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 |
|---|---|---|---|---|
| Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review CPT 88175 | $58.00 | $58.00 | $15.97 – $34.59 | 2 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $17.00 | $17.00 | $0.11 – $0.15 | 2 |
| Diabetes (HbA1c) Test CPT 83036 | $65.00 | $65.00 | $4.08 – $18.25 | 2 |
| Digoxin total therapeutic drug level CPT 80162 | $67.00 | $67.00 | $5.58 – $24.95 | 2 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $38.00 | $38.00 | $0.73 – $0.94 | 2 |
| Dna antibody native/double stranded CPT 86225 | $48.00 | $48.00 | $5.77 – $25.82 | 2 |
| Drug of abuse screen urine CPT 80305 | $26.00 | $26.00 | $5.29 – $20.25 | 2 |
| Drug test prsmv instrmnt CPT 80306 | $150.00 | $150.00 | $7.20 – $27.00 | 2 |
| Ductogram sgl duct CPT 77053 | $64.00 | $64.00 | $42.99 – $53.68 | 2 |
| Ear irrigation 69209 CPT 69209 | $95.00 | $95.00 | $16.97 – $19.25 | 2 |
| Ecg 12 lead tracing only CPT 93005 | $100.00 | $100.00 | $11.33 – $12.61 | 2 |
| Embolization s&i CPT 75894 | $76.00 | $76.00 | $76.00 – $76.00 | 2 |
| Endo cath panc duct s&i CPT 74329 | $44.00 | $44.00 | $44.00 – $44.00 | 2 |
| Enzyme histochemistry CPT 88319 | $93.00 | $93.00 | $66.40 – $93.00 | 2 |
| Epstein barr early antigen antibody CPT 86663 | $47.00 | $47.00 | $5.51 – $24.66 | 2 |
| Epstein barr nuclear antigen antibody CPT 86664 | $70.00 | $70.00 | $6.42 – $28.74 | 2 |
| Epstein barr viral capsid antigen antibody igm CPT 86665 | $68.00 | $68.00 | $7.62 – $34.10 | 2 |
| ER Visit (level 1, minor) CPT 99281 | $37.00 | $37.00 | $26.38 – $29.35 | 2 |
| ER Visit (level 2) CPT 99282 | $59.00 | $59.00 | $50.70 – $57.24 | 2 |
| ER Visit (level 3) CPT 99283 | $81.00 | $81.00 | $75.89 – $81.00 | 2 |
| ER Visit (level 4) CPT 99284 | $140.00 | $140.00 | $139.40 – $140.00 | 2 |
| ER Visit (level 5, high severity) CPT 99285 | $200.00 | $200.00 | $200.00 – $200.00 | 2 |
| Esophageal dilat s&i CPT 74360 | $35.00 | $35.00 | $35.00 – $35.00 | 2 |
| Established Patient Office Visit (level 1) CPT 99211 | $35.00 | $35.00 | $26.38 – $27.24 | 2 |
| Established Patient Office Visit (level 2) CPT 99212 | $75.00 | $75.00 | $52.12 – $59.05 | 2 |
| Established Patient Office Visit (level 3) CPT 99213 | $92.00 | $92.00 | $86.14 – $92.00 | 2 |
| Established Patient Office Visit (level 4) CPT 99214 | $129.00 | $129.00 | $125.04 – $129.00 | 2 |
| Estradiol total CPT 82670 | $102.00 | $102.00 | $11.73 – $52.50 | 2 |
| Expose art endoprosth iliac 34820 CPT 34820 | $554.00 | $554.00 | $554.00 – $554.00 | 2 |
| Expose endoprosth brachial 34834 CPT 34834 | $316.00 | $316.00 | $223.55 – $316.00 | 2 |
| Facial bones <3 CPT 70140 | $35.00 | $35.00 | $23.27 – $25.45 | 2 |
| Feeding tube reposition CPT 74355 | $46.00 | $46.00 | $46.00 – $46.00 | 2 |
| Ferritin CPT 82728 | $81.00 | $81.00 | $5.72 – $25.62 | 2 |
| Fibrin degradation d dimer quantitative CPT 85379 | $48.00 | $48.00 | $4.28 – $19.13 | 2 |
| Fibrinogen activity CPT 85384 | $68.00 | $68.00 | $4.08 – $15.96 | 2 |
| Folic acid CPT 82746 | $50.00 | $50.00 | $6.17 – $27.63 | 2 |
| Foot X-ray CPT 73630 | $74.00 | $74.00 | $26.83 – $27.33 | 2 |
| Full mouth x-ray of teeth CPT 70320 | $58.00 | $58.00 | $48.51 – $54.16 | 2 |
| Gammaglobulin iga CPT 82784 | $53.00 | $53.00 | $3.91 – $10.47 | 2 |
| Gammaglobulin ige CPT 82785 | $68.00 | $68.00 | $6.91 – $30.93 | 2 |
| Ghs antibodies (torch) igm CPT 86694 | $58.00 | $58.00 | $6.04 – $27.04 | 2 |
| Ghs excision ingrown nail CPT 11765 | $180.00 | $180.00 | $180.00 – $180.00 | 2 |
| Ghs HIV antibody CPT 86703 | $60.00 | $60.00 | $5.76 – $25.76 | 2 |
| Ghs immun0electrophoresis CPT 86320 | $26.00 | $26.00 | $12.57 – $26.00 | 2 |
| Ghs ppd (tb intradermal) CPT 86580 | $52.00 | $52.00 | $5.45 – $10.86 | 2 |
| Ghs sensitivity (per antimicro) CPT 87184 | $53.00 | $53.00 | $3.14 – $12.96 | 2 |
| Gi inhouse confirmation CPT 87045 | $58.00 | $58.00 | $3.96 – $17.74 | 2 |
| Glucagon plasma - sendout CPT 82943 | $47.00 | $47.00 | $6.00 – $26.22 | 2 |
| Glucose blood quantitative CPT 82947 | $45.00 | $45.00 | $2.36 – $7.38 | 2 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $16.00 | $16.00 | $2.35 – $7.37 | 2 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $110.00 | $110.00 | $7.80 – $34.92 | 2 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $108.00 | $108.00 | $7.78 – $34.80 | 2 |
| Gu dilat ureter/urethra s&i CPT 74485 | $101.00 | $101.00 | $80.85 – $87.09 | 2 |
| Hand X-ray CPT 73130 | $69.00 | $69.00 | $28.79 – $29.21 | 2 |
| Hc fl sm bowel enteroclss tube w kub double contrast CPT 74251 | $411.00 | $411.00 | $148.26 – $380.61 | 2 |
| Hcg qualitative CPT 84703 | $26.00 | $26.00 | $3.16 – $14.14 | 2 |
| Hcg quantitative CPT 84702 | $65.00 | $65.00 | $9.03 – $13.14 | 2 |
| Helicobacter pylori antibody igm CPT 86677 | $37.00 | $37.00 | $7.08 – $27.26 | 2 |
| Hematocrit CPT 85014 | $42.00 | $42.00 | $1.42 – $4.45 | 2 |
| Hemoglobin CPT 85018 | $42.00 | $42.00 | $1.42 – $4.45 | 2 |
| Hepatitis a antibody igm CPT 86709 | $61.00 | $61.00 | $4.73 – $21.15 | 2 |
| Hepatitis b core antibody igm CPT 86705 | $58.00 | $58.00 | $4.94 – $22.13 | 2 |
| Hepatitis b core antibody total CPT 86704 | $55.00 | $55.00 | $5.06 – $22.65 | 2 |
| Hepatitis b surface antibody CPT 86706 | $71.00 | $71.00 | $4.51 – $20.18 | 2 |
| Hepatitis c antibody CPT 86803 | $54.00 | $54.00 | $5.99 – $26.81 | 2 |
| Herpes simplex type 1 antibody igg CPT 86695 | $60.00 | $60.00 | $5.54 – $24.78 | 2 |
| Herpes simplex type 2 antibody igg CPT 86696 | $78.00 | $78.00 | $8.13 – $36.37 | 2 |
| Heterophile antibodies screening CPT 86308 | $68.00 | $68.00 | $3.11 – $9.73 | 2 |
| Hip X-ray CPT 73502 | $84.00 | $84.00 | $50.38 – $55.59 | 2 |
| Home visit est patient 99348 CPT 99348 | $108.00 | $108.00 | $97.39 – $108.00 | 2 |
| Homocysteine CPT 83090 | $45.00 | $45.00 | $7.53 – $31.70 | 2 |
| H pylori (c-13) breath CPT 83013 | $279.00 | $279.00 | $28.29 – $126.59 | 2 |
| H pylori drug admin CPT 83014 | $50.00 | $50.00 | $3.30 – $14.77 | 2 |
| Hydroxyzine hcl 50 mg/ml intramuscular solution HCPCS J3410 | $45.00 | $45.00 | $12.31 – $20.78 | 2 |
| Hysterosalpingography s&i CPT 74740 | $82.00 | $82.00 | $73.91 – $78.88 | 2 |
| Immunoassay tumor antigen quantitative ca 125 CPT 86304 | $100.00 | $100.00 | $8.74 – $39.11 | 2 |
| Infect ag eia influenza a or b ea CPT 87400 | $61.00 | $61.00 | $5.93 – $22.52 | 2 |
| Infect ag ia optc obs influenza CPT 87804 | $49.00 | $49.00 | $14.00 – $22.52 | 2 |
| Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin CPT 87324 | $50.00 | $50.00 | $5.03 – $22.52 | 2 |
| Infectious agent antigen immunoassay ql/sq multi step cryptosporidium CPT 87328 | $58.00 | $58.00 | $5.80 – $22.52 | 2 |
| Infectious agent antigen immunoassay ql/sq multi step giardia CPT 87329 | $59.00 | $59.00 | $5.03 – $22.52 | 2 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn CPT 87340 | $60.00 | $60.00 | $4.34 – $19.08 | 2 |
| Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies CPT 87389 | $49.00 | $49.00 | $10.11 – $45.25 | 2 |
| Infectious agent antigen immunoassay ql/sq multi step rotavirus CPT 87425 | $100.00 | $100.00 | $5.03 – $22.52 | 2 |
| Infectious agent nucleic acid amplified probe CPT 87798 | $87.00 | $87.00 | $14.74 – $65.95 | 2 |
| Infectious agent nucleic acid amplified probe chlamydia trachomatis CPT 87491 | $110.00 | $110.00 | $14.74 – $65.95 | 2 |
| Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s) CPT 87493 | $100.00 | $100.00 | $15.65 – $65.95 | 2 |
| Infectious agent nucleic acid amplified probe neisseria gonorrhoeae CPT 87591 | $84.00 | $84.00 | $14.74 – $65.95 | 2 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | $168.00 | $168.00 | $17.99 – $80.50 | 2 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $169.00 | $169.00 | $17.99 – $80.50 | 2 |
| Initial nursing facility care/day 35 minutes CPT 99305 | $210.00 | $210.00 | $149.91 – $178.73 | 2 |
| Initial nursing facility care/day 45 minutes CPT 99306 | $262.00 | $262.00 | $193.48 – $228.86 | 2 |
| Initial nursing facility care/day low severity 99304 CPT 99304 | $154.00 | $154.00 | $104.73 – $125.31 | 2 |
| Injection therapeutic/prophylactic/diagnostic subcutaneous/im CPT 96372 | $25.00 | $25.00 | $21.30 – $25.00 | 2 |
| Insulin total CPT 83525 | $67.00 | $67.00 | $4.80 – $21.48 | 2 |
| Intro long gi tube w/mult fluo CPT 74340 | $34.00 | $34.00 | $34.00 – $34.00 | 2 |
| Iron CPT 83540 | $45.00 | $45.00 | $2.72 – $12.17 | 2 |
| Iron binding capacity CPT 83550 | $55.00 | $55.00 | $3.67 – $16.43 | 2 |
| Ketorolac 15 mg/ml injection (wrapper) HCPCS J1885 | $42.00 | $42.00 | $0.47 – $0.75 | 2 |
| Knee X-ray CPT 73564 | $80.00 | $80.00 | $35.90 – $37.69 | 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.