Mercy Health Love County Rural Health Clinic
301 WANDA ST, MARIETTA, OK · Mercy · · NPI 1578513792
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 |
|---|---|---|---|---|
| 99381 initial comp preventive med less than 1 year new CPT 99381 | $179.00 | $179.00 | $127.86 – $127.86 | 1 |
| 99382 initial comp preventive med 1 to 4 years new CPT 99382 | $179.00 | $179.00 | $134.03 – $134.03 | 1 |
| 99383 initial comp preventive med 5 to 11 years new CPT 99383 | $179.00 | $179.00 | $139.79 – $139.79 | 1 |
| 99391 periodic comp preventive med less than 1 year est CPT 99391 | $152.00 | $152.00 | $115.63 – $115.63 | 1 |
| 99392 periodic comp preventive med 1 to 4 years est CPT 99392 | $152.00 | $152.00 | $123.04 – $123.04 | 1 |
| 99393 periodic comp preventive med 5 to 11 years est CPT 99393 | $152.00 | $152.00 | $122.64 – $122.64 | 1 |
| 99394 periodic comp preventive med 12 to 17 years est CPT 99394 | $152.00 | $152.00 | $134.97 – $134.97 | 1 |
| 99397 periodic comp preventive med 65+ years est CPT 99397 | $152.00 | $152.00 | $152.00 – $152.00 | 1 |
| Aco annual medicare visit (awv), subsq g0439aco HCPCS G0439 | $137.00 | $137.00 | $132.69 – $137.00 | 2 |
| Acute hepatitis panel CPT 80074 | $179.00 | $179.00 | $20.00 – $89.17 | 2 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $48.00 | $48.00 | $2.43 – $10.86 | 2 |
| Albumin serum plasma or whole blood CPT 82040 | $47.00 | $47.00 | $2.08 – $9.30 | 2 |
| Alcohol (ethanol) any specimen except urine/breath CPT 82077 | $75.00 | $75.00 | $7.25 – $7.25 | 1 |
| Alkaline phosphatase CPT 84075 | $37.00 | $37.00 | $2.18 – $9.73 | 2 |
| Allergy injections; 2 or more 95117 CPT 95117 | $42.00 | $42.00 | $13.04 – $13.69 | 2 |
| Allergy injection; single 95115 CPT 95115 | $26.00 | $26.00 | $11.30 – $11.81 | 2 |
| Alpha-fetoprotein tumor marker CPT 82105 | $58.00 | $58.00 | $7.04 – $31.52 | 2 |
| Alt/sgpt CPT 84460 | $45.00 | $45.00 | $2.23 – $9.96 | 2 |
| Amphetamine confirm urine -sendout CPT 80324 | $185.00 | $185.00 | $9.83 – $9.83 | 1 |
| Amylase CPT 82150 | $53.00 | $53.00 | $2.72 – $12.18 | 2 |
| Ana ds-dna CPT 86226 | $38.00 | $38.00 | $5.09 – $22.76 | 2 |
| Ankle X-ray CPT 73610 | $80.00 | $80.00 | $28.79 – $30.15 | 2 |
| Annual Physical, Established Patient (age 18-39) CPT 99395 | $152.00 | $152.00 | $138.25 – $138.25 | 1 |
| Annual Physical, Established Patient (age 40-64) CPT 99396 | $152.00 | $152.00 | $147.30 – $147.30 | 1 |
| Annual Physical, New Patient (age 18-39) CPT 99385 | $179.00 | $179.00 | $153.36 – $153.36 | 1 |
| Annual Physical, New Patient (age 40-64) CPT 99386 | $179.00 | $179.00 | $177.63 – $177.63 | 1 |
| Antibody id rbc panel CPT 86870 | $110.00 | $110.00 | $18.34 – $18.34 | 1 |
| Antibody screen rbc CPT 86850 | $58.00 | $58.00 | $4.10 – $7.19 | 2 |
| Antinuclear antibodies CPT 86038 | $67.00 | $67.00 | $5.08 – $22.71 | 2 |
| Antinuclear antibodies titer CPT 86039 | $68.00 | $68.00 | $4.69 – $20.97 | 2 |
| Antistreptolysin o titer CPT 86060 | $44.00 | $44.00 | $3.07 – $13.71 | 2 |
| Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right CPT 20605 | $66.00 | $66.00 | $66.00 – $66.00 | 2 |
| Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance CPT 20600 | $64.00 | $64.00 | $64.00 – $64.00 | 2 |
| Arthrocentesis/aspiration/inj major joint/bursa without Ultrasound guidance (both sides) CPT 20610 | $130.00 | $130.00 | $83.09 – $95.58 | 2 |
| Assay of breath ethanol CPT 82075 | $44.00 | $44.00 | $12.60 – $22.65 | 2 |
| Assess aphasia/interp/rpt/per hr 96105 CPT 96105 | $121.00 | $121.00 | $121.00 – $121.00 | 2 |
| Assess cyst contrast inject CPT 49424 | $160.00 | $160.00 | $160.00 – $160.00 | 2 |
| Assessment leukocyte fecal qualitative/semiquantitative CPT 89055 | $53.00 | $53.00 | $2.56 – $7.88 | 2 |
| Assistive tech assessment, ot CPT 97755 | $53.00 | $53.00 | $34.92 – $48.91 | 2 |
| Ast/sgot CPT 84450 | $45.00 | $45.00 | $2.18 – $9.73 | 2 |
| Autgrft implnt knee w/scope CPT 29866 | $1,106.00 | $1,106.00 | $1,106.00 – $1,106.00 | 2 |
| Autochondrocyte implant knee CPT 27412 | $1,745.00 | $1,745.00 | $1,745.00 – $1,745.00 | 2 |
| Autonomic nrv adrenrg inervj CPT 95922 | $122.00 | $122.00 | $122.00 – $122.00 | 2 |
| Autonomic nrv syst funj test CPT 95923 | $217.00 | $217.00 | $189.88 – $192.70 | 2 |
| Av fistula revision CPT 36833 | $727.00 | $727.00 | $727.00 – $727.00 | 2 |
| Av fuse uppr arm basilic CPT 36819 | $812.00 | $812.00 | $812.00 – $812.00 | 2 |
| Av fuse uppr arm cephalic CPT 36818 | $740.00 | $740.00 | $740.00 – $740.00 | 2 |
| Av fusion direct any site CPT 36821 | $763.00 | $763.00 | $763.00 – $763.00 | 2 |
| Av fusion/forearm vein 36820 CPT 36820 | $886.00 | $886.00 | $886.00 – $886.00 | 2 |
| Bacterial meningitis antigen CPT 86403 | $58.00 | $58.00 | $6.92 – $19.15 | 2 |
| Bacterial vaginosis pcr CPT 87801 | $87.00 | $87.00 | $29.48 – $87.00 | 2 |
| #_benzodiazconfur CPT 80346 | $79.00 | $79.00 | $9.83 – $9.83 | 1 |
| Betamethasone acetate and sodium phos 6 mg/ml suspension for injection HCPCS J0702 | $37.00 | $37.00 | $7.51 – $9.55 | 2 |
| Bilirubin direct CPT 82248 | $25.00 | $25.00 | $2.11 – $9.43 | 2 |
| Bilirubin total CPT 82247 | $42.00 | $42.00 | $2.11 – $9.43 | 2 |
| Blood Clotting (PT/INR) Test CPT 85610 | $45.00 | $45.00 | $2.57 – $7.38 | 2 |
| Blood Clotting (PTT) Test CPT 85730 | $53.00 | $53.00 | $2.52 – $11.29 | 2 |
| Blood Count (CBC) Test CPT 85025 | $55.00 | $55.00 | $3.26 – $14.60 | 2 |
| Blood Culture Test CPT 87040 | $89.00 | $89.00 | $4.33 – $19.40 | 2 |
| Blood occult feces colorectal neoplasm screening qualitative CPT 82270 | $40.00 | $40.00 | $2.63 – $6.11 | 2 |
| Blood smear interpretation CPT 85060 | $42.00 | $42.00 | $10.49 – $34.44 | 2 |
| Blood typing abo CPT 86900 | $39.00 | $39.00 | $1.26 – $5.62 | 2 |
| Blood typing rh (d) CPT 86901 | $40.00 | $40.00 | $1.26 – $5.62 | 2 |
| Bone survey-lead poisoning CPT 77074 | $76.00 | $76.00 | $45.36 – $55.09 | 2 |
| Borrelia burgdorferi (lyme disease) antibody nonspecific CPT 86618 | $138.00 | $138.00 | $7.15 – $32.00 | 2 |
| Calcium ionized CPT 82330 | $68.00 | $68.00 | $5.75 – $25.70 | 2 |
| Calcium total CPT 82310 | $37.00 | $37.00 | $2.17 – $9.70 | 2 |
| Carbamazepine total therapeutic drug level CPT 80156 | $67.00 | $67.00 | $6.12 – $27.37 | 2 |
| Carboxyhemoglobin quantitative CPT 82375 | $61.00 | $61.00 | $5.17 – $23.15 | 2 |
| Carcinoembryonic ag (cea) CPT 82378 | $53.00 | $53.00 | $7.96 – $35.63 | 2 |
| Cefazolin 10 mg/10 ml (dilution #2) IV desensitization - cnr HCPCS J0690 | $55.00 | $55.00 | $0.81 – $1.16 | 2 |
| Cefoxitin 1 gram intravenous solution HCPCS J0694 | $42.00 | $42.00 | $4.45 – $4.88 | 2 |
| Ceftriaxone 1 gram solution for injection HCPCS J0696 | $55.00 | $55.00 | $0.45 – $0.59 | 2 |
| Chest X-ray CPT 71046 | $141.00 | $141.00 | $36.58 – $36.58 | 1 |
| Chest X-ray (single view) CPT 71045 | $110.00 | $110.00 | $28.63 – $28.63 | 1 |
| Chlamydia culture CPT 87110 | $96.00 | $96.00 | $8.23 – $36.83 | 2 |
| Chlnggrphy intraop addl s&i CPT 74301 | $17.00 | $17.00 | $17.00 – $17.00 | 2 |
| Chlorpromazine 0.125 mg/ml IV syringe - cnr HCPCS J3230 | $37.00 | $37.00 | $28.71 – $30.48 | 2 |
| Cholesterol CPT 82465 | $53.00 | $53.00 | $1.83 – $8.18 | 2 |
| Cholesterol (Lipid) Test CPT 80061 | $61.00 | $61.00 | $5.62 – $25.17 | 2 |
| Complement antigen each component c3 CPT 86160 | $80.00 | $80.00 | $5.04 – $22.55 | 2 |
| C-peptide CPT 84681 | $90.00 | $90.00 | $8.74 – $39.11 | 2 |
| C-reactive protein CPT 86140 | $44.00 | $44.00 | $2.18 – $9.73 | 2 |
| C-reactive protein high sensitivity CPT 86141 | $46.00 | $46.00 | $5.44 – $24.33 | 2 |
| Creatine kinase CPT 82550 | $53.00 | $53.00 | $2.73 – $12.23 | 2 |
| Creatine kinase mb CPT 82553 | $160.00 | $160.00 | $4.85 – $21.70 | 2 |
| Creatinine CPT 82565 | $58.00 | $58.00 | $2.15 – $9.63 | 2 |
| Creatinine 24 hour urine CPT 82570 | $42.00 | $42.00 | $2.18 – $9.73 | 2 |
| Creatinine clearance urine CPT 82575 | $78.00 | $78.00 | $3.97 – $17.77 | 2 |
| #creutz-prot.,western blot CPT 84182 | $26.00 | $26.00 | $12.27 – $12.84 | 2 |
| Cryofibrinogen qualitative - sendout CPT 82585 | $40.00 | $40.00 | $5.94 – $16.12 | 2 |
| Culture aerobic additional method definitive id each CPT 87077 | $41.00 | $41.00 | $3.39 – $15.18 | 2 |
| Culture anaerobic except blood CPT 87075 | $110.00 | $110.00 | $3.98 – $13.15 | 2 |
| Culture bact stool aero addl path ea CPT 87046 | $47.00 | $47.00 | $3.96 – $17.74 | 2 |
| Culture body fluid CPT 87070 | $48.00 | $48.00 | $3.62 – $16.19 | 2 |
| Culture fungi other (except blood) CPT 87102 | $77.00 | $77.00 | $3.53 – $15.80 | 2 |
| Culture screening strep group a CPT 87081 | $60.00 | $60.00 | $2.78 – $12.45 | 2 |
| Culture typing immunologic CPT 87147 | $38.00 | $38.00 | $2.18 – $7.88 | 2 |
| Culture urine each isolate CPT 87088 | $41.00 | $41.00 | $3.40 – $10.47 | 2 |
| Cyclic citrullinated peptide antibody CPT 86200 | $79.00 | $79.00 | $5.44 – $24.33 | 2 |
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.