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 |
|---|---|---|---|---|
| Tlh w/t/o 250 g or less CPT 58571 | $16,562.31 | $25,480.47 | $363.00 – $17,699.07 | 79 |
| Tlh w/t/o uterus over 250 g CPT 58573 | $18,214.68 | $28,022.58 | $363.00 – $17,699.07 | 79 |
| Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr HCPCS J3260 | $247.00 | $380.00 | $1.83 – $19.11 | 21 |
| Tobramycin peak therapeutic drug level CPT 80200 | $73.45 | $113.00 | $14.35 – $73.59 | 86 |
| Tocilizumab 162 mg/0.9 ml subcutaneous pen injector HCPCS J3262 | $6,048.49 | $9,305.37 | $5.50 – $1,668.80 | 79 |
| Tomosynthesis breast diagnostic left HCPCS G0279 | $63.70 | $98.00 | $10.75 – $57.12 | 69 |
| Tomosynthesis breast screen bilateral CPT 77063 | $73.45 | $113.00 | $19.80 – $86.27 | 78 |
| Tonsillectomy (age 12+) CPT 42826 | $3,618.35 | $5,566.70 | $206.19 – $5,513.22 | 80 |
| Tonsillectomy (child under 12) CPT 42825 | $2,979.01 | $4,583.09 | $216.65 – $10,056.62 | 80 |
| Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution HCPCS J9351 | $325.00 | $500.00 | $58.00 – $2,483.38 | 20 |
| Toripalimab-tpzi 240 mg/6 ml (40 mg/ml) intravenous solution HCPCS J3263 | $22,204.24 | $34,160.37 | $39.45 – $18,847.20 | 69 |
| Total hysterectomy CPT 58150 | $8,783.60 | $13,513.23 | $53.00 – $4,578.00 | 78 |
| Toxoplasma antibody igg CPT 86777 | $34.45 | $53.00 | $12.80 – $65.72 | 86 |
| Toxoplasma antibody igm CPT 86778 | $72.80 | $112.00 | $12.82 – $65.75 | 86 |
| Tpmt gene com vrnts CPT 81335 | $393.90 | $606.00 | $155.49 – $396.82 | 78 |
| Tprnl plmt biodegrdabl matrl CPT 55874 | $9,652.16 | $14,849.47 | $130.75 – $12,562.00 | 76 |
| Trabectedin 1 mg intravenous solution HCPCS J9352 | $8,987.27 | $13,826.57 | $383.64 – $7,637.60 | 78 |
| Trabeculoplasty laser surg CPT 65855 | $828.75 | $1,275.00 | $156.22 – $1,153.00 | 77 |
| Training self management diabetes individual outpatient department per 30 minutes HCPCS G0108 | $119.60 | $184.00 | $46.76 – $280.00 | 65 |
| Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution HCPCS J3290 | $64.84 | $99.75 | $6.00 – $16.00 | 4 |
| Transcatheter bx s&i CPT 75970 | $1,326.65 | $2,041.00 | $62.94 – $1,201.71 | 9 |
| Transferrin CPT 84466 | $28.60 | $44.00 | $11.35 – $58.32 | 86 |
| Transfusion blood/blood component(s) CPT 36430 | $1,828.77 | $2,813.50 | $39.83 – $766.24 | 66 |
| Trastuzumab 150 mg intravenous solution HCPCS J9355 | $3,551.91 | $5,464.47 | $72.09 – $3,047.82 | 78 |
| Trastuzumab-anns 150 mg intravenous solution HCPCS Q5117 | $8,670.11 | $13,338.63 | $50.46 – $4,270.56 | 69 |
| Trastuzumab-qyyp 150 mg intravenous solution HCPCS Q5116 | $7,721.21 | $11,878.78 | $8.05 – $348.75 | 69 |
| Trauma partial team response w/critical care services level 4 HCPCS G0390 | $3,452.80 | $5,312.00 | $1,266.49 – $2,089.78 | 49 |
| Treat ectopic pregnancy CPT 59151 | $7,020.05 | $10,800.08 | $363.00 – $9,918.41 | 79 |
| Treatment incomplete abortion completed surgically any trimester CPT 59812 | $4,089.57 | $6,291.65 | $241.35 – $5,075.27 | 79 |
| Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour CPT 94644 | $86.45 | $133.00 | $46.65 – $237.88 | 74 |
| Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour CPT 94645 | $86.45 | $133.00 | $13.58 – $41.08 | 6 |
| Treatment inhalation pressurized/nonpressurized acute airway obstruction CPT 94640 | $105.95 | $163.00 | $6.00 – $391.51 | 74 |
| Treatment missed abortion completed surgically 1st trimester CPT 59820 | $3,975.19 | $6,115.67 | $302.50 – $5,075.27 | 79 |
| Treatment of urethra lesion CPT 53265 | $4,815.27 | $7,408.11 | $153.40 – $3,482.47 | 80 |
| Treatment radiation delivery level 2 CPT 77407 | $29,071.90 | $44,726.00 | $66.00 – $788.10 | 77 |
| Tremelimumab-actl 20 mg/ml intravenous solution HCPCS J9347 | $96,516.06 | $148,486.25 | $140.30 – $6,982.75 | 69 |
| Treponema pallidum antibody CPT 86780 | $81.90 | $126.00 | $11.78 – $60.30 | 86 |
| Trg gene rearrangement anal CPT 81342 | $111.80 | $172.00 | $110.20 – $919.97 | 86 |
| Triamcinolone acetonide 40 mg/ml suspension for injection HCPCS J3301 | $24.98 | $38.43 | $0.90 – $4.59 | 21 |
| Trichinella antibody CPT 86784 | $59.15 | $91.00 | $11.17 – $57.37 | 80 |
| Trichomonas assay w/optic CPT 87808 | $42.25 | $65.00 | $12.29 – $41.12 | 80 |
| #tricyclicantidprssnt CPT 80337 | $96.85 | $149.00 | $27.18 – $61.70 | 11 |
| Triglycerides CPT 84478 | $57.85 | $89.00 | $5.11 – $26.23 | 86 |
| Trilaciclib 300 mg intravenous solution HCPCS J1448 | $4,043.12 | $6,220.19 | $5.32 – $6,048.00 | 70 |
| Trimethobenzamide hcl inj HCPCS J3250 | $204.03 | $313.89 | $3.76 – $214.26 | 21 |
| Trnscath plc vas stent w/s&i ea addl artery CPT 37237 | $30,686.66 | $47,210.24 | $166.87 – $18,099.34 | 75 |
| Trnscath plc vas stent w/s&i ini vein CPT 37238 | $19,390.58 | $29,831.66 | $27.49 – $18,099.34 | 78 |
| Trnscath retrv pq vasc fb w/guide CPT 37197 | $4,455.75 | $6,855.00 | $275.72 – $5,350.75 | 79 |
| Troponin quantitative CPT 84484 | $170.30 | $262.00 | $11.09 – $44.92 | 86 |
| Tte w or without contr, cont ecg HCPCS C8930 | $1,669.20 | $2,568.00 | $467.42 – $1,361.53 | 58 |
| Tx atrial fib pulm vein isol CPT 93656 | $34,596.25 | $53,225.00 | $530.95 – $41,704.91 | 73 |
| Tx l/r atrial fib addl CPT 93657 | $6,028.75 | $9,275.00 | $163.31 – $370.71 | 13 |
| Tympanic membrane repair CPT 69610 | $2,303.49 | $3,543.83 | $224.52 – $2,518.18 | 79 |
| Ua w/micro/comp poc CPT 81000 | $55.25 | $85.00 | $3.58 – $14.46 | 86 |
| Ugt1a1 gene analy common variants CPT 81350 | $715.65 | $1,101.00 | $120.26 – $450.50 | 75 |
| Ultrasound abdomen aorta screening study aaa CPT 76706 | $286.65 | $441.00 | $67.46 – $252.18 | 78 |
| Ultrasound bone density measure CPT 76977 | $100.75 | $155.00 | $3.86 – $252.18 | 75 |
| Ultrasound breast complete CPT 76641 | $460.20 | $708.00 | $56.90 – $252.18 | 78 |
| Ultrasound breast unilateral limited (both sides) CPT 76642 | $312.00 | $480.00 | $44.13 – $179.57 | 78 |
| Ultrasound chest CPT 76604 | $430.30 | $662.00 | $23.00 – $252.18 | 81 |
| Ultrasound encephalogram CPT 76506 | $440.05 | $677.00 | $18.80 – $268.44 | 81 |
| Ultrasound exam k transpl w/doppler CPT 76776 | $478.40 | $736.00 | $76.26 – $341.09 | 81 |
| Ultrasound fetal biophysical profile without non-stress testing CPT 76819 | $245.05 | $377.00 | $41.33 – $252.18 | 81 |
| Ultrasound guidance for vascular access CPT 76937 | $269.10 | $414.00 | $17.63 – $66.55 | 22 |
| Ultrasound guided needle placement supervision & interpretation CPT 76942 | $533.65 | $821.00 | $23.58 – $259.27 | 13 |
| Ultrasound guide intraoperative CPT 76998 | $514.15 | $791.00 | $54.38 – $245.87 | 18 |
| Ultrasound guide tissue ablation CPT 76940 | $377.00 | $580.00 | $47.21 – $220.48 | 18 |
| Ultrasound hips infant dynamic CPT 76885 | $247.65 | $381.00 | $58.13 – $326.58 | 81 |
| Ultrasound infant hips ltd without stress CPT 76886 | $161.20 | $248.00 | $54.00 – $223.79 | 81 |
| Ultrasound joint complete left CPT 76881 | $557.05 | $857.00 | $9.14 – $253.91 | 81 |
| Ultrasound joint/nonvascular extremity limited left CPT 76882 | $612.30 | $942.00 | $11.99 – $252.18 | 81 |
| Ultrasound ob >=14wks ea addl gest CPT 76810 | $325.00 | $500.00 | $34.41 – $148.03 | 22 |
| Ultrasound pregnant uterus < 14 weeks each additional gestation CPT 76802 | $209.30 | $322.00 | $17.50 – $102.11 | 22 |
| Ultrasound pregnant uterus detailed fetal exam single/1st gestation CPT 76811 | $413.40 | $636.00 | $73.52 – $524.34 | 81 |
| Ultrasound pregnant uterus follow up per fetus CPT 76816 | $228.15 | $351.00 | $26.00 – $252.18 | 81 |
| Ultrasound pregnant uterus limited >= 1 fetuses CPT 76815 | $310.70 | $478.00 | $26.00 – $252.18 | 81 |
| Ultrasound pregnant uterus transvaginal CPT 76817 | $356.20 | $548.00 | $47.74 – $252.18 | 81 |
| Ultrasound prostate/transrectal CPT 76872 | $278.20 | $428.00 | $46.00 – $252.18 | 81 |
| Ultrasound retroperitoneal limited CPT 76775 | $193.70 | $298.00 | $15.00 – $252.18 | 81 |
| Ultrasound scrotum and contents CPT 76870 | $411.45 | $633.00 | $31.00 – $252.18 | 81 |
| Ultrasound spinal canal and contents CPT 76800 | $414.70 | $638.00 | $32.00 – $252.18 | 81 |
| Ultrasound transabd ea addl gest CPT 76812 | $340.60 | $524.00 | $51.75 – $351.49 | 22 |
| Ultrasound transvaginal non obstetric CPT 76830 | $312.65 | $481.00 | $68.00 – $268.44 | 81 |
| Unlisted laparoscopic liver biopy 47379 CPT 47379 | $8,603.64 | $13,236.37 | $320.00 – $9,918.41 | 79 |
| Unlisted laparoscopic reduction intestine 44238 CPT 44238 | $6,658.92 | $10,244.49 | $8.45 – $9,918.41 | 79 |
| Unlisted laparoscopy procedure biliary tract 47579 CPT 47579 | $10,057.79 | $15,473.52 | $28.00 – $9,918.41 | 76 |
| Unlisted laps px appendix CPT 44979 | $6,322.02 | $9,726.18 | $363.00 – $9,918.41 | 79 |
| Unlisted laps px ovidct ovry CPT 58679 | $14,120.77 | $21,724.26 | $363.00 – $17,699.07 | 79 |
| Unlisted mr procedure CPT 76498 | $1,032.20 | $1,588.00 | $70.12 – $179.57 | 64 |
| Unlisted neurological dx px CPT 95999 | $138.45 | $213.00 | $122.26 – $201.74 | 60 |
| Unlisted procedure microbiology CPT 87999 | $99.45 | $153.00 | $116.70 – $116.70 | 1 |
| Unlisted procedure rectum CPT 45999 | $18,088.92 | $27,829.11 | $46.00 – $1,615.17 | 76 |
| Unlisted px arthroscopy CPT 29999 | $13,085.92 | $20,132.19 | $29.60 – $3,834.00 | 74 |
| Unlisted px small intestine CPT 44799 | $4,691.21 | $7,217.25 | $39.60 – $1,577.00 | 76 |
| Unsched dialysis esrd pt hos HCPCS G0257 | $1,316.90 | $2,026.00 | $652.12 – $1,076.03 | 59 |
| Upper Back (Thoracic Spine) MRI (with and without contrast) CPT 72157 | $2,886.00 | $4,440.00 | $185.15 – $1,900.56 | 77 |
| Upper Back (Thoracic Spine) MRI (with contrast) CPT 72147 | $2,338.70 | $3,598.00 | $159.77 – $1,470.99 | 77 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | $1,976.00 | $3,040.00 | $105.20 – $1,470.99 | 77 |
| Upper Endoscopy (EGD, diagnostic) CPT 43235 | $3,620.53 | $5,570.04 | $100.39 – $1,575.27 | 77 |
| Upper Endoscopy (EGD, with biopsy) CPT 43239 | $4,093.84 | $6,298.21 | $112.42 – $1,575.27 | 77 |
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.