Mercy Hospital Logan County
200 S. Academy Road, Guthrie, OK · Mercy · · NPI 1306126818
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 |
|---|---|---|---|---|
| 11-desoxycortisol - sendout CPT 82634 | $96.20 | $148.00 | $26.04 – $36.60 | 5 |
| 5' nucleotidase - sendout CPT 83915 | $71.50 | $110.00 | $9.92 – $13.94 | 5 |
| #a/b/c/c/h pnl-candida albicans ab CPT 86628 | $61.75 | $95.00 | $10.68 – $15.01 | 5 |
| Abdominal CT scan (with and without contrast) CPT 74170 | $2,187.90 | $3,366.00 | $143.16 – $2,175.00 | 6 |
| Abdominal CT scan (with contrast) CPT 74160 | $1,933.10 | $2,974.00 | $158.53 – $1,720.00 | 6 |
| Abdominal CT scan (without contrast) CPT 74150 | $1,675.70 | $2,578.00 | $70.23 – $1,457.00 | 6 |
| Abdominal MRI (with and without contrast) CPT 74183 | $3,443.70 | $5,298.00 | $204.04 – $2,307.00 | 6 |
| Abdominal MRI (with contrast) CPT 74182 | $2,644.85 | $4,069.00 | $191.82 – $801.97 | 5 |
| Abdominal MRI (without contrast) CPT 74181 | $2,451.80 | $3,772.00 | $110.75 – $548.48 | 5 |
| Abdominal paracentesis w/image guidance CPT 49083 | $444.60 | $684.00 | $87.82 – $1,853.26 | 48 |
| Abdominal Ultrasound (complete) CPT 76700 | $800.80 | $1,232.00 | $65.49 – $511.92 | 6 |
| Abdominal Ultrasound (limited) CPT 76705 | $510.90 | $786.00 | $49.68 – $475.00 | 6 |
| Abd paracentesis/w/o image guide 49082 CPT 49082 | $360.10 | $554.00 | $66.14 – $180.09 | 47 |
| Ablation of upper extremity nerves rf CPT 64999 | $505.70 | $778.00 | $627.20 – $627.20 | 1 |
| Acetaminophen 10 mg/ml soln 100 ml glass cont HCPCS J0131 | $47.25 | $72.69 | $5.00 – $6.00 | 5 |
| Acetaminophen level CPT 80143 | $146.90 | $226.00 | $16.58 – $25.16 | 7 |
| Acetone qualitative CPT 82009 | $31.85 | $49.00 | $4.02 – $7.46 | 49 |
| Acetylcholine receptor modulating antibody CPT 86043 | $96.85 | $149.00 | $10.72 – $15.06 | 5 |
| Acetylcholinesterase assay CPT 82013 | $168.35 | $259.00 | $10.93 – $10.93 | 4 |
| Acetylcysteine 200 mg/ml (20 %) intravenous solution HCPCS J0132 | $232.95 | $358.38 | $33.00 – $37.80 | 5 |
| Acute hepatitis panel CPT 80074 | $272.35 | $419.00 | $42.37 – $397.87 | 6 |
| Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr HCPCS J0133 | $49.22 | $75.72 | $5.00 – $5.00 | 4 |
| #acylcarnitineprfl CPT 82017 | $124.15 | $191.00 | $15.01 – $21.09 | 5 |
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | $13.12 | $20.19 | $0.96 – $1.80 | 5 |
| Adh-sendout CPT 84588 | $144.95 | $223.00 | $30.19 – $30.19 | 4 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $163.25 | $251.16 | $18.00 – $2,854.80 | 6 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $338.00 | $520.00 | $63.38 – $125.05 | 5 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | $338.00 | $520.00 | $63.38 – $125.05 | 5 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $338.00 | $520.00 | $295.37 – $573.68 | 5 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | $253.50 | $390.00 | $295.37 – $573.68 | 5 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | $166.40 | $256.00 | $63.38 – $125.05 | 5 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $166.40 | $256.00 | $63.38 – $125.05 | 5 |
| Administration immunization 1 vaccine CPT 90471 | $85.80 | $132.00 | $63.38 – $147.12 | 6 |
| Administration immunization each additional vaccine CPT 90472 | $53.95 | $83.00 | $12.70 – $25.18 | 5 |
| Administration immunization first component each vaccine CPT 90460 | $35.10 | $54.00 | $18.34 – $36.75 | 5 |
| Administration vaccine influenza virus HCPCS G0008 | $49.40 | $76.00 | $2.46 – $83.72 | 6 |
| Administration vaccine pneumococcal HCPCS G0009 | $49.40 | $76.00 | $2.46 – $83.72 | 6 |
| Advance care planning each additional 30 min 99498 CPT 99498 | $144.30 | $222.00 | $60.46 – $126.57 | 44 |
| Albumin body fluid quantitative each specimen CPT 82042 | $40.95 | $63.00 | $6.92 – $134.00 | 44 |
| Albumin (human), 25%, 50ml HCPCS P9047 | $393.70 | $605.70 | $49.70 – $65.82 | 5 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $59.80 | $92.00 | $5.14 – $66.00 | 6 |
| Albumin serum plasma or whole blood CPT 82040 | $31.85 | $49.00 | $4.40 – $24.00 | 7 |
| Alcohol (ethanol) any specimen except urine/breath CPT 82077 | $113.10 | $174.00 | $17.28 – $21.59 | 2 |
| Alkaline phosphatase CPT 84075 | $33.15 | $51.00 | $4.61 – $6.99 | 6 |
| Allergen alpha lactalbumin ige CPT 86008 | $44.85 | $69.00 | $15.95 – $29.58 | 48 |
| Allergen egg white ige CPT 86003 | $55.90 | $86.00 | $4.64 – $8.61 | 49 |
| Allograft epieffect 2x3cm-q4186-cost per sq cm HCPCS Q4186 | $423.15 | $651.00 | $148.25 – $222.50 | 5 |
| Alpha-fetoprotein amniotic CPT 82106 | $72.15 | $111.00 | $15.12 – $15.12 | 4 |
| Alpha-fetoprotein tumor marker CPT 82105 | $76.70 | $118.00 | $14.92 – $106.80 | 6 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | $25,741.05 | $39,601.62 | $182.94 – $235.82 | 5 |
| Alt/sgpt CPT 84460 | $32.50 | $50.00 | $4.71 – $25.00 | 7 |
| Aluminum - quest CPT 82108 | $90.35 | $139.00 | $22.66 – $31.85 | 5 |
| Alys cplx sp/pn npgt w/prgrm CPT 95972 | $507.00 | $780.00 | $49.73 – $49.73 | 4 |
| Amikacin 4 mg/ml intravitreal injection - cnr HCPCS J0278 | $50.97 | $78.41 | $2.70 – $3.80 | 5 |
| Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV HCPCS J0283 | $202.10 | $310.93 | $12.60 – $12.60 | 4 |
| Amiodarone 50 mg/ml intravenous solution HCPCS J0282 | $8.76 | $13.47 | $1.95 – $2.40 | 5 |
| Ammonia CPT 82140 | $99.45 | $153.00 | $12.96 – $103.60 | 7 |
| Ampicillin 1 gram solution for injection HCPCS J0290 | $31.08 | $47.82 | $0.71 – $0.79 | 5 |
| Ampicillin-sulbactam 1.5 gram solution for injection HCPCS J0295 | $30.62 | $47.11 | $1.64 – $43.08 | 6 |
| Amylase CPT 82150 | $76.70 | $118.00 | $5.76 – $55.00 | 7 |
| Ana ds-dna CPT 86226 | $75.40 | $116.00 | $10.77 – $10.77 | 4 |
| Anal/urinary muscle study CPT 51784 | $353.60 | $544.00 | $139.33 – $417.60 | 6 |
| Analysis gene f2 20210g>a variant CPT 81240 | $271.70 | $418.00 | $58.43 – $82.11 | 5 |
| Analysis gene f5 leiden variant CPT 81241 | $263.90 | $406.00 | $65.26 – $91.71 | 5 |
| Anaplsma phgcytophlm amp prb CPT 87468 | $133.90 | $206.00 | $43.86 – $43.86 | 1 |
| Anca screen with reflex to titer -quest CPT 86021 | $90.35 | $139.00 | $13.39 – $18.81 | 5 |
| Ankle X-ray CPT 73610 | $468.00 | $720.00 | $23.58 – $268.00 | 6 |
| Anora (draw only) CPT 99001 | $12.35 | $19.00 | $8.00 – $8.00 | 1 |
| Antibody bacterium, not elsewhere specified CPT 86609 | $48.10 | $74.00 | $11.46 – $75.16 | 6 |
| Antibody elution rbc reference CPT 86860 | $187.20 | $288.00 | $6.55 – $304.61 | 5 |
| Antibody htlv/hiv confirm test CPT 86689 | $137.80 | $212.00 | $17.21 – $24.19 | 5 |
| Antibody htlv-i CPT 86687 | $61.75 | $95.00 | $8.09 – $8.09 | 4 |
| Antibody identification platelet antibodies heparin-pf4 igg CPT 86022 | $305.50 | $470.00 | $16.34 – $22.96 | 5 |
| Antibody id rbc panel CPT 86870 | $198.25 | $305.00 | $23.42 – $640.87 | 5 |
| Antibody influenza virus CPT 86710 | $76.70 | $118.00 | $12.05 – $12.05 | 4 |
| Antibody screen rbc CPT 86850 | $109.20 | $168.00 | $8.69 – $93.17 | 6 |
| Anti mog serum - sendout CPT 86362 | $446.55 | $687.00 | $10.72 – $10.72 | 4 |
| Antineutrophil cytoplasmic antibody screen each antibody CPT 86036 | $85.80 | $132.00 | $10.72 – $15.06 | 5 |
| Antineutrophil cytoplasmic antibody titer each antibody CPT 86037 | $108.55 | $167.00 | $10.72 – $15.06 | 5 |
| Antinuclear antibodies CPT 86038 | $91.65 | $141.00 | $10.75 – $82.00 | 8 |
| Antinuclear antibodies titer CPT 86039 | $53.95 | $83.00 | $9.93 – $13.95 | 6 |
| Antiphosphatidylserine antibody CPT 86148 | $82.55 | $127.00 | $14.29 – $14.29 | 4 |
| Antistreptolysin o titer CPT 86060 | $66.95 | $103.00 | $6.49 – $72.00 | 6 |
| Antithrombin iii activity CPT 85300 | $136.50 | $210.00 | $10.54 – $14.81 | 5 |
| App high cost ss t/a/l >100sq cm addl 100sq cm CPT 15274 | $2,574.00 | $3,960.00 | $69.79 – $69.79 | 4 |
| App high cost ss t/a/l <100sq cm addl <25sq cm CPT 15272 | $75.40 | $116.00 | $13.87 – $23.33 | 47 |
| Application finger splntstatic 29130 CPT 29130 | $104.65 | $161.00 | $24.06 – $271.86 | 49 |
| Application long leg splint 29505 CPT 29505 | $236.60 | $364.00 | $50.09 – $84.25 | 47 |
| Application lower leg splint 29515 CPT 29515 | $165.10 | $254.00 | $45.86 – $332.04 | 49 |
| Application multi layer compression below knee (both sides) CPT 29581 | $377.65 | $581.00 | $22.33 – $332.04 | 48 |
| Application of paste boot 29580 CPT 29580 | $248.30 | $382.00 | $22.22 – $332.04 | 48 |
| Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm CPT 15275 | $223.60 | $344.00 | $79.61 – $1,510.16 | 48 |
| Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm CPT 15271 | $118.95 | $183.00 | $70.50 – $1,510.16 | 48 |
| Appl modality 1/> areas paraffin bath 97018 CPT 97018 | $71.50 | $110.00 | $9.42 – $9.42 | 1 |
| Appl modality 1/> areas vasopneumatic devices 97016 CPT 97016 | $71.50 | $110.00 | $19.28 – $19.28 | 1 |
| Appl multlay comprs arm/hand CPT 29584 | $214.50 | $330.00 | $67.81 – $67.81 | 4 |
| #aptt mix-1:1 incubated CPT 87532 | $125.45 | $193.00 | $31.21 – $31.21 | 4 |
| Aqaprn-4 antb flo cytmtry ea CPT 86053 | $258.05 | $397.00 | $33.56 – $33.56 | 4 |
| Aquaporin-4 antibody cba each CPT 86052 | $261.30 | $402.00 | $10.72 – $15.06 | 5 |
| Aquaporin-4 antibody elisa CPT 86051 | $135.20 | $208.00 | $10.26 – $10.26 | 4 |
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.