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 |
|---|---|---|---|---|
| Culture aerobic additional method definitive id each CPT 87077 | $53.30 | $82.00 | $7.19 – $13.33 | 52 |
| Culture afb any source CPT 87116 | $122.20 | $188.00 | $9.61 – $14.58 | 6 |
| Culture anaerobic additional method definitive id each CPT 87076 | $100.75 | $155.00 | $7.19 – $10.10 | 6 |
| Culture anaerobic except blood CPT 87075 | $123.50 | $190.00 | $8.42 – $15.63 | 42 |
| Culture bact stool aero addl path ea CPT 87046 | $50.70 | $78.00 | $8.40 – $15.58 | 50 |
| Culture body fluid CPT 87070 | $125.45 | $193.00 | $7.67 – $10.78 | 5 |
| Culture fungi definitive id mold CPT 87107 | $87.10 | $134.00 | $9.18 – $12.90 | 5 |
| Culture fungi definitive id yeast CPT 87106 | $87.10 | $134.00 | $9.18 – $17.03 | 49 |
| Culture fungi other (except blood) CPT 87102 | $117.65 | $181.00 | $7.48 – $11.35 | 6 |
| Culture fungi skin/hair/nail CPT 87101 | $84.50 | $130.00 | $6.86 – $9.64 | 5 |
| Culture mycoplasma any source CPT 87109 | $172.25 | $265.00 | $13.69 – $13.69 | 4 |
| Culture screening strep group a CPT 87081 | $87.75 | $135.00 | $5.90 – $8.95 | 9 |
| Culture typing immunologic CPT 87147 | $41.60 | $64.00 | $4.61 – $8.55 | 44 |
| Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets CPT 87154 | $754.65 | $1,161.00 | $193.96 – $272.58 | 5 |
| Culture typing nucleic acid probe amplified per culture/isolate each organism CPT 87150 | $28.60 | $44.00 | $31.21 – $57.90 | 50 |
| Culture urine each isolate CPT 87088 | $72.80 | $112.00 | $7.20 – $13.35 | 50 |
| Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution HCPCS J3420 | $7.15 | $11.00 | $0.83 – $1.27 | 5 |
| Cyclic citrullinated peptide antibody CPT 86200 | $108.55 | $167.00 | $11.52 – $16.19 | 6 |
| Cyclosporine 2 hour CPT 80158 | $180.70 | $278.00 | $16.06 – $29.78 | 52 |
| Cystatin c CPT 82610 | $92.30 | $142.00 | $16.47 – $23.15 | 5 |
| Cystic fibrosis cftr CPT 81223 | $1,190.80 | $1,832.00 | $443.85 – $443.85 | 4 |
| Cytogenetics 25-99 CPT 88274 | $104.65 | $161.00 | $37.70 – $37.70 | 4 |
| Cytomegalovirus (cmv) antibody igg CPT 86644 | $102.70 | $158.00 | $12.80 – $17.99 | 6 |
| Cytomegalovirus (cmv) antibody igm CPT 86645 | $94.90 | $146.00 | $14.99 – $21.06 | 5 |
| Cytopathology cellular enhancement technique non-gyn CPT 88112 | $169.00 | $260.00 | $58.50 – $93.17 | 5 |
| Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review CPT 88175 | $76.70 | $118.00 | $23.67 – $33.26 | 7 |
| Cytopathology cervical/vaginal thin layer manual screening CPT 88142 | $80.60 | $124.00 | $18.02 – $18.02 | 4 |
| Cytopath tbs c/v manual CPT 88164 | $49.40 | $76.00 | $16.18 – $16.18 | 4 |
| Dalbavancin 500 mg intravenous solution HCPCS J0875 | $4,741.39 | $7,294.44 | $1,560.00 – $1,860.00 | 5 |
| Daptomycin 500 mg/10 ml intravenous solution HCPCS J0878 | $146.25 | $225.00 | $20.00 – $20.00 | 5 |
| Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe HCPCS J0881 | $10,313.55 | $15,867.00 | $178.20 – $228.60 | 5 |
| Dch validity tests CPT 81002 | $22.10 | $34.00 | $3.10 – $4.35 | 5 |
| Deamidated gliadin antibody iga CPT 86258 | $93.60 | $144.00 | $10.72 – $15.06 | 5 |
| Debridement (>20 cm) charge pt CPT 97598 | $286.00 | $440.00 | $39.04 – $75.09 | 5 |
| Declotting thrombolytic agent implanted vas access device 36 CPT 36593 | $323.70 | $498.00 | $28.83 – $674.92 | 5 |
| Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device CPT 94664 | $147.55 | $227.00 | $14.95 – $447.44 | 5 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | $222.30 | $342.00 | $18.58 – $200.05 | 5 |
| Dexamethasone 4 mg tablet HCPCS J8540 | $4.87 | $7.50 | $0.64 – $0.96 | 5 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $7.15 | $11.00 | $0.22 – $0.28 | 5 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | $42.25 | $65.00 | $1.80 – $2.32 | 5 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $109.20 | $168.00 | $19.77 – $27.79 | 6 |
| Diabetes (HbA1c) Test CPT 83036 | $77.35 | $119.00 | $8.64 – $12.14 | 5 |
| Dialysis one evaluation CPT 90945 | $978.90 | $1,506.00 | $75.59 – $852.60 | 5 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $15.04 | $23.14 | $8.55 – $10.55 | 5 |
| Dicyclomine injection HCPCS J0500 | $59.96 | $92.25 | $11.62 – $14.90 | 5 |
| Diffusing capacity CPT 94729 | $390.65 | $601.00 | $47.81 – $97.36 | 51 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $7.15 | $11.00 | $8.82 – $12.86 | 5 |
| Digoxin total therapeutic drug level CPT 80162 | $77.35 | $119.00 | $11.81 – $17.93 | 7 |
| Diltiazem 5 mg/ml intravenous solution HCPCS J1163 | $7.15 | $11.00 | $1.00 – $1.00 | 1 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $7.15 | $11.00 | $0.73 – $0.86 | 5 |
| Disability dlco CPT 94727 | $354.90 | $546.00 | $38.05 – $441.20 | 5 |
| Disaccharidases CPT 82657 | $21.45 | $33.00 | $19.72 – $27.71 | 5 |
| Dna antibody native/double stranded CPT 86225 | $104.00 | $160.00 | $12.22 – $17.18 | 6 |
| Dna gardnerella CPT 87510 | $70.85 | $109.00 | $17.83 – $25.06 | 7 |
| Dna trichomonas CPT 87660 | $75.40 | $116.00 | $17.83 – $25.06 | 7 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $69.47 | $106.88 | $9.90 – $9.90 | 1 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $406.90 | $626.00 | $114.79 – $271.86 | 5 |
| Doxycycline hyclate 100 mg intravenous powder for solution HCPCS J1271 | $117.78 | $181.20 | $11.00 – $11.00 | 1 |
| Drainage ext aud canal abscess 69020 CPT 69020 | $317.20 | $488.00 | $121.49 – $204.34 | 50 |
| Drainage external ear complex 69005 CPT 69005 | $386.10 | $594.00 | $134.98 – $227.02 | 50 |
| Drainage external ear simple 69000 CPT 69000 | $299.00 | $460.00 | $107.77 – $1,446.94 | 51 |
| Drainage mouth roof lesion CPT 42000 | $304.20 | $468.00 | $91.06 – $153.15 | 50 |
| Drain blood from under nail 11740 CPT 11740 | $94.90 | $146.00 | $28.79 – $271.86 | 51 |
| Drain finger abscess;simple 26010 CPT 26010 | $396.50 | $610.00 | $132.01 – $409.96 | 51 |
| Dress/debride pt-thick burn/<5% bs 16020 CPT 16020 | $167.70 | $258.00 | $49.90 – $409.96 | 51 |
| Drng of finger abscess comp 26011 CPT 26011 | $731.25 | $1,125.00 | $166.59 – $1,442.85 | 50 |
| Drug assay caffeine CPT 80155 | $110.50 | $170.00 | $34.31 – $34.31 | 4 |
| Drug assay posaconazole CPT 80187 | $143.65 | $221.00 | $24.11 – $24.11 | 4 |
| Drug assay voriconazole CPT 80285 | $102.70 | $158.00 | $24.11 – $24.11 | 4 |
| Drug test prsmv instrmnt CPT 80306 | $95.55 | $147.00 | $15.25 – $28.28 | 48 |
| Drug test(s) presumptive any class instrument chemistry analyzers CPT 80307 | $236.60 | $364.00 | $55.27 – $83.89 | 6 |
| Drvvt confirm - quest CPT 85597 | $111.80 | $172.00 | $15.99 – $15.99 | 4 |
| Dup scan/ue art/graft/bilat/comp 93930 CPT 93930 | $702.00 | $1,080.00 | $167.40 – $487.54 | 5 |
| Dxa bone density axl vrt fx CPT 77085 | $462.80 | $712.00 | $32.72 – $240.32 | 5 |
| Ear irrigation 69209 CPT 69209 | $111.80 | $172.00 | $14.96 – $120.54 | 47 |
| Ecg 12 lead tracing only CPT 93005 | $126.10 | $194.00 | $5.25 – $120.54 | 5 |
| Echocardiogram (Heart Ultrasound) CPT 93306 | $1,541.15 | $2,371.00 | $168.33 – $1,116.50 | 5 |
| Echocardiography transthoracic 2d followup/limited CPT 93308 | $594.10 | $914.00 | $90.78 – $487.54 | 51 |
| Echo tte 2d comp wo ctrst wo clr/dplr CPT 93307 | $1,380.60 | $2,124.00 | $215.26 – $487.54 | 5 |
| E coli 0157 ag ia CPT 87335 | $71.50 | $110.00 | $11.26 – $11.26 | 4 |
| Egfr gene com variants CPT 81235 | $726.70 | $1,118.00 | $288.71 – $405.73 | 5 |
| Ehrlicha chaffeensis amp prb CPT 87484 | $144.95 | $223.00 | $43.86 – $47.37 | 2 |
| Electrical stimulation/unattended 97014 CPT 97014 | $68.25 | $105.00 | $20.30 – $20.30 | 1 |
| Electrolyte panel CPT 80051 | $83.20 | $128.00 | $6.24 – $8.76 | 5 |
| Enoxaparin 30 mg/0.3 ml subcutaneous syringe HCPCS J1650 | $45.43 | $69.90 | $1.68 – $2.01 | 5 |
| Epinephrine 0.1 mg/ml injection syringe HCPCS J0168 | $73.61 | $113.25 | $35.70 – $35.70 | 1 |
| Epinephrine 1 mg/ml im kit - adult HCPCS J0169 | $11.99 | $18.45 | $3.24 – $3.24 | 1 |
| Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr HCPCS J0885 | $712.22 | $1,095.73 | $67.00 – $90.60 | 5 |
| Epstein barr early antigen antibody CPT 86663 | $89.70 | $138.00 | $11.67 – $16.40 | 5 |
| Epstein barr nuclear antigen antibody CPT 86664 | $79.95 | $123.00 | $13.60 – $19.11 | 5 |
| Epstein barr viral capsid antigen antibody igm CPT 86665 | $96.20 | $148.00 | $16.14 – $22.68 | 5 |
| Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr HCPCS J1335 | $676.65 | $1,041.00 | $17.90 – $22.02 | 5 |
| ER Visit (level 1, minor) CPT 99281 | $294.45 | $453.00 | $10.47 – $129.23 | 51 |
| ER Visit (level 2) CPT 99282 | $405.60 | $624.00 | $38.44 – $235.31 | 51 |
| ER Visit (level 3) CPT 99283 | $761.15 | $1,171.00 | $66.04 – $418.34 | 51 |
| ER Visit (level 4) CPT 99284 | $1,111.50 | $1,710.00 | $112.41 – $639.45 | 51 |
| ER Visit (level 5, high severity) CPT 99285 | $2,888.27 | $4,443.50 | $163.11 – $912.65 | 51 |
| Established Patient Office Visit (level 1) CPT 99211 | $137.15 | $211.00 | $20.03 – $38.05 | 5 |
| Established Patient Office Visit (level 2) CPT 99212 | $148.85 | $229.00 | $49.44 – $94.11 | 5 |
| Established Patient Office Visit (level 3) CPT 99213 | $133.25 | $205.00 | $79.99 – $151.81 | 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.