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 |
|---|---|---|---|---|
| Cystic fibrosis cftr CPT 81223 | $1,231.10 | $1,894.00 | $443.85 – $2,026.66 | 72 |
| Cystine urine quantitative CPT 82131 | $104.00 | $160.00 | $20.44 – $76.98 | 86 |
| Cystogram >= 3 views supervision & interpretation CPT 74430 | $246.35 | $379.00 | $21.91 – $859.16 | 72 |
| Cystorrhaphy wound simple 51860 CPT 51860 | $11,250.54 | $17,308.53 | $363.00 – $17,699.07 | 79 |
| Cysto rx balo cath urtl strx CPT 52284 | $8,683.56 | $13,359.32 | $3.30 – $8,642.15 | 75 |
| Cystoscopy and treatment CPT 52214 | $4,775.97 | $7,347.64 | $139.66 – $5,526.57 | 79 |
| Cystoscopy and treatment CPT 52234 | $4,918.76 | $7,567.32 | $18.08 – $5,526.57 | 80 |
| Cystoscopy and treatment CPT 52235 | $5,769.46 | $8,876.10 | $9.04 – $5,526.57 | 80 |
| Cystoscopy and treatment CPT 52240 | $6,475.26 | $9,961.94 | $314.81 – $8,642.15 | 80 |
| Cystoscopy and treatment CPT 52260 | $3,908.31 | $6,012.78 | $169.18 – $5,526.57 | 79 |
| Cystoscopy and treatment CPT 52276 | $4,771.60 | $7,340.92 | $213.31 – $3,482.47 | 80 |
| Cystoscopy and treatment CPT 52290 | $4,529.78 | $6,968.90 | $196.75 – $3,482.47 | 80 |
| Cystoscopy and treatment CPT 52310 | $8,683.32 | $13,358.96 | $122.63 – $5,526.57 | 79 |
| Cystoscopy (Bladder Scope) CPT 52000 | $2,887.13 | $4,441.74 | $64.90 – $1,153.00 | 79 |
| Cystoscopy chemodenervation CPT 52287 | $4,466.24 | $6,871.14 | $135.77 – $3,482.47 | 79 |
| Cystoscopy implant stent CPT 52282 | $6,803.86 | $10,467.48 | $4.52 – $5,526.57 | 80 |
| Cystoscopy removal of clots CPT 52001 | $5,391.29 | $8,294.29 | $231.04 – $5,526.57 | 79 |
| Cystoscopy & ureter catheter CPT 52005 | $5,798.26 | $8,920.40 | $108.70 – $3,482.47 | 80 |
| Cystouretero & or pyeloscope CPT 52351 | $3,971.03 | $6,109.27 | $243.73 – $5,526.57 | 79 |
| Cystouretero w/biopsy CPT 52354 | $5,971.01 | $9,186.17 | $250.00 – $8,642.15 | 80 |
| Cysto/uretero w/lithotripsy CPT 52356 | $11,311.56 | $17,402.40 | $333.83 – $8,642.15 | 79 |
| Cystouretero w/lithotripsy CPT 52353 | $10,865.58 | $16,716.27 | $314.48 – $8,642.15 | 79 |
| Cystouretero w/stone remove CPT 52352 | $5,014.02 | $7,713.88 | $9.04 – $5,526.57 | 80 |
| Cystourethroscop/calib/dilat stric 52281 CPT 52281 | $3,979.80 | $6,122.77 | $124.06 – $3,482.47 | 80 |
| Cystourethroscopy w/biopsy(s) 52204 CPT 52204 | $3,985.40 | $6,131.39 | $115.39 – $3,482.47 | 80 |
| Cysto w/renal stricture tx CPT 52343 | $18,331.22 | $28,201.88 | $276.66 – $15,720.16 | 80 |
| Cytarabine 20 mg/ml injection solution HCPCS J9100 | $48.31 | $74.33 | $0.79 – $14.19 | 20 |
| Cytogenetics 25-99 CPT 88274 | $131.30 | $202.00 | $37.70 – $158.92 | 85 |
| Cytomegalovirus (cmv) antibody igg CPT 86644 | $91.00 | $140.00 | $12.80 – $65.72 | 86 |
| Cytomegalovirus (cmv) antibody igm CPT 86645 | $78.65 | $121.00 | $14.99 – $76.91 | 86 |
| Cytopathology cellular enhancement technique non-gyn CPT 88112 | $92.95 | $143.00 | $29.96 – $126.85 | 85 |
| Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review CPT 88175 | $43.55 | $67.00 | $20.75 – $84.00 | 86 |
| Cytopathology cervical/vaginal thin layer manual screening CPT 88142 | $45.50 | $70.00 | $18.02 – $68.92 | 80 |
| Cytopathology concentration technique smears & interpretation CPT 88108 | $70.20 | $108.00 | $22.00 – $161.51 | 85 |
| Cytopathology fluids/washings/brushings smears with interpretation CPT 88104 | $79.95 | $123.00 | $11.00 – $129.32 | 85 |
| Cytopathology fna adequacy evaluation each separate additional episode same site CPT 88177 | $62.40 | $96.00 | $6.38 – $31.49 | 27 |
| Cytopathology fna adequacy evaluation first episode each site CPT 88172 | $98.80 | $152.00 | $15.69 – $267.11 | 85 |
| Cytopathology fna adequacy evaluation first episode each site interp/rpt CPT 88173 | $143.00 | $220.00 | $36.44 – $216.54 | 76 |
| Cytopath smear other source CPT 88160 | $68.90 | $106.00 | $9.00 – $109.61 | 85 |
| Cytopath smear oth prep screen & interp CPT 88161 | $98.80 | $152.00 | $20.88 – $96.10 | 76 |
| Cytopath tbs c/v manual CPT 88164 | $55.25 | $85.00 | $7.39 – $48.27 | 80 |
| Dactinomycin 0.5 mg intravenous solution HCPCS J9120 | $1,144.00 | $1,760.00 | $10.54 – $637.12 | 78 |
| Dalbavancin 500 mg intravenous solution HCPCS J0875 | $3,226.46 | $4,963.79 | $15.29 – $5,800.00 | 79 |
| Daptomycin 500 mg/10 ml intravenous solution HCPCS J0878 | $92.62 | $142.50 | $10.50 – $230.41 | 21 |
| Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln HCPCS J9144 | $25,572.72 | $39,342.64 | $54.01 – $19,355.40 | 69 |
| Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe HCPCS J0881 | $7,798.05 | $11,997.00 | $2.96 – $260.48 | 78 |
| Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution HCPCS J9153 | $26,100.75 | $40,155.00 | $255.54 – $22,384.56 | 71 |
| Daunorubicin 5 mg/ml intravenous solution HCPCS J9150 | $311.67 | $479.49 | $47.04 – $570.45 | 20 |
| D&c after delivery 59160 CPT 59160 | $3,777.64 | $5,811.75 | $144.63 – $5,075.27 | 79 |
| D&c/diagnostic/therapeutic/non ob 58120 CPT 58120 | $3,988.43 | $6,136.04 | $4.52 – $5,075.27 | 80 |
| Dch glucoscan CPT 82948 | $1.95 | $3.00 | $4.32 – $14.46 | 80 |
| Dch pulmonary stress test CPT 94621 | $686.40 | $1,056.00 | $41.10 – $667.17 | 74 |
| Dch validity tests CPT 81002 | $40.30 | $62.00 | $3.10 – $11.68 | 86 |
| Deamidated gliadin antibody iga CPT 86258 | $197.60 | $304.00 | $10.72 – $19.51 | 67 |
| Debridement (>20 cm) charge pt CPT 97598 | $208.00 | $320.00 | $19.98 – $735.00 | 74 |
| Decalcification CPT 88311 | $5,470.71 | $8,416.47 | $6.69 – $5,129.94 | 87 |
| Decitabine 50 mg intravenous solution HCPCS J0894 | $234.00 | $360.00 | $57.00 – $3,005.48 | 20 |
| Declotting thrombolytic agent implanted vas access device 36 CPT 36593 | $263.90 | $406.00 | $28.83 – $735.00 | 73 |
| Deferoxamine 500 mg solution for injection HCPCS J0895 | $107.20 | $164.92 | $8.94 – $31.50 | 21 |
| Degarelix 120 mg subcutaneous solution HCPCS J9155 | $3,474.01 | $5,344.63 | $4.37 – $1,324.80 | 79 |
| Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device CPT 94664 | $126.10 | $194.00 | $6.00 – $391.51 | 74 |
| Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution HCPCS J0897 | $8,090.10 | $12,446.31 | $28.90 – $6,574.80 | 79 |
| Depo-estradiol cypionate inj HCPCS J1000 | $796.39 | $1,225.22 | $22.80 – $963.80 | 21 |
| Design mlc device for imrt CPT 77338 | $35,160.48 | $54,093.04 | $203.89 – $1,268.00 | 82 |
| Desmopressin 4 mcg/ml injection solution HCPCS J2597 | $463.12 | $712.50 | $3.89 – $51.10 | 21 |
| Desoxycorticosterone CPT 82633 | $87.75 | $135.00 | $27.56 – $141.44 | 86 |
| Destroy cervthor facet jnt 64633 CPT 64633 | $2,568.11 | $3,950.94 | $157.89 – $3,319.71 | 77 |
| Destroy cth facet jnt addl 64634 CPT 64634 | $2,568.11 | $3,950.94 | $53.56 – $3,319.71 | 77 |
| Destroy vulva lesion extensive 56515 CPT 56515 | $5,952.89 | $9,158.30 | $169.10 – $4,351.77 | 79 |
| Destroy vulva lesion simple 56501 CPT 56501 | $6,183.84 | $9,513.60 | $105.87 – $3,583.55 | 76 |
| Destruction anal lesion(s) CPT 46924 | $5,952.89 | $9,158.30 | $153.53 – $4,351.77 | 79 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides) CPT 64636 | $2,601.99 | $4,003.06 | $47.00 – $3,319.71 | 77 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides) CPT 64635 | $2,598.70 | $3,998.00 | $158.28 – $3,319.71 | 77 |
| Destruction laser surgery anal lesions 46917 CPT 46917 | $4,499.50 | $6,922.31 | $107.75 – $4,351.77 | 79 |
| Developmental screen/score/document 96110 CPT 96110 | $203.45 | $313.00 | $9.70 – $23.43 | 5 |
| Dexamethasone 4 mg tablet HCPCS J8540 | $50.39 | $77.52 | $0.04 – $0.14 | 11 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $7.15 | $11.00 | $0.22 – $33.60 | 21 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | $617.50 | $950.00 | $56.91 – $664.52 | 78 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | $37.50 | $57.70 | $1.18 – $4.88 | 12 |
| Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 | $37.50 | $57.70 | $1.12 – $25.86 | 20 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | $37.50 | $57.70 | $1.80 – $6.50 | 12 |
| Dextrose 5 % IV bolus HCPCS J7070 | $37.50 | $57.70 | $3.50 – $10.92 | 12 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $79.30 | $122.00 | $19.77 – $101.49 | 86 |
| Diabetes (HbA1c) Test CPT 83036 | $55.25 | $85.00 | $8.64 – $44.29 | 86 |
| Diab manage trn ind/group HCPCS G0109 | $64.35 | $99.00 | $13.38 – $280.00 | 65 |
| Diag laparo separate proc 49320 CPT 49320 | $6,713.90 | $10,329.08 | $277.20 – $9,918.41 | 80 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $175.50 | $270.00 | $93.26 – $297.92 | 78 |
| Diagnostic Mammogram (one breast) CPT 77065 | $162.50 | $250.00 | $72.73 – $237.08 | 78 |
| Dialysis one evaluation CPT 90945 | $713.05 | $1,097.00 | $71.38 – $746.03 | 63 |
| Diathermy eg microwave CPT 97024 | $29.90 | $46.00 | $6.19 – $19.20 | 55 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | $100.03 | $153.90 | $11.25 – $17.50 | 5 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $13.00 | $20.00 | $6.15 – $24.88 | 21 |
| Diffusing capacity CPT 94729 | $308.75 | $475.00 | $42.75 – $130.35 | 18 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $7.15 | $11.00 | $3.47 – $35.62 | 21 |
| Digoxin total therapeutic drug level CPT 80162 | $63.05 | $97.00 | $11.81 – $60.64 | 86 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | $120.41 | $185.25 | $9.97 – $212.34 | 21 |
| Dilate esophagus CPT 43453 | $4,905.07 | $7,546.26 | $134.64 – $1,575.27 | 77 |
| Dilate esophagus 1/mult pass CPT 43450 | $4,214.62 | $6,484.03 | $66.05 – $1,575.27 | 77 |
| Diltiazem 5 mg/ml intravenous solution HCPCS J1163 | $35.24 | $54.21 | $1.00 – $2.40 | 5 |
| Dimethyl sulfoxide 50% 50 ml HCPCS J1212 | $2,253.11 | $3,466.32 | $2.14 – $2,787.14 | 76 |
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.