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 |
|---|---|---|---|---|
| Lap rmvl gastr adj all parts CPT 43774 | $11,053.74 | $17,005.75 | $1.65 – $12,577.45 | 56 |
| Laps abltj uterine fibroids CPT 58674 | $12,563.92 | $19,329.11 | $8.45 – $22,114.90 | 56 |
| Laps surg prst8ect rpbic rad CPT 55866 | $20,602.81 | $31,696.63 | $363.00 – $22,114.90 | 56 |
| Laps surg prst8ect smpl stot CPT 55867 | $24,024.53 | $36,960.81 | $331.43 – $22,114.90 | 56 |
| Laps tot hyst resj mal CPT 58575 | $26,279.16 | $40,429.48 | $363.00 – $22,114.90 | 56 |
| Largsc w/ther injection CPT 31573 | $763.61 | $1,174.79 | $119.63 – $3,703.00 | 56 |
| Laryngoscope w/vc inj CPT 31570 | $5,939.41 | $9,137.55 | $8.45 – $7,756.66 | 56 |
| Laryngoscop w/vc inj + scope CPT 31571 | $5,950.42 | $9,154.49 | $204.55 – $7,756.66 | 55 |
| Laryngoscopy and dilation CPT 31528 | $6,466.69 | $9,948.75 | $48.18 – $7,756.66 | 56 |
| Laryngoscopy and dilation CPT 31529 | $5,707.08 | $8,780.12 | $8.45 – $7,756.66 | 56 |
| Laryngoscopy direct w/wo tracheoscopy dx exc newborn CPT 31525 | $5,388.51 | $8,290.01 | $132.66 – $3,703.00 | 56 |
| Laryngoscopy w/biopsy CPT 31535 | $6,670.93 | $10,262.97 | $156.39 – $7,756.66 | 56 |
| Laryngoscopy w/bx & op scope CPT 31536 | $5,640.67 | $8,677.95 | $48.18 – $7,756.66 | 56 |
| Laryngoscopy w/fb & op scope CPT 31531 | $6,161.31 | $9,478.94 | $13.47 – $7,756.66 | 56 |
| Larynscop w/tumr exc + scope CPT 31541 | $6,197.04 | $9,533.91 | $48.18 – $7,756.66 | 56 |
| Laser surgery of cervix 57513 CPT 57513 | $5,942.70 | $9,142.61 | $8.45 – $6,734.70 | 56 |
| Laser surgery of prostate CPT 52648 | $11,052.50 | $17,003.84 | $363.00 – $11,154.98 | 55 |
| Laser surg penis lesion(s) CPT 54057 | $5,862.45 | $9,019.15 | $13.47 – $4,292.56 | 53 |
| Lead acuity x4 spiral l 86cm HCPCS C1900 | $2,445.95 | $3,763.00 | not published | 0 |
| Lead capillary CPT 83655 | $106.60 | $164.00 | $9.86 – $26.73 | 60 |
| Lead ingevity 45cm pfret MRI HCPCS C1898 | $633.75 | $975.00 | not published | 0 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $1,532.70 | $2,358.00 | $42.00 – $496.40 | 55 |
| Lens iol 23.0 d 1.5 cyl eyhance toric HCPCS V2787 | $1,617.20 | $2,488.00 | not published | 0 |
| Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 | $517.29 | $795.83 | $4.09 – $9.46 | 8 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | $49,431.22 | $76,048.03 | $164.04 – $463.78 | 58 |
| Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 | $49,890.44 | $76,754.52 | $397.04 – $4,647.14 | 58 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $13.12 | $20.19 | $1.50 – $4.19 | 8 |
| Levetiracetam therapeutic drug level CPT 80177 | $128.05 | $197.00 | $10.79 – $29.25 | 59 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $47.90 | $73.70 | $1.89 – $92.30 | 9 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | $461.86 | $710.56 | $53.90 – $195.02 | 8 |
| Liberta rc ipg HCPCS C1820 | $48,321.00 | $74,340.00 | not published | 0 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | $39.37 | $60.57 | $20.00 – $55.80 | 7 |
| Lidocaine therapeutic drug level CPT 80176 | $152.10 | $234.00 | $11.96 – $32.43 | 56 |
| Ligation/biopsy of temporal artery 37609 CPT 37609 | $5,158.81 | $7,936.63 | $48.18 – $3,436.08 | 56 |
| Lig/band angioaccess av fistula CPT 37607 | $5,792.97 | $8,912.26 | $13.47 – $6,569.00 | 56 |
| Lincomycin injection HCPCS J2010 | $12.03 | $18.51 | $4.16 – $12.42 | 7 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $82.68 | $127.20 | $8.49 – $19.59 | 8 |
| Lipase CPT 83690 | $184.60 | $284.00 | $5.61 – $15.96 | 59 |
| Lipoprotein blood high res frac & quant CPT 83701 | $160.55 | $247.00 | $27.57 – $74.74 | 56 |
| Lipoprotein blood quant CPT 83704 | $178.10 | $274.00 | $27.83 – $75.47 | 60 |
| Lipoprotein direct measurement hdl CPT 83718 | $55.90 | $86.00 | $6.67 – $18.08 | 56 |
| Lipoprotein direct measurement ldl CPT 83721 | $76.70 | $118.00 | $8.55 – $23.18 | 60 |
| Lithium therapeutic drug level CPT 80178 | $59.15 | $91.00 | $5.38 – $14.59 | 60 |
| Liver Function Test CPT 80076 | $99.45 | $153.00 | $6.66 – $18.03 | 59 |
| Liver imaging CPT 78201 | $44,123.49 | $67,882.29 | $102.00 – $1,129.62 | 57 |
| Liver/spleen imag static only CPT 78215 | $915.20 | $1,408.00 | $30.00 – $831.71 | 57 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $90.79 | $139.68 | $1.35 – $13.86 | 9 |
| Low back disk surgery CPT 63030 | $14,258.51 | $21,936.17 | $297.00 – $15,096.24 | 56 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $1,972.10 | $3,034.00 | $119.64 – $712.73 | 61 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $1,815.45 | $2,793.00 | $146.01 – $752.18 | 61 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $1,595.10 | $2,454.00 | $91.74 – $475.95 | 61 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $2,995.20 | $4,608.00 | $184.04 – $2,007.25 | 60 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $1,950.65 | $3,001.00 | $162.10 – $1,083.28 | 60 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $2,147.60 | $3,304.00 | $105.76 – $1,003.42 | 60 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $317.20 | $488.00 | $24.41 – $222.38 | 61 |
| Lsh uterus 250 g or less CPT 58541 | $32,509.91 | $50,015.24 | $250.00 – $22,114.90 | 56 |
| Lsh w/t/o ut 250 g or less CPT 58542 | $26,998.75 | $41,536.54 | $250.00 – $22,114.90 | 56 |
| Lsh w/t/o uterus above 250 g CPT 58544 | $28,804.46 | $44,314.55 | $250.00 – $22,114.90 | 56 |
| L/s ratio fetal lung CPT 83661 | $193.70 | $298.00 | $17.90 – $48.54 | 56 |
| Lumbar diskogram s&i CPT 72295 | $2,575.30 | $3,962.00 | $74.21 – $4,062.56 | 61 |
| Lung Function Test (Spirometry) CPT 94010 | $477.10 | $734.00 | $23.30 – $449.22 | 55 |
| Lung perfusion imaging CPT 78580 | $906.75 | $1,395.00 | $63.00 – $987.29 | 57 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | $30,757.48 | $47,319.20 | $197.46 – $22,330.04 | 58 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | $46,012.99 | $70,789.22 | $39.80 – $11,252.07 | 58 |
| Lutetium lu 177 dotatat ther HCPCS A9513 | $631.80 | $972.00 | $263.81 – $706.21 | 56 |
| Lutetium lu 177 vipivotide HCPCS A9607 | $482.95 | $743.00 | $212.50 – $573.01 | 55 |
| Lymphatics/lymph node imaging CPT 78195 | $18,029.90 | $27,738.31 | $33.00 – $1,451.51 | 57 |
| Lymph vessel x-ray trunk CPT 75805 | $2,118.35 | $3,259.00 | $492.08 – $6,569.00 | 60 |
| Lymph vessel x-ray trunk CPT 75807 | $3,452.15 | $5,311.00 | $492.08 – $6,569.00 | 54 |
| Lysis of labial adhesions CPT 56441 | $9,376.91 | $14,426.01 | $48.18 – $6,734.70 | 56 |
| Lysis penil circumic lesion CPT 54162 | $7,542.16 | $11,603.33 | $48.18 – $4,348.95 | 34 |
| Macro exam dissect molec study ea CPT 88387 | $94.25 | $145.00 | $7.22 – $35.13 | 10 |
| Macroscopic exam arthropod CPT 87168 | $80.60 | $124.00 | $3.48 – $9.43 | 60 |
| Macroscopic exam parasite CPT 87169 | $39.65 | $61.00 | $3.51 – $9.51 | 59 |
| Magnesium CPT 83735 | $232.70 | $358.00 | $5.46 – $14.79 | 59 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $39.81 | $61.25 | $0.98 – $2.29 | 8 |
| Male sling procedure CPT 53440 | $17,818.76 | $27,413.48 | $0.33 – $27,448.41 | 56 |
| Mammosite ced HCPCS C1728 | $4,468.75 | $6,875.00 | not published | 0 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $243.10 | $374.00 | $32.70 – $276.80 | 55 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $98.15 | $151.00 | $20.78 – $276.80 | 55 |
| Mapping io sentinel lymph node CPT 38900 | $19,950.10 | $30,692.46 | $118.06 – $13,814.58 | 56 |
| Marker biop eviva buckle ss HCPCS A4648 | $650.00 | $1,000.00 | not published | 0 |
| Mastoids complete CPT 70130 | $310.70 | $478.00 | $35.00 – $222.38 | 61 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $83.85 | $129.00 | $11.77 – $31.92 | 60 |
| Mayo aathr protein s free CPT 85306 | $258.70 | $398.00 | $12.47 – $33.82 | 60 |
| Mayo activated protein c resistance assay CPT 85307 | $211.25 | $325.00 | $12.47 – $33.82 | 60 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $254.80 | $392.00 | $31.39 – $85.14 | 58 |
| Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation CPT 80321 | $169.65 | $261.00 | $0.01 – $15.08 | 2 |
| Mayo alcohol definitive assay volatile screen CPT 80320 | $128.70 | $198.00 | $0.01 – $28.28 | 3 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $87.75 | $135.00 | $12.03 – $32.62 | 60 |
| Mayo alkaloids definitive assay nicotine/cotinine CPT 80323 | $134.55 | $207.00 | $0.01 – $45.59 | 3 |
| Mayo alpha 1 antitrypsin CPT 82103 | $156.00 | $240.00 | $10.95 – $29.67 | 60 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $128.05 | $197.00 | $12.28 – $33.72 | 60 |
| Mayo amphu amphetamines definitive assay 3 or 4 urine CPT 80325 | $93.60 | $144.00 | $0.01 – $23.60 | 2 |
| Mayo amphu methylenedioxyamphetamines definitive assay urine CPT 80359 | $100.75 | $155.00 | $0.01 – $28.28 | 3 |
| Mayo analysis gene calr common variants exon 9 CPT 81219 | $762.45 | $1,173.00 | $99.01 – $268.47 | 59 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $195.00 | $300.00 | $64.66 – $202.32 | 58 |
| Mayo analysis gene smn1 dosage/deletion CPT 81329 | $551.85 | $849.00 | $111.52 – $302.40 | 55 |
| Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 | $3,172.65 | $4,881.00 | $625.50 – $2,560.47 | 58 |
| Mayo androstenedione CPT 82157 | $123.50 | $190.00 | $23.84 – $64.63 | 60 |
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.