Mercy Hospital Oklahoma City
4300 W. Memorial Road, Oklahoma City, OK · Mercy · · NPI 1184721722
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 |
|---|---|---|---|---|
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | $150.80 | $232.00 | $28.57 – $77.45 | 58 |
| Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae CPT 87494 | $282.10 | $434.00 | $57.12 – $154.91 | 52 |
| Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance CPT 87564 | $143.00 | $220.00 | $62.49 – $169.45 | 54 |
| Infectious agent nucleic acid joint space pathogens multiplex amplified probe >= 26 targets CPT 87627 | $483.60 | $744.00 | $553.33 – $1,500.46 | 53 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | $676.00 | $1,040.00 | $339.26 – $919.96 | 54 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | $512.85 | $789.00 | $34.87 – $94.56 | 59 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | $295.10 | $454.00 | $34.87 – $94.56 | 59 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $369.20 | $568.00 | $34.87 – $94.56 | 60 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $198.25 | $305.00 | $69.27 – $187.84 | 60 |
| Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets CPT 87631 | $287.95 | $443.00 | $92.72 – $314.83 | 56 |
| Infliximab 100 mg intravenous solution HCPCS J1745 | $4,301.80 | $6,618.15 | $28.90 – $816.91 | 58 |
| Infliximab-axxq 100 mg intravenous solution HCPCS Q5121 | $1,862.25 | $2,865.00 | $26.11 – $717.03 | 57 |
| Infliximab-dyyb 100 mg intravenous solution HCPCS Q5103 | $3,492.51 | $5,373.10 | $24.24 – $660.95 | 58 |
| Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis CPT 94642 | $523.90 | $806.00 | $4.61 – $455.57 | 55 |
| Initiation & management bipap/cpap initial day CPT 94660 | $1,044.55 | $1,607.00 | $192.15 – $455.57 | 51 |
| Inj, abilify maintena, 1 mg HCPCS J0401 | $9,742.05 | $14,987.77 | $6.77 – $7,655.76 | 58 |
| Inj, adzynma, 10 iu HCPCS J7171 | $5,340.66 | $8,216.40 | $33.12 – $4,681.62 | 58 |
| Inj allopurinol sodium 1 mg HCPCS J0206 | $12,983.87 | $19,975.18 | $3.74 – $5,008.05 | 53 |
| Inj alymsys 10 mg HCPCS Q5126 | $2,660.80 | $4,093.54 | $48.03 – $1,282.84 | 57 |
| Inj anifrolumab-fnia 1mg HCPCS J0491 | $20,208.53 | $31,090.05 | $17.04 – $14,454.99 | 58 |
| Inj., benralizumab, 1 mg HCPCS J0517 | $22,035.84 | $33,901.29 | $152.09 – $12,899.01 | 58 |
| Inj, bezlotoxumab, 10 mg HCPCS J0565 | $13,917.15 | $21,411.00 | $37.08 – $10,482.03 | 58 |
| Inj, bupivacaine liposome HCPCS J0666 | $886.63 | $1,364.04 | $1.31 – $393.33 | 57 |
| Inj calcitriol per 0.1 mcg HCPCS J0636 | $28.63 | $44.04 | $4.50 – $6.90 | 3 |
| Inj cefazolin sodium, hikma HCPCS J0688 | $38.39 | $59.06 | $3.88 – $8.93 | 8 |
| Inj, cefiderocol, 10 mg HCPCS J0699 | $1,079.68 | $1,661.04 | $2.25 – $636.12 | 58 |
| Inj ceftolozane tazobactam HCPCS J0695 | $838.29 | $1,289.67 | $8.23 – $465.37 | 58 |
| Inj. cetirizine hcl 0.5mg HCPCS J1201 | $424.35 | $652.85 | $15.75 – $222.64 | 57 |
| Inj, clevidipine butyrate HCPCS C9248 | $793.97 | $1,221.50 | $536.00 – $536.00 | 1 |
| Inj cntr knee arthro incl ct/mri CPT 27369 | $352.30 | $542.00 | not published | 0 |
| Inj crotalidae im f(ab')2 eq HCPCS J0841 | $4,298.58 | $6,613.20 | $1,027.17 – $8,126.51 | 6 |
| Inj cyclophosphamd (ingenus) HCPCS J9073 | $2,711.57 | $4,171.65 | $0.47 – $438.00 | 58 |
| Inj. denosumab-bbdz, 1 mg HCPCS Q5136 | $11,755.53 | $18,085.43 | $25.99 – $4,300.51 | 53 |
| Inj, donanemab-azbt, 2 mg HCPCS J0175 | $2,633.18 | $4,051.05 | $3.85 – $1,909.06 | 58 |
| Inj dx for sinogram CPT 20501 | $308.75 | $475.00 | not published | 0 |
| Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides) CPT 64454 | $2,729.35 | $4,199.00 | $7.66 – $1,468.55 | 56 |
| Injection arthrography hip without anesthesia (both sides) CPT 27093 | $344.50 | $530.00 | not published | 0 |
| Injection, daratumumab 10 mg HCPCS J9145 | $12,083.13 | $18,589.43 | $65.89 – $1,862.88 | 58 |
| Injection, doxercalciferol HCPCS J1270 | $30.43 | $46.82 | $1.52 – $3.24 | 7 |
| Injection during cath supravalvular aortography CPT 93567 | $1,248.65 | $1,921.00 | $31.24 – $32.54 | 5 |
| Injection epidural blood patch or clot CPT 62273 | $1,090.86 | $1,678.24 | $99.53 – $1,468.55 | 52 |
| Injection eye drug CPT 67028 | $3,779.10 | $5,814.00 | $73.15 – $687.19 | 56 |
| Injection for arthrography wrist (both sides) CPT 25246 | $356.20 | $548.00 | not published | 0 |
| Injection for bladder x-ray CPT 51600 | $2,679.43 | $4,122.20 | $36.71 – $475.95 | 54 |
| Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides) CPT 23350 | $280.15 | $431.00 | not published | 0 |
| Injection for ureter x-ray CPT 50684 | $1,873.95 | $2,883.00 | not published | 0 |
| Injection for ureter x-ray CPT 50690 | $7,201.20 | $11,078.77 | $60.00 – $7,333.57 | 56 |
| Injection, fulvestrant HCPCS J9395 | $583.70 | $898.00 | $112.60 – $260.03 | 8 |
| Injection glatiramer acetate HCPCS J1595 | $1,037.34 | $1,595.91 | $72.90 – $237.13 | 5 |
| Injection, inclisiran, 1 mg HCPCS J1306 | $12,150.78 | $18,693.51 | $11.74 – $9,429.08 | 58 |
| Injection into brain canal CPT 61055 | $4,909.39 | $7,552.91 | $102.05 – $1,630.91 | 56 |
| Injection, isavuconazonium HCPCS J1833 | $1,776.97 | $2,733.80 | $0.99 – $461.28 | 51 |
| Injection,onabotulinumtoxina HCPCS J0585 | $2,119.98 | $3,261.51 | $6.06 – $856.53 | 58 |
| Injection radioactive tracer sentinel node (both sides) CPT 38792 | $2,594.15 | $3,991.00 | not published | 0 |
| Injection, renflexis HCPCS Q5104 | $2,787.89 | $4,289.06 | $24.95 – $682.43 | 58 |
| Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides) HCPCS G0260 | $2,405.65 | $3,701.00 | not published | 0 |
| Injection(s) anesthetic agent(s) and/or steroid femoral nerve left CPT 64447 | $19,231.76 | $29,587.33 | $59.44 – $2,548.70 | 56 |
| Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides) CPT 64450 | $13,907.74 | $21,396.53 | $65.09 – $5,084.56 | 56 |
| Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides) CPT 64483 | $2,960.36 | $4,554.40 | $3.86 – $1,840.11 | 53 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level CPT 64491 | $4,272.29 | $6,572.75 | $3.86 – $1,840.11 | 53 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level CPT 64490 | $4,272.29 | $6,572.75 | $3.86 – $1,840.11 | 53 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance CPT 64494 | $3,682.67 | $5,665.64 | $42.95 – $1,840.11 | 52 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level CPT 64493 | $3,671.69 | $5,648.75 | $78.77 – $1,840.11 | 52 |
| Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance CPT 62321 | $2,559.72 | $3,938.03 | $8.45 – $1,468.55 | 53 |
| Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance CPT 62323 | $2,264.95 | $3,484.54 | $86.63 – $1,468.55 | 51 |
| Injection, siltuximab HCPCS J2860 | $24,631.77 | $37,895.03 | $162.06 – $18,326.95 | 58 |
| Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 | $5,395.65 | $8,301.00 | not published | 0 |
| Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s) CPT 20552 | $295.75 | $455.00 | $45.92 – $638.60 | 55 |
| Injection(s) trigger point(s) single/multiple >= 3 muscle(s) CPT 20553 | $453.70 | $698.00 | $39.31 – $638.60 | 55 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug CPT 96375 | $252.20 | $388.00 | $41.09 – $97.42 | 55 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 | $146.25 | $225.00 | $33.36 – $33.36 | 1 |
| Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug CPT 96374 | $369.20 | $568.00 | $136.48 – $442.52 | 55 |
| Injection therapeutic/prophylactic/diagnostic subcutaneous/im CPT 96372 | $107.90 | $166.00 | $63.18 – $149.79 | 55 |
| Inj efgart-alfa 2mg hya-qvfc HCPCS J9334 | $59,982.32 | $92,280.49 | $31.96 – $45,531.46 | 58 |
| Inj epidural sgl lumb-sacral without img CPT 62322 | $9,225.45 | $14,193.00 | not published | 0 |
| Inj, evinacumab-dgnb, 5mg HCPCS J1305 | $163,496.87 | $251,533.64 | $184.00 – $124,846.92 | 57 |
| Inj. fe derisomaltose 10 mg HCPCS J1437 | $16,615.53 | $25,562.36 | $21.51 – $5,772.51 | 53 |
| Inj for ext venography CPT 36005 | $6,711.34 | $10,325.14 | $159.15 – $6,569.00 | 56 |
| Inj for mammo ductogram CPT 19030 | $312.65 | $481.00 | not published | 0 |
| Inj. herceptin hylecta, 10mg HCPCS J9356 | $17,114.40 | $26,329.85 | $55.78 – $9,461.45 | 58 |
| Inj hrt cath w/s&i nonsel p-art angrp CPT 93568 | $1,580.80 | $2,432.00 | $40.32 – $40.32 | 4 |
| Inj hrt cath w/s&i sel hrt ang CPT 93563 | $3,786.90 | $5,826.00 | $44.94 – $44.94 | 4 |
| Inj hrt cath w/s&i sel hrt art CPT 93564 | $1,176.50 | $1,810.00 | $47.90 – $47.90 | 4 |
| Inj hrt cath w/s&i sel left vent CPT 93565 | $1,916.20 | $2,948.00 | $23.35 – $23.35 | 4 |
| Inj hrt cath w/s&i sel right vent CPT 93566 | $1,204.45 | $1,853.00 | $22.59 – $22.59 | 4 |
| Inj hydroxocobalamin IV 25mg HCPCS J3424 | $4,584.48 | $7,053.04 | $5.34 – $1,222.00 | 47 |
| Inj hydroxyprogst capoat nos HCPCS J1729 | $97.69 | $150.30 | $397.75 – $397.75 | 1 |
| Inj/inf neurolyt sbst spinal canal lesion 62282 CPT 62282 | $4,106.02 | $6,316.96 | $3.86 – $1,468.55 | 53 |
| Inj, invega hafyera/trinza HCPCS J2427 | $23,804.37 | $36,622.11 | $12.06 – $18,615.21 | 58 |
| Inj ivig privigen 500 mg HCPCS J1459 | $25,741.98 | $39,603.05 | $46.12 – $2,607.53 | 58 |
| Inj, lanreotide, (cipla) 1mg HCPCS J1932 | $32,520.64 | $50,031.75 | $29.97 – $10,167.88 | 58 |
| Inj, lecanemab-irmb, 1 mg HCPCS J0174 | $1,009.20 | $1,552.62 | $1.24 – $703.08 | 58 |
| Inj levocarnitine per 1 gm HCPCS J1955 | $156.04 | $240.06 | $25.56 – $60.77 | 8 |
| Inj, levothyroxine, freskabi HCPCS J0651 | $193.99 | $298.45 | $6.48 – $91.65 | 58 |
| Inj lwr xtr fscl pln blk uni w/wo image CPT 64473 | $21,986.26 | $33,825.02 | $53.99 – $26,710.31 | 56 |
| Inj mepivacaine hcl/10 ml HCPCS J0670 | $75.33 | $115.90 | $10.65 – $29.46 | 8 |
| Inj meropenem (wg crit care) HCPCS J2183 | $131.23 | $201.90 | $16.50 – $38.78 | 8 |
| Inj, mirikizumab-mrkz, 1 mg HCPCS J2267 | $35,079.78 | $53,968.90 | $39.19 – $33,237.27 | 58 |
| Inj mogamulizumab-kpkc, 1 mg HCPCS J9204 | $17,855.23 | $27,469.59 | $235.98 – $13,342.90 | 58 |
| Inj multihance HCPCS A9577 | $129.69 | $199.52 | $10.20 – $23.58 | 4 |
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.