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 |
|---|---|---|---|---|
| Reconstruct shoulder joint CPT 23472 | $3,209.70 | $4,938.00 | $1,204.17 – $16,376.61 | 47 |
| Red blood cells each unit HCPCS P9021 | $356.85 | $549.00 | $93.35 – $188.21 | 6 |
| Red blood cells leukocytes reduced cmv negative irradiated each unit HCPCS P9058 | $650.00 | $1,000.00 | $225.26 – $309.26 | 5 |
| Red blood cells leukocytes reduced each unit HCPCS P9016 | $437.45 | $673.00 | $136.54 – $404.00 | 6 |
| Red blood cells leukocytes reduced irradiated each unit HCPCS P9040 | $611.65 | $941.00 | $169.40 – $331.76 | 5 |
| Rem/biv cast full arm/leg CPT 29705 | $144.95 | $223.00 | $37.98 – $571.50 | 48 |
| Remdesivir 100 mg intravenous powder for solution HCPCS J0248 | $2,072.75 | $3,188.84 | $635.00 – $855.00 | 5 |
| Removal cerumen impacted (both sides) CPT 69210 | $161.85 | $249.00 | $25.63 – $120.54 | 44 |
| Removal devitalized tissue non-selective debridement without anesthesia per session CPT 97602 | $236.60 | $364.00 | $23.64 – $348.47 | 5 |
| Removal foreign body foot subcutaneous right CPT 28190 | $526.50 | $810.00 | $118.44 – $1,446.94 | 48 |
| Removal of implant deep CPT 20680 | $1,266.85 | $1,949.00 | $363.71 – $2,548.70 | 48 |
| Removal sutr or stapl no anes CPT 15853 | $99.45 | $153.00 | $9.70 – $20.21 | 47 |
| Renal function panel CPT 80069 | $109.85 | $169.00 | $7.72 – $94.00 | 6 |
| Repair achilles tendon CPT 27650 | $1,493.05 | $2,297.00 | $575.70 – $6,361.60 | 48 |
| Repair complex wound scalp/arms/legs 2.6 - 7.5 cm CPT 13121 | $789.10 | $1,214.00 | $201.73 – $366.79 | 47 |
| Repair dental ellis ii fx CPT 41899 | $246.35 | $379.00 | $1,724.00 – $1,724.00 | 1 |
| Repair elbow perc CPT 24357 | $1,117.35 | $1,719.00 | $355.06 – $2,889.37 | 47 |
| Repair lip full thkns >one-half vert height/cmplx CPT 40654 | $1,096.55 | $1,687.00 | $363.40 – $1,319.10 | 47 |
| Repair of ruptured tendon CPT 24342 | $1,800.50 | $2,770.00 | $659.72 – $6,361.60 | 47 |
| Repair rpr lac tongue floor mouth > 2.6 cm/cmplx CPT 41252 | $719.55 | $1,107.00 | $180.47 – $303.55 | 47 |
| Repair rpr lip full thickness vermilion only CPT 40650 | $785.20 | $1,208.00 | $317.76 – $534.45 | 47 |
| Repair shoulder capsule CPT 23455 | $3,131.70 | $4,818.00 | $815.10 – $6,361.60 | 47 |
| Repair tendon extensor foot 1/2 each tendon CPT 28208 | $751.40 | $1,156.00 | $286.26 – $2,889.37 | 47 |
| Repair tongue lac <2.5cm past 1/3 tongue 41251 CPT 41251 | $662.35 | $1,019.00 | $205.82 – $346.19 | 47 |
| Reptilase test CPT 85635 | $62.40 | $96.00 | $8.76 – $8.76 | 4 |
| #resp virpnl dfa-adenovirus CPT 87260 | $70.85 | $109.00 | $12.84 – $12.84 | 4 |
| Resuscitation cardiopulmonary CPT 92950 | $670.80 | $1,032.00 | $162.03 – $441.20 | 48 |
| Resuscitation delivery/birthing room CPT 99465 | $491.40 | $756.00 | $134.98 – $134.98 | 4 |
| Reticulated platelet assay CPT 85055 | $83.85 | $129.00 | $31.79 – $58.97 | 49 |
| Reticulocyte automated CPT 85045 | $54.60 | $84.00 | $3.55 – $17.00 | 7 |
| Reticulocyte direct measurement automated CPT 85046 | $37.05 | $57.00 | $4.95 – $6.96 | 5 |
| Rheumatoid factor quantitative CPT 86431 | $56.55 | $87.00 | $5.04 – $7.09 | 7 |
| Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe HCPCS J2791 | $517.61 | $796.32 | $73.35 – $90.15 | 5 |
| Romosozumab-aqqg 105 mg/1.17 ml subcutaneous syringe (wrapper) HCPCS J3111 | $8,074.09 | $12,421.67 | $2,412.90 – $3,173.10 | 5 |
| Rsv assay w/optic CPT 87807 | $81.90 | $126.00 | $11.65 – $16.38 | 5 |
| Rubella antibody igg CPT 86762 | $79.30 | $122.00 | $12.80 – $96.00 | 6 |
| Rubeola antibody igg CPT 86765 | $76.70 | $118.00 | $11.46 – $17.39 | 6 |
| Russell viper venom diluted CPT 85613 | $79.30 | $122.00 | $8.52 – $11.98 | 5 |
| Sarscov coronavirus ag ia CPT 87426 | $71.50 | $110.00 | $31.43 – $44.16 | 5 |
| Sarscov & inf vir a&b ag ia CPT 87428 | $128.70 | $198.00 | $62.52 – $87.86 | 5 |
| Sbsq nurs facil care/day unstabl/new prob 35 min 99310 CPT 99310 | $214.50 | $330.00 | $132.57 – $222.98 | 47 |
| Sbsq nursing facil care/day minor complj 15 min CPT 99308 | $109.85 | $169.00 | $63.97 – $107.60 | 47 |
| Sbsq nursing facil care/day new problem 25 min CPT 99309 | $144.30 | $222.00 | $92.98 – $156.39 | 47 |
| Sbsq nursing facility care/day e/m stable 10 min CPT 99307 | $78.00 | $120.00 | $34.91 – $58.72 | 47 |
| Scan duplex abd/pelvis/retroperitoneal complete CPT 93975 | $973.05 | $1,497.00 | $223.84 – $873.94 | 6 |
| Scan duplex abd/pelvis/retroperitoneal limited CPT 93976 | $698.10 | $1,074.00 | $94.70 – $368.60 | 6 |
| Scan duplex extracranial arteries unilateral/limited study CPT 93882 | $586.30 | $902.00 | $105.36 – $105.36 | 4 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $623.35 | $959.00 | $94.70 – $506.64 | 6 |
| Scan duplex lower extremity arteries complete bilateral CPT 93925 | $1,103.05 | $1,697.00 | $202.67 – $796.00 | 6 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $639.60 | $984.00 | $105.04 – $562.00 | 6 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $677.95 | $1,043.00 | $104.56 – $213.62 | 5 |
| Screening Mammogram CPT 77067 | $251.55 | $387.00 | $76.90 – $230.40 | 6 |
| Screening prostate cancer PSA HCPCS G0103 | $105.30 | $162.00 | $17.18 – $17.18 | 4 |
| Sedation moderate same physician performing a gastrointestinal endoscopic service >= 5 years initial 15 minutes intra-service time HCPCS G0500 | $194.35 | $299.00 | $48.03 – $48.03 | 4 |
| Sedimentation rate erythrocyte automated CPT 85652 | $41.60 | $64.00 | $2.40 – $4.46 | 44 |
| Self-mgmt educ/train 2-4 pt 30min CPT 98961 | $37.05 | $57.00 | $12.19 – $12.19 | 4 |
| Semen analysis presence/motility CPT 89321 | $120.90 | $186.00 | $15.06 – $16.27 | 2 |
| Sho arthrs srg lmtd dbrdmt CPT 29822 | $1,450.15 | $2,231.00 | $473.08 – $2,889.37 | 47 |
| Sho arthrs srg rpr slap les CPT 29807 | $3,064.75 | $4,715.00 | $877.56 – $6,361.60 | 47 |
| Shoulder Arthroscopy (Rotator Cuff Repair) CPT 29827 | $2,154.75 | $3,315.00 | $901.45 – $6,361.60 | 48 |
| Shoulder MRI (with and without contrast) CPT 73223 | $4,343.95 | $6,683.00 | $247.64 – $801.97 | 5 |
| Shoulder MRI (with contrast) CPT 73222 | $2,419.95 | $3,723.00 | $204.87 – $1,802.03 | 6 |
| Shoulder MRI (without contrast) CPT 73221 | $3,249.35 | $4,999.00 | $120.75 – $1,751.00 | 6 |
| Shoulder X-ray CPT 73030 | $564.20 | $868.00 | $21.64 – $318.00 | 6 |
| Sickling rbc CPT 85660 | $72.15 | $111.00 | $4.90 – $6.89 | 5 |
| Sildenafil citrate, 25 mg HCPCS S0090 | $4.87 | $7.50 | $0.28 – $0.28 | 1 |
| Sinus CT scan (with and without contrast) CPT 70488 | $2,115.10 | $3,254.00 | $107.98 – $492.80 | 5 |
| Sinus CT scan (with contrast) CPT 70487 | $1,965.60 | $3,024.00 | $86.04 – $1,349.00 | 6 |
| Sinus CT scan (without contrast) CPT 70486 | $1,304.55 | $2,007.00 | $76.07 – $1,366.00 | 6 |
| Skin Biopsy CPT 11102 | $283.40 | $436.00 | $28.49 – $830.64 | 48 |
| Sleep Study (Polysomnography) CPT 95810 | $3,783.00 | $5,820.00 | $527.77 – $2,956.00 | 6 |
| Sleep study unattended CPT 95806 | $715.65 | $1,101.00 | $81.63 – $441.20 | 5 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $59.15 | $91.00 | $4.79 – $53.00 | 7 |
| Smear gram stain CPT 87205 | $61.75 | $95.00 | $3.80 – $42.00 | 6 |
| Smear nasal eosinophil CPT 89190 | $45.50 | $70.00 | $5.15 – $5.15 | 4 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $69.55 | $107.00 | $5.33 – $7.49 | 5 |
| Smear wet mount CPT 87210 | $62.40 | $96.00 | $5.18 – $42.00 | 6 |
| Snrpn/ube3a gene CPT 81331 | $380.90 | $586.00 | $45.43 – $63.84 | 5 |
| Sodium 24 hour urine CPT 84300 | $48.75 | $75.00 | $4.50 – $39.00 | 7 |
| Sodium chloride 0.9 % intravenous solution HCPCS J7030 | $42.25 | $65.00 | $2.50 – $45.00 | 6 |
| Sodium chloride 0.9 % IV bolus HCPCS J7050 | $42.25 | $65.00 | $0.63 – $20.00 | 6 |
| Sodium chloride 3 % ivpb HCPCS J7131 | $42.25 | $65.00 | $8.00 – $19.00 | 5 |
| Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous HCPCS J2916 | $139.11 | $214.02 | $10.95 – $14.80 | 5 |
| Sodium serum/plasma/whole blood CPT 84295 | $36.40 | $56.00 | $4.28 – $11.00 | 6 |
| Specific gravity body fluid CPT 84315 | $26.00 | $40.00 | $2.92 – $14.00 | 5 |
| Spirometry bronchodilation responsiveness pre/post bronchodilator administration CPT 94060 | $573.95 | $883.00 | $33.19 – $762.48 | 49 |
| Splint rstrc wrst/cmc right med HCPCS L3923 | $34.45 | $53.00 | $171.17 – $171.17 | 1 |
| St analysis behavior qualitative voice/resonance CPT 92524 | $430.30 | $662.00 | $97.72 – $177.28 | 5 |
| Staph a dna amp probe CPT 87640 | $110.50 | $170.00 | $43.86 – $43.86 | 1 |
| St cognitve performance testing healthcare professional each hour CPT 96125 | $263.25 | $405.00 | $90.88 – $166.24 | 5 |
| St evaluate speech sound production CPT 92522 | $430.30 | $662.00 | $99.10 – $181.27 | 5 |
| St evaluate speech sound production comprehensive/expressive CPT 92523 | $430.30 | $662.00 | $202.75 – $367.05 | 5 |
| St evaluation motion fluoroscopic swallow function cine/video CPT 92611 | $329.55 | $507.00 | $81.03 – $146.56 | 5 |
| St evaluation swallow function CPT 92610 | $430.30 | $662.00 | $75.41 – $243.00 | 6 |
| Strapping of ankle and/or ft 29540 CPT 29540 | $69.55 | $107.00 | $14.75 – $24.82 | 47 |
| Strapping of elbow or wrist 29260 CPT 29260 | $137.15 | $211.00 | $25.41 – $120.54 | 5 |
| Strapping of knee CPT 29530 | $68.25 | $105.00 | $14.82 – $25.71 | 47 |
| Strapping of toes 29550 CPT 29550 | $60.45 | $93.00 | $9.30 – $120.54 | 48 |
| Strep a ag ia CPT 87430 | $96.85 | $149.00 | $14.95 – $21.01 | 5 |
| Strep b dna amp probe CPT 87653 | $102.70 | $158.00 | $43.86 – $43.86 | 1 |
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.