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 |
|---|---|---|---|---|
| Rbc irradiated each unit HCPCS P9038 | $490.75 | $755.00 | $97.88 – $97.88 | 4 |
| Red blood cells leukocytes reduced cmv negative irradiated each unit HCPCS P9058 | $656.50 | $1,010.00 | $225.26 – $309.26 | 5 |
| Red blood cells leukocytes reduced each unit HCPCS P9016 | $288.60 | $444.00 | $136.54 – $231.14 | 5 |
| Remdesivir 100 mg intravenous powder for solution HCPCS J0248 | $1,888.50 | $2,905.39 | $635.00 – $855.00 | 5 |
| Removal cerumen impacted (both sides) CPT 69210 | $159.90 | $246.00 | $25.63 – $120.54 | 47 |
| Removal devitalized tissue non-selective debridement without anesthesia per session CPT 97602 | $189.15 | $291.00 | $23.64 – $348.47 | 5 |
| Removal foreign body foot subcutaneous right CPT 28190 | $505.70 | $778.00 | $118.44 – $1,446.94 | 51 |
| Renal function panel CPT 80069 | $155.35 | $239.00 | $7.72 – $11.72 | 7 |
| Reptilase test CPT 85635 | $68.25 | $105.00 | $8.76 – $8.76 | 4 |
| Resuscitation cardiopulmonary CPT 92950 | $774.15 | $1,191.00 | $162.03 – $441.20 | 51 |
| Reticulocyte automated CPT 85045 | $48.10 | $74.00 | $3.55 – $4.99 | 6 |
| Reticulocyte direct measurement automated CPT 85046 | $30.55 | $47.00 | $4.95 – $6.96 | 6 |
| Rheumatoid factor qualitative CPT 86430 | $65.00 | $100.00 | $5.46 – $10.13 | 49 |
| Rheumatoid factor quantitative CPT 86431 | $53.30 | $82.00 | $5.04 – $7.09 | 8 |
| Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe HCPCS J2791 | $471.60 | $725.54 | $73.35 – $90.15 | 5 |
| Rsv assay w/optic CPT 87807 | $89.05 | $137.00 | $11.65 – $16.38 | 5 |
| Rubella antibody igg CPT 86762 | $79.30 | $122.00 | $12.80 – $17.99 | 5 |
| Rubeola antibody igg CPT 86765 | $79.30 | $122.00 | $11.46 – $17.39 | 6 |
| Russell viper venom diluted CPT 85613 | $62.40 | $96.00 | $8.52 – $11.98 | 5 |
| Sarscov coronavirus ag ia CPT 87426 | $71.50 | $110.00 | $31.43 – $44.16 | 5 |
| Sarscov & inf vir a&b ag ia CPT 87428 | $125.45 | $193.00 | $62.52 – $87.86 | 5 |
| Sbsq nurs facil care/day unstabl/new prob 35 min 99310 CPT 99310 | $215.80 | $332.00 | $132.57 – $222.98 | 50 |
| Sbsq nursing facil care/day minor complj 15 min CPT 99308 | $113.10 | $174.00 | $63.97 – $107.60 | 50 |
| Sbsq nursing facil care/day new problem 25 min CPT 99309 | $134.55 | $207.00 | $92.98 – $156.39 | 50 |
| Sbsq nursing facility care/day e/m stable 10 min CPT 99307 | $75.40 | $116.00 | $34.91 – $58.72 | 50 |
| Scan duplex abd/pelvis/retroperitoneal complete CPT 93975 | $966.55 | $1,487.00 | $223.84 – $487.54 | 5 |
| Scan duplex abd/pelvis/retroperitoneal limited CPT 93976 | $630.50 | $970.00 | $94.70 – $213.62 | 5 |
| Scan duplex aorta/ivc/iliac or bypass grafts complete CPT 93978 | $822.25 | $1,265.00 | $152.64 – $487.54 | 5 |
| Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 | $530.40 | $816.00 | $99.81 – $213.62 | 5 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $1,038.05 | $1,597.00 | $94.70 – $213.62 | 5 |
| Scan duplex lower extremity arteries complete bilateral CPT 93925 | $458.25 | $705.00 | $202.67 – $487.54 | 5 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $381.55 | $587.00 | $105.04 – $213.62 | 5 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $370.50 | $570.00 | $104.56 – $213.62 | 5 |
| Screening prostate cancer PSA HCPCS G0103 | $101.40 | $156.00 | $17.18 – $17.18 | 4 |
| Sedation moderate same physician performing a gastrointestinal endoscopic service >= 5 years initial 15 minutes intra-service time HCPCS G0500 | $180.70 | $278.00 | $48.03 – $48.03 | 4 |
| Sedimentation rate erythrocyte automated CPT 85652 | $44.20 | $68.00 | $2.40 – $3.38 | 5 |
| Semen analysis presence/motility CPT 89321 | $113.10 | $174.00 | $15.06 – $16.27 | 2 |
| Shoulder X-ray CPT 73030 | $391.95 | $603.00 | $21.64 – $200.05 | 5 |
| Sickling rbc CPT 85660 | $75.40 | $116.00 | $4.90 – $6.89 | 5 |
| Sildenafil citrate, 25 mg HCPCS S0090 | $4.87 | $7.50 | $0.28 – $0.28 | 1 |
| Sinus CT scan (with and without contrast) CPT 70488 | $2,299.05 | $3,537.00 | $107.98 – $492.80 | 5 |
| Sinus CT scan (with contrast) CPT 70487 | $1,848.60 | $2,844.00 | $86.04 – $492.80 | 5 |
| Sinus CT scan (without contrast) CPT 70486 | $1,306.50 | $2,010.00 | $76.07 – $293.73 | 5 |
| Slp ther svc non-spch gen CPT 92606 | $204.10 | $314.00 | $69.82 – $69.82 | 4 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $57.20 | $88.00 | $4.79 – $7.28 | 6 |
| Smear gram stain CPT 87205 | $66.30 | $102.00 | $3.80 – $5.76 | 10 |
| Smear nasal eosinophil CPT 89190 | $49.40 | $76.00 | $5.15 – $5.15 | 4 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $72.80 | $112.00 | $5.33 – $7.49 | 5 |
| Smear wet mount CPT 87210 | $70.85 | $109.00 | $5.18 – $7.28 | 5 |
| Snrpn/ube3a gene CPT 81331 | $380.90 | $586.00 | $45.43 – $63.84 | 5 |
| Sodium 24 hour urine CPT 84300 | $46.15 | $71.00 | $4.50 – $6.33 | 6 |
| Sodium chloride 0.9 % intravenous solution HCPCS J7030 | $42.25 | $65.00 | $2.50 – $2.72 | 5 |
| Sodium chloride 0.9 % IV bolus HCPCS J7040 | $42.25 | $65.00 | $1.25 – $1.69 | 5 |
| Sodium chloride 0.9 % IV bolus HCPCS J7050 | $42.25 | $65.00 | $0.63 – $0.87 | 5 |
| Sodium serum/plasma/whole blood CPT 84295 | $40.95 | $63.00 | $4.28 – $6.01 | 6 |
| Specific gravity body fluid CPT 84315 | $24.70 | $38.00 | $2.92 – $2.92 | 4 |
| Spirometry bronchodilation responsiveness pre/post bronchodilator administration CPT 94060 | $449.15 | $691.00 | $33.19 – $762.48 | 51 |
| Staph a dna amp probe CPT 87640 | $109.20 | $168.00 | $34.42 – $43.86 | 2 |
| St evaluate speech sound production CPT 92522 | $430.30 | $662.00 | $99.10 – $181.27 | 5 |
| St evaluate speech sound production comprehensive/expressive CPT 92523 | $437.45 | $673.00 | $202.75 – $367.05 | 5 |
| St evaluation swallow function CPT 92610 | $426.40 | $656.00 | $75.41 – $136.63 | 5 |
| Strapping of ankle and/or ft 29540 CPT 29540 | $156.00 | $240.00 | $24.58 – $24.58 | 4 |
| Strapping of knee CPT 29530 | $241.80 | $372.00 | $25.71 – $25.71 | 4 |
| Strep a ag ia CPT 87430 | $96.85 | $149.00 | $14.95 – $21.01 | 5 |
| Strep b dna amp probe CPT 87653 | $110.50 | $170.00 | $43.86 – $43.86 | 1 |
| Stress test pulmonary CPT 94618 | $243.10 | $374.00 | $29.88 – $231.08 | 51 |
| Str markers specimen anal CPT 81265 | $843.05 | $1,297.00 | $207.31 – $207.31 | 4 |
| St treatment speech individual CPT 92507 | $670.15 | $1,031.00 | $67.94 – $123.44 | 5 |
| St treatment swallow dysfunction/oral CPT 92526 | $254.80 | $392.00 | $75.02 – $135.85 | 5 |
| Succinylcholine chloride 20 mg/ml injection solution (wrapper) HCPCS J0330 | $7.15 | $11.00 | $0.63 – $0.80 | 5 |
| Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution HCPCS J2865 | $30.57 | $47.03 | $0.80 – $0.80 | 1 |
| Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 | $58.50 | $90.00 | $6.42 – $51.45 | 5 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $225.55 | $347.00 | $36.52 – $93.17 | 5 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $304.85 | $469.00 | $62.20 – $93.17 | 5 |
| Susceptibility agar dilution per agent CPT 87181 | $28.60 | $44.00 | $4.23 – $5.94 | 6 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $32.50 | $50.00 | $4.23 – $5.94 | 6 |
| Susceptibility mic per plate CPT 87186 | $81.90 | $126.00 | $7.69 – $14.27 | 52 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $49.40 | $76.00 | $3.91 – $5.50 | 5 |
| T3 (triiodothyronine) free CPT 84481 | $126.75 | $195.00 | $15.07 – $27.95 | 46 |
| T3 (triiodothyronine) total CPT 84480 | $100.75 | $155.00 | $12.61 – $23.40 | 47 |
| T4 (thyroxine) free CPT 84439 | $101.40 | $156.00 | $8.02 – $11.28 | 5 |
| T4 (thyroxine) total CPT 84436 | $56.55 | $87.00 | $6.11 – $8.59 | 6 |
| Tacrolimus therapeutic drug level CPT 80197 | $173.55 | $267.00 | $12.21 – $17.16 | 5 |
| Target gsa panel hmtlmph neop CPT 81450 | $1,759.55 | $2,707.00 | $675.59 – $949.41 | 5 |
| Target gsa panel organ neop CPT 81445 | $2,072.85 | $3,189.00 | $531.83 – $531.83 | 4 |
| Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe HCPCS J1447 | $665.88 | $1,024.43 | $93.00 – $120.00 | 5 |
| Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells CPT 86481 | $131.95 | $203.00 | $88.95 – $135.00 | 6 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $205.40 | $316.00 | $55.13 – $77.48 | 6 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $230.75 | $355.00 | $41.79 – $63.42 | 7 |
| T cells total count CPT 86359 | $117.65 | $181.00 | $33.56 – $50.94 | 7 |
| Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) HCPCS J3101 | $22,112.20 | $34,018.77 | $8,121.50 – $12,241.50 | 5 |
| Terbutaline 1 mg/ml subcutaneous solution HCPCS J3105 | $19.50 | $30.00 | $2.14 – $3.67 | 5 |
| Theophylline therapeutic drug level CPT 80198 | $103.35 | $159.00 | $12.58 – $17.68 | 5 |
| Therapeutic procd strg endur HCPCS G0237 | $95.55 | $147.00 | $51.71 – $51.71 | 1 |
| Therapy nutrition individual initial f2f w/patient each 15 minutes CPT 97802 | $42.90 | $66.00 | $32.05 – $58.94 | 5 |
| Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes CPT 97803 | $39.65 | $61.00 | $27.89 – $50.85 | 5 |
| Ther/proph/diag inj ia CPT 96373 | $66.95 | $103.00 | $17.91 – $187.62 | 50 |
| Thiamine hcl (vitamin b1) 100 mg/ml injection solution HCPCS J3411 | $35.10 | $54.00 | $3.52 – $3.84 | 5 |
| Thrombin time CPT 85670 | $63.70 | $98.00 | $5.13 – $7.21 | 5 |
| Thromboplastin time partial (ptt) substitution fractions each CPT 85732 | $49.40 | $76.00 | $5.75 – $8.09 | 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.