Mercy Hospital Ardmore
1011 14th Avenue, Northwest Ardmore, OK · Mercy · · NPI 1386741635
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 |
|---|---|---|---|---|
| Epoprostenol (arginine) 1 mg in 50 ml ns inhalation syringe - cnr HCPCS J1325 | $216.94 | $333.75 | $18.45 – $42.09 | 4 |
| Epstein barr early antigen antibody CPT 86663 | $85.80 | $132.00 | $11.67 – $28.96 | 59 |
| Epstein barr nuclear antigen antibody CPT 86664 | $64.35 | $99.00 | $13.60 – $33.75 | 59 |
| Epstein barr viral capsid antigen antibody igm CPT 86665 | $79.95 | $123.00 | $16.14 – $40.04 | 59 |
| Eptifibatide 0.75 mg/ml intravenous solution HCPCS J1327 | $487.50 | $750.00 | $3.20 – $74.50 | 57 |
| Eptinezumab-jjmr 100 mg/ml intravenous solution HCPCS J3032 | $5,868.47 | $9,028.41 | $20.16 – $5,814.00 | 59 |
| Ercp biliary & pancreas CPT 74330 | $1,588.60 | $2,444.00 | $214.79 – $430.26 | 7 |
| Ercp w/specimen collection CPT 43260 | $4,011.80 | $6,172.00 | not published | 0 |
| Eribulin 1 mg/2 ml (0.5 mg/ml) intravenous solution HCPCS J9179 | $2,492.75 | $3,835.00 | $75.30 – $2,172.30 | 59 |
| Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr HCPCS J1335 | $517.39 | $795.99 | $17.90 – $40.86 | 8 |
| ER Visit (level 1, minor) CPT 99281 | $254.80 | $392.00 | $10.79 – $191.72 | 56 |
| ER Visit (level 2) CPT 99282 | $403.00 | $620.00 | $39.61 – $349.10 | 56 |
| ER Visit (level 3) CPT 99283 | $1,706.25 | $2,625.00 | $68.06 – $620.65 | 56 |
| ER Visit (level 4) CPT 99284 | $2,726.10 | $4,194.00 | $62.00 – $948.70 | 57 |
| ER Visit (level 5, high severity) CPT 99285 | $6,297.07 | $9,687.80 | $168.10 – $1,354.02 | 57 |
| Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1364 | $962.99 | $1,481.52 | $33.26 – $258.18 | 7 |
| Esmolol 2,500 mg/250 ml (10 mg/ml) in sterile water intravenous soln HCPCS J1806 | $582.56 | $896.25 | $90.00 – $170.00 | 7 |
| Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only HCPCS J1805 | $1,574.62 | $2,422.50 | $1.68 – $5.28 | 8 |
| Esophagoscopy/flex/diagnostic 43200 CPT 43200 | $1,898.00 | $2,920.00 | not published | 0 |
| Esophagoscopy lesion ablate CPT 43229 | $5,131.38 | $7,894.43 | $169.23 – $8,765.96 | 58 |
| Esophagus motility study CPT 91010 | $1,125.15 | $1,731.00 | $188.27 – $848.43 | 56 |
| Esoph egd dilation <30 mm CPT 43249 | $2,724.93 | $4,192.20 | $131.91 – $4,362.91 | 58 |
| Established Patient Office Visit (level 1) CPT 99211 | $348.40 | $536.00 | $7.36 – $38.05 | 53 |
| Established Patient Office Visit (level 2) CPT 99212 | $602.55 | $927.00 | $29.59 – $94.11 | 53 |
| Established Patient Office Visit (level 3) CPT 99213 | $1,191.45 | $1,833.00 | $54.82 – $151.81 | 53 |
| Established Patient Office Visit (level 4) CPT 99214 | $293.15 | $451.00 | $80.63 – $216.61 | 53 |
| Established Patient Office Visit (level 5) CPT 99215 | $344.50 | $530.00 | $119.63 – $307.70 | 53 |
| Estradiol total CPT 82670 | $74.75 | $115.00 | $24.85 – $61.67 | 58 |
| Estradiol valerate 10 mg inj HCPCS J1380 | $1,124.76 | $1,730.40 | $79.40 – $203.40 | 8 |
| Estrogens total-sendout CPT 82672 | $158.60 | $244.00 | $19.30 – $49.82 | 59 |
| Ethylene glycol -sendout CPT 82693 | $85.80 | $132.00 | $13.25 – $32.89 | 56 |
| Etoposide 20 mg/ml intravenous solution HCPCS J9181 | $504.78 | $776.58 | $9.80 – $25.50 | 8 |
| Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen CPT 84112 | $114.40 | $176.00 | $87.27 – $216.56 | 58 |
| Evaluation of speech fluency 92521 CPT 92521 | $363.35 | $559.00 | $118.27 – $281.67 | 54 |
| Event monitor CPT 93270 | $182.00 | $280.00 | $6.92 – $84.86 | 56 |
| Evoked potentials auditory screening automated analysis CPT 92650 | $489.45 | $753.00 | $23.29 – $71.18 | 5 |
| Evok oa screening qual CPT 92558 | $105.30 | $162.00 | not published | 0 |
| Exam plvc w/anes othr thn lcl CPT 57410 | $4,632.79 | $7,127.37 | $92.61 – $7,360.06 | 58 |
| Exc ben+marg excep skin tag tal 0.6-1cm 11401 CPT 11401 | $1,065.35 | $1,639.00 | not published | 0 |
| Exchange biliary drg cath CPT 47536 | $5,390.45 | $8,293.00 | not published | 0 |
| Exchange blood transfusion newborn 36450 CPT 36450 | $731.25 | $1,125.00 | $389.32 – $1,003.07 | 51 |
| Exchange drainage catheter CPT 49423 | $1,993.55 | $3,067.00 | not published | 0 |
| Exchange nephrostomy cath CPT 50435 | $3,196.05 | $4,917.00 | $85.34 – $4,752.78 | 58 |
| Excise intrspinl lesion lmbr CPT 63267 | $15,457.58 | $23,780.89 | $1,208.74 – $16,498.03 | 57 |
| Excision floor mouth lesion 41116 CPT 41116 | $8,993.52 | $13,836.19 | $190.26 – $7,538.16 | 58 |
| Excision of anal lesion(s) CPT 46922 | $6,121.60 | $9,417.85 | $127.16 – $6,310.86 | 58 |
| Exc malig snhfg 2.1-3 cm 11623 CPT 11623 | $3,832.40 | $5,896.00 | not published | 0 |
| Exc malig tal 0.6-1.0cm 11601 CPT 11601 | $3,954.60 | $6,084.00 | not published | 0 |
| Exc rect tum transanal part CPT 45171 | $6,676.15 | $10,271.00 | $2,442.14 – $6,310.86 | 53 |
| Exc snhfg mal+mrg 1.1-2 11622 CPT 11622 | $1,743.95 | $2,683.00 | not published | 0 |
| Exc thrombosed hemorrhoid 46320 CPT 46320 | $7,856.39 | $12,086.76 | $102.90 – $3,047.00 | 54 |
| Exc vagina lesion 57135 CPT 57135 | $5,618.01 | $8,643.10 | $160.48 – $7,360.06 | 58 |
| Exercise tst brncspsm w/ecg CPT 94617 | $447.20 | $688.00 | $55.95 – $302.50 | 56 |
| Exercise w/hemodynamic meas CPT 93464 | $529.75 | $815.00 | $123.00 – $187.16 | 5 |
| Expander tiss 133s-mv-12-t 300ml natrelle smth HCPCS C1789 | $1,332.50 | $2,050.00 | not published | 0 |
| External chromosome analysis 20-25 cells CPT 88264 | $394.55 | $607.00 | $128.63 – $319.20 | 57 |
| External pretreatment of serum for use in antibody identification by dilution CPT 86976 | $74.75 | $115.00 | $29.23 – $65.76 | 57 |
| External tissue culture neoplastic disorders bone marrow/blood cells CPT 88237 | $130.65 | $201.00 | $127.86 – $317.30 | 57 |
| Extractable nuclear antigen/antibody any method each antibody centromere CPT 86235 | $83.85 | $129.00 | $15.95 – $39.58 | 58 |
| F-18 fdg pet diag HCPCS A9552 | $1,302.60 | $2,004.00 | $257.48 – $400.00 | 5 |
| F-18 florbetapir less than or equal to 10 mci HCPCS A9586 | $4,006.60 | $6,164.00 | $1,790.95 – $4,029.74 | 56 |
| Factor ix CPT 85250 | $143.00 | $220.00 | $16.94 – $42.03 | 59 |
| Factor viii CPT 85240 | $308.10 | $474.00 | $15.92 – $40.18 | 59 |
| Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr HCPCS J1308 | $7.15 | $11.00 | $0.40 – $1.20 | 3 |
| Fam-trastuzumab deruxtecan-nxki 100 mg intravenous solution HCPCS J9358 | $9,485.81 | $14,593.56 | $30.67 – $8,847.00 | 59 |
| Fat/lipids feces qualitative CPT 82705 | $46.15 | $71.00 | $4.54 – $12.20 | 59 |
| Fatty acids nonesterified CPT 82725 | $96.20 | $148.00 | $16.70 – $41.43 | 59 |
| Fecal microbiota, live-jslm 150 ml rectal suspension enema HCPCS J1440 | $25,080.72 | $38,585.72 | $63.10 – $27,306.00 | 59 |
| #fecal-sodium CPT 84302 | $25.35 | $39.00 | $4.32 – $10.73 | 59 |
| Felbamate (felbatol(r)) - sendout CPT 80167 | $99.45 | $153.00 | $16.58 – $41.14 | 55 |
| Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper) HCPCS J3010 | $232.24 | $357.30 | $0.85 – $3.30 | 8 |
| Fern test HCPCS Q0114 | $59.15 | $91.00 | $8.66 – $21.50 | 58 |
| Ferric carboxymaltose 50 mg iron/ml intravenous solution HCPCS J1439 | $527.65 | $811.77 | $1.08 – $156.00 | 59 |
| Ferritin CPT 82728 | $48.75 | $75.00 | $12.12 – $30.09 | 58 |
| Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution HCPCS Q0138 | $3,601.50 | $5,540.77 | $0.22 – $336.60 | 59 |
| Fetal biophys profile w/nst 76818 CPT 76818 | $543.40 | $836.00 | $57.69 – $240.32 | 59 |
| Fetal chrom aneuploidy gsa panel CPT 81420 | $1,469.65 | $2,261.00 | $675.16 – $1,675.45 | 55 |
| Fetal contract stress test 59020 - 26 CPT 59020 | $1,085.50 | $1,670.00 | $32.69 – $459.66 | 56 |
| Fetal fibronectin CPT 82731 | $172.90 | $266.00 | $57.29 – $142.17 | 58 |
| Fetal hemoglobin (kleihauer betke) CPT 85460 | $27.95 | $43.00 | $6.88 – $17.06 | 58 |
| Fetal hemoglobin rosette CPT 85461 | $46.80 | $72.00 | $8.33 – $20.66 | 58 |
| Fetal lung maturity assess lam body dnst CPT 83664 | $85.80 | $132.00 | $17.18 – $42.65 | 56 |
| Fetal non stress test CPT 59025 | $1,000.35 | $1,539.00 | $19.06 – $459.66 | 57 |
| #_fet/norfentcnfrmur CPT 80354 | $72.15 | $111.00 | $32.17 – $32.17 | 1 |
| Fibrin degradation d dimer quantitative CPT 85379 | $243.75 | $375.00 | $9.05 – $22.47 | 58 |
| Fibrin degrade semiquant CPT 85378 | $115.70 | $178.00 | $8.65 – $21.45 | 56 |
| Fibrinogen activity CPT 85384 | $22.75 | $35.00 | $8.65 – $21.45 | 58 |
| Fibrinolysins/coagulopathy screen interpretation/report CPT 85390 | $61.75 | $95.00 | $8.43 – $34.17 | 59 |
| Fibrinolytic antiplasmin CPT 85410 | $88.40 | $136.00 | $6.86 – $17.02 | 56 |
| Fibrinolytic plasminogen CPT 85415 | $110.50 | $170.00 | $15.29 – $37.94 | 59 |
| Fibrinolytic plasminogen xcpt antgnc asa CPT 85420 | $122.85 | $189.00 | $5.81 – $14.41 | 56 |
| Filgrastim-aafi 300 mcg/0.5 ml subcutaneous syringe HCPCS Q5110 | $933.82 | $1,436.64 | $0.28 – $189.00 | 59 |
| Filter spider fx 3mmx320cm HCPCS C1884 | $1,917.50 | $2,950.00 | not published | 0 |
| Filter vena cava fem denali HCPCS C1880 | $2,307.50 | $3,550.00 | not published | 0 |
| Finasteride, 5 mg HCPCS S0138 | $4.87 | $7.50 | $0.14 – $0.24 | 2 |
| Fine needle aspiration biopsy w/fluor gdn;1st lesion 10007 CPT 10007 | $1,348.10 | $2,074.00 | not published | 0 |
| Fine needle aspiration biopsy w/us gdn; ea addtl 10006 CPT 10006 | $2,414.98 | $3,715.35 | $42.22 – $3,047.00 | 58 |
| Flecainide (tambocor)-sendout CPT 80181 | $102.70 | $158.00 | $16.58 – $41.14 | 58 |
| Fl exam g/colon tube w contrast CPT 49465 | $668.85 | $1,029.00 | not published | 0 |
| Flexible Sigmoidoscopy CPT 45330 | $1,950.65 | $3,001.00 | $51.30 – $3,047.00 | 54 |
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.