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 |
|---|---|---|---|---|
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | $758.55 | $1,167.00 | $74.00 – $752.18 | 60 |
| X-ray ribs 2 views left CPT 71100 | $450.45 | $693.00 | $17.00 – $181.05 | 61 |
| X-ray ribs 3 views bilateral CPT 71110 | $675.35 | $1,039.00 | $25.00 – $222.38 | 61 |
| X-ray ribs w/posterior anterior chest 3 views left CPT 71101 | $320.45 | $493.00 | $17.00 – $222.38 | 61 |
| X-ray ribs w/posterior anterior chest > 4 views bilateral CPT 71111 | $419.90 | $646.00 | $31.08 – $222.38 | 61 |
| X-ray sacroiliac joints >= 3 views CPT 72202 | $300.30 | $462.00 | $21.00 – $222.38 | 61 |
| X-ray sacrum/coccyx >= 2 views CPT 72220 | $271.05 | $417.00 | $17.00 – $181.05 | 61 |
| X-ray scapula complete (both sides) CPT 73010 | $642.20 | $988.00 | $12.75 – $222.38 | 61 |
| X-ray shoulder 1 view (both sides) CPT 73020 | $490.75 | $755.00 | $11.92 – $181.05 | 61 |
| X-ray sinuses paranasal complete > 3 views CPT 70220 | $353.60 | $544.00 | $22.75 – $181.05 | 61 |
| X-ray sinus tract/fistula/abscess CPT 76080 | $552.50 | $850.00 | $29.41 – $1,136.79 | 61 |
| X-ray skull < 4 views CPT 70250 | $273.65 | $421.00 | $22.00 – $222.38 | 61 |
| X-ray skull > 4 views complete CPT 70260 | $353.60 | $544.00 | $26.08 – $222.38 | 61 |
| X-ray slg plne bdy sect without urogr CPT 76100 | $902.85 | $1,389.00 | $48.00 – $283.23 | 61 |
| X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study CPT 74250 | $686.40 | $1,056.00 | $35.00 – $375.46 | 61 |
| X-ray small intestine follow-through study CPT 74248 | $1,071.85 | $1,649.00 | $41.35 – $170.20 | 5 |
| X-ray spine single view CPT 72020 | $246.35 | $379.00 | $13.86 – $181.05 | 61 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | $211.25 | $325.00 | $18.00 – $181.05 | 61 |
| X-ray sternum > 2 views CPT 71120 | $228.15 | $351.00 | $14.00 – $181.05 | 61 |
| X-ray surgical specimen CPT 76098 | $477.75 | $735.00 | $14.00 – $1,136.79 | 61 |
| X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study CPT 74230 | $582.40 | $896.00 | $29.00 – $474.38 | 61 |
| X-ray temporomandibular joint open/closed mouth bilateral CPT 70330 | $248.95 | $383.00 | $22.00 – $181.05 | 61 |
| X-ray thoracic spine 2 views CPT 72070 | $286.65 | $441.00 | $19.41 – $222.38 | 61 |
| X-ray thoracic spine 3 views CPT 72072 | $575.90 | $886.00 | $24.14 – $222.38 | 61 |
| X-ray thoracolumbar spine >=2 views CPT 72080 | $286.65 | $441.00 | $20.53 – $181.05 | 61 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | $301.60 | $464.00 | $23.51 – $181.05 | 59 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views CPT 72082 | $375.70 | $578.00 | $42.84 – $222.38 | 59 |
| X-ray tibia/fibula 2 views (both sides) CPT 73590 | $642.85 | $989.00 | $19.97 – $181.05 | 61 |
| X-ray toe(s) > 2 views (both sides) CPT 73660 | $518.70 | $798.00 | $13.00 – $181.05 | 61 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast CPT 74246 | $1,500.20 | $2,308.00 | $41.00 – $432.44 | 61 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study CPT 74240 | $1,124.50 | $1,730.00 | $30.00 – $367.06 | 61 |
| X-ray wrist 2 views (both sides) CPT 73100 | $453.05 | $697.00 | $19.00 – $181.05 | 61 |
| Xyntha inj HCPCS J7185 | $19,148.22 | $29,458.80 | $1.46 – $11,801.70 | 58 |
| Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr HCPCS J3485 | $127.74 | $196.52 | $1.48 – $79.79 | 53 |
| Zidovudine, oral, 100 mg HCPCS S0104 | $100.62 | $154.80 | $2.50 – $2.50 | 1 |
| Zika virus dna/rna amp probe CPT 87662 | $481.65 | $741.00 | $41.77 – $113.26 | 55 |
| Zika virus igm antibody CPT 86794 | $293.80 | $452.00 | $13.72 – $37.19 | 58 |
| Ziprasidone 20 mg/ml (final concentration) intramuscular solution HCPCS J3486 | $143.44 | $220.68 | $14.38 – $30.91 | 7 |
| Ziv-aflibercept 25 mg/ml intravenous solution (wrapper) HCPCS J9400 | $11,725.35 | $18,039.00 | $8.01 – $2,265.48 | 58 |
| Zolbetuximab-clzb 100 mg intravenous solution HCPCS J1326 | $5,939.00 | $9,136.92 | $31.33 – $4,427.73 | 54 |
| Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 | $354.31 | $545.09 | $22.40 – $325.09 | 8 |
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.