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 |
|---|---|---|---|---|
| Ot therapeutic activities direct patient contact each 15 minutes CPT 97530 | $85.80 | $132.00 | $32.02 – $55.85 | 5 |
| Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes CPT 97130 | $27.30 | $42.00 | $19.38 – $34.87 | 5 |
| Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes CPT 97129 | $87.75 | $135.00 | $20.28 – $36.94 | 5 |
| Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes CPT 97110 | $82.55 | $127.00 | $25.94 – $46.78 | 5 |
| Ot therapeutic procedure neuromuscular reeducate each 15 minutes CPT 97112 | $91.00 | $140.00 | $29.72 – $52.67 | 5 |
| Ot training self care/home management direct contact each 15 minutes CPT 97535 | $90.35 | $139.00 | $28.72 – $51.85 | 5 |
| Oxytocin 10 unit/ml injection solution HCPCS J2590 | $16.82 | $25.88 | $0.65 – $0.87 | 5 |
| Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr HCPCS J2470 | $8.29 | $12.75 | $1.98 – $5.08 | 5 |
| Parathormone (pth) intact CPT 83970 | $120.90 | $186.00 | $36.72 – $68.11 | 44 |
| Pdgfra gene CPT 81314 | $570.70 | $878.00 | $293.09 – $411.89 | 5 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $2,295.15 | $3,531.00 | $143.16 – $403.20 | 5 |
| Pelvic CT scan (with contrast) CPT 72193 | $2,121.60 | $3,264.00 | $158.53 – $492.80 | 5 |
| Pelvic CT scan (without contrast) CPT 72192 | $1,738.10 | $2,674.00 | $71.07 – $293.73 | 5 |
| Pelvic Ultrasound (complete) CPT 76856 | $636.35 | $979.00 | $61.07 – $240.32 | 5 |
| Pelvic Ultrasound (limited) CPT 76857 | $298.35 | $459.00 | $21.91 – $240.32 | 5 |
| Peng benzathine/procaine inj HCPCS J0558 | $592.60 | $911.70 | $104.22 – $104.22 | 4 |
| Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 | $989.48 | $1,522.28 | $160.92 – $234.12 | 5 |
| Perq rplcmt g-tube req revsn gstrst trk CPT 43763 | $328.90 | $506.00 | $76.98 – $281.83 | 50 |
| Ph body fluid CPT 83986 | $51.35 | $79.00 | $3.18 – $4.48 | 5 |
| Phenobarbital therapeutic drug level CPT 80184 | $98.15 | $151.00 | $13.61 – $19.13 | 5 |
| Phenylephrine 10 mg/ml injection solution HCPCS J2371 | $7.15 | $11.00 | $0.05 – $0.05 | 5 |
| Phenytoin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1165 | $7.15 | $11.00 | $0.94 – $0.94 | 4 |
| Phenytoin total therapeutic drug level CPT 80185 | $107.90 | $166.00 | $11.79 – $17.89 | 7 |
| Phosphorus CPT 84100 | $44.85 | $69.00 | $4.22 – $6.40 | 8 |
| Phosphorus 24 hour urine CPT 84105 | $37.05 | $57.00 | $5.14 – $9.54 | 51 |
| Phytonadione (vitamin k1) 10 mg/ml injection solution HCPCS J3430 | $62.56 | $96.24 | $6.63 – $11.76 | 5 |
| Pinworm exam CPT 87172 | $28.60 | $44.00 | $3.80 – $3.80 | 4 |
| Piperacillin-tazobactam 3.375 gram intravenous solution HCPCS J2543 | $59.77 | $91.95 | $2.28 – $2.70 | 5 |
| Platelet automated CPT 85049 | $59.80 | $92.00 | $3.98 – $5.60 | 5 |
| Platelets pheresis leukocytes reduced irradiated each unit HCPCS P9037 | $1,366.30 | $2,102.00 | $483.98 – $850.76 | 5 |
| Platelets pheresis pathogen-reduced each unit HCPCS P9073 | $1,046.50 | $1,610.00 | $753.21 – $753.21 | 1 |
| Plethysmography lung volumes/airway resistance CPT 94726 | $954.85 | $1,469.00 | $47.46 – $762.48 | 51 |
| Poct blood gases ph pco2 po2 arterial calculated o2 CPT 82803 | $176.80 | $272.00 | $23.19 – $32.59 | 5 |
| Potassium 24 hour urine CPT 84133 | $50.70 | $78.00 | $4.21 – $5.91 | 6 |
| Potassium chloride 10 meq/100ml in sterile water intravenous piggyback HCPCS J3480 | $42.25 | $65.00 | $1.00 – $1.60 | 5 |
| Potassium serum/plasma/whole blood CPT 84132 | $35.10 | $54.00 | $4.23 – $5.95 | 5 |
| Pr application of long arm splint CPT 29105 | $226.20 | $348.00 | $35.33 – $332.04 | 51 |
| Pr application splint static short arm CPT 29125 | $189.80 | $292.00 | $37.55 – $271.86 | 51 |
| Pr counseling smoke/tobacco intermediate greater 3 - 10 minutes CPT 99406 | $39.65 | $61.00 | $10.18 – $76.56 | 51 |
| Pr debridement open wound topical appl/wound asmt per session 20 sq cm/< CPT 97597 | $286.00 | $440.00 | $29.80 – $348.47 | 51 |
| Pr discharge day management hospital ip/obs <=30 min on ecounter date CPT 99238 | $131.95 | $203.00 | $70.70 – $111.30 | 33 |
| Pr discharge day management hospital ip/obs > 30 min on encounter date CPT 99239 | $189.80 | $292.00 | $102.72 – $163.85 | 11 |
| Prealbumin CPT 84134 | $101.40 | $156.00 | $12.98 – $18.24 | 5 |
| Pr ecg 12 lead report only CPT 93010 | $39.65 | $61.00 | $7.22 – $13.20 | 11 |
| Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution HCPCS J7510 | $4.87 | $7.50 | $1.71 – $2.76 | 5 |
| Prednisone 1 mg tablet HCPCS J7512 | $4.87 | $7.50 | $0.10 – $0.10 | 5 |
| Pregnancy Ultrasound (first trimester) CPT 76801 | $541.45 | $833.00 | $59.13 – $240.32 | 5 |
| Pressure max expiratory/inspiratory CPT 94799 | $113.10 | $174.00 | $262.92 – $262.92 | 1 |
| Pr hospital ip/obs care initial high level per day CPT 99223 | $337.35 | $519.00 | $151.77 – $311.68 | 11 |
| Pr hospital ip/obs care initial moderate level per day CPT 99222 | $274.95 | $423.00 | $111.21 – $210.52 | 33 |
| Pr hospital ip/obs care initial straightforward or low level per day CPT 99221 | $180.05 | $277.00 | $70.59 – $118.73 | 50 |
| Pr hospital ip/obs care subsequent high level per day CPT 99233 | $189.80 | $292.00 | $101.87 – $171.34 | 50 |
| Pr hospital ip/obs care subsequent moderate level per day CPT 99232 | $133.90 | $206.00 | $67.19 – $111.11 | 33 |
| Pr hospital ip/obs care subsequent straightforward or low level per day CPT 99231 | $75.40 | $116.00 | $42.04 – $59.98 | 33 |
| Pr incision & drainage abscess complicated/multiple CPT 10061 | $384.80 | $592.00 | $159.78 – $830.64 | 51 |
| Pr incision & drainage abscess simple/single CPT 10060 | $221.00 | $340.00 | $92.21 – $409.96 | 51 |
| Pr incision & drainage abscess vulva/perineal CPT 56405 | $351.65 | $541.00 | $107.04 – $622.66 | 51 |
| Pr incision & removal foreign body subcutaneous tissues simple CPT 10120 | $281.45 | $433.00 | $93.64 – $830.64 | 51 |
| Pr moderate sedation same physician >= 5 years initial 15 minutes CPT 99152 | $180.70 | $278.00 | $10.47 – $79.41 | 51 |
| Procainamide 100 mg/ml injection (wrapper) HCPCS J2690 | $2,925.00 | $4,500.00 | $486.28 – $486.28 | 4 |
| Procalcitonin CPT 84145 | $153.40 | $236.00 | $24.21 – $44.91 | 48 |
| Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution HCPCS J0780 | $35.35 | $54.39 | $2.95 – $4.13 | 5 |
| Progesterone CPT 84144 | $98.15 | $151.00 | $18.55 – $26.08 | 5 |
| Prolactin CPT 84146 | $118.95 | $183.00 | $17.24 – $31.98 | 48 |
| Promethazine hcl injection HCPCS J2550 | $9.01 | $13.86 | $3.57 – $4.14 | 5 |
| Propofol infusion 10 mg/ml HCPCS J2704 | $105.30 | $162.00 | $11.00 – $11.00 | 1 |
| Protamine 10 mg/ml intravenous solution HCPCS J2720 | $43.00 | $66.15 | $3.42 – $6.21 | 5 |
| Protein c activity CPT 85303 | $146.90 | $226.00 | $12.31 – $17.30 | 5 |
| Protein electrophoretic fractionation & quantitation serum CPT 84165 | $97.50 | $150.00 | $9.55 – $13.43 | 6 |
| Protein total 24 hour urine CPT 84156 | $46.15 | $71.00 | $3.26 – $4.59 | 5 |
| Protein total body fluid CPT 84157 | $53.95 | $83.00 | $3.56 – $6.60 | 42 |
| Protein total serum plasma whole blood CPT 84155 | $32.50 | $50.00 | $3.26 – $4.95 | 7 |
| Prothrombin time substitution plasma fractions each CPT 85611 | $37.05 | $57.00 | $3.50 – $3.50 | 4 |
| Pr planning advance care 1st 30 minutes CPT 99497 | $130.00 | $200.00 | $62.87 – $207.58 | 47 |
| Pr removal foreign body external auditory canal without anesthesia CPT 69200 | $200.85 | $309.00 | $38.98 – $271.86 | 51 |
| Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm CPT 12032 | $403.00 | $620.00 | $152.94 – $830.64 | 51 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm CPT 12011 | $298.35 | $459.00 | $50.72 – $409.96 | 51 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm CPT 12013 | $282.75 | $435.00 | $52.27 – $409.96 | 51 |
| Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm CPT 12001 | $270.40 | $416.00 | $41.02 – $409.96 | 51 |
| Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm CPT 12002 | $321.10 | $494.00 | $53.57 – $409.96 | 51 |
| Pr tube thoracostomy w/connection to drainage open CPT 32551 | $631.15 | $971.00 | $134.19 – $3,216.50 | 51 |
| PSA (Prostate) Test CPT 84153 | $119.60 | $184.00 | $16.36 – $24.83 | 10 |
| Pt application of modality >=1 area electrical stimulation each 15 minutes CPT 97032 | $86.45 | $133.00 | $23.77 – $23.77 | 1 |
| Pt application of modality >=1 area hot/cold packs CPT 97010 | $27.95 | $43.00 | $5.81 – $5.81 | 1 |
| Pt application of modality >=1 area ultrasound each 15 minutes CPT 97035 | $82.55 | $127.00 | $23.02 – $23.02 | 1 |
| Pt evaluation high complexity patient/family CPT 97163 | $433.55 | $667.00 | $88.72 – $158.37 | 5 |
| Pt evaluation low complexity patient/family CPT 97161 | $380.25 | $585.00 | $88.72 – $158.37 | 5 |
| Pt evaluation moderate complexity patient/family CPT 97162 | $404.95 | $623.00 | $88.72 – $158.37 | 5 |
| Pt re-evaluation patient/family CPT 97164 | $351.65 | $541.00 | $61.23 – $108.19 | 5 |
| Pt therapeutic procedure >=1 area gait training each 15 minutes CPT 97116 | $67.60 | $104.00 | $25.94 – $46.78 | 5 |
| Pt therapeutic procedure >=1 area massage each 15 minutes CPT 97124 | $79.30 | $122.00 | $26.44 – $47.19 | 5 |
| Pt wheelchair management each 15 minutes CPT 97542 | $71.50 | $110.00 | $27.99 – $50.51 | 5 |
| Pulse ox continuous overnight monitoring CPT 94762 | $377.00 | $580.00 | $21.08 – $262.92 | 5 |
| Pulse ox multiple CPT 94761 | $169.65 | $261.00 | $3.31 – $6.53 | 5 |
| Pulse ox single CPT 94760 | $101.40 | $156.00 | $6.02 – $6.02 | 1 |
| Puncture arterial withdrawal blood for diagnosis CPT 36600 | $79.95 | $123.00 | $23.81 – $271.86 | 5 |
| Puncture aspiration abscess/hematoma/bulla/cyst CPT 10160 | $215.15 | $331.00 | $84.26 – $830.64 | 51 |
| Pyruvate CPT 84210 | $70.20 | $108.00 | $12.88 – $18.10 | 5 |
| Quest t3 uptake CPT 84479 | $65.00 | $100.00 | $5.75 – $8.09 | 5 |
| Rapid Strep Test CPT 87880 | $80.60 | $124.00 | $14.70 – $20.66 | 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.