Top 40 services provided by MERCY ORTHOPEDIC HOSPITAL FORT SMITH
Services CPT Price Est. Cash Price
Upper endoscopy; diagnostic exam to diagnose or treat conditions in the upper part of your digestive tract. 43235 $2,000.00 $1,500.00
Epidural steroid injections for lower back pain 64483 $1,286.00 $964.50
CT scan of the head or brain without contrast or dye 70450 $1,709.00 $427.25
CT scan of the head or brain without contrast or dye 70450 $1,323.00 $992.25
MRI scan of the brain with and without contrast 70553 $3,456.00 $2,592.00
X-ray of the chest, 2 views 71046 $337.00 $252.75
X-ray of the lower spine with 4 or more views 72110 $551.00 $413.25
CT scan of the pelvis with contrast or dye 72193 $2,315.00 $1,736.25
CT scan of the pelvis with contrast or dye 72193 $2,114.00 $528.50
CT scan of the abdomen with contrast or dye 74160 $2,251.00 $1,688.25
Ultrasound of the abdomen 76700 $841.00 $630.75
Ultrasound for pregnancy after 1st trimester or after 14 weeks for a single baby or first baby for multiples 76805 $527.00 $395.25
Mammogram of both breasts 77067 $188.00 $141.00
Mammogram of both breasts 77067 $292.00 $219.00
Mammogram of both breasts 77067 $212.00 $159.00
Basic Metabolic Panel 80048 $155.00 $116.25
Comprehensive Metabolic Panel 80053 $187.00 $140.25
Comprehensive Metabolic Panel 80053 $270.00 $67.50
Lipid Panel 80061 $219.00 $54.75
Lipid Panel 80061 $100.00 $75.00
Urinalysis, by dipstick or tablet reagent automated with microscopy 81000 $85.00 $63.75
Urinalysis, by dipstick or tablet reagent not automated without a microscope 81001 $44.00 $33.00
Urinalysis, by dipstick or tablet reagent non-automated with microscopy 81002 $50.00 $37.50
Urinalysis, by dipstick or tablet reagent non-automated with microscopy 81002 $29.00 $21.75
Blood test for creatine kinase level; test for heart attack, stroke and for skeletal muscular damage 82550 $63.00 $47.25
Blood test that measures gases in the blood including the acidity, or pH, and the levels of oxygen (O2) and carbon dioxide (CO2) from an artery. 82805 $217.00 $162.75
Blood test that measures the amount of thyroid stimulating hormone (TSH). It helps determine how well your thyroid is functioning. 84443 $25.00 $18.75
Blood test that measures the amount of thyroid stimulating hormone (TSH). It helps determine how well your thyroid is functioning. 84443 $74.00 $55.50
Blood test that measures the amount of thyroid stimulating hormone (TSH). It helps determine how well your thyroid is functioning. 84443 $202.00 $50.50
Blood test used to test Troponin levels in the blood; generally used to diagnose heart attacks 84484 $200.00 $50.00
Blood test used to test Troponin levels in the blood; generally used to diagnose heart attacks 84484 $147.00 $110.25
Complete blood cell count (red cells, white blood cell, platelets), automated test 85025 $154.00 $38.50
Complete blood cell count (red cells, white blood cell, platelets), automated test 85025 $67.00 $50.25
Blood test for the amount of time it takes to form clots; called a Prothrombin Time (PT) test. 85610 $36.00 $27.00
Blood test for the amount of time it takes to form clots; called a Prothrombin Time (PT) test. 85610 $84.00 $21.00
Blood test for the amount of time it takes to form clots; called a Prothrombin Time (PT) test. 85610 $38.00 $28.50
Blood test for the amount of time it takes to form clots; called a Prothrombin Time (PT) test. 85610 $80.00 $60.00
Routine electrocardiogram (EKG) with tracing using at least 12 leads 93005 $286.00 $214.50
Ultrasound of chest to examine the heart 93307 $1,208.00 $906.00
Treatment to relieve airway obstruction or for sputum specimen; used to relieve conditions of COPD 94640 $104.00 $78.00
Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes 97110 $132.00 $99.00
Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes 97110 $97.00 $72.75
Training for walking to 1 or more areas for 15 minutes 97116 $86.00 $64.50
Training for walking to 1 or more areas for 15 minutes 97116 $208.00 $52.00
Physical therapy evaluation session for 20 minutes 97161 $295.00 $221.25
Physical therapy evaluation session for 20 minutes 97161 $255.00 $191.25
Physical therapy evaluation session for 20 minutes 97161 $568.00 $142.00
Physical therapy evaluation session for 20 minutes 97161 $215.00 $161.25
Physical therapy evaluation session for 20 minutes 97161 $135.00 $101.25
Physical therapy evaluation session for 20 minutes 97161 $335.00 $251.25
Physical therapy evaluation session for 20 minutes 97161 $175.00 $131.25
Office visit for an established patient (moderate severity) typically 15 minutes 99213 $228.00 $171.00
Office visit for an established patient (moderate severity) typically 15 minutes 99213 $108.00 $81.00
Office visit for an established patient (moderate severity) typically 15 minutes 99213 $1,174.00 $880.50
Office visit for an established patient (moderate severity) typically 15 minutes 99213 $1,501.00 $1,125.75
Office visit for an established patient (moderate severity) typically 15 minutes 99213 $546.00 $409.50
Office visit for an established patient (moderate severity) typically 15 minutes 99213 $792.00 $594.00
Emergency department visit facility fees for a visit of moderate severity 99283 $897.00 $224.25
Emergency department visit facility fees for a visit of moderate severity 99283 $652.00 $489.00
Emergency department visit facility fees for a visit of high to moderate severity 99284 $974.00 $730.50
Emergency department visit facility fees for a visit of high to moderate severity 99284 $1,244.00 $311.00