Mercy Hospital Tishomingo
1000 S. Byrd Street, Tishomingo, OK · Mercy · · NPI 1932404431
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 |
|---|---|---|---|---|
| 11-desoxycortisol - sendout CPT 82634 | $97.50 | $150.00 | $26.04 – $36.60 | 5 |
| Abdominal CT scan (with and without contrast) CPT 74170 | $2,499.25 | $3,845.00 | $143.16 – $492.80 | 5 |
| Abdominal CT scan (with contrast) CPT 74160 | $2,132.65 | $3,281.00 | $158.53 – $492.80 | 5 |
| Abdominal CT scan (without contrast) CPT 74150 | $1,768.00 | $2,720.00 | $70.23 – $240.32 | 5 |
| Abdominal Ultrasound (complete) CPT 76700 | $282.75 | $435.00 | $65.49 – $240.32 | 5 |
| Abdominal Ultrasound (limited) CPT 76705 | $198.25 | $305.00 | $49.68 – $240.32 | 5 |
| Acetaminophen level CPT 80143 | $136.50 | $210.00 | $16.58 – $25.16 | 8 |
| Acetazolamide 500 mg solution for injection HCPCS J1120 | $153.56 | $236.25 | $21.62 – $30.21 | 5 |
| Acetone qualitative CPT 82009 | $52.00 | $80.00 | $4.02 – $7.46 | 51 |
| Acetylcholine receptor modulating antibody CPT 86043 | $109.85 | $169.00 | $10.72 – $15.06 | 5 |
| Acetylcholinesterase assay CPT 82013 | $161.85 | $249.00 | $10.93 – $10.93 | 4 |
| Acetylcysteine 200 mg/ml (20 %) intravenous solution HCPCS J0132 | $536.30 | $825.08 | $33.00 – $37.80 | 5 |
| Acute hepatitis panel CPT 80074 | $286.00 | $440.00 | $42.37 – $78.59 | 47 |
| #acylcarnitineprfl CPT 82017 | $16.90 | $26.00 | $15.01 – $21.09 | 5 |
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | $14.62 | $22.50 | $0.96 – $1.80 | 5 |
| Adh-sendout CPT 84588 | $149.50 | $230.00 | $30.19 – $30.19 | 4 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $136.99 | $210.75 | $18.00 – $22.20 | 5 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $414.70 | $638.00 | $63.38 – $125.05 | 5 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $414.70 | $638.00 | $295.37 – $573.68 | 5 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | $328.90 | $506.00 | $295.37 – $573.68 | 5 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | $168.35 | $259.00 | $63.38 – $125.05 | 5 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $177.45 | $273.00 | $63.38 – $125.05 | 5 |
| Administration immunization 1 vaccine CPT 90471 | $70.20 | $108.00 | $63.38 – $147.12 | 5 |
| Administration immunization each additional vaccine CPT 90472 | $52.65 | $81.00 | $12.70 – $25.18 | 5 |
| Administration immunization first component each vaccine CPT 90460 | $36.40 | $56.00 | $18.34 – $36.75 | 5 |
| Administration vaccine influenza virus HCPCS G0008 | $54.60 | $84.00 | $2.46 – $83.72 | 6 |
| Administration vaccine pneumococcal HCPCS G0009 | $54.60 | $84.00 | $2.46 – $83.72 | 6 |
| Advance care planning each additional 30 min 99498 CPT 99498 | $144.30 | $222.00 | $60.46 – $126.57 | 47 |
| Albumin body fluid quantitative each specimen CPT 82042 | $42.90 | $66.00 | $6.92 – $12.84 | 44 |
| Albumin (human), 25%, 50ml HCPCS P9047 | $438.75 | $675.00 | $49.70 – $65.82 | 5 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $75.40 | $116.00 | $5.14 – $7.23 | 5 |
| Albumin serum plasma or whole blood CPT 82040 | $32.50 | $50.00 | $4.40 – $6.68 | 6 |
| Alcohol (ethanol) any specimen except urine/breath CPT 82077 | $103.35 | $159.00 | $16.94 – $21.59 | 3 |
| Alkaline phosphatase CPT 84075 | $37.05 | $57.00 | $4.61 – $6.99 | 6 |
| Allergen alpha lactalbumin ige CPT 86008 | $45.50 | $70.00 | $15.95 – $29.58 | 50 |
| Allergen egg white ige CPT 86003 | $55.25 | $85.00 | $4.64 – $8.61 | 50 |
| Alpha-fetoprotein amniotic CPT 82106 | $79.30 | $122.00 | $15.12 – $15.12 | 4 |
| Alpha-fetoprotein tumor marker CPT 82105 | $87.10 | $134.00 | $14.92 – $27.67 | 50 |
| Alt/sgpt CPT 84460 | $37.05 | $57.00 | $4.71 – $7.16 | 6 |
| Aluminum - quest CPT 82108 | $102.70 | $158.00 | $22.66 – $31.85 | 5 |
| Amikacin 4 mg/ml intravitreal injection - cnr HCPCS J0278 | $69.71 | $107.25 | $5.40 – $7.60 | 5 |
| Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV HCPCS J0283 | $225.22 | $346.50 | $12.60 – $12.60 | 4 |
| Amiodarone 50 mg/ml intravenous solution HCPCS J0282 | $9.76 | $15.01 | $1.95 – $2.40 | 5 |
| Ammonia CPT 82140 | $106.60 | $164.00 | $12.96 – $18.21 | 6 |
| Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J0285 | $234.00 | $360.00 | $50.07 – $54.97 | 5 |
| Ampicillin 1 gram solution for injection HCPCS J0290 | $34.64 | $53.29 | $1.42 – $1.58 | 5 |
| Ampicillin-sulbactam 1.5 gram solution for injection HCPCS J0295 | $73.12 | $112.50 | $1.64 – $1.67 | 5 |
| Amylase CPT 82150 | $83.20 | $128.00 | $5.76 – $8.10 | 5 |
| Ana ds-dna CPT 86226 | $81.25 | $125.00 | $10.77 – $10.77 | 4 |
| Analysis gene f2 20210g>a variant CPT 81240 | $304.20 | $468.00 | $58.43 – $82.11 | 5 |
| Analysis gene f5 leiden variant CPT 81241 | $280.80 | $432.00 | $65.26 – $91.71 | 5 |
| Anaplsma phgcytophlm amp prb CPT 87468 | $154.05 | $237.00 | $43.86 – $43.86 | 1 |
| Anca screen with reflex to titer -quest CPT 86021 | $102.70 | $158.00 | $13.39 – $18.81 | 5 |
| Ankle X-ray CPT 73610 | $267.15 | $411.00 | $23.58 – $200.05 | 5 |
| Anora (draw only) CPT 99001 | $13.00 | $20.00 | $8.00 – $8.00 | 1 |
| Antibody bacterium, not elsewhere specified CPT 86609 | $49.40 | $76.00 | $11.46 – $16.10 | 5 |
| Antibody htlv/hiv confirm test CPT 86689 | $141.70 | $218.00 | $17.21 – $24.19 | 5 |
| Antibody htlv-i CPT 86687 | $65.00 | $100.00 | $8.09 – $8.09 | 4 |
| Antibody identification platelet antibodies heparin-pf4 igg CPT 86022 | $312.00 | $480.00 | $16.34 – $22.96 | 5 |
| Antibody id rbc panel CPT 86870 | $212.55 | $327.00 | $23.42 – $640.87 | 5 |
| Antibody influenza virus CPT 86710 | $78.00 | $120.00 | $12.05 – $12.05 | 4 |
| Antibody screen rbc CPT 86850 | $108.55 | $167.00 | $8.69 – $93.17 | 5 |
| Anti mog serum - sendout CPT 86362 | $446.55 | $687.00 | $10.72 – $10.72 | 4 |
| Antineutrophil cytoplasmic antibody screen each antibody CPT 86036 | $92.30 | $142.00 | $10.72 – $15.06 | 6 |
| Antineutrophil cytoplasmic antibody titer each antibody CPT 86037 | $104.00 | $160.00 | $10.72 – $15.06 | 5 |
| Antinuclear antibodies CPT 86038 | $84.50 | $130.00 | $10.75 – $15.11 | 8 |
| Antinuclear antibodies titer CPT 86039 | $76.70 | $118.00 | $9.93 – $13.95 | 6 |
| Antiphosphatidylserine antibody CPT 86148 | $83.85 | $129.00 | $14.29 – $14.29 | 4 |
| Antistreptolysin o screen CPT 86063 | $55.25 | $85.00 | $5.13 – $5.13 | 4 |
| Antistreptolysin o titer CPT 86060 | $66.30 | $102.00 | $6.49 – $9.13 | 5 |
| Antithrombin iii activity CPT 85300 | $135.20 | $208.00 | $10.54 – $14.81 | 5 |
| Application finger splntstatic 29130 CPT 29130 | $116.35 | $179.00 | $24.06 – $271.86 | 51 |
| Application long leg splint 29505 CPT 29505 | $189.80 | $292.00 | $50.09 – $84.25 | 50 |
| Application lower leg splint 29515 CPT 29515 | $188.50 | $290.00 | $45.86 – $332.04 | 51 |
| Appl modality 1/> areas vasopneumatic devices 97016 CPT 97016 | $71.50 | $110.00 | $19.28 – $19.28 | 1 |
| #aptt mix-1:1 incubated CPT 87532 | $145.60 | $224.00 | $31.21 – $31.21 | 4 |
| Aqaprn-4 antb flo cytmtry ea CPT 86053 | $258.05 | $397.00 | $33.56 – $33.56 | 4 |
| Aquaporin-4 antibody cba each CPT 86052 | $261.30 | $402.00 | $10.72 – $15.06 | 5 |
| Aquaporin-4 antibody elisa CPT 86051 | $115.05 | $177.00 | $10.26 – $10.26 | 4 |
| Aquatic exercise - group charge CPT 97150 | $100.10 | $154.00 | $15.96 – $29.07 | 5 |
| Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right CPT 20605 | $145.60 | $224.00 | $30.25 – $627.20 | 51 |
| Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides) CPT 20611 | $239.20 | $368.00 | $47.34 – $627.20 | 51 |
| Arthrocentesis/aspiration/inj major joint/bursa without Ultrasound guidance (both sides) CPT 20610 | $175.50 | $270.00 | $37.21 – $627.20 | 51 |
| Assay of adp & amp CPT 82030 | $127.40 | $196.00 | $22.95 – $22.95 | 4 |
| Assay of feces porphyrins CPT 84126 | $176.80 | $272.00 | $34.79 – $34.79 | 4 |
| Assay of galactose CPT 82760 | $11.05 | $17.00 | $9.96 – $14.00 | 5 |
| Assay of interleukin-6 (il-6) CPT 83529 | $123.50 | $190.00 | $15.36 – $21.59 | 5 |
| Assay of leflunomide CPT 80193 | $150.80 | $232.00 | $34.31 – $34.31 | 4 |
| Assay of osteocalcin CPT 83937 | $102.70 | $158.00 | $26.55 – $37.31 | 5 |
| Assay of prostaglandin CPT 84150 | $289.25 | $445.00 | $37.15 – $52.21 | 5 |
| Assay of salicylate CPT 80179 | $63.05 | $97.00 | $16.58 – $30.76 | 52 |
| Assay of thiocyanate CPT 84430 | $59.80 | $92.00 | $10.34 – $10.34 | 4 |
| Assay of urine sulfate CPT 84392 | $36.40 | $56.00 | $4.88 – $6.86 | 5 |
| Assess aphasia/interp/rpt/per hr 96105 CPT 96105 | $280.15 | $431.00 | $85.75 – $157.86 | 5 |
| Assessment leukocyte fecal qualitative/semiquantitative CPT 89055 | $44.20 | $68.00 | $3.80 – $5.34 | 6 |
| Ast/sgot CPT 84450 | $37.05 | $57.00 | $4.61 – $6.99 | 6 |
| Atropine 0.1 mg/ml injection syringe HCPCS J0461 | $27.91 | $42.94 | $5.50 – $6.00 | 5 |
| Attn at delivery+ 1 stabilization of newborn 99464 CPT 99464 | $127.40 | $196.00 | $68.95 – $68.95 | 4 |
| Avulsion nail plate partial/complete simple single nail plate CPT 11730 | $175.50 | $270.00 | $46.22 – $409.96 | 51 |
| Azithromycin 500 mg intravenous solution HCPCS J0456 | $65.01 | $100.02 | $2.13 – $2.41 | 5 |
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.