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 |
|---|---|---|---|---|
| Cytarabine 20 mg/ml injection solution HCPCS J9100 | $92.35 | $142.08 | $0.79 – $2.25 | 8 |
| Cytogenetics 25-99 CPT 88274 | $120.90 | $186.00 | $37.70 – $93.55 | 58 |
| Cytomegalovirus (cmv) antibody igg CPT 86644 | $51.35 | $79.00 | $12.80 – $31.76 | 58 |
| Cytomegalovirus (cmv) antibody igm CPT 86645 | $60.45 | $93.00 | $14.99 – $37.19 | 58 |
| Cyto/molecular report CPT 88291 | $113.10 | $174.00 | $29.49 – $69.38 | 59 |
| Cytopathology cellular enhancement technique non-gyn CPT 88112 | $171.60 | $264.00 | $35.72 – $118.48 | 61 |
| Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review CPT 88175 | $55.90 | $86.00 | $23.67 – $116.37 | 59 |
| Cytopathology cervical/vaginal thin layer manual screening CPT 88142 | $72.80 | $112.00 | $18.02 – $44.72 | 56 |
| Cytopathology concentration technique smears & interpretation CPT 88108 | $70.20 | $108.00 | $37.74 – $84.92 | 61 |
| Cytopathology fluids/washings/brushings smears with interpretation CPT 88104 | $70.20 | $108.00 | $37.74 – $84.92 | 61 |
| Cytopathology fna adequacy evaluation each separate additional episode same site CPT 88177 | $104.00 | $160.00 | $7.88 – $48.37 | 11 |
| Cytopathology fna adequacy evaluation first episode each site CPT 88172 | $312.65 | $481.00 | $19.06 – $387.36 | 61 |
| Cytopathology fna adequacy evaluation first episode each site interp/rpt CPT 88173 | $143.00 | $220.00 | $52.66 – $160.45 | 61 |
| Cytopath smear other source CPT 88160 | $76.05 | $117.00 | $29.23 – $71.65 | 61 |
| Cytopath smear oth prep screen & interp CPT 88161 | $79.30 | $122.00 | $29.23 – $74.26 | 61 |
| Cytopath tbs c/v manual CPT 88164 | $68.90 | $106.00 | $16.18 – $40.92 | 56 |
| Cytotoxic antibody screening CPT 86807 | $373.10 | $574.00 | $64.63 – $173.60 | 59 |
| Dacarbazine 100 mg intravenous solution HCPCS J9130 | $42.74 | $65.76 | $4.17 – $10.89 | 8 |
| Dalbavancin 500 mg intravenous solution HCPCS J0875 | $4,741.39 | $7,294.44 | $14.72 – $4,245.00 | 59 |
| Daptomycin 500 mg/10 ml intravenous solution HCPCS J0878 | $146.25 | $225.00 | $14.00 – $31.50 | 8 |
| Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln HCPCS J9144 | $32,877.34 | $50,580.53 | $53.99 – $28,036.80 | 59 |
| Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe HCPCS J0881 | $10,313.55 | $15,867.00 | $3.01 – $217.50 | 59 |
| Daunorubicin 5 mg/ml intravenous solution HCPCS J9150 | $398.86 | $613.63 | $47.04 – $140.10 | 8 |
| D&c after delivery 59160 CPT 59160 | $6,285.86 | $9,670.55 | $158.47 – $7,360.06 | 58 |
| Dch glucoscan CPT 82948 | $19.50 | $30.00 | $4.48 – $11.12 | 56 |
| Dch validity tests CPT 81002 | $23.40 | $36.00 | $3.10 – $7.68 | 58 |
| Deamidated gliadin antibody iga CPT 86258 | $96.20 | $148.00 | $10.72 – $26.60 | 58 |
| Debridement (>20 cm) charge pt CPT 97598 | $406.25 | $625.00 | $20.61 – $75.09 | 53 |
| Debridement bone <= 20 sq cm CPT 11044 | $1,030.90 | $1,586.00 | not published | 0 |
| Debridement/bone/20 sq cm or less 11046 CPT 11046 | $213.85 | $329.00 | not published | 0 |
| Debridement/bone/ea add 20 sq cm 11047 CPT 11047 | $2,656.55 | $4,087.00 | not published | 0 |
| Debridement subcutaneous tissue <= 20 sq cm CPT 11042 | $687.70 | $1,058.00 | not published | 0 |
| Debride/subq tissue/ea add 20sq cm 11045 CPT 11045 | $175.50 | $270.00 | not published | 0 |
| Debr musc/fascia 20sq cm/< 11043 CPT 11043 | $1,390.35 | $2,139.00 | $202.31 – $1,680.38 | 56 |
| Decalcification CPT 88311 | $6,016.25 | $9,255.77 | $7.54 – $6,604.28 | 61 |
| Decitabine 50 mg intravenous solution HCPCS J0894 | $299.00 | $460.00 | $53.50 – $141.00 | 8 |
| Declotting thrombolytic agent implanted vas access device 36 CPT 36593 | $906.10 | $1,394.00 | $28.83 – $751.00 | 56 |
| Deferoxamine 500 mg solution for injection HCPCS J0895 | $71.95 | $110.70 | $8.94 – $24.27 | 8 |
| Degarelix 120 mg subcutaneous solution HCPCS J9155 | $4,464.73 | $6,868.81 | $4.37 – $3,031.20 | 59 |
| Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device CPT 94664 | $182.00 | $280.00 | $14.95 – $497.88 | 56 |
| Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution HCPCS J0897 | $10,399.70 | $15,999.54 | $28.95 – $5,011.20 | 59 |
| Depo-estradiol cypionate inj HCPCS J1000 | $1,257.46 | $1,934.55 | $193.25 – $733.35 | 8 |
| Design mlc device for imrt CPT 77338 | $39,068.25 | $60,105.00 | $203.89 – $860.72 | 57 |
| Desmopressin 4 mcg/ml injection solution HCPCS J2597 | $18.28 | $28.13 | $4.23 – $9.66 | 8 |
| Desoxycorticosterone CPT 82633 | $158.60 | $244.00 | $27.56 – $69.53 | 59 |
| Destroy cervthor facet jnt 64633 CPT 64633 | $3,792.08 | $5,833.97 | $167.26 – $4,439.80 | 58 |
| Destroy cth facet jnt addl 64634 CPT 64634 | $3,792.08 | $5,833.97 | $56.64 – $4,439.80 | 58 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides) CPT 64636 | $3,653.67 | $5,621.03 | $49.73 – $4,869.00 | 58 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides) CPT 64635 | $3,653.67 | $5,621.03 | $167.60 – $4,869.00 | 58 |
| Device ablt adv novasure HCPCS C1886 | $3,250.00 | $5,000.00 | not published | 0 |
| Device sut capio slim opn HCPCS C2631 | $696.80 | $1,072.00 | not published | 0 |
| Dexamethasone 4 mg tablet HCPCS J8540 | $4.87 | $7.50 | $0.02 – $0.24 | 8 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $14.62 | $22.50 | $0.22 – $0.60 | 8 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | $1,337.02 | $2,056.95 | $48.79 – $160.93 | 59 |
| Dextran 40 infusion HCPCS J7100 | $234.51 | $360.79 | $17.77 – $52.88 | 5 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | $42.25 | $65.00 | $1.18 – $3.63 | 8 |
| Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 | $42.25 | $65.00 | $5.25 – $11.52 | 6 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | $42.25 | $65.00 | $1.80 – $5.31 | 8 |
| Dextrose 5 % IV bolus HCPCS J7070 | $42.25 | $65.00 | $3.60 – $8.70 | 8 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $124.15 | $191.00 | $19.77 – $49.07 | 59 |
| Diabetes (HbA1c) Test CPT 83036 | $83.20 | $128.00 | $8.64 – $21.43 | 58 |
| Diab manage trn ind/group HCPCS G0109 | $40.95 | $63.00 | $13.88 – $33.66 | 54 |
| Diag laparo separate proc 49320 CPT 49320 | $7,500.96 | $11,539.94 | $300.35 – $13,745.36 | 57 |
| Diagnostic anoscopy spx 46600 CPT 46600 | $3,324.88 | $5,115.20 | $159.61 – $3,261.00 | 53 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $319.80 | $492.00 | not published | 0 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $431.60 | $664.00 | $93.26 – $327.99 | 54 |
| Diagnostic Mammogram (one breast) CPT 77065 | $280.15 | $431.00 | $72.73 – $259.08 | 54 |
| Diagnostic radio unlisted proc CPT 76499 | $360.75 | $555.00 | $87.94 – $197.86 | 48 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | $4,197.70 | $6,458.00 | not published | 0 |
| Dialysis one evaluation CPT 90945 | $1,103.05 | $1,697.00 | $75.17 – $948.70 | 56 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | $157.95 | $243.00 | $30.00 – $63.00 | 4 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $15.04 | $23.14 | $8.15 – $24.09 | 8 |
| Dicyclomine injection HCPCS J0500 | $59.96 | $92.25 | $11.62 – $37.21 | 8 |
| Diffusing capacity CPT 94729 | $360.10 | $554.00 | $47.81 – $97.36 | 5 |
| Digital analysis of eeg CPT 95957 | $313.95 | $483.00 | $250.81 – $250.81 | 4 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $7.29 | $11.22 | $8.82 – $29.34 | 8 |
| Digoxin total therapeutic drug level CPT 80162 | $126.10 | $194.00 | $11.81 – $29.31 | 59 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | $190.12 | $292.50 | $41.04 – $155.34 | 8 |
| Dilate esophagus 1/mult pass CPT 43450 | $1,684.80 | $2,592.00 | not published | 0 |
| Dilator fascial 10fx20cm HCPCS C2627 | $138.45 | $213.00 | not published | 0 |
| Dilat xst trc new access rcs CPT 50437 | $5,842.20 | $8,988.00 | not published | 0 |
| Diltiazem 5 mg/ml intravenous solution HCPCS J1163 | $55.63 | $85.59 | $1.00 – $2.40 | 3 |
| Dimethyl sulfoxide 50% 50 ml HCPCS J1212 | $3,557.53 | $5,473.13 | $734.74 – $2,119.74 | 55 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $14.68 | $22.58 | $0.73 – $1.95 | 8 |
| Disability dlco CPT 94727 | $495.95 | $763.00 | $34.20 – $490.93 | 56 |
| Disaccharidases CPT 82657 | $351.65 | $541.00 | $19.72 – $48.94 | 58 |
| Discography cerv/thor spine CPT 72285 | $1,777.75 | $2,735.00 | $64.12 – $4,439.80 | 52 |
| Dna antibody native/double stranded CPT 86225 | $68.25 | $105.00 | $12.22 – $36.11 | 59 |
| Dna gardnerella CPT 87510 | $79.95 | $123.00 | $17.83 – $44.26 | 59 |
| Dna probe chlamydia CPT 87490 | $76.05 | $117.00 | $20.24 – $50.22 | 56 |
| Dna probe gc CPT 87590 | $94.25 | $145.00 | $23.91 – $59.33 | 56 |
| Dna trichomonas CPT 87660 | $84.50 | $130.00 | $17.83 – $44.26 | 59 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $109.69 | $168.75 | $7.39 – $22.32 | 8 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | $474.50 | $730.00 | $13.80 – $31.20 | 8 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $112.12 | $172.50 | $9.90 – $22.80 | 4 |
| Doppler echo complete CPT 93320 | $430.30 | $662.00 | not published | 0 |
| Doppler intravascular pressure flow initial vessel CPT 93571 | $3,093.35 | $4,759.00 | not published | 0 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $757.90 | $1,166.00 | $101.71 – $490.93 | 56 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $250.25 | $385.00 | $114.79 – $302.50 | 56 |
| Dostarlimab-gxly 50 mg/ml intravenous solution HCPCS J9272 | $35,898.82 | $55,228.96 | $242.39 – $34,965.00 | 59 |
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.