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 |
|---|---|---|---|---|
| Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback HCPCS J0744 | $39.00 | $60.00 | $1.66 – $1.88 | 5 |
| C-kit mutation liquid tumor - sendout CPT 81272 | $564.20 | $868.00 | $293.09 – $411.89 | 5 |
| Clearance of airways CPT 31720 | $157.95 | $243.00 | $181.12 – $447.44 | 5 |
| Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J0736 | $70.69 | $108.75 | $2.13 – $2.31 | 5 |
| Closed tx humerus fx w/manip 24505 CPT 24505 | $1,075.10 | $1,654.00 | $430.97 – $1,425.19 | 50 |
| Closed tx metatarsophalangeal jnt disl without anes CPT 28630 | $280.15 | $431.00 | $102.54 – $172.47 | 50 |
| Closed tx orbit without manipulj CPT 21400 | $523.90 | $806.00 | $156.80 – $263.74 | 50 |
| Closure laceration vestibule mouth > 2.5 cm cmplx CPT 40831 | $599.95 | $923.00 | $177.81 – $299.06 | 50 |
| Clot factor xii hageman CPT 85280 | $128.05 | $197.00 | $17.21 – $24.19 | 5 |
| Clot factor xiii fibrin scrn CPT 85291 | $120.25 | $185.00 | $8.10 – $8.10 | 4 |
| Clozapine, 25 mg HCPCS S0136 | $4.87 | $7.50 | $3.16 – $3.16 | 1 |
| Clsd/shoulder dislo/manip/no anest 23650 CPT 23650 | $707.20 | $1,088.00 | $299.58 – $559.68 | 50 |
| Clsd tx carpo/metacarpl disl thmb manip ea without anes CPT 26670 | $514.80 | $792.00 | $316.05 – $545.80 | 50 |
| Clsd tx/clavicular fx without manip 23500 CPT 23500 | $352.30 | $542.00 | $201.38 – $373.38 | 50 |
| Clsd tx/dis phalan fx without manip/ea 26750 CPT 26750 | $314.60 | $484.00 | $169.94 – $317.18 | 50 |
| Clsd tx elbow dislocation child 24640 CPT 24640 | $214.50 | $330.00 | $66.96 – $504.02 | 51 |
| Clsd tx/fx grt toe/phalanx/phalang 28490 CPT 28490 | $306.15 | $471.00 | $119.82 – $201.53 | 50 |
| Clsd tx/fx/phalanx/phalang/manip 28515 CPT 28515 | $300.95 | $463.00 | $132.58 – $223.00 | 50 |
| Clsd tx fx radius/ulna dist without manip 25600 CPT 25600 | $537.55 | $827.00 | $303.61 – $518.99 | 50 |
| Clsd tx fx radius/ulna dist w/manip 25605 CPT 25605 | $1,174.55 | $1,807.00 | $500.25 – $3,285.64 | 51 |
| Clsd tx fx radius/ulna w/manip 25565 CPT 25565 | $936.00 | $1,440.00 | $464.37 – $1,425.19 | 50 |
| Clsd tx/metacarpal fx/sg without manip 26600 CPT 26600 | $531.70 | $818.00 | $270.60 – $457.05 | 50 |
| Clsd tx/metacarpal fx/sng/w manip 26605 CPT 26605 | $626.60 | $964.00 | $283.01 – $476.01 | 50 |
| Clsd tx/metatarsal fx without manip 28470 CPT 28470 | $363.35 | $559.00 | $189.66 – $318.99 | 50 |
| Clsd tx of ankle fracture w/manip 28435 CPT 28435 | $587.60 | $904.00 | $299.02 – $1,425.19 | 50 |
| Clsd tx/prox/mid phalnx fx/no manp 26720 CPT 26720 | $313.30 | $482.00 | $181.47 – $311.57 | 50 |
| Clsd tx temporomandibular dislocat 21480 CPT 21480 | $262.60 | $404.00 | $28.34 – $119.80 | 50 |
| Clsd tx toe dislocation without anes28660 CPT 28660 | $281.45 | $433.00 | $92.55 – $155.66 | 50 |
| Clsd tx trimall ankle fx w/manip 27818 CPT 27818 | $1,027.00 | $1,580.00 | $434.11 – $1,425.19 | 50 |
| Clsd/ulnar fx/prox end without manip 24670 CPT 24670 | $401.05 | $617.00 | $255.35 – $429.50 | 50 |
| #cmvcul-virus inoculation shell CPT 87254 | $130.00 | $200.00 | $17.40 – $24.45 | 5 |
| Cmv pcr-sendout CPT 87496 | $215.80 | $332.00 | $43.86 – $43.86 | 1 |
| Cold agglutinin screen (arc) CPT 86156 | $48.10 | $74.00 | $7.18 – $10.09 | 5 |
| Cold agglutinin titer CPT 86157 | $53.30 | $82.00 | $7.17 – $10.08 | 5 |
| Collar cerv ascend 172 reg HCPCS L0172 | $61.75 | $95.00 | $283.43 – $283.43 | 1 |
| Collection blood specimen from completely implantable venous access device CPT 36591 | $116.35 | $179.00 | $23.02 – $271.86 | 5 |
| Collection blood specimen using established central/peripheral catheter venous nos CPT 36592 | $116.35 | $179.00 | $114.79 – $271.86 | 5 |
| Collection of venous blood by venipuncture CPT 36415 | $186.55 | $287.00 | $8.09 – $9.43 | 5 |
| Compatibility test each unit antiglobulin technique CPT 86922 | $166.40 | $256.00 | $42.14 – $304.61 | 5 |
| Compatibility test each unit immediate spin technique CPT 86920 | $128.05 | $197.00 | $14.05 – $304.61 | 5 |
| Compatibility test incubate CPT 86921 | $143.65 | $221.00 | $18.72 – $304.61 | 5 |
| Complement antigen each component c3 CPT 86160 | $99.45 | $153.00 | $10.67 – $15.00 | 5 |
| Complx repair enel 2.6-7.5 cm 13152 CPT 13152 | $1,042.60 | $1,604.00 | $261.28 – $439.46 | 50 |
| Complx repair fccmnaxghf 13131 CPT 13131 | $718.25 | $1,105.00 | $190.85 – $830.64 | 51 |
| Computed tomographic angiography head and neck with contrast CPT 70471 | $2,252.90 | $3,466.00 | $801.97 – $801.97 | 1 |
| Concentration infection agents any type CPT 87015 | $44.85 | $69.00 | $5.94 – $11.02 | 45 |
| Condylomata destruction 56420 CPT 56420 | $384.15 | $591.00 | $92.23 – $413.10 | 51 |
| Contrast baths charges CPT 97034 | $56.55 | $87.00 | $22.51 – $22.51 | 1 |
| Control nosebleed pack+caut 30905 CPT 30905 | $467.35 | $719.00 | $92.62 – $155.78 | 50 |
| Control of nosebleed ant comp 30903 CPT 30903 | $326.95 | $503.00 | $65.68 – $114.79 | 50 |
| Control of nosebleedantersmpl 30901 CPT 30901 | $248.95 | $383.00 | $46.86 – $133.79 | 50 |
| Coombs direct CPT 86880 | $72.80 | $112.00 | $4.79 – $105.47 | 6 |
| Coombs indirect qualitative each reagent red cell reference CPT 86885 | $93.60 | $144.00 | $5.09 – $304.61 | 5 |
| Coombs indirect titer reference CPT 86886 | $101.40 | $156.00 | $4.61 – $304.61 | 5 |
| Cortisol acth stimulation test - sendout CPT 80400 | $209.95 | $323.00 | $29.02 – $40.78 | 5 |
| Cortisol total am CPT 82533 | $126.10 | $194.00 | $14.50 – $22.01 | 6 |
| Cosyntropin 0.25 mg solution for injection HCPCS J0834 | $519.58 | $799.35 | $20.16 – $33.43 | 5 |
| Counseling smoke cess interm >10mins CPT 99407 | $50.70 | $78.00 | $21.01 – $76.56 | 51 |
| Covid-19 administration immunization im inj 1st/only component CPT 90480 | $42.90 | $66.00 | $37.45 – $70.58 | 5 |
| #covid19rsv-rsv CPT 87634 | $141.05 | $217.00 | $62.44 – $62.44 | 4 |
| #coxa-coxsackie a serotype a16 CPT 86658 | $65.00 | $100.00 | $11.59 – $11.59 | 4 |
| C-peptide CPT 84681 | $118.30 | $182.00 | $18.51 – $26.01 | 5 |
| C-reactive protein CPT 86140 | $50.70 | $78.00 | $4.61 – $6.48 | 5 |
| C-reactive protein high sensitivity CPT 86141 | $100.75 | $155.00 | $11.52 – $16.19 | 5 |
| C-reactive protein, quantitative CPT 86406 | $84.50 | $130.00 | $9.46 – $17.56 | 51 |
| Creatine kinase CPT 82550 | $50.70 | $78.00 | $5.79 – $8.14 | 5 |
| Creatine kinase isoenzymes CPT 82552 | $70.20 | $108.00 | $11.91 – $16.74 | 5 |
| Creatine kinase mb CPT 82553 | $68.25 | $105.00 | $10.27 – $19.06 | 51 |
| Creatinine CPT 82565 | $39.00 | $60.00 | $4.55 – $6.40 | 5 |
| Creatinine 24 hour urine CPT 82570 | $59.80 | $92.00 | $4.61 – $6.48 | 5 |
| Creatinine clearance urine CPT 82575 | $94.25 | $145.00 | $8.41 – $11.83 | 5 |
| #creutz-prot.,western blot CPT 84182 | $178.10 | $274.00 | $25.98 – $36.51 | 5 |
| Critical care 30-74 minutes CPT 99291 | $1,123.85 | $1,729.00 | $189.36 – $750.36 | 50 |
| Critical care each additional 30 minutes CPT 99292 | $505.70 | $778.00 | $95.26 – $160.23 | 50 |
| Crystal identification light microscopy CPT 89060 | $57.85 | $89.00 | $6.52 – $12.09 | 51 |
| Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast CPT 75635 | $3,038.10 | $4,674.00 | $143.14 – $403.20 | 5 |
| Cta lower extremity without & w/contrast (both sides) CPT 73706 | $2,060.50 | $3,170.00 | $143.14 – $403.20 | 5 |
| Cta neck without &/or w/contrast CPT 70498 | $2,252.90 | $3,466.00 | $143.14 – $403.20 | 5 |
| CT Angiogram of Abdomen and Pelvis CPT 74174 | $3,777.80 | $5,812.00 | $239.84 – $801.97 | 5 |
| CT Angiogram of the Chest (for blood clot) CPT 71275 | $2,191.80 | $3,372.00 | $143.19 – $403.20 | 5 |
| CT Angiogram of the Head CPT 70496 | $2,146.95 | $3,303.00 | $143.14 – $403.20 | 5 |
| CT lower extremity w/contrast (both sides) CPT 73701 | $1,805.70 | $2,778.00 | $97.15 – $403.20 | 5 |
| CT lower extremity without contrast (both sides) CPT 73700 | $2,912.65 | $4,481.00 | $71.62 – $240.32 | 5 |
| CT lwr extremity w/o&w/dye CPT 73702 | $1,989.65 | $3,061.00 | $119.64 – $403.20 | 5 |
| CT neck soft tissue w/contrast CPT 70491 | $1,581.45 | $2,433.00 | $103.53 – $403.20 | 5 |
| CT neck soft tissue without contrast CPT 70490 | $1,247.35 | $1,919.00 | $78.01 – $240.32 | 5 |
| CT neck soft tissue without & w/contrast CPT 70492 | $2,165.15 | $3,331.00 | $158.53 – $403.20 | 5 |
| CT orbit/sella/fossa w/wo contrast CPT 70482 | $2,369.25 | $3,645.00 | $130.75 – $403.20 | 5 |
| CT orbit/sella/ or posterior outer inner or middle ear w/contrast CPT 70481 | $1,961.05 | $3,017.00 | $110.20 – $403.20 | 5 |
| CT orbit/sella/ or posterior outer inner or middle ear without contrast CPT 70480 | $916.50 | $1,410.00 | $85.48 – $240.32 | 5 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $3,587.35 | $5,519.00 | $212.92 – $801.97 | 5 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $2,871.05 | $4,417.00 | $188.51 – $801.97 | 5 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $2,527.85 | $3,889.00 | $88.54 – $548.48 | 5 |
| CT thoracic spine w/contrast CPT 72129 | $2,103.40 | $3,236.00 | $158.53 – $403.20 | 5 |
| CT thoracic spine without contrast CPT 72128 | $1,732.90 | $2,666.00 | $71.90 – $240.32 | 5 |
| CT thorax low dose for lung screening without contrast CPT 71271 | $330.85 | $509.00 | $75.21 – $240.32 | 5 |
| CT t-spine w /wo contrast CPT 72130 | $2,020.20 | $3,108.00 | $120.20 – $403.20 | 5 |
| CT upper extremity w/contrast (both sides) CPT 73201 | $1,651.65 | $2,541.00 | $126.31 – $801.97 | 5 |
| CT upper extremity without contrast (both sides) CPT 73200 | $1,627.60 | $2,504.00 | $85.22 – $240.32 | 5 |
| CT uppr extremity w/o&w/dye CPT 73202 | $1,756.30 | $2,702.00 | $143.16 – $403.20 | 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.