Observation/inpatient hospital care mod severity 99235 at Mercy Hospital Tishomingo
1000 S. Byrd Street, Tishomingo, OK · Mercy · · NPI 1932404431
$471.90
Cash price Discounted cash price What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge. Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.
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What you pay up front if you don't use insurance.
$726.00
Gross charge Gross charge (chargemaster price) The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this. Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.
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The hospital's undiscounted list price — almost no one pays this.
$136.32 with CHEROKEE NATION HEALTH SERV CONTRACTED [320066] vs $229.28 with CENTIVO CONTRACTED [320505] — same scan, same building. Share
Negotiated rates by payer
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →Payer ?Payer The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on. Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509. Full explanation → |
Plan ?Plan The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates. Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible. Full explanation → |
Negotiated rate | vs. cash |
|---|---|---|---|
| CHEROKEE NATION HEALTH SERV CONTRACTED [320066] | HB TISH MANAGED MEDICARE 100% W/SEQ | $136.32 | ↓ -71% |
| AETNA MEDICARE ADVANTAGE CONTRACTED [320010] | HB TISH MANAGED MEDICARE 100% W/SEQ | $136.32 | ↓ -71% |
| BCBS MEDICARE ADVANTAGE CONTRACTED [320047] | HB TISH MANAGED MEDICARE 100% W/SEQ | $136.32 | ↓ -71% |
| TRICARE [20380] | HB TISH TRICARE | $136.32 | ↓ -71% |
| TRIBUTE HEALTH PLAN MCR CONTRACTED [320338] | HB TISH MANAGED MEDICARE 100% W/SEQ | $136.32 | ↓ -71% |
| CROSS TIMBERS HOSPICE [20098] | HB TISH MANAGED MEDICARE 100% W/SEQ | $136.32 | ↓ -71% |
| ELARA CARING ASPIRE HOSPICE CONTRACTED [320433] | HB TISH MANAGED MEDICARE 100% W/SEQ | $136.32 | ↓ -71% |
| ELARA CARING ASPIRE HOSPICE [20433] | HB TISH MANAGED MEDICARE 100% W/SEQ | $136.32 | ↓ -71% |
| HALO HCR INC HOSPICE CONTRACTED [320432] | HB TISH MANAGED MEDICARE 100% W/SEQ | $136.32 | ↓ -71% |
| HALO HCR INC HOSPICE [20432] | HB TISH MANAGED MEDICARE 100% W/SEQ | $136.32 | ↓ -71% |
| HEALTH FIRST HEALTH PLANS MEDICARE [20170] | HB TISH MANAGED MEDICARE 100% W/SEQ | $136.32 | ↓ -71% |
| QUAL CHOICE CONTRACTED [320325] | HB TISH MANAGED MEDICARE 100% W/SEQ | $136.32 | ↓ -71% |
| HORIZONS MEDICARE [20190] | HB TISH MANAGED MEDICARE 100% W/SEQ | $136.32 | ↓ -71% |
| PROVIDER PARTNERS HEALTH PLANS CONTRACTED [320450] | HB TISH MANAGED MEDICARE 100% W/SEQ | $136.32 | ↓ -71% |
| HUMANA MEDICARE ADVANTAGE CONTRACTED [320194] | HB TISH MANAGED MEDICARE 100% W/SEQ | $136.32 | ↓ -71% |
| INDEPENDENT HEALTH [20197] | HB TISH MANAGED MEDICARE 100% W/SEQ | $136.32 | ↓ -71% |
| INDIAN HEALTH SERVICE CONTRACTED [320198] | HB TISH MANAGED MEDICARE 100% W/SEQ | $136.32 | ↓ -71% |
| KINDFUL HOSPICE CONTRACTED [320434] | HB TISH MANAGED MEDICARE 100% W/SEQ | $136.32 | ↓ -71% |
| KINDFUL HOSPICE [20434] | HB TISH MANAGED MEDICARE 100% W/SEQ | $136.32 | ↓ -71% |
| PROMINENCE HEALTH PLAN MEDICARE ADVANTAGE CONTRACTED [320496] | HB TISH MANAGED MEDICARE 100% W/SEQ | $136.32 | ↓ -71% |
| ESSENCE HEALTHCARE MEDICARE CONTRACTED [320122] | HB TISH MANAGED MEDICARE 100% W/SEQ | $136.32 | ↓ -71% |
| DEPT OF VETERAN AFFAIRS CONTRACTED [320106] | HB TISH MANAGED MEDICARE 100% W/SEQ | $136.32 | ↓ -71% |
| NHC ADVANTAGE MEDICARE CONTRACTED [320282] | HB TISH MANAGED MEDICARE 100% W/SEQ | $136.32 | ↓ -71% |
| MEDICAL ASSOCIATES HEALTH [20444] | HB TISH MANAGED MEDICARE 100% W/SEQ | $136.32 | ↓ -71% |
| MENTAL HEALTH NETWORK MEDICARE [20250] | HB TISH MANAGED MEDICARE 100% W/SEQ | $136.32 | ↓ -71% |
| MERCY HOSPICE OKC [20252] | HB TISH MANAGED MEDICARE 100% W/SEQ | $136.32 | ↓ -71% |
| MEDICARE [20244] | HB TISH MEDICARE | $136.32 | ↓ -71% |
| TRICARE CONTRACTED [320380] | HB TISH MANAGED MEDICARE 100% W/SEQ | $136.32 | ↓ -71% |
| UNITED HEALTHCARE CONTRACTED [320396] | HB TISH MANAGED MEDICARE 100% W/SEQ | $136.32 | ↓ -71% |
| WELLCARE MEDICARE ADVANTAGE CONTRACTED [320421] | HB TISH MANAGED MEDICARE 100% W/SEQ | $136.32 | ↓ -71% |
| WINDSOR MEDICARE [20424] | HB TISH MANAGED MEDICARE 100% W/SEQ | $136.32 | ↓ -71% |
| LONGEVITY HEALTH PLAN MEDICARE CONTRACTED [320225] | HB TISH MANAGED MEDICARE 100% W/SEQ | $136.32 | ↓ -71% |
| BCBS MEDICARE ADVANTAGE [20047] | HB TISH MANAGED MEDICARE 100% W/SEQ | $136.32 | ↓ -71% |
| MEDICA MEDICARE ADVANTAGE CONTRACTED [320477] | HB TISH MEDICA MEDICARE NEW 031523 | $138.96 | ↓ -71% |
| MEDICA MEDICARE ADVANTAGE [20477] | HB TISH MEDICA MEDICARE NEW 031523 | $138.96 | ↓ -71% |
| GLOBALHEALTH CONTRACTED [320145] | HB TISH GLOBALHEALTH MCR 102% W/SEQ | $139.04 | ↓ -71% |
| DEVOTED HEALTH MEDICARE CONTRACTED [320500] | HB TISH DEVOTED HEALTH MCR 104% W/O SEQ | $139.04 | ↓ -71% |
| HEALTHSPRING MEDICARE ADVANTAGE CONTRACTED [320526] | HB TISH CIGNA MCR W/SEQ 103% | $140.49 | ↓ -70% |
| CIGNA MEDICARE ADVANTAGE CONTRACTED [320072] | HB TISH CIGNA MCR W/SEQ 103% | $140.49 | ↓ -70% |
| AETNA MEDICAID CONTRACTED [320009] | HB TISH OK MEDICAID (SOONERCARE) | $141.78 | ↓ -70% |
| HUMANA MEDICAID CONTRACTED [320486] | HB TISH OK MEDICAID (SOONERCARE) | $141.78 | ↓ -70% |
| MEDICAID [20240] | HB TISH OK MEDICAID (SOONERCARE) | $141.78 | ↓ -70% |
| OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] | HB TISH OK MEDICAID (SOONERCARE) | $141.78 | ↓ -70% |
| BLUE CROSS AND BLUE SHIELD [20053] | HB TISH BCBS OF OK NATIVEBLUE MCR 103% (NO SEQ) | $143.13 | ↓ -70% |
| NOVASYS CONTRACTED [320285] | HB TISH AMBETTER EXCHANGE MEDICARE | $187.60 | ↓ -60% |
| HOME STATE HEALTH PLAN CONTRACTED [320187] | HB TISH AMBETTER EXCHANGE MEDICARE | $187.60 | ↓ -60% |
| AMBETTER CONTRACTED [320452] | HB TISH AMBETTER EXCHANGE MEDICARE | $187.60 | ↓ -60% |
| SUNFLOWER HEALTH PLAN CONTRACTED [320369] | HB TISH AMBETTER EXCHANGE MEDICARE | $187.60 | ↓ -60% |
| MEDICA CONTRACTED [320239] | HB TISH MEDICA EXHANGE 136% MCR NO SEQ | $188.99 | ↓ -60% |
| MEDICA MEDICARE ADVANTAGE CONTRACTED [320477] | HB TISH MEDICA EXHANGE 136% MCR NO SEQ | $188.99 | ↓ -60% |
| CENTIVO CONTRACTED [320505] | HB TISH CENTIVO MCR 165% | $229.28 | ↓ -51% |
Visitor-reported prices
Comments
Observation/inpatient hospital care mod severity 99235 at other Oklahoma hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Love County Health Center | Marietta | $726.00 | $136.32 – $143.13 |
| Mercy Hospital Healdton | Healdton | $471.90 | $136.32 – $229.28 |
| Mercy Hospital Kingfisher | Kingfisher | $482.30 | $136.32 – $229.28 |
| Mercy Hospital Logan County | Guthrie | $482.30 | $136.32 – $229.28 |
| Mercy Hospital Watonga | Watonga | $482.30 | $136.32 – $229.28 |
| Mercy Health Love County Rural Health Clinic | MARIETTA | $193.00 | $193.00 – $193.00 |