Does Mercy Hospital Logan County have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Mercy Hospital Logan County. In a medical emergency, call 911.

Where is Mercy Hospital Logan County?

200 S Academy Rd, Guthrie, OK 73044, in Logan County, Oklahoma.

What is the phone number of Mercy Hospital Logan County?

(405) 282-6700, as listed by Medicare (CMS).

What is the Medicare star rating of Mercy Hospital Logan County?

CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Mercy Hospital Logan County — Guthrie, OK

Quick answers

Does Mercy Hospital Logan County have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Mercy Hospital Logan County. In a medical emergency, call 911.
Where is Mercy Hospital Logan County?: 200 S Academy Rd, Guthrie, OK 73044, in Logan County, Oklahoma.
What is the phone number of Mercy Hospital Logan County?: (405) 282-6700, as listed by Medicare (CMS).
What is the Medicare star rating of Mercy Hospital Logan County?: CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Specialties and care areas^[4][5]

Cardiology
Hematology/oncology
Obstetrics and gynecology
Orthopedics
Podiatry
Pulmonology
Nephrology
Spine care and pain management
Sports medicine and rehabilitation

Conditions treated^[5]

Treatments^[4][5]

Wound care
Diabetes education
Therapy services
Sleep center
Respiratory care
Infusion services
Imaging services
Laboratory services
IV fluids and hydration
IV antibiotics
Blood transfusions
Therapeutic phlebotomy
Port draws and flushes
PICC line maintenance
Cortisol stimulation testing

Programs and centers^[4][5]

Swing bed program
Senior Life Solutions
Infusion therapy

Emergency care (hospital website)^[5]

Emergency room	Yes
Stroke designation	Level 3 stroke center (State of Oklahoma designation)

Visiting and practical information

Visiting	Open visiting 24/7; ICU limited to two visitors at a time; children under 12 need adult supervision^[5]
Interpreters and languages	Free medical interpreters and translation services; hearing-impaired aids at no cost^[5]

Recognition^[5]

Level 3 stroke center (designated by the State of Oklahoma)

Doctors and clinicians (148)

148 doctors and other clinicians list Mercy Hospital Logan County as a hospital where they work, in Medicare's official clinician data (updated 2026-10-02). It is not a complete staff list.

Main specialties

And 124 more: the button below opens the full list.

Other emergency rooms nearby

Hospitals that list emergency services, by straight-line distance (not driving distance).

INTEGRIS Health Edmond Hospital12 mi · Edmond, OK · Acute Care Hospital
Summit Medical Center, LLC17 mi · Edmond, OK · Acute Care Hospital
Oklahoma Spine Hospital19 mi · Oklahoma City, OK · Acute Care Hospital
Oklahoma Heart Hospital, LLC20 mi · Oklahoma City, OK · Acute Care Hospital
Mercy Hospital Oklahoma City, Inc20 mi · Oklahoma City, OK · Acute Care Hospital

Other hospitals nearby

Okc-Amg Specialty Hospital20 mi · Oklahoma City, OK · Long-Term Acute Care Hospital

Nursing homes, hospice, home health and dialysis nearby

Medicare-certified providers within 25 miles, by straight-line distance. Hospice and home health care is given at home: their address is the office.

Nursing homes

Willow Creek Health Care0.5 mi · Guthrie, OK · 3 of 5 stars
Golden Age Nursing Home of Guthrie, LLC2.2 mi · Guthrie, OK · 5 of 5 stars
Bradford Village Healthcare Center12 mi · Edmond, OK · 4 of 5 stars

All nursing homes in the state →

Hospice providers

Companion Hospice, L.L.C.1.6 mi · Guthrie, OK · 4 of 5 stars
Traditions Health of Edmond14 mi · Edmond, OK · 3 of 5 stars
Caring Hearts Hospice Inc16 mi · Edmond, OK

All hospice providers in the state →

Home health agencies

Companion Home Health, LLC1.6 mi · Guthrie, OK
Lifespring Edmond Home Health12 mi · Edmond, OK · 5 of 5 stars
Traditions Health of Central Oklahoma14 mi · Edmond, OK · 4 of 5 stars

All home health agencies in the state →

Dialysis facilities

Fmcna - Edmond East12 mi · Edmond, OK · 2 of 5 stars
Fmcna - Oklahoma Kidney Care DX, LLC19 mi · Oklahoma City, OK · 3 of 5 stars
Fresenius Kidney Care Okcd Northlake19 mi · Oklahoma City, OK · 3 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

Medicare-certified ambulatory surgery centers within 25 miles, by straight-line distance.

Cataract Institute of Oklahoma, LLC18 mi · Edmond, OK
Advanced Surgical & Research Solutions, LLC19 mi · Oklahoma City, OK
Oklahoma Surgicare19 mi · Oklahoma City, OK

All outpatient surgery centers in the state →

Community care nearby

Health centers, clinics, urgent care and pharmacies closest to this hospital, by straight-line distance, from official HRSA, Medicare and NPI Registry data. In a medical emergency, call 911.

Community health centers

Mary Mahoney Hlth Ctr @ Langston13 mi · Langston, OK · Community health center
Variety Care Turtle Creek-Edmond16 mi · Edmond, OK · Community health center
Britton Health Center22 mi · Oklahoma City, OK · Community health center

Clinics and urgent care

Mercy Hospital Logan County -Guthrie Division Primary Care1.6 mi · Guthrie, OK · Rural health clinic
Xpress Wellness Urgent Care1.6 mi · Guthrie, OK · Rural health clinic
Mercy Hospital Logan County-Crescent Primary Care12 mi · Crescent, OK · Rural health clinic

Pharmacies

Anderson-Britton LLC1.6 mi · Guthrie, OK · Community/retail pharmacy
Simplified RX Inc1.6 mi · Guthrie, OK · Community/retail pharmacy
Wal-Mart Stores East LP1.6 mi · Guthrie, OK · Community/retail pharmacy

Assisted living nearby

Licensed homes from the official state licence list, by straight-line distance.

Ash Street Place1.6 mi · Guthrie, OK
Eden Care - Oak Tree12 mi · Edmond, OK
Bradford Village Healthcare Center12 mi · Edmond, OK
Jasmine Estates of Edmond12 mi · Edmond, OK

About the Medicare star rating

CMS (the federal Medicare agency) gives many hospitals an overall rating from 1 to 5 stars, based on measures of mortality, safety, readmissions, patient experience and timely care. It is one piece of information: ask your doctor what matters for your care. See the full Medicare profile →

Medicare quality data

What Mercy Hospital Logan County reported to Medicare (CMS), the federal agency that publishes these results for hospitals nationwide. These are averages for many patients, not a prediction for any one person: ask your doctor what matters for your care. In a medical emergency, call 911.

What patients said (patient survey)

What this means: Patients who stayed overnight answered a national survey (HCAHPS) about their stay. More stars mean patients reported a better experience than at other hospitals. The percentages show how often patients gave the best answer, next to the national average.

Summary star rating (all survey topics)	Not reported to Medicare
Overall rating of the hospital	Not reported to Medicare
Would recommend the hospital	Not reported to Medicare
Nurses communicated well	Not reported to Medicare
Doctors communicated well	Not reported to Medicare
Staff explained medicines	Not reported to Medicare
Information about recovery at home	Not reported to Medicare
Room and bathroom kept clean	Not reported to Medicare
Quiet at night	Not reported to Medicare
Rated the hospital 9 or 10 out of 10	71%National average: 72%
Would definitely recommend the hospital	71%National average: 71%
Nurses “always” communicated well	77%National average: 80%
Doctors “always” communicated well	71%National average: 80%
Staff “always” explained medicines before giving them	50%National average: 62%
Were given information about recovery at home	82%National average: 86%
Room and bathroom “always” clean	69%National average: 74%
Area around the room “always” quiet at night	69%National average: 60%
Completed surveys	74Response rate: 19%

Source: Patient survey (HCAHPS) - Hospital — CMS, released July 22, 2026; patients discharged October 2024 to September 2025.

Infections caught in the hospital

What this means: CMS compares the number of infections patients caught in this hospital with the number expected for a hospital like it. The number shown is that ratio: below 1 means fewer infections than expected, above 1 means more. “Better” or “worse” is shown only when the difference is clear in the data.

Central line bloodstream infections (CLABSI)	Not reported to Medicare
Catheter-associated urinary tract infections (CAUTI)	1.847No different from the national benchmark
Surgical site infections after colon surgery	Not reported to Medicare
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	Not reported to Medicare
Clostridioides difficile (C. diff) intestinal infections	0No different from the national benchmark

Source: Healthcare Associated Infections - Hospital — CMS, released July 22, 2026; data from October 2024 to September 2025.

Complications and deaths

What this means: Death rates are the share of patients who died within 30 days of going into the hospital for that condition, adjusted for how sick they were. PSI-90 combines several serious complications (a lower number is better). “No different from the national rate” is the most common result and means the hospital is in line with hospitals nationwide.

Deaths within 30 days: heart attack patients	Not reported to Medicare
Deaths within 30 days: heart failure patients	Too few cases to report
Deaths within 30 days: pneumonia patients	13.5%
Deaths within 30 days: COPD patients	Too few cases to report
Deaths within 30 days: stroke patients	Too few cases to report
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	Not reported to Medicare
Complications after hip or knee replacement	Not reported to Medicare

Source: Complications and Deaths - Hospital — CMS, released September 10, 2026; data from July 2022 to June 2025.

Return visits to the hospital (readmissions)

What this means: The share of patients who had to be admitted to a hospital again within 30 days after going home, adjusted for how sick they were. A lower percentage is better.

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	Not reported to Medicare
Readmitted within 30 days: heart failure	Too few cases to report
Readmitted within 30 days: pneumonia	16.7%
Readmitted within 30 days: COPD	Too few cases to report
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	Not reported to Medicare

Source: Unplanned Hospital Visits - Hospital — CMS, released September 10, 2026; data from July 2023 to June 2025.

Emergency room times and sepsis care

What this means: ER time is the middle (median) time from arriving at the emergency room to leaving it; busier ERs usually have longer times, so the ER volume is shown too. Leaving before being seen: a lower percentage is better. Sepsis is a life-threatening reaction to an infection; a higher percentage means more patients got every recommended early step.

Emergency room volume (patients per year)	Low (under 20,000)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	68 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	0%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	Not reported to Medicare

Source: Timely and Effective Care - Hospital — CMS, released July 22, 2026; data from January 2024 to December 2024.

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

How this hospital compares with others in the area, ranked only by official Medicare (CMS) numbers.

ER wait times in Oklahoma Best hospitals in Oklahoma

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 55 common services exactly as Mercy Hospital Logan County lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

Hospital charge: The hospital’s list price (“gross charge”) before any discount or insurance. Few people pay this amount.
Cash price: The price the hospital offers if you pay yourself, without insurance (“discounted cash price”).
Insurance rates: The lowest and highest amounts the hospital has agreed with any insurance plan for the service (“de-identified minimum and maximum”), and some of the rates it lists by insurer and plan. Your share depends on your deductible, copay and coinsurance.
Hospital and doctor fees: A service can have a hospital (facility) fee and a separate doctor (professional) fee; the total for your care can include both, plus other services.

How to use hospital prices: estimates, financial assistance and your rights →

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CAH OP Visit Level III New Pt Mlp	$288	$187.20	$67.95 – $98.08
New patient office visit (about 30–44 minutes): 10 of 32 insurance plan rates AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $98.08 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $67.95 BCBS MEDICARE ADVANTAGE [20047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $67.95 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $67.95 BLUE CROSS AND BLUE SHIELD [20053] — HB LGNOK BCBS OF OK NATIVEBLUE MCR 103% (NO SEQ): $69.27 CIGNA MEDICARE ADVANTAGE CONTRACTED [320072] — HB LGNOK CIGNA MCR W/SEQ 103%: $70.03 DEPT OF VETERAN AFFAIRS CONTRACTED [320106] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $67.95 DEVOTED HEALTH MEDICARE CONTRACTED [320500] — HB LGNOK DEVOTED HEALTH MCR 104% W/O SEQ: $69.31 ESSENCE HEALTHCARE MEDICARE CONTRACTED [320122] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $67.95 GLOBALHEALTH CONTRACTED [320145] — HB LGNOK GLOBALHEALTH MCR 102% W/SEQ: $69.31
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OP Visit Level III New Pt Pf	$306	$198.90	$67.95 – $98.08
New patient office visit (about 30–44 minutes): 10 of 32 insurance plan rates AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $98.08 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $67.95 BCBS MEDICARE ADVANTAGE [20047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $67.95 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $67.95 BLUE CROSS AND BLUE SHIELD [20053] — HB LGNOK BCBS OF OK NATIVEBLUE MCR 103% (NO SEQ): $69.27 CIGNA MEDICARE ADVANTAGE CONTRACTED [320072] — HB LGNOK CIGNA MCR W/SEQ 103%: $70.03 DEPT OF VETERAN AFFAIRS CONTRACTED [320106] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $67.95 DEVOTED HEALTH MEDICARE CONTRACTED [320500] — HB LGNOK DEVOTED HEALTH MCR 104% W/O SEQ: $69.31 ESSENCE HEALTHCARE MEDICARE CONTRACTED [320122] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $67.95 GLOBALHEALTH CONTRACTED [320145] — HB LGNOK GLOBALHEALTH MCR 102% W/SEQ: $69.31
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OP Visit Level III New Pt	$306	$198.90	$69.27 – $98.08
New patient office visit (about 30–44 minutes): rates for 6 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $98.08 BLUE CROSS AND BLUE SHIELD [20053] — HB LGNOK BCBS OF OK NATIVEBLUE MCR 103% (NO SEQ): $69.27 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $73.24 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $98.08 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $98.08 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $98.08
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CAH OP Visit Level IV New Pt Mlp	$392	$254.80	$111.17 – $147.66
New patient office visit (about 45–59 minutes): 10 of 32 insurance plan rates AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $147.66 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $111.17 BCBS MEDICARE ADVANTAGE [20047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $111.17 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $111.17 BLUE CROSS AND BLUE SHIELD [20053] — HB LGNOK BCBS OF OK NATIVEBLUE MCR 103% (NO SEQ): $113.32 CIGNA MEDICARE ADVANTAGE CONTRACTED [320072] — HB LGNOK CIGNA MCR W/SEQ 103%: $114.57 DEPT OF VETERAN AFFAIRS CONTRACTED [320106] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $111.17 DEVOTED HEALTH MEDICARE CONTRACTED [320500] — HB LGNOK DEVOTED HEALTH MCR 104% W/O SEQ: $113.39 ESSENCE HEALTHCARE MEDICARE CONTRACTED [320122] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $111.17 GLOBALHEALTH CONTRACTED [320145] — HB LGNOK GLOBALHEALTH MCR 102% W/SEQ: $113.39
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OP Visit Level IV New Pt Pf	$416	$270.40	$111.17 – $147.66
New patient office visit (about 45–59 minutes): 10 of 32 insurance plan rates AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $147.66 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $111.17 BCBS MEDICARE ADVANTAGE [20047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $111.17 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $111.17 BLUE CROSS AND BLUE SHIELD [20053] — HB LGNOK BCBS OF OK NATIVEBLUE MCR 103% (NO SEQ): $113.32 CIGNA MEDICARE ADVANTAGE CONTRACTED [320072] — HB LGNOK CIGNA MCR W/SEQ 103%: $114.57 DEPT OF VETERAN AFFAIRS CONTRACTED [320106] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $111.17 DEVOTED HEALTH MEDICARE CONTRACTED [320500] — HB LGNOK DEVOTED HEALTH MCR 104% W/O SEQ: $113.39 ESSENCE HEALTHCARE MEDICARE CONTRACTED [320122] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $111.17 GLOBALHEALTH CONTRACTED [320145] — HB LGNOK GLOBALHEALTH MCR 102% W/SEQ: $113.39
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OP Visit Level IV New Pt	$351	$228.15	$113.32 – $147.66
New patient office visit (about 45–59 minutes): rates for 6 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $147.66 BLUE CROSS AND BLUE SHIELD [20053] — HB LGNOK BCBS OF OK NATIVEBLUE MCR 103% (NO SEQ): $113.32 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $119.81 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $147.66 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $147.66 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $147.66
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CAH OP Visit Level V New Pt Mlp	$458	$297.70	$152.10 – $378.40
New patient office visit (about 60–74 minutes): 10 of 48 insurance plan rates AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $194.93 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $152.10 AMBETTER CONTRACTED [320452] — HB LGNOK AMBETTER EXCHANGE MEDICARE: $209.32 BCBS MEDICARE ADVANTAGE [20047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $152.10 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $152.10 BLUE CROSS AND BLUE SHIELD [20053] — HB LGNOK BCBS OF OK NATIVEBLUE MCR 103% (NO SEQ): $159.70 CENTIVO CONTRACTED [320505] — HB LGNOK CENTIVO MCR 165%: $255.83 CHEROKEE NATION HEALTH SERV CONTRACTED [320066] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $152.10 CIGNA MEDICARE ADVANTAGE CONTRACTED [320072] — HB LGNOK CIGNA MCR W/SEQ 103%: $156.76 CROSS TIMBERS HOSPICE [20098] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $152.10
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OP Visit Level V New Pt Pf	$538	$349.70	$152.10 – $378.40
New patient office visit (about 60–74 minutes): 10 of 48 insurance plan rates AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $194.93 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $152.10 AMBETTER CONTRACTED [320452] — HB LGNOK AMBETTER EXCHANGE MEDICARE: $209.32 BCBS MEDICARE ADVANTAGE [20047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $152.10 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $152.10 BLUE CROSS AND BLUE SHIELD [20053] — HB LGNOK BCBS OF OK NATIVEBLUE MCR 103% (NO SEQ): $159.70 CENTIVO CONTRACTED [320505] — HB LGNOK CENTIVO MCR 165%: $255.83 CHEROKEE NATION HEALTH SERV CONTRACTED [320066] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $152.10 CIGNA MEDICARE ADVANTAGE CONTRACTED [320072] — HB LGNOK CIGNA MCR W/SEQ 103%: $156.76 CROSS TIMBERS HOSPICE [20098] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $152.10
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OP Visit Level V New Pt	$439	$285.35	$194.93 – $378.40
New patient office visit (about 60–74 minutes): rates for 5 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $194.93 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $378.40 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $194.93 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $194.93 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $194.93
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CAH OP Visit Level III Est Pt Mlp	$212	$137.80	$54.82 – $151.81
Established patient office visit (about 20–29 minutes): 10 of 49 insurance plan rates AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $79.99 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $54.82 AMBETTER CONTRACTED [320452] — HB LGNOK AMBETTER EXCHANGE MEDICARE: $75.44 BCBS MEDICARE ADVANTAGE [20047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $54.82 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $54.82 BLUE CROSS AND BLUE SHIELD [20053] — HB LGNOK BCBS OF OK NATIVEBLUE MCR 103% (NO SEQ): $57.56 CENTIVO CONTRACTED [320505] — HB LGNOK CENTIVO MCR 165%: $92.20 CHEROKEE NATION HEALTH SERV CONTRACTED [320066] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $54.82 CIGNA MEDICARE ADVANTAGE CONTRACTED [320072] — HB LGNOK CIGNA MCR W/SEQ 103%: $56.49 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $150.09
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OP Visit Level III Est Pt Pf	$224	$145.60	$54.82 – $151.81
Established patient office visit (about 20–29 minutes): 10 of 49 insurance plan rates AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $79.99 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $54.82 AMBETTER CONTRACTED [320452] — HB LGNOK AMBETTER EXCHANGE MEDICARE: $75.44 BCBS MEDICARE ADVANTAGE [20047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $54.82 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $54.82 BLUE CROSS AND BLUE SHIELD [20053] — HB LGNOK BCBS OF OK NATIVEBLUE MCR 103% (NO SEQ): $57.56 CENTIVO CONTRACTED [320505] — HB LGNOK CENTIVO MCR 165%: $92.20 CHEROKEE NATION HEALTH SERV CONTRACTED [320066] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $54.82 CIGNA MEDICARE ADVANTAGE CONTRACTED [320072] — HB LGNOK CIGNA MCR W/SEQ 103%: $56.49 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $150.09
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OP Visit Level III Est Pt	$276	$179.40	$79.99 – $151.81
Established patient office visit (about 20–29 minutes): rates for 6 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $79.99 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $150.09 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $151.81 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $79.99 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $79.99 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $79.99
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CAH OP Visit Level IV Est Pt Mlp	$261	$169.65	$80.63 – $216.61
Established patient office visit (about 30–39 minutes): 10 of 49 insurance plan rates AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $113.10 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $80.63 AMBETTER CONTRACTED [320452] — HB LGNOK AMBETTER EXCHANGE MEDICARE: $110.96 BCBS MEDICARE ADVANTAGE [20047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $80.63 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $80.63 BLUE CROSS AND BLUE SHIELD [20053] — HB LGNOK BCBS OF OK NATIVEBLUE MCR 103% (NO SEQ): $84.66 CENTIVO CONTRACTED [320505] — HB LGNOK CENTIVO MCR 165%: $135.61 CHEROKEE NATION HEALTH SERV CONTRACTED [320066] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $80.63 CIGNA MEDICARE ADVANTAGE CONTRACTED [320072] — HB LGNOK CIGNA MCR W/SEQ 103%: $83.09 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $200
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OP Visit Level IV Est Pt Pf	$276	$179.40	$80.63 – $216.61
Established patient office visit (about 30–39 minutes): 10 of 49 insurance plan rates AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $113.10 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $80.63 AMBETTER CONTRACTED [320452] — HB LGNOK AMBETTER EXCHANGE MEDICARE: $110.96 BCBS MEDICARE ADVANTAGE [20047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $80.63 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $80.63 BLUE CROSS AND BLUE SHIELD [20053] — HB LGNOK BCBS OF OK NATIVEBLUE MCR 103% (NO SEQ): $84.66 CENTIVO CONTRACTED [320505] — HB LGNOK CENTIVO MCR 165%: $135.61 CHEROKEE NATION HEALTH SERV CONTRACTED [320066] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $80.63 CIGNA MEDICARE ADVANTAGE CONTRACTED [320072] — HB LGNOK CIGNA MCR W/SEQ 103%: $83.09 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $200
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OP Visit Level IV Est Pt	$269	$174.85	$113.10 – $216.61
Established patient office visit (about 30–39 minutes): rates for 6 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $113.10 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $200 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $216.61 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $113.10 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $113.10 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $113.10
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: New/Est Office/OP Cnslt Low 30-39 Min Pf	$307	$199.55	$54.82 – $219
Office consultation with a specialist (moderate): rates for 6 insurance plans COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $219 DEPT OF VETERAN AFFAIRS CONTRACTED [320106] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $54.82 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $164 INDIAN HEALTH SERVICE CONTRACTED [320198] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $54.82 MEDICARE [20244] — HB LGNOK MEDICARE: $54.82 WELLCARE MEDICARE ADVANTAGE CONTRACTED [320421] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $54.82
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: New/Est Office/OP Cnslt Mod 40-54 Min Pf	$416	$270.40	$80.63 – $233.39
Office consultation with a specialist (moderate to high): rates for 5 insurance plans DEPT OF VETERAN AFFAIRS CONTRACTED [320106] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $80.63 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $233.39 INDIAN HEALTH SERVICE CONTRACTED [320198] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $80.63 MEDICARE [20244] — HB LGNOK MEDICARE: $80.63 WELLCARE MEDICARE ADVANTAGE CONTRACTED [320421] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $80.63
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED Phys Care Level 3 Pf	$362	$235.30	$66.04 – $456.62
Emergency room visit (moderate): 10 of 49 insurance plan rates AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $246.57 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $66.04 AMBETTER CONTRACTED [320452] — HB LGNOK AMBETTER EXCHANGE MEDICARE: $90.88 BCBS MEDICARE ADVANTAGE [20047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $66.04 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $66.04 BLUE CROSS AND BLUE SHIELD [20053] — HB LGNOK BCBS OF OK NATIVEBLUE MCR 103% (NO SEQ): $69.34 CENTIVO CONTRACTED [320505] — HB LGNOK CENTIVO MCR 165%: $111.08 CHEROKEE NATION HEALTH SERV CONTRACTED [320066] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $66.04 CIGNA MEDICARE ADVANTAGE CONTRACTED [320072] — HB LGNOK CIGNA MCR W/SEQ 103%: $68.06 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $456.62
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED Phys Care Level 3 Mlp	$309	$200.85	$66.04 – $456.62
Emergency room visit (moderate): 10 of 49 insurance plan rates AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $246.57 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $66.04 AMBETTER CONTRACTED [320452] — HB LGNOK AMBETTER EXCHANGE MEDICARE: $90.88 BCBS MEDICARE ADVANTAGE [20047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $66.04 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $66.04 BLUE CROSS AND BLUE SHIELD [20053] — HB LGNOK BCBS OF OK NATIVEBLUE MCR 103% (NO SEQ): $69.34 CENTIVO CONTRACTED [320505] — HB LGNOK CENTIVO MCR 165%: $111.08 CHEROKEE NATION HEALTH SERV CONTRACTED [320066] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $66.04 CIGNA MEDICARE ADVANTAGE CONTRACTED [320072] — HB LGNOK CIGNA MCR W/SEQ 103%: $68.06 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $456.62
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED Visit Care Level 3	$462	$300.30	$550
Emergency room visit (moderate): rates for 7 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $246.57 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $456.62 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $418.34 HUMANA CONTRACTED [320193] — HB LGNOK HUMANA CHOICECARE: $550 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $246.57 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $246.57 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $246.57
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED Phys Care Level 4 Mlp	$454	$295.10	$112.41 – $694.08
Emergency room visit (moderately high): 10 of 49 insurance plan rates AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $379.20 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $112.41 AMBETTER CONTRACTED [320452] — HB LGNOK AMBETTER EXCHANGE MEDICARE: $154.70 BCBS MEDICARE ADVANTAGE [20047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $112.41 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $112.41 BLUE CROSS AND BLUE SHIELD [20053] — HB LGNOK BCBS OF OK NATIVEBLUE MCR 103% (NO SEQ): $118.03 CENTIVO CONTRACTED [320505] — HB LGNOK CENTIVO MCR 165%: $189.07 CHEROKEE NATION HEALTH SERV CONTRACTED [320066] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $112.41 CIGNA MEDICARE ADVANTAGE CONTRACTED [320072] — HB LGNOK CIGNA MCR W/SEQ 103%: $115.85 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $694.08
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED Phys Care Level 4 Pf	$532	$345.80	$112.41 – $694.08
Emergency room visit (moderately high): 10 of 49 insurance plan rates AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $379.20 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $112.41 AMBETTER CONTRACTED [320452] — HB LGNOK AMBETTER EXCHANGE MEDICARE: $154.70 BCBS MEDICARE ADVANTAGE [20047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $112.41 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $112.41 BLUE CROSS AND BLUE SHIELD [20053] — HB LGNOK BCBS OF OK NATIVEBLUE MCR 103% (NO SEQ): $118.03 CENTIVO CONTRACTED [320505] — HB LGNOK CENTIVO MCR 165%: $189.07 CHEROKEE NATION HEALTH SERV CONTRACTED [320066] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $112.41 CIGNA MEDICARE ADVANTAGE CONTRACTED [320072] — HB LGNOK CIGNA MCR W/SEQ 103%: $115.85 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $694.08
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED Visit Care Level 4	$743	$482.95	$650
Emergency room visit (moderately high): rates for 7 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $379.20 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $694.08 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $639.45 HUMANA CONTRACTED [320193] — HB LGNOK HUMANA CHOICECARE: $650 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $379.20 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $379.20 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $379.20
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED Phys Care Level 5 Pf	$907	$589.55	$163.11 – $1,090
Emergency room visit (high): 10 of 49 insurance plan rates AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $545.97 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $163.11 AMBETTER CONTRACTED [320452] — HB LGNOK AMBETTER EXCHANGE MEDICARE: $224.46 BCBS MEDICARE ADVANTAGE [20047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $163.11 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $163.11 BLUE CROSS AND BLUE SHIELD [20053] — HB LGNOK BCBS OF OK NATIVEBLUE MCR 103% (NO SEQ): $171.26 CENTIVO CONTRACTED [320505] — HB LGNOK CENTIVO MCR 165%: $274.35 CHEROKEE NATION HEALTH SERV CONTRACTED [320066] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $163.11 CIGNA MEDICARE ADVANTAGE CONTRACTED [320072] — HB LGNOK CIGNA MCR W/SEQ 103%: $168.10 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $1,090
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED Phys Care Level 5 Mlp	$772	$501.80	$163.11 – $1,090
Emergency room visit (high): 10 of 49 insurance plan rates AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $545.97 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $163.11 AMBETTER CONTRACTED [320452] — HB LGNOK AMBETTER EXCHANGE MEDICARE: $224.46 BCBS MEDICARE ADVANTAGE [20047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $163.11 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $163.11 BLUE CROSS AND BLUE SHIELD [20053] — HB LGNOK BCBS OF OK NATIVEBLUE MCR 103% (NO SEQ): $171.26 CENTIVO CONTRACTED [320505] — HB LGNOK CENTIVO MCR 165%: $274.35 CHEROKEE NATION HEALTH SERV CONTRACTED [320066] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $163.11 CIGNA MEDICARE ADVANTAGE CONTRACTED [320072] — HB LGNOK CIGNA MCR W/SEQ 103%: $168.10 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $1,090
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED Visit Care Level 5	$1,204	$782.60	$545.97 – $1,090
Emergency room visit (high): rates for 7 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $545.97 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $1,090 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $912.65 HUMANA CONTRACTED [320193] — HB LGNOK HUMANA CHOICECARE: $650 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $545.97 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $545.97 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $545.97

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Basic Metabolic Pnl Calcium Total	$148	$96.20	$7.53 – $105
Basic metabolic panel (blood test): rates for 6 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $7.53 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $105 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $10.58 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $7.53 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $7.53 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $7.53
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Comprehensive Metabolic Panel	$206	$133.90	$9.39 – $110
Comprehensive metabolic panel (blood test): rates for 6 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $9.39 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $110 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $13.20 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $9.39 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $9.39 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $9.39
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Lipid Panel	$155	$100.75	$11.91 – $91
Cholesterol panel (lipid panel): rates for 6 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $11.91 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $91 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $16.74 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $11.91 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $11.91 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $11.91
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POC Lipid Panel	$155	$100.75	$11.91 – $91
Cholesterol panel (lipid panel): rates for 6 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $11.91 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $91 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $16.74 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $11.91 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $11.91 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $11.91
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Renal Function Panel	$169	$109.85	$7.72 – $94
Kidney function panel: rates for 6 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $7.72 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $94 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $10.85 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $7.72 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $7.72 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $7.72
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hepatic Function Panel	$147	$95.55	$7.27 – $77
Liver function panel: rates for 6 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $7.27 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $77 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $10.21 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $7.27 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $7.27 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $7.27
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis Automated W Micro	$79	$51.35	$2.82 – $36
Urine test (automated, with microscope): rates for 6 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $2.82 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $36 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $3.96 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $2.82 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $2.82 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $2.82
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POC Urinalysis Non-Auto	$43	$27.95	$3.10 – $4.35
Urine test (manual, without microscope): rates for 5 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $3.10 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $4.35 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $3.10 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $3.10 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $3.10
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis Non Automated WO Micro	$42	$27.30	$3.10 – $4.35
Urine test (manual, without microscope): rates for 5 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $3.10 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $4.35 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $3.10 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $3.10 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $3.10
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urine Ketones Nonautomated	$43	$27.95	$3.10 – $4.35
Urine test (manual, without microscope): rates for 5 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $3.10 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $4.35 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $3.10 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $3.10 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $3.10
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POC Urinalysis Automated W/O Micro	$61	$39.65	$2 – $19
Urine test (automated, without microscope): rates for 6 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $2 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $19 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $2.81 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $2 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $2 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $2
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urine Ph Automated	$61	$39.65	$2 – $19
Urine test (automated, without microscope): rates for 6 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $2 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $19 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $2.81 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $2 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $2 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $2
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urine Ketones Automated	$61	$39.65	$2 – $19
Urine test (automated, without microscope): rates for 6 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $2 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $19 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $2.81 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $2 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $2 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $2
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psa Total Diagnostic	$162	$105.30	$16.36 – $130.99
PSA (prostate specific antigen) blood test: rates for 6 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $16.36 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $130.99 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $22.99 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $16.36 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $16.36 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $16.36
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psa Ultrasensitive	$162	$105.30	$16.36 – $130.99
PSA (prostate specific antigen) blood test: rates for 6 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $16.36 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $130.99 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $22.99 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $16.36 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $16.36 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $16.36
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Tsh Newborn	$24	$15.60	$14.94 – $128.54
Thyroid stimulating hormone (TSH) test: rates for 6 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $14.94 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $128.54 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $21 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $14.94 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $14.94 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $14.94
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Tsh Thyroid Stimulating Hormone	$152	$98.80	$14.94 – $128.54
Thyroid stimulating hormone (TSH) test: rates for 6 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $14.94 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $128.54 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $21 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $14.94 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $14.94 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $14.94
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Cbc W Auto Diff	$104	$67.60	$6.91 – $65
Complete blood count (CBC) with differential: rates for 6 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $6.91 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $65 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $9.71 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $6.91 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $6.91 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $6.91
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Cbc Automated WO Diff	$90	$58.50	$5.75 – $53
Complete blood count (CBC), automated: rates for 6 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $5.75 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $53 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $8.09 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $5.75 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $5.75 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $5.75
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prothrombin Time	$68	$44.20	$3.82 – $36
Blood clotting time test (prothrombin time, PT): rates for 6 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $3.82 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $36 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $5.36 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $3.82 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $3.82 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $3.82
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prothrombin Time Mixing Test	$82	$53.30	$3.82 – $36
Blood clotting time test (prothrombin time, PT): rates for 6 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $3.82 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $36 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $5.36 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $3.82 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $3.82 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $3.82
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ptt Partial Thromboplastin Time	$128	$83.20	$5.35 – $68
Blood clotting test (partial thromboplastin time, PTT): rates for 6 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $5.35 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $68 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $7.51 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $5.35 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $5.35 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $5.35
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ptt Mixing	$112	$72.80	$5.35 – $68
Blood clotting test (partial thromboplastin time, PTT): rates for 6 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $5.35 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $68 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $7.51 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $5.35 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $5.35 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $5.35

Imaging (X-ray, CT, MRI, ultrasound, mammogram)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT Head/Brain WO Cont	$2,039	$1,325.35	$360
CT scan of the head or brain, without contrast: rates for 7 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $57.46 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $1,236 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $293.73 HUMANA CONTRACTED [320193] — HB LGNOK HUMANA CHOICECARE: $360 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $57.46 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $57.46 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $57.46
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI Brain W/WO Cont	$4,014	$2,609.10	$570
MRI of the brain, before and after contrast: rates for 7 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $183.49 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $2,598 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $980.18 HUMANA CONTRACTED [320193] — HB LGNOK HUMANA CHOICECARE: $570 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $183.49 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $183.49 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $183.49
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Xr Chest 2 Views	$333	$216.45	$19.41 – $200.05
Chest X-ray, 2 views: rates for 5 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $19.41 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $200.05 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $19.41 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $19.41 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $19.41
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Xr Spine Lumbar Min 4 Views	$794	$516.10	$33.02 – $240.32
X-ray of the lower spine, at least 4 views: rates for 5 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $33.02 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $240.32 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $33.02 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $33.02 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $33.02
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI Lumbar Spine WO Cont	$3,705	$2,408.25	$570
MRI of the lower back (lumbar spine), without contrast: rates for 7 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $105.76 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $1,886 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $670.37 HUMANA CONTRACTED [320193] — HB LGNOK HUMANA CHOICECARE: $570 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $105.76 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $105.76 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $105.76
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT Pelvis W Cont	$3,131	$2,035.15	$360
CT scan of the pelvis, with contrast: rates for 7 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $158.53 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $1,532 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $492.80 HUMANA CONTRACTED [320193] — HB LGNOK HUMANA CHOICECARE: $360 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $158.53 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $158.53 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $158.53
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI Extr Lwr Jt WO Cont Lt	$3,435	$2,232.75	$570
MRI of a leg joint (such as the knee), without contrast: rates for 7 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $120.47 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $1,726 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $548.48 HUMANA CONTRACTED [320193] — HB LGNOK HUMANA CHOICECARE: $570 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $120.47 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $120.47 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $120.47
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI Extr Lwr Jt WO Cont Rt	$3,435	$2,232.75	$120.47 – $1,726
MRI of a leg joint (such as the knee), without contrast: rates for 7 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $120.47 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $1,726 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $548.48 HUMANA CONTRACTED [320193] — HB LGNOK HUMANA CHOICECARE: $570 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $120.47 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $120.47 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $120.47
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI Extr Lwr Jt WO Cont Bi	$5,326	$3,461.90	$570
MRI of a leg joint (such as the knee), without contrast: rates for 7 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $120.47 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $1,726 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $548.48 HUMANA CONTRACTED [320193] — HB LGNOK HUMANA CHOICECARE: $570 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $120.47 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $120.47 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $120.47
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT Abd Pelvis With Contrast	$2,865	$1,862.25	$188.51 – $801.97
CT scan of the abdomen and pelvis, with contrast: rates for 6 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $188.51 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $801.97 HUMANA CONTRACTED [320193] — HB LGNOK HUMANA CHOICECARE: $360 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $188.51 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $188.51 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $188.51
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US Abdomen Complete	$1,232	$800.80	$65.49 – $511.92
Ultrasound of the abdomen, complete: rates for 6 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $65.49 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $511.92 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $240.32 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $65.49 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $65.49 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $65.49
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US Preg Uter 14 Wks Or>	$879	$571.35	$94.70 – $544
Pregnancy ultrasound (after the first trimester): rates for 6 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $94.70 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $544 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $240.32 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $94.70 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $94.70 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $94.70
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US Transvaginal Non OB	$827	$537.55	$72.43 – $433
Transvaginal ultrasound: rates for 6 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $72.43 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $433 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $240.32 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $72.43 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $72.43 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $72.43
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mamm Diagnostic Unilat Lt W Cad	$364	$236.60	$72.73 – $226.50
Diagnostic mammogram, one breast: rates for 5 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $72.73 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $226.50 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $72.73 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $72.73 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $72.73
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mamm Diagnostic Unilat Rt W Cad	$364	$236.60	$72.73 – $226.50
Diagnostic mammogram, one breast: rates for 5 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $72.73 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $226.50 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $72.73 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $72.73 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $72.73
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mamm Diagnostic Bilat W Cad	$458	$297.70	$93.26 – $286.76
Diagnostic mammogram, both breasts: rates for 5 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $93.26 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $286.76 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $93.26 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $93.26 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $93.26
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mamm Scrn Right W Cad	$339	$220.35	$76.90 – $230.40
Screening mammogram, both breasts: rates for 6 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $76.90 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $230.40 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $76.90 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $76.90 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $76.90 UNITED HEALTHCARE MEDICARE ADVANTAGE CONTRACTED [320398] — HB LGNOK UHC MEDICARE NEW 040122 W/SEQ 98.1%: $119.73
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mamm Scrn Bilat Implant W Cad	$387	$251.55	$76.90 – $230.40
Screening mammogram, both breasts: rates for 6 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $76.90 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $230.40 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $76.90 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $76.90 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $76.90 UNITED HEALTHCARE MEDICARE ADVANTAGE CONTRACTED [320398] — HB LGNOK UHC MEDICARE NEW 040122 W/SEQ 98.1%: $119.73
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mamm Scrn Bilateral W Cad	$375	$243.75	$76.90 – $230.40
Screening mammogram, both breasts: rates for 6 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $76.90 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $230.40 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $76.90 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $76.90 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $76.90 UNITED HEALTHCARE MEDICARE ADVANTAGE CONTRACTED [320398] — HB LGNOK UHC MEDICARE NEW 040122 W/SEQ 98.1%: $119.73

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Polysom Attended >3 Chn 6/> Yrs	$5,820	$3,783	$527.77 – $2,956
Sleep study (overnight, in a sleep lab): rates for 6 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $527.77 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $2,956 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $1,754.68 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $527.77 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $527.77 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $527.77

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ot Cpm Fitting Recovery Room Ea 15min	$116	$75.40	$25.94 – $87.08
Physical therapy: therapeutic exercise (each 15 minutes): rates for 6 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $25.94 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $87.08 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $46.78 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $25.94 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $25.94 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $25.94
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ot Cpm Set Up Ea 15min	$116	$75.40	$25.94 – $87.08
Physical therapy: therapeutic exercise (each 15 minutes): rates for 6 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $25.94 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $87.08 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $46.78 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $25.94 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $25.94 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $25.94
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Cpm Fitting Recovery Room Ea 15in	$116	$75.40	$25.94 – $87.08
Physical therapy: therapeutic exercise (each 15 minutes): rates for 6 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $25.94 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $87.08 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $46.78 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $25.94 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $25.94 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $25.94
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval Level I 135 Min	$524	$340.60	$88.72 – $158.37
Physical therapy evaluation (low complexity): rates for 5 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $88.72 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $158.37 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $88.72 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $88.72 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $88.72
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval Level I 75 Min	$349	$226.85	$88.72 – $158.37
Physical therapy evaluation (low complexity): rates for 5 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $88.72 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $158.37 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $88.72 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $88.72 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $88.72
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval Level I 105 Min	$436	$283.40	$88.72 – $158.37
Physical therapy evaluation (low complexity): rates for 5 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $88.72 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $158.37 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $88.72 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $88.72 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $88.72
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval Level II 105 Min	$475	$308.75	$88.72 – $158.37
Physical therapy evaluation (moderate complexity): rates for 5 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $88.72 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $158.37 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $88.72 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $88.72 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $88.72
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval Level II 120 Min	$519	$337.35	$88.72 – $158.37
Physical therapy evaluation (moderate complexity): rates for 5 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $88.72 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $158.37 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $88.72 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $88.72 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $88.72
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval Level II 135 Min	$563	$365.95	$88.72 – $158.37
Physical therapy evaluation (moderate complexity): rates for 5 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $88.72 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $158.37 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $88.72 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $88.72 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $88.72
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval Level III 15 Min	$259	$168.35	$88.72 – $158.37
Physical therapy evaluation (high complexity): rates for 5 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $88.72 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $158.37 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $88.72 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $88.72 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $88.72
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval Level III 45 Min	$349	$226.85	$88.72 – $158.37
Physical therapy evaluation (high complexity): rates for 5 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $88.72 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $158.37 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $88.72 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $88.72 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $88.72
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval Level III 60 Min	$393	$255.45	$88.72 – $158.37
Physical therapy evaluation (high complexity): rates for 5 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $88.72 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $158.37 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $88.72 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $88.72 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $88.72
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psych Ther 30 Min With Patient	$308	$200.20	$71.19 – $362.68
Psychotherapy, 30 minutes: rates for 5 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $71.19 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $362.68 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $71.19 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $71.19 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $71.19
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psych Ther 45 Min With Patient	$343	$222.95	$93.92 – $362.68
Psychotherapy, 45 minutes: rates for 5 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $93.92 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $362.68 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $93.92 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $93.92 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $93.92
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psych Ther 60 Min With Patient	$362	$235.30	$138.48 – $362.68
Psychotherapy, 60 minutes: rates for 5 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $138.48 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $362.68 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $138.48 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $138.48 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $138.48
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psych Fam Ther WO Pt 50min (Max Qty 2)	$453	$294.45	$89.72
Family psychotherapy, without the patient: rates for 4 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $89.72 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $89.72 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $89.72 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $89.72
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psych Fam Ther W Pt 50min (Max Qty 2)	$343	$222.95	$93.98 – $362.68
Family psychotherapy, with the patient: rates for 5 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $93.98 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $362.68 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $93.98 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $93.98 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $93.98
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Group Therapy 45 Min	$423	$274.95	$25.11 – $207.58
Group psychotherapy: rates for 5 insurance plans AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $25.11 HEALTH CHOICE CONTRACTED [320166] — HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOI: $207.58 HUMANA MEDICAID CONTRACTED [320486] — HB LGNOK OK MEDICAID (SOONERCARE): $25.11 MEDICAID [20240] — HB LGNOK OK MEDICAID (SOONERCARE): $25.11 OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] — HB LGNOK OK MEDICAID (SOONERCARE): $25.11

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Arthroplasty Hip Total Pf	$5,255	$3,415.75	$1,074.65 – $1,807.51
Total hip replacement: 10 of 47 insurance plan rates AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $1,129.55 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $1,074.65 AMBETTER CONTRACTED [320452] — HB LGNOK AMBETTER EXCHANGE MEDICARE: $1,478.87 BCBS MEDICARE ADVANTAGE [20047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $1,074.65 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $1,074.65 BLUE CROSS AND BLUE SHIELD [20053] — HB LGNOK BCBS OF OK NATIVEBLUE MCR 103% (NO SEQ): $1,128.32 CENTIVO CONTRACTED [320505] — HB LGNOK CENTIVO MCR 165%: $1,807.51 CHEROKEE NATION HEALTH SERV CONTRACTED [320066] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $1,074.65 CIGNA MEDICARE ADVANTAGE CONTRACTED [320072] — HB LGNOK CIGNA MCR W/SEQ 103%: $1,107.51 CROSS TIMBERS HOSPICE [20098] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $1,074.65
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Arthroplasty Knee Total Med and Lat Pf	$4,872	$3,166.80	$1,072.96 – $11,458.10
Total knee replacement: 10 of 47 insurance plan rates AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $11,458.10 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $1,072.96 AMBETTER CONTRACTED [320452] — HB LGNOK AMBETTER EXCHANGE MEDICARE: $1,476.55 BCBS MEDICARE ADVANTAGE [20047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $1,072.96 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $1,072.96 BLUE CROSS AND BLUE SHIELD [20053] — HB LGNOK BCBS OF OK NATIVEBLUE MCR 103% (NO SEQ): $1,126.55 CENTIVO CONTRACTED [320505] — HB LGNOK CENTIVO MCR 165%: $1,804.67 CHEROKEE NATION HEALTH SERV CONTRACTED [320066] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $1,072.96 CIGNA MEDICARE ADVANTAGE CONTRACTED [320072] — HB LGNOK CIGNA MCR W/SEQ 103%: $1,105.77 CROSS TIMBERS HOSPICE [20098] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $1,072.96
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Arthro Sholdr Decomp W Part Acromioplsty Pf	$2,421	$1,573.65	$138.09 – $2,560.42
Shoulder arthroscopy: shaving of shoulder bone: 10 of 48 insurance plan rates AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $150.41 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $138.09 AMBETTER CONTRACTED [320452] — HB LGNOK AMBETTER EXCHANGE MEDICARE: $190.03 BCBS MEDICARE ADVANTAGE [20047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $138.09 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $138.09 BLUE CROSS AND BLUE SHIELD [20053] — HB LGNOK BCBS OF OK NATIVEBLUE MCR 103% (NO SEQ): $144.98 CENTIVO CONTRACTED [320505] — HB LGNOK CENTIVO MCR 165%: $232.25 CHEROKEE NATION HEALTH SERV CONTRACTED [320066] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $138.09 CIGNA MEDICARE ADVANTAGE CONTRACTED [320072] — HB LGNOK CIGNA MCR W/SEQ 103%: $142.31 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $2,560.42
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Arthroscopy Knee Surg W Menisc Med or Lat Pf	$2,787	$1,811.55	$473.12 – $2,889.37
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 48 insurance plan rates AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $2,889.37 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $473.12 AMBETTER CONTRACTED [320452] — HB LGNOK AMBETTER EXCHANGE MEDICARE: $651.08 BCBS MEDICARE ADVANTAGE [20047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $473.12 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $473.12 BLUE CROSS AND BLUE SHIELD [20053] — HB LGNOK BCBS OF OK NATIVEBLUE MCR 103% (NO SEQ): $496.75 CENTIVO CONTRACTED [320505] — HB LGNOK CENTIVO MCR 165%: $795.76 CHEROKEE NATION HEALTH SERV CONTRACTED [320066] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $473.12 CIGNA MEDICARE ADVANTAGE CONTRACTED [320072] — HB LGNOK CIGNA MCR W/SEQ 103%: $487.59 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $2,586.25
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Inj Epi/Lumb/Sacral Sngl Level Pf	$862	$560.30	$93.50 – $1,807.26
Nerve root injection, lower back, with imaging guidance: 10 of 49 insurance plan rates AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $211.52 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $93.50 AMBETTER CONTRACTED [320452] — HB LGNOK AMBETTER EXCHANGE MEDICARE: $128.67 BCBS MEDICARE ADVANTAGE [20047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $93.50 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $93.50 BLUE CROSS AND BLUE SHIELD [20053] — HB LGNOK BCBS OF OK NATIVEBLUE MCR 103% (NO SEQ): $98.17 CENTIVO CONTRACTED [320505] — HB LGNOK CENTIVO MCR 165%: $157.26 CHEROKEE NATION HEALTH SERV CONTRACTED [320066] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $93.50 CIGNA MEDICARE ADVANTAGE CONTRACTED [320072] — HB LGNOK CIGNA MCR W/SEQ 103%: $96.36 COMMUNITY CARE CONTRACTED [320080] — HB LGNOK COMMUNITY CARE: $1,124.01
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Neuroplas/ Tranposit Median Nerve at Carp Tiunn Pf	$1,832	$1,190.80	$385.89 – $459.13
Carpal tunnel release: 10 of 32 insurance plan rates AETNA MEDICAID CONTRACTED [320009] — HB LGNOK OK MEDICAID (SOONERCARE): $392.10 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $385.89 BCBS MEDICARE ADVANTAGE [20047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $385.89 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $385.89 BLUE CROSS AND BLUE SHIELD [20053] — HB LGNOK BCBS OF OK NATIVEBLUE MCR 103% (NO SEQ): $393.36 CIGNA MEDICARE ADVANTAGE CONTRACTED [320072] — HB LGNOK CIGNA MCR W/SEQ 103%: $397.69 DEPT OF VETERAN AFFAIRS CONTRACTED [320106] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $385.89 DEVOTED HEALTH MEDICARE CONTRACTED [320500] — HB LGNOK DEVOTED HEALTH MCR 104% W/O SEQ: $393.60 ESSENCE HEALTHCARE MEDICARE CONTRACTED [320122] — HB LGNOK MANAGED MEDICARE 100% W/SEQ: $385.89 GLOBALHEALTH CONTRACTED [320145] — HB LGNOK GLOBALHEALTH MCR 102% W/SEQ: $393.60

Source: Mercy Hospital Logan County’s standard charges file (mercy.net, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on June 11, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

Found through the hospital’s cms-hpt.txt file, as required by the federal hospital price transparency rule (CMS). We show a selection of common services; the file has every item and service.

Hospital information

Hospital type	Critical Access Hospital
Address	200 S Academy Rd, Guthrie, OK 73044
County	Logan County
State	Oklahoma
Phone	(405) 282‑6700
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	Not rated by CMS
CMS Certification Number	371317
Name in Medicare records	MERCY HOSPITAL LOGAN COUNTY
Profile level	Medicare data + hospital website
Official website	mercy.net
Corrections	Report an error or suggest an update →

Sources

Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-07-22, retrieved 2026-10-29
Medicare Care Compare — official Medicare profile of this hospital
U.S. Census Bureau Geocoder — map position used for distances

From the hospital’s website

Numbers match the citations above. Checked 2026-10-30.

Mercy Hospital Logan County Quick Facts — mercy.net
Mercy Hospital Logan County — mercy.net

Mercy Hospital Logan County

Summary

Profile from official sources

At a glance