Supplies, drugs & other prices at Mercy Hospital Northwest Arkansas

Rogers, AR · every code in this section with a posted price and a Medicare benchmark.

96 codes. Prices are the hospital's own posted facility charges.

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ProcedureCash priceGross charge× Medicare
2d tee w or w/o fol w/con,in (C8925) $2,867.15 $4,411 3.9×
2d tte w or w/o fol w/con,co (C8923) $2,033.20 $3,128 2.8×
2d tte w or w/o fol w/con,fu (C8924) $1,363.70 $2,098 4.2×
Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance (0673T) $855.40 $1,316 0.6×
Adm tocilizu covid-19 1st (M0249) $438.75 $675 1.1×
Adm tocilizu covid-19 2nd (M0250) $482.95 $743 1.2×
Admin hepatitis b vaccine (G0010) $37.70 $58 0.9×
Admin influenza virus vac (G0008) $26 $40 0.6×
Admin pneumococcal vaccine (G0009) $28.60 $44 0.7×
Antibody, Treponema pallidum, total and rapid plasma reagin (RPR), immunoassay, qualitative Other Outpatient (0064U) $56.55 $87 1.8×
Catheterize for urine spec (P9612) $59.15 $91 6.3×
Chemo extend iv infus w/pump (G0498) $450.45 $693 1.5×
CYP1A2 (cytochrome P450 family 1, subfamily A, member 2) (eg, drug metabolism) gene analysis, common variants (ie, *1F,… (0031U) $490.75 $755 2.8×
Cyp2d6 gen com&slct rar vrnt (0070U) $629.85 $969 0.9×
Diab manage trn per indiv (G0108) $90.35 $139 1.6×
Diab manage trn ind/group (G0109) $59.15 $91 3.7×
Direct refer hospital observ (G0379) $409.50 $630 0.7×
Esophagogastroduodenoscopy , flexible, transoral, with volume adjustment of intragastric bariatric balloon (0813T) $2,003.95 $3,083 2.4×
Fern test (Q0114) $56.22 $86.50 5.8×
Hbot, full body chamber, 30m (G0277) $708.50 $1,090 5.5×
Histotripsy mal hepatocellular tiss w/img gdn (0686T)
likely a partial charge, not the full procedure
$3,974.10 $6,114 0.2×
Home sleep test/type 3 porta (G0399) $763.10 $1,174 3.8×
Ig paraprotein qual bld/ur (0077U) $198.25 $305 4.6×
Inj for sacroiliac jt anesth (G0260) $1,828.78 $2,813.50 2.8×
Intrav inf, toci, first dose (M0237) $482.95 $743 1.2×
Intrav inf, toci, second dos (M0238) $482.95 $743 1.2×
Jak2 Gene Analysis Trgt Seq Alys Exons 12-15 (0027U) $280.15 $431 2.3×
Liver dis 10 assays w/nash (0003M) $423.15 $651 0.8×
Mra w/cont, abd (C8900) $1,619.15 $2,491 5.0×
Mra w/cont, chest (C8909) $1,602.25 $2,465 4.9×
Mra w/cont, lwr ext (C8912) $1,452.75 $2,235 4.5×
Mra w/cont, pelvis (C8918) $2,114.45 $3,253 6.5×
Mra w/o cont, abd (C8901) $1,461.85 $2,249 6.6×
Mra w/o cont, chest (C8910) $1,406.60 $2,164 6.3×
Mra w/o cont, lwr ext (C8913) $1,214.20 $1,868 5.5×
Mra w/o cont, pelvis (C8919) $1,906.45 $2,933 8.6×
Mra w/o fol w/cont, abd (C8902) $1,647.10 $2,534 5.1×
Mra w/o fol w/cont, chest (C8911) $1,803.10 $2,774 5.5×
Mra w/o fol w/cont, lwr ext (C8914) $1,610.05 $2,477 4.9×
Mra w/o fol w/cont, pelvis (C8920) $2,376.40 $3,656 7.3×
Mri w/cont, breast, bi (C8906) $2,330.25 $3,585 7.2×
Mri w/cont, breast, uni (C8903) $1,569.75 $2,415 9.6×
Mri w/o fol w/cont, breast, (C8908) $2,665 $4,100 8.2×
Mri w/o fol w/cont, brst, un (C8905) $1,842.75 $2,835 5.7×
Neuro csf detcj prion prtn quakg conf conv qual (0035U) $149.50 $230 0.3×
Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography… (0712T) $1,215.50 $1,870 6.0×
Oth resp proc, group (G0239) $101.40 $156 2.9×
Oth resp proc, indiv (G0238) $80.60 $124 3.0×
Pathogen test for platelets (P9100) $59.15 $91 1.1×
Perc d-e cor revasc chro sin (C9607) $14,857.05 $22,857 0.9×
Perc d-e cor revasc t cabg s (C9604) $16,677.05 $25,657 1.5×
Perc d-e cor stent ather s (C9602) $10,104.90 $15,546 0.6×
Perc drug-el cor stent sing (C9600) $14,127.75 $21,735 1.3×
Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries, including right heart… (0793T) $12,711.40 $19,556 0.7×
Perq Sacral Augmt Bilat Inj (0201T) $5,480.80 $8,432 0.8×
Perq Sacral Augmt Unilat Inj (0200T) $8,763.95 $13,483 1.3×
Perq Tcat Ther Rx Dlvr Ntrac Rx Balo 1 Maj C Art (0913T) $14,389.70 $22,138 1.3×
Prgrmg dev eval ldls pm sys 2chmbr in person (0804T) $144.30 $222 4.1×
Psa screening (G0103) $117.65 $181 6.1×
Quan mr alys tis compj wo MRI same sess mlt orgn (0697T) $1,399.45 $2,153 1.6×
Quan mr alys tiss composition w/MRI mlt organs (0698T) $1,281.80 $1,972 1.5×
Quan us tiss charac i&r w/o dx us same anat (0689T) $290.55 $447 3.6×
Rbc DNA hea 35 ag 11 bld grp whl bld cmn allel (0001U) $527.80 $812 0.7×
Revasc intra lithotrip-ather (C9766) $11,823.50 $18,190 0.7×
Revasc intra lithotrip-stent (C9765) $12,928.50 $19,890 0.8×
Revasc intravasc lithotripsy (C9764) $8,287.50 $12,750 0.8×
Revasc lith-sten-ath tib/per (C9775) $23,920 $36,800 1.4×
Revasc lithotr-ather tib/per (C9774) $17,491.50 $26,910 1.0×
Revasc lithotr-stent tib/per (C9773) $12,928.50 $19,890 0.8×
Revasc lithotrip tibi/perone (C9772) $12,928.50 $19,890 1.2×
Revasc lithotrip-stent-ather (C9767) $17,680 $27,200 1.0×
Scr c/v cyto,thinlayer,rescr (G0145) $69.55 $107 2.6×
Tcat insj perm 1chmbr ldls pacemaker r atrial (0823T) $19,249.10 $29,614 1.1×
Tcat insj perm 2chmbr ldls pm r atr pm compnt (0796T) $21,143.85 $32,529 1.2×
Tcat insj perm 2chmbr ldls pm r ventr pm compnt (0797T) $19,029.40 $29,276 1.1×
Tcat Insj Perm Dual Chamber Ldls Pm Compl Sys (0795T) $21,143.85 $32,529 1.2×
Tcat rmvl perm 2chmbr ldls pm r atr pm compnt (0799T) $2,250.95 $3,463 0.8×
Tcat rmvl perm 2chmbr ldls pm r ventr pm compnt (0800T) $2,250.95 $3,463 0.8×
Tcat rmvl perm dual chamber ldls pm compl sys (0798T) $2,250.95 $3,463 0.8×
Tcat rmvl&rplcmt perm 2chmbr ldls pm 2chmbr sys (0801T)
likely a partial charge, not the full procedure
$2,250.95 $3,463 0.1×
Tcat rmvl&rplcmt perm 2chmbr ldls pm r atr cmpnt (0802T)
likely a partial charge, not the full procedure
$2,250.95 $3,463 0.1×
Tcat rmvl&rplcmt prm 2chmbr ldls pm r vntr cmpnt (0803T)
likely a partial charge, not the full procedure
$2,250.95 $3,463 0.1×
Tcat Rmvl/Debulk Icar Mass Suction Device Perq (0644T) $14,139.45 $21,753 2.7×
Therapeutic procd strg endur (G0237) $80.60 $124 3.0×
Tomosynthesis, mammo (G0279) $61.75 $95 4.9×
Tpmt Nudt15 Gene Analysis Common Variants (0034U) $351.65 $541 0.8×
Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation;… (0236T) $7,673.25 $11,805 0.7×
Trauma respons w/hosp criti (G0390) $3,124.55 $4,807 2.5×
Trluml Perip Athrc Renal Art (0234T) $9,734.40 $14,976 0.9×
Trluml periph athrc w/rs&i brchiocphl ea vsl (0237T) $8,876.40 $13,656 0.8×
Trluml peripheral atherectomy iliac artery ea (0238T) $12,052.95 $18,543 0.7×
Tte w or w/o contr, cont ecg (C8930) $2,242.50 $3,450 3.1×
Tte w or w/o fol w/con,stres (C8928) $2,139.80 $3,292 2.9×
Tte w or wo fol wcon,doppler (C8929) $2,715.70 $4,178 3.7×
Unsched dialysis esrd pt hos (G0257) $1,753.05 $2,697 2.7×
Visit to determ ldct elig (G0296) $16.25 $25 0.2×