $172.20 | 86 |
| Tebentafusp-tebn 100 mcg/0.5 ml intravenous solution HCPCS J9274 | $9,793.55 | $15,067.00 | $217.99 – $8,679.60 | 69 |
| Telehealth original site facility fee HCPCS Q3014 | $37.70 | $58.00 | $2.54 – $39.20 | 14 |
| Telethx isodose plan cplx CPT 77307 | $30,207.45 | $46,473.00 | $113.48 – $765.08 | 77 |
| Telethx isodose plan simple CPT 77306 | $5,317.65 | $8,181.00 | $62.71 – $765.08 | 77 |
| Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln HCPCS J9330 | $4,424.69 | $6,807.21 | $19.93 – $2,718.89 | 79 |
| Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) HCPCS J3101 | $17,220.55 | $26,493.16 | $183.42 – $34,777.00 | 79 |
| Terbutaline 1 mg/ml subcutaneous solution HCPCS J3105 | $12.35 | $19.00 | $1.62 – $9.20 | 21 |
| Test for porphobilinogen CPT 84106 | $57.85 | $89.00 | $5.18 – $19.55 | 80 |
| Testicular imaging w/vasc flow CPT 78761 | $641.55 | $987.00 | $43.00 – $828.29 | 75 |
| Test pathogen(s) for platelets reference HCPCS P9100 | $60.45 | $93.00 | $35.50 – $92.49 | 58 |
| Test stress cardiovascular tracing only CPT 93017 | $966.55 | $1,487.00 | $31.33 – $409.17 | 74 |
| Tetanus immune globulin inj HCPCS J1670 | $2,024.35 | $3,114.39 | $11.42 – $2,189.36 | 79 |
| Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe HCPCS J2356 | $10,442.86 | $16,065.94 | $17.48 – $13,923.00 | 70 |
| Theophylline therapeutic drug level CPT 80198 | $85.15 | $131.00 | $12.58 – $64.60 | 86 |
| Therapy nutrition individual initial f2f w/patient each 15 minutes CPT 97802 | $52.00 | $80.00 | $24.69 – $103.72 | 64 |
| Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes CPT 97803 | $52.00 | $80.00 | $20.65 – $88.94 | 64 |
| Ther nma rdctj intus/obstrcj CPT 74283 | $757.25 | $1,165.00 | $31.00 – $410.00 | 75 |
| Ther/proph/diag inj ia CPT 96373 | $104.00 | $160.00 | $58.35 – $336.83 | 58 |
| Thiamine hcl (vitamin b1) 100 mg/ml injection solution HCPCS J3411 | $18.52 | $28.50 | $3.52 – $13.44 | 12 |
| Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides) CPT 32555 | $2,162.55 | $3,327.00 | $87.25 – $1,153.00 | 79 |
| Thrombectomy/inf pq dialysis circuit CPT 36904 | $7,541.62 | $11,602.49 | $250.00 – $9,692.58 | 75 |
| Thrombectomy/inf pq dialysis circuit w/pta CPT 36905 | $7,591.58 | $11,679.36 | $13.56 – $18,099.34 | 79 |
| Thrombin time CPT 85670 | $51.35 | $79.00 | $5.13 – $26.34 | 86 |
| Thromboplastin time partial (ptt) substitution fractions each CPT 85732 | $71.50 | $110.00 | $5.75 – $29.56 | 86 |
| Thyroglobulin antibody CPT 86800 | $98.15 | $151.00 | $14.15 – $72.63 | 86 |
| Thyroid mets imag whole body CPT 78018 | $1,354.60 | $2,084.00 | $46.00 – $1,109.46 | 83 |
| Thyroid (TSH) Test CPT 84443 | $59.80 | $92.00 | $14.94 – $76.75 | 86 |
| Thyroid Ultrasound CPT 76536 | $403.65 | $621.00 | $54.00 – $274.67 | 81 |
| Thyrotropin alfa 0.9 mg intramuscular solution HCPCS J3240 | $4,698.85 | $7,229.00 | $495.60 – $7,907.36 | 79 |
| Thyroxine binding globulin (tbg) CPT 84442 | $78.00 | $120.00 | $13.15 – $67.50 | 86 |
| Tigecycline injection HCPCS J3243 | $254.72 | $391.88 | $17.00 – $86,850.20 | 21 |
| Tilt table study CPT 93660 | $1,633.45 | $2,513.00 | $63.38 – $1,153.00 | 78 |
| Tirofiban 12.5 mg/50 ml HCPCS J3246 | $737.91 | $1,135.25 | $54.30 – $263.89 | 21 |
| Tisotumab vedotin-tftv 40 mg intravenous solution HCPCS J9273 | $16,843.32 | $25,912.80 | $192.34 – $15,316.80 | 69 |
| Tissue culture placenta CPT 88235 | $427.05 | $657.00 | $87.19 – $373.23 | 86 |
| Tissue culture skin/biopsy CPT 88233 | $321.75 | $495.00 | $87.19 – $357.24 | 85 |
| Tissue exam koh skin/hair/nails CPT 87220 | $14.95 | $23.00 | $3.80 – $15.75 | 86 |
| Tissue transglutaminase iga CPT 86364 | $173.55 | $267.00 | $10.26 – $18.66 | 67 |
| Tl-201 thallium diag per mci HCPCS A9505 | $48.10 | $74.00 | $16.88 – $40.95 | 17 |
| Tlh uterus 250 g or less CPT 58570 | $20,561.34 | $31,632.83 | $363.00 – $17,699.07 | 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.