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 |
|---|---|---|---|---|
| Established Patient Office Visit (level 4) CPT 99214 | $170.95 | $263.00 | $113.10 – $216.61 | 5 |
| Established Patient Office Visit (level 5) CPT 99215 | $226.85 | $349.00 | $159.49 – $307.70 | 5 |
| Estradiol total CPT 82670 | $137.15 | $211.00 | $24.85 – $34.93 | 6 |
| Ethylene glycol -sendout CPT 82693 | $108.55 | $167.00 | $13.25 – $13.25 | 4 |
| Eval/fit voice prosthesis iii, st CPT 92607 | $321.75 | $495.00 | $109.47 – $109.47 | 4 |
| Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen CPT 84112 | $172.25 | $265.00 | $87.27 – $122.64 | 5 |
| Exercise tst brncspsm w/ecg CPT 94617 | $239.20 | $368.00 | $76.43 – $231.08 | 5 |
| External chromosome analysis 20-25 cells CPT 88264 | $376.35 | $579.00 | $128.63 – $195.22 | 6 |
| External tissue culture neoplastic disorders bone marrow/blood cells CPT 88237 | $295.10 | $454.00 | $127.86 – $194.06 | 6 |
| Extractable nuclear antigen/antibody any method each antibody centromere CPT 86235 | $111.80 | $172.00 | $15.95 – $24.21 | 7 |
| Facial bones <3 CPT 70140 | $251.55 | $387.00 | $18.86 – $200.05 | 5 |
| Factor ix CPT 85250 | $139.75 | $215.00 | $16.94 – $23.80 | 5 |
| Factor viii CPT 85240 | $138.45 | $213.00 | $15.92 – $22.38 | 5 |
| Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr HCPCS J1308 | $7.15 | $11.00 | $0.40 – $0.40 | 1 |
| Fatty acids nonesterified CPT 82725 | $79.30 | $122.00 | $16.70 – $23.46 | 5 |
| #fecal-sodium CPT 84302 | $39.65 | $61.00 | $4.32 – $6.08 | 5 |
| Felbamate (felbatol(r)) - sendout CPT 80167 | $119.60 | $184.00 | $16.58 – $16.58 | 4 |
| Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper) HCPCS J3010 | $25.56 | $39.32 | $0.85 – $1.44 | 5 |
| Ferritin CPT 82728 | $92.30 | $142.00 | $12.12 – $17.04 | 5 |
| Fetal chrom aneuploidy gsa panel CPT 81420 | $1,140.10 | $1,754.00 | $675.16 – $675.16 | 4 |
| Fetal fibronectin CPT 82731 | $354.25 | $545.00 | $57.29 – $106.28 | 50 |
| Fetal hemoglobin (kleihauer betke) CPT 85460 | $113.75 | $175.00 | $6.88 – $9.66 | 5 |
| Fibrin degradation d dimer quantitative CPT 85379 | $114.40 | $176.00 | $9.05 – $16.80 | 52 |
| Fibrinogen activity CPT 85384 | $89.05 | $137.00 | $8.65 – $12.15 | 5 |
| Fibrinolysins/coagulopathy screen interpretation/report CPT 85390 | $53.95 | $83.00 | $13.77 – $19.35 | 5 |
| Fibrinolytic antiplasmin CPT 85410 | $69.55 | $107.00 | $6.86 – $6.86 | 4 |
| Fibrinolytic plasminogen CPT 85415 | $75.40 | $116.00 | $15.29 – $21.49 | 5 |
| Fibrinolytic plasminogen xcpt antgnc asa CPT 85420 | $86.45 | $133.00 | $5.81 – $5.81 | 4 |
| Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr HCPCS J1442 | $889.33 | $1,368.20 | $294.00 – $378.00 | 5 |
| Finasteride, 5 mg HCPCS S0138 | $4.87 | $7.50 | $0.14 – $0.14 | 1 |
| Flecainide (tambocor)-sendout CPT 80181 | $130.00 | $200.00 | $16.58 – $23.30 | 5 |
| Flow cytometry marker each additional CPT 88185 | $100.10 | $154.00 | $19.72 – $25.73 | 5 |
| Flow cytometry one marker technical component CPT 88184 | $229.45 | $353.00 | $64.93 – $640.87 | 5 |
| #flow interp 9 - 15 markers CPT 88188 | $189.15 | $291.00 | $54.19 – $70.19 | 5 |
| Flt3 gene CPT 81245 | $421.20 | $648.00 | $147.22 – $206.89 | 5 |
| Flt3 gene analysis CPT 81246 | $460.85 | $709.00 | $73.83 – $103.75 | 5 |
| Fluidotherapy charges pt CPT 97022 | $101.40 | $156.00 | $14.72 – $24.80 | 5 |
| Fluorescent antibody titer dna CPT 86256 | $137.80 | $212.00 | $10.72 – $19.88 | 51 |
| Folic acid CPT 82746 | $81.90 | $126.00 | $13.08 – $24.26 | 42 |
| Folic acid 5 mg/ml injection solution HCPCS J1808 | $355.19 | $546.45 | $30.00 – $30.00 | 1 |
| Foot X-ray CPT 73630 | $304.20 | $468.00 | $21.91 – $200.05 | 5 |
| Fresh frozen plasma frozen within 8 hours of collection each unit HCPCS P9017 | $208.00 | $320.00 | $52.21 – $107.48 | 5 |
| Fructosamine glycated protein CPT 82985 | $63.05 | $97.00 | $14.91 – $20.95 | 5 |
| Ftl cgen abnor four anal CPT 81511 | $200.85 | $309.00 | $191.88 – $191.88 | 1 |
| Furosemide 10 mg/ml injection solution HCPCS J1938 | $7.15 | $11.00 | $0.40 – $0.40 | 1 |
| Galac-1-phosphate uridyltran - sendout CPT 82775 | $151.45 | $233.00 | $18.74 – $26.34 | 5 |
| Gammaglobulin iga CPT 82784 | $98.80 | $152.00 | $8.27 – $11.63 | 5 |
| Gammaglobulin ige CPT 82785 | $87.10 | $134.00 | $14.64 – $20.58 | 7 |
| Gamma glutamyltransferase CPT 82977 | $63.70 | $98.00 | $6.40 – $9.00 | 5 |
| Gentamicin 10 mg/ml liquid compound - enteral use only HCPCS J1580 | $34.27 | $52.73 | $2.39 – $2.47 | 5 |
| Gentamicin peak therapeutic drug level CPT 80170 | $84.50 | $130.00 | $14.57 – $20.48 | 5 |
| Ghs abscess perianal iandd CPT 46050 | $399.10 | $614.00 | $96.34 – $201.35 | 11 |
| Ghs acetylcholinesterase, rbc CPT 82482 | $59.15 | $91.00 | $8.73 – $8.73 | 4 |
| Ghs antibodies (torch) igm CPT 86694 | $79.95 | $123.00 | $12.80 – $17.99 | 5 |
| Ghs bladder cath - complex-foley CPT 51703 | $330.20 | $508.00 | $139.33 – $262.92 | 5 |
| Ghs change cysto/gastrost CPT 43762 | $286.00 | $440.00 | $32.28 – $510.52 | 51 |
| Ghs chlamydia pneumoniae by pcr (arup) (306630) CPT 87486 | $133.25 | $205.00 | $31.21 – $31.21 | 4 |
| Ghs closd tx interphalang jt disloc w/ma CPT 26770 | $437.45 | $673.00 | $261.35 – $469.79 | 50 |
| Ghs closed reduction ankle dislocation CPT 27840 | $777.40 | $1,196.00 | $347.09 – $691.80 | 50 |
| Ghs closed tx bimalleolar fracture w/manip CPT 27810 | $930.80 | $1,432.00 | $422.57 – $1,425.19 | 50 |
| Ghs closed tx radiocarpal disloc w manip CPT 25660 | $653.90 | $1,006.00 | $401.23 – $682.34 | 50 |
| Ghs closed tx tibial fracture w/manip CPT 27752 | $1,363.70 | $2,098.00 | $457.20 – $1,425.19 | 50 |
| Ghs clsd red med malleolus fx without manip CPT 27760 | $589.55 | $907.00 | $290.19 – $488.09 | 50 |
| Ghs cl tx metacarpophal disloc without anes CPT 26700 | $622.05 | $957.00 | $306.64 – $532.64 | 50 |
| Ghs conjunctiva foreign body-superf bil CPT 65205 | $105.95 | $163.00 | $23.08 – $271.86 | 51 |
| Ghs corneal fb without slit lamp bilat CPT 65220 | $200.85 | $309.00 | $35.32 – $59.40 | 50 |
| Ghs corneal fb with slit lamp bilat CPT 65222 | $157.30 | $242.00 | $39.50 – $271.86 | 51 |
| Ghs dislocation elbow closed treatment CPT 24600 | $683.80 | $1,052.00 | $339.77 – $614.20 | 50 |
| Ghs excision ingrown nail CPT 11765 | $175.50 | $270.00 | $82.36 – $830.64 | 51 |
| Ghs eyelid foreign body-embedded - bil CPT 67938 | $310.05 | $477.00 | $92.74 – $228.85 | 50 |
| Ghs fb removal - incisional CPT 10121 | $500.50 | $770.00 | $159.11 – $1,442.85 | 50 |
| Ghs fish cytogen CPT 88271 | $266.50 | $410.00 | $19.05 – $26.78 | 5 |
| Ghs fish hybrid in situ 100-300 CPT 88275 | $126.10 | $194.00 | $45.53 – $63.99 | 5 |
| Ghs flow volume loop CPT 94375 | $275.60 | $424.00 | $33.50 – $441.20 | 5 |
| Ghs gastric intub aspiration lavage CPT 43753 | $286.00 | $440.00 | $19.11 – $441.20 | 51 |
| Ghs hgb stability-thal CPT 83068 | $82.55 | $127.00 | $8.42 – $15.63 | 52 |
| Ghs histoplasma antigen CPT 87385 | $176.80 | $272.00 | $11.79 – $16.56 | 5 |
| Ghs HIV antibody CPT 86703 | $87.75 | $135.00 | $7.91 – $17.14 | 5 |
| Ghs i and d pilonidal cyst complex CPT 10081 | $557.05 | $857.00 | $155.26 – $1,446.94 | 51 |
| Ghs i and d pilonidal cyst simple CPT 10080 | $267.15 | $411.00 | $96.35 – $213.04 | 50 |
| Ghs immun0electrophoresis CPT 86320 | $131.95 | $203.00 | $26.61 – $26.61 | 4 |
| Ghs inhibitor screen CPT 85335 | $167.05 | $257.00 | $11.45 – $21.24 | 52 |
| Ghs init tx 1st degree burn CPT 16000 | $117.65 | $181.00 | $39.54 – $409.96 | 51 |
| Ghs insertion of needle - bone CPT 36680 | $221.00 | $340.00 | $52.69 – $91.01 | 50 |
| Ghs intermed repair 12.6 - 20.0 cm-12035 CPT 12035 | $613.60 | $944.00 | $207.26 – $348.60 | 50 |
| Ghs layer closure 2.5 cm or less - 12031 CPT 12031 | $399.10 | $614.00 | $123.32 – $830.64 | 51 |
| Ghs layer closure 2.5 cm or less - 12041 CPT 12041 | $382.20 | $588.00 | $120.07 – $830.64 | 51 |
| Ghs layer closure 2.5cm or less - 12051 CPT 12051 | $458.25 | $705.00 | $138.34 – $830.64 | 51 |
| Ghs layer closure 2.6 - 5.0 cm - 12052 CPT 12052 | $433.55 | $667.00 | $160.60 – $830.64 | 51 |
| Ghs layer closure 2.6 - 7.5 cm - 12042 CPT 12042 | $433.55 | $667.00 | $156.65 – $830.64 | 51 |
| Ghs layer closure 5.1 - 7.5 cm - 12053 CPT 12053 | $586.30 | $902.00 | $174.07 – $313.32 | 50 |
| Ghs layer closure 7.6 - 12.5 cm - 12034 CPT 12034 | $573.30 | $882.00 | $167.23 – $830.64 | 51 |
| Ghs layer closure 7.6 - 12.5 cm - 12044 CPT 12044 | $542.75 | $835.00 | $177.19 – $1,510.16 | 51 |
| Ghs layer closure 7.6 - 12.5 cm - 12054 CPT 12054 | $703.95 | $1,083.00 | $183.56 – $330.26 | 50 |
| Ghs layered repair 12.6 - 20.0 cm -12055 CPT 12055 | $707.85 | $1,089.00 | $271.18 – $456.11 | 50 |
| Ghs mbp CPT 83873 | $115.05 | $177.00 | $15.30 – $21.50 | 5 |
| Ghs moderate sedation < 5 yr, 30 min CPT 99151 | $180.70 | $278.00 | $52.17 – $97.16 | 5 |
| Ghs moderate sedation ea addtl 15 min CPT 99153 | $167.70 | $258.00 | $9.67 – $19.14 | 5 |
| Ghs nailbed repair/nail removal CPT 11760 | $444.60 | $684.00 | $96.33 – $1,510.16 | 51 |
| Ghs ot dds rom CPT 95851 | $56.55 | $87.00 | $18.57 – $40.46 | 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.