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 |
|---|---|---|---|---|
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $9.29 | $14.30 | $0.73 – $7.08 | 21 |
| Disability dlco CPT 94727 | $287.30 | $442.00 | $31.89 – $386.05 | 74 |
| Disaccharidases CPT 82657 | $352.30 | $542.00 | $19.72 – $82.42 | 86 |
| Discography cerv/thor spine CPT 72285 | $1,330.55 | $2,047.00 | $64.12 – $3,868.54 | 66 |
| Dise eval slp do brth flx dx CPT 42975 | $2,157.90 | $3,319.85 | $1.32 – $2,931.60 | 72 |
| Dna antibody native/double stranded CPT 86225 | $144.30 | $222.00 | $12.22 – $62.72 | 86 |
| Dna gardnerella CPT 87510 | $37.70 | $58.00 | $17.83 – $91.55 | 86 |
| Dna probe chlamydia CPT 87490 | $70.85 | $109.00 | $20.24 – $91.55 | 80 |
| Dna probe gc CPT 87590 | $113.75 | $175.00 | $23.91 – $91.55 | 80 |
| Dna trichomonas CPT 87660 | $37.70 | $58.00 | $17.83 – $91.55 | 86 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $123.50 | $190.00 | $7.39 – $48.92 | 21 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | $996.12 | $1,532.50 | $12.80 – $799.95 | 21 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $60.98 | $93.82 | $3.55 – $14.90 | 18 |
| Doppler echo complete CPT 93320 | $645.45 | $993.00 | $31.79 – $113.50 | 14 |
| Doppler intravascular pressure flow initial vessel CPT 93571 | $2,018.90 | $3,106.00 | $478.22 – $735.00 | 5 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $822.90 | $1,266.00 | $73.00 – $375.02 | 75 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $432.90 | $666.00 | $27.30 – $231.08 | 75 |
| Doripenem 50 mg/ml inj 10 ml HCPCS J1267 | $118.35 | $182.07 | $32.50 – $73.78 | 13 |
| Dostarlimab-gxly 50 mg/ml intravenous solution HCPCS J9272 | $27,922.75 | $42,958.08 | $242.74 – $24,162.00 | 69 |
| Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 | $604.90 | $930.61 | $15.55 – $478.74 | 20 |
| Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension HCPCS Q2050 | $1,030.25 | $1,585.00 | $102.03 – $15,951.20 | 78 |
| Doxycycline hyclate 100 mg intravenous powder for solution HCPCS J1271 | $49.40 | $76.00 | $10.00 – $38.00 | 8 |
| Drainage external ear complex 69005 CPT 69005 | $3,255.75 | $5,008.85 | $129.95 – $2,589.43 | 78 |
| Drainage external ear simple 69000 CPT 69000 | $3,618.21 | $5,566.48 | $103.74 – $1,229.90 | 76 |
| Drainage of kidney lesion CPT 50390 | $5,664.22 | $8,714.19 | $74.94 – $1,268.00 | 77 |
| Drain cath image guided visceral pq CPT 49405 | $5,664.22 | $8,714.19 | $74.94 – $1,268.00 | 77 |
| Dress/debride pt-tck burn/5-10% bs 16025 CPT 16025 | $306.80 | $472.00 | $91.11 – $735.00 | 64 |
| Dress/debride pt-thick burn/<5% bs 16020 CPT 16020 | $270.40 | $416.00 | $74.04 – $735.00 | 63 |
| Dress/debrid prtl-thick burn l 16030 CPT 16030 | $352.30 | $542.00 | $108.65 – $735.00 | 64 |
| Droperidol 2.5 mg/ml injection solution HCPCS J1790 | $32.82 | $50.50 | $3.40 – $26.70 | 21 |
| Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm HCPCS Q4102 | $146.25 | $225.00 | $4.35 – $205.80 | 70 |
| Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm HCPCS Q4124 | $11.05 | $17.00 | $124.72 – $205.80 | 49 |
| Drug admin & hemodynmic meas CPT 93463 | $586.30 | $902.00 | $85.83 – $735.00 | 8 |
| Drug assay caffeine CPT 80155 | $113.10 | $174.00 | $19.30 – $64.60 | 70 |
| Drug assay posaconazole CPT 80187 | $175.50 | $270.00 | $24.11 – $44.73 | 61 |
| Drug assay vedolizumab CPT 80280 | $220.35 | $339.00 | $34.31 – $63.64 | 67 |
| Drug assay voriconazole CPT 80285 | $14.30 | $22.00 | $24.11 – $44.73 | 67 |
| Drug of abuse screen urine CPT 80305 | $58.50 | $90.00 | $11.21 – $33.96 | 83 |
| Drug test prsmv instrmnt CPT 80306 | $85.80 | $132.00 | $15.25 – $45.29 | 83 |
| Drug test(s) presumptive any class instrument chemistry analyzers CPT 80307 | $346.45 | $533.00 | $55.27 – $181.17 | 83 |
| Drvvt confirm - quest CPT 85597 | $108.55 | $167.00 | $15.99 – $82.04 | 80 |
| Dstrj nulyt agt gnclr nrv CPT 64624 | $2,314.49 | $3,560.75 | $0.85 – $3,319.71 | 72 |
| Ductogram sgl duct CPT 77053 | $216.45 | $333.00 | $30.72 – $524.34 | 72 |
| Duplex scan bilateral study 93985 CPT 93985 | $824.20 | $1,268.00 | $179.05 – $414.41 | 64 |
| Duplex scan unilateral study 93986 CPT 93986 | $598.00 | $920.00 | $90.66 – $181.58 | 64 |
| Dup scan/hemodialysis access 93990 CPT 93990 | $488.80 | $752.00 | $90.66 – $530.05 | 66 |
| Dup scan/lwr xtr vasc stdy bilat 93924 CPT 93924 | $542.75 | $835.00 | $55.80 – $436.60 | 75 |
| Dup scan/ue art/graft/bilat/comp 93930 CPT 93930 | $530.40 | $816.00 | $33.00 – $602.72 | 75 |
| Durvalumab 50 mg/ml intravenous solution HCPCS J9173 | $10,021.12 | $15,417.11 | $84.63 – $2,176.75 | 78 |
| Dx bronchoscope/brush 31623 CPT 31623 | $13,312.56 | $20,480.86 | $110.15 – $6,267.82 | 80 |
| Dx bronchoscope/lavage 31624 CPT 31624 | $13,360.41 | $20,554.47 | $111.57 – $11,768.20 | 80 |
| Dx bronchoscope/wash 31622 CPT 31622 | $2,861.18 | $4,401.81 | $109.90 – $2,931.60 | 80 |
| Dx laryngoscopy w/oper scope CPT 31526 | $4,013.29 | $6,174.30 | $122.03 – $2,931.60 | 80 |
| Ecg 12 lead tracing only CPT 93005 | $236.60 | $364.00 | $5.25 – $102.46 | 74 |
| Ecg/1-3 leads/tracing only 93041 CPT 93041 | $133.90 | $206.00 | $5.25 – $102.46 | 74 |
| Ecg external < 48 hours recording CPT 93225 | $302.25 | $465.00 | $15.25 – $238.35 | 74 |
| Ecg external < 48 hours scanning analysis w/report CPT 93226 | $309.40 | $476.00 | $29.69 – $274.86 | 74 |
| Ecg external > 48 hours up to 7 days recording CPT 93242 | $325.65 | $501.00 | $9.97 – $64.87 | 64 |
| Ecg external >7 days up to 15 days recording CPT 93246 | $546.65 | $841.00 | $9.97 – $64.87 | 64 |
| Echocardiogram (Heart Ultrasound) CPT 93306 | $2,030.60 | $3,124.00 | $168.33 – $949.03 | 74 |
| Echocardiography doppler color flow mapping CPT 93325 | $463.45 | $713.00 | $16.00 – $64.96 | 14 |
| Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler HCPCS C8929 | $2,119.65 | $3,261.00 | $467.42 – $1,361.53 | 58 |
| Echocardiography transthoracic 2d followup/limited CPT 93308 | $773.50 | $1,190.00 | $59.00 – $414.41 | 74 |
| Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast HCPCS C8924 | $1,122.55 | $1,727.00 | $206.06 – $605.93 | 58 |
| Echocardiograpy doppler follow up/limited study CPT 93321 | $389.35 | $599.00 | $17.41 – $86.26 | 14 |
| Echo exam of fetal heart CPT 76827 | $260.65 | $401.00 | $35.52 – $252.18 | 81 |
| Echo exam of fetal heart CPT 76828 | $240.50 | $370.00 | $18.86 – $252.18 | 81 |
| Echo exam uterus 76831- CPT 76831 | $323.70 | $498.00 | $58.13 – $524.34 | 81 |
| Echograp trans r pros study CPT 76873 | $523.90 | $806.00 | $83.54 – $272.58 | 81 |
| Echo guide for amniocentesis CPT 76946 | $282.10 | $434.00 | $12.61 – $56.93 | 13 |
| Echo guide for artery repair CPT 76936 | $599.30 | $922.00 | $16.99 – $569.48 | 81 |
| Echo tee guidance CPT 93355 | $2,145.65 | $3,301.00 | $131.22 – $419.61 | 17 |
| Echo tee probe placement image acquisition interpretation & report CPT 93312 | $2,076.10 | $3,194.00 | $66.00 – $949.03 | 74 |
| Echo tte 2d comp wo ctrst wo clr/dplr CPT 93307 | $714.35 | $1,099.00 | $76.00 – $414.41 | 74 |
| E coli 0157 ag ia CPT 87335 | $84.50 | $130.00 | $11.26 – $41.12 | 80 |
| Eculizumab 300 mg/30 ml intravenous solution HCPCS J1299 | $14,846.31 | $22,840.47 | $44.17 – $25,125.00 | 66 |
| Eeg 41-60 minutes 95812-26 CPT 95812 | $662.35 | $1,019.00 | $79.50 – $1,087.69 | 74 |
| Eeg/cerebral death evaluation only 95824 -26 CPT 95824 | $808.60 | $1,244.00 | $28.00 – $667.17 | 67 |
| Eeg monitor/record/awake/drowsy 95816 CPT 95816 | $743.60 | $1,144.00 | $25.00 – $857.24 | 74 |
| Eeg recording awake and asleep CPT 95819 | $959.40 | $1,476.00 | $64.00 – $682.53 | 74 |
| E equine encephalitis igg CPT 86652 | $54.60 | $84.00 | $11.73 – $60.24 | 80 |
| Efgartigimod alfa-fcab 20 mg/ml intravenous solution HCPCS J9332 | $14,371.30 | $22,109.70 | $31.61 – $23,972.00 | 70 |
| Egd balloon dil esoph30 mm/> CPT 43233 | $1,781.65 | $2,741.00 | $184.24 – $184.24 | 1 |
| Egd control bleeding any CPT 43255 | $4,764.45 | $7,329.92 | $161.61 – $3,224.88 | 80 |
| Egd dilate stricture CPT 43245 | $3,157.83 | $4,858.20 | $142.12 – $3,224.88 | 80 |
| Egd guide wire insertion CPT 43248 | $4,553.60 | $7,005.54 | $134.64 – $1,575.27 | 77 |
| Egd/insert intraluminal tube/cath 43241 CPT 43241 | $387.40 | $596.00 | $1,268.00 – $3,224.88 | 56 |
| Egd lesion ablation CPT 43270 | $3,734.70 | $5,745.69 | $180.63 – $3,224.88 | 76 |
| Egd remove foreign body CPT 43247 | $3,203.13 | $4,927.89 | $142.99 – $3,224.88 | 80 |
| Egd remove lesion snare CPT 43251 | $4,167.28 | $6,411.20 | $157.80 – $3,224.88 | 80 |
| Egd varices ligation CPT 43244 | $3,272.23 | $5,034.20 | $197.04 – $3,224.88 | 80 |
| Egfr gene com variants CPT 81235 | $721.50 | $1,110.00 | $288.71 – $1,104.38 | 86 |
| Ehrlicha chaffeensis amp prb CPT 87484 | $274.30 | $422.00 | $31.58 – $56.80 | 64 |
| Elbow arthroscopy/surgery CPT 29834 | $8,679.13 | $13,352.51 | $250.00 – $5,515.84 | 80 |
| Elbow arthroscopy/surgery CPT 29837 | $8,679.13 | $13,352.51 | $250.00 – $5,515.84 | 80 |
| Electrical stimulation/unattended 97014 CPT 97014 | $61.75 | $95.00 | $9.92 – $49.15 | 12 |
| Electrolyte panel CPT 80051 | $119.60 | $184.00 | $6.24 – $32.02 | 86 |
| Electronic analysis with brain program first 15 min 95983 CPT 95983 | $76.70 | $118.00 | $35.29 – $150.55 | 73 |
| Electron microscopy diagnostic CPT 88348 | $7,056.20 | $10,855.70 | $168.00 – $1,810.11 | 87 |
| Electrophysiology evaluation CPT 93619 | $7,388.55 | $11,367.00 | $383.00 – $12,899.77 | 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.