Does Mercy Hospital Oklahoma City, Inc have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Mercy Hospital Oklahoma City, Inc. In a medical emergency, call 911.

Where is Mercy Hospital Oklahoma City, Inc?

4300 West Memorial Road, Oklahoma City, OK 73120, in Oklahoma County, Oklahoma.

What is the phone number of Mercy Hospital Oklahoma City, Inc?

(405) 755-1515, as listed by Medicare (CMS).

What is the Medicare star rating of Mercy Hospital Oklahoma City, Inc?

4 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Mercy Hospital Oklahoma City, Inc

Quick answers

Does Mercy Hospital Oklahoma City, Inc have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Mercy Hospital Oklahoma City, Inc. In a medical emergency, call 911.
Where is Mercy Hospital Oklahoma City, Inc?: 4300 West Memorial Road, Oklahoma City, OK 73120, in Oklahoma County, Oklahoma.
What is the phone number of Mercy Hospital Oklahoma City, Inc?: (405) 755-1515, as listed by Medicare (CMS).
What is the Medicare star rating of Mercy Hospital Oklahoma City, Inc?: 4 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[4][5][6]

Cancer care
Stroke care
Neuroscience (Meinders NeuroScience Institute)
Women's health
Maternity (Mercy Birthplace)
Breast imaging
Maternity and childbirth
Neonatal intensive care

Conditions treated^[4]

Stroke

Treatments^[4][5]

Radiotherapy (TrueBeam linear accelerator)
Robotic surgery
Hernia surgery

Procedures^[4][5]

Robotic surgery (da Vinci)
Hernia surgery
Robotic-assisted surgery

Programs and centers^[4][5][6][7]

Level III neonatal intensive care unit
Coletta Cancer Center
Mercy Breast Center
Meinders NeuroScience Institute
Birthing Center
Lactation support
Pelvic floor physical therapy (Mercy Therapy Services, Love Family Women's Center)

Emergency care (hospital website)^[4][5]

Stroke designation	Comprehensive Stroke Center (Joint Commission)

Visiting and practical information

Interpreters and languages	Free language assistance; nondiscrimination notice posted in 29 languages^[4]

Recognition^[4][5]

Comprehensive Stroke Center certification (Joint Commission)
Hernia surgery Center of Excellence (Surgical Review Corporation)
Comprehensive Stroke Center certified by The Joint Commission

Doctors and clinicians (1,108)

1,108 doctors and other clinicians list Mercy Hospital Oklahoma City, Inc 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

Doctors with a page on this site (1,108)

Aaron C. Bryan, CNACertified Registered Nurse Anesthetist (CRNA)
Aaron C. WadePhysician Assistant
Aaron Farrow, MDNeurology
Aaron L. Morgan, MDHand Surgery
Aaron Paul, MDAnesthesiology
Abbey R. Krahl, PAPhysician Assistant
Abbey Woods, MDFamily Practice
Abbie A. Poss, PAPhysician Assistant
Abbie N. Davis, PAPhysician Assistant
Abby R. Bova, MDHematology/Oncology
Abdul B. Khan, MDNeurosurgery
Abel J. Arzu, PAPhysician Assistant
Abigail Pearson, PAPhysician Assistant
Adam D. Gardner, MDFamily Practice
Adam S. Przebinda, MDPulmonary Disease
Adam T. Krouse, DOFamily Practice
Adanma Anji Ayanambakkam Attanathi, MDHematology/Oncology
Adeel Siddiqui, MDPediatric Medicine
Afsaneh Faramarzi, NPNurse Practitioner
Agha K. Khan, MDInterventional Cardiology
Agnes Tonkumoh, NPNurse Practitioner
Ahmad Al-Taee, MDGastroenterology
Ahmad Arslan, MDPulmonary Disease
Alan Tran, DOPhysical Medicine and Rehabilitation

And 1,084 more: the button below opens the full list.

Other emergency rooms nearby

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

Oklahoma Heart Hospital, LLC0.3 mi · Oklahoma City, OK · Acute Care Hospital
Oklahoma Spine Hospital1.1 mi · Oklahoma City, OK · Acute Care Hospital
Lakeside Women's Hospital, a Member of INTEGRIS He…2.0 mi · Oklahoma City, OK · Acute Care Hospital
Northwest Surgical Hospital3.7 mi · Oklahoma City, OK · Acute Care Hospital
INTEGRIS Community Hospital - Council Crossing4.3 mi · Oklahoma City, OK · Acute Care Hospital

Other hospitals nearby

Okc-Amg Specialty Hospital0.0 mi · Oklahoma City, OK · Long-Term Acute Care Hospital
Mercy Rehabilitation Hospital Oklahoma City0.8 mi · Oklahoma City, OK · Inpatient Rehabilitation 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

Heritage at Brandon Place Health & Rehabilitation1.6 mi · Oklahoma City, OK · 1 of 5 stars
Epworth Villa Health Services3.0 mi · Oklahoma City, OK · 4 of 5 stars
The Lakes3.1 mi · Oklahoma City, OK · 2 of 5 stars

All nursing homes in the state →

Hospice providers

INTEGRIS Hospice House1.9 mi · Oklahoma City, OK · 4 of 5 stars
Mercy Hospice2.5 mi · Oklahoma City, OK · 3 of 5 stars
INTEGRIS Hospice House2.5 mi · Oklahoma City, OK · 4 of 5 stars

All hospice providers in the state →

Home health agencies

Mercy Home Health1.9 mi · Oklahoma City, OK · 4 of 5 stars
Caring Home Health Agency, LLC2.5 mi · Oklahoma City, OK
Select Home Health2.5 mi · Oklahoma City, OK · 2 of 5 stars

All home health agencies in the state →

Dialysis facilities

Fmcna - Oklahoma Kidney Care DX, LLC1.9 mi · Oklahoma City, OK · 3 of 5 stars
Fresenius Kidney Care Okcd Northlake1.9 mi · Oklahoma City, OK · 3 of 5 stars
Concerto Oklahoma LLC4.8 mi · Oklahoma City, OK

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

Advanced Surgical & Research Solutions, LLC1.9 mi · Oklahoma City, OK
Oklahoma Surgicare1.9 mi · Oklahoma City, OK
The Surgery Center at Meridian Park2.5 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

Variety Care - Putnam North2.7 mi · Oklahoma City, OK · Community health center
Britton Health Center5.2 mi · Oklahoma City, OK · Community health center
Variety Care Baptist Portland5.8 mi · Oklahoma City, OK · Community health center

Clinics and urgent care

QS Peds Med LLC2.5 mi · Oklahoma City, OK · Urgent care center
Creekside Urgent Care LLC4.5 mi · Edmond, OK · Urgent care center
Edmond Urgent Care Inc.4.5 mi · Edmond, OK · Urgent care center

Pharmacies

Oklahoma Specialty Pharmacy, LLC1.9 mi · Oklahoma City, OK · Community/retail pharmacy
Sams East Inc1.9 mi · Oklahoma City, OK · Community/retail pharmacy
SBM Ventures LLC1.9 mi · Oklahoma City, OK · Pharmacy

Assisted living nearby

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

Epworth Villa Health Services1.9 mi · Oklahoma City, OK
The Gardens at Quail Springs Assisted and Memory1.9 mi · Oklahoma City, OK
Dorset Place - Assisted Living2.5 mi · Oklahoma City, OK
Dorset Place-Memory Care2.5 mi · Oklahoma City, 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 Oklahoma City, Inc 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)	3 of 5 stars
Overall rating of the hospital	4 of 5 stars
Would recommend the hospital	5 of 5 stars
Nurses communicated well	3 of 5 stars
Doctors communicated well	3 of 5 stars
Staff explained medicines	2 of 5 stars
Information about recovery at home	4 of 5 stars
Room and bathroom kept clean	4 of 5 stars
Quiet at night	3 of 5 stars
Rated the hospital 9 or 10 out of 10	74%National average: 72%
Would definitely recommend the hospital	79%National average: 71%
Nurses “always” communicated well	75%National average: 80%
Doctors “always” communicated well	77%National average: 80%
Staff “always” explained medicines before giving them	56%National average: 62%
Were given information about recovery at home	87%National average: 86%
Room and bathroom “always” clean	73%National average: 74%
Area around the room “always” quiet at night	54%National average: 60%
Completed surveys	1,823Response rate: 20%

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)	0.427No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)	0.688No different from the national benchmark
Surgical site infections after colon surgery	1.009No different from the national benchmark
Surgical site infections after abdominal hysterectomy	0.958No different from the national benchmark
MRSA bloodstream infections	0.298Better than the national benchmark
Clostridioides difficile (C. diff) intestinal infections	0.128Better than 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	Too few cases to report
Deaths within 30 days: heart failure patients	11.9%
Deaths within 30 days: pneumonia patients	14.1%
Deaths within 30 days: COPD patients	7.9%
Deaths within 30 days: stroke patients	13.1%
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	0.77No different from the national rate
Complications after hip or knee replacement	4.9%

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	Too few cases to report
Readmitted within 30 days: heart failure	20.3%
Readmitted within 30 days: pneumonia	16.4%
Readmitted within 30 days: COPD	19.4%
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	6.1%

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)	Very high (60,000 or more)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	151 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	1%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	78%National average: 65%

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 City Best hospitals in Oklahoma City

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 63 common services exactly as Mercy Hospital Oklahoma City, Inc 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: OP Visit Level III New Pt Mlp	$84	$54.60	$64.49 – $170.64
New patient office visit (about 30–44 minutes): 10 of 119 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $52.42 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $57.96 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $50.74 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $59.56 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $98.08 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $67.95 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $67.95 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $50.40 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $50.40 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $93.51
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	$99	$64.35	$31.38 – $99
New patient office visit (about 30–44 minutes): 10 of 119 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $61.78 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $68.31 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $59.80 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $70.19 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $98.08 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $67.95 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $67.95 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $59.40 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $59.40 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $93.51
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 Patient	$459	$298.35	$64.49 – $170.64
New patient office visit (about 30–44 minutes): 10 of 118 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $286.42 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $316.71 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $277.24 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $325.43 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $98.08 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $67.95 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $67.95 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $275.40 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $275.40 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $93.51
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 Mlp	$137	$89.05	$43.43 – $137
New patient office visit (about 45–59 minutes): 10 of 119 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $85.49 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $94.53 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $82.75 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $97.13 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $147.66 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $111.17 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $111.17 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $82.20 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $82.20 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $152.98
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	$161	$104.65	$105.50 – $258.45
New patient office visit (about 45–59 minutes): 10 of 119 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $100.46 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $111.09 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $97.24 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $114.15 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $147.66 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $111.17 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $111.17 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $96.60 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $96.60 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $152.98
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	$558	$362.70	$176.89 – $558
New patient office visit (about 45–59 minutes): 10 of 118 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $348.19 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $385.02 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $337.03 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $395.62 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $147.66 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $111.17 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $111.17 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $334.80 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $334.80 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $152.98
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 Patient	$765	$497.25	$12 – $345.01
New patient office visit (about 60–74 minutes): 10 of 119 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $477.36 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $527.85 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $462.06 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $542.39 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $194.93 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $152.10 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $152.10 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $459 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $459 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $209.32
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	$218	$141.70	$69.11 – $218
New patient office visit (about 60–74 minutes): 10 of 119 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $136.03 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $150.42 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $131.67 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $154.56 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $194.93 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $152.10 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $152.10 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $130.80 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $130.80 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $209.32
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 Mlp	$186	$120.90	$12 – $345.01
New patient office visit (about 60–74 minutes): 10 of 119 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $116.06 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $128.34 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $112.34 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $131.87 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $194.93 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $152.10 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $152.10 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $111.60 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $111.60 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $209.32
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: L&D Level II, 12-18 Hrs	$1,055	$685.75	$312 – $468
Established patient office visit (about 20–29 minutes): 10 of 119 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $658.32 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $727.95 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $637.22 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $748 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $79.99 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $54.82 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $54.82 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $633 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $633 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $75.44
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: L&D Level II, 18-24 Hrs	$1,304	$847.60	$52.02 – $138.42
Established patient office visit (about 20–29 minutes): 10 of 119 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $813.70 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $899.76 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $787.62 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $924.54 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $79.99 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $54.82 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $54.82 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $782.40 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $782.40 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $75.44
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: L&D Level II, 6-12 Hrs	$946	$614.90	$312 – $468
Established patient office visit (about 20–29 minutes): 10 of 119 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $590.30 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $652.74 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $571.38 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $670.71 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $79.99 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $54.82 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $54.82 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $567.60 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $567.60 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $75.44
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 Mlp	$99	$64.35	$5
Established patient office visit (about 30–39 minutes): 10 of 119 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $61.78 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $68.31 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $59.80 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $70.19 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $113.10 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $80.63 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $80.63 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $59.40 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $59.40 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $110.96
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	$117	$76.05	$76.52 – $197.50
Established patient office visit (about 30–39 minutes): 10 of 119 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $73.01 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $80.73 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $70.67 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $82.95 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $113.10 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $80.63 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $80.63 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $70.20 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $70.20 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $110.96
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Est Pt-Level 4 Twoc	$576	$374.40	$182.59 – $576
Established patient office visit (about 30–39 minutes): 10 of 118 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $359.42 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $397.44 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $347.90 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $408.38 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $113.10 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $80.63 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $80.63 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $345.60 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $345.60 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $110.96
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	$106	$68.90	$5
Office consultation with a specialist (moderate): 10 of 79 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $66.14 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $73.14 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $64.02 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $75.15 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $15.26 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $63.60 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $63.60 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $31.80 AUXIANT CONTRACTED [320462] — HB ARDM, OKLC NETWORK AFFILIATION AGREEMENT: $68.90 AUXIANT CONTRACTED [320462] — HB OKLC ADA ARDM BUCHHEIT DEC: $63.60
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 Mlp	$90	$58.50	$12.96 – $90
Office consultation with a specialist (moderate): 10 of 72 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $56.16 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $62.10 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $54.36 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $63.81 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $12.96 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $54 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $54 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $27 AUXIANT CONTRACTED [320462] — HB ARDM, OKLC NETWORK AFFILIATION AGREEMENT: $58.50 AUXIANT CONTRACTED [320462] — HB OKLC ADA ARDM BUCHHEIT DEC: $54
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	$160	$104	$136.66 – $172.42
Office consultation with a specialist (moderate): 10 of 71 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $99.84 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $110.40 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $96.64 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $113.44 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $23.04 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $96 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $96 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $48 AUXIANT CONTRACTED [320462] — HB ARDM, OKLC NETWORK AFFILIATION AGREEMENT: $104 AUXIANT CONTRACTED [320462] — HB OKLC ADA ARDM BUCHHEIT DEC: $96
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	$161	$104.65	$76.52 – $194.49
Office consultation with a specialist (moderate to high): 10 of 79 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $100.46 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $111.09 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $97.24 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $114.15 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $23.18 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $96.60 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $96.60 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $48.30 AUXIANT CONTRACTED [320462] — HB ARDM, OKLC NETWORK AFFILIATION AGREEMENT: $104.65 AUXIANT CONTRACTED [320462] — HB OKLC ADA ARDM BUCHHEIT DEC: $96.60
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 Mlp	$137	$89.05	$19.73 – $137
Office consultation with a specialist (moderate to high): 10 of 72 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $85.49 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $94.53 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $82.75 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $97.13 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $19.73 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $82.20 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $82.20 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $41.10 AUXIANT CONTRACTED [320462] — HB ARDM, OKLC NETWORK AFFILIATION AGREEMENT: $89.05 AUXIANT CONTRACTED [320462] — HB OKLC ADA ARDM BUCHHEIT DEC: $82.20
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	$199	$129.35	$28.66 – $199
Office consultation with a specialist (moderate to high): 10 of 71 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $124.18 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $137.31 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $120.20 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $141.09 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $28.66 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $119.40 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $119.40 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $59.70 AUXIANT CONTRACTED [320462] — HB ARDM, OKLC NETWORK AFFILIATION AGREEMENT: $129.35 AUXIANT CONTRACTED [320462] — HB OKLC ADA ARDM BUCHHEIT DEC: $119.40
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED Visit Care Level 3	$2,861	$1,859.65	$21 – $4,590
Emergency room visit (moderate): 10 of 125 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $4,590 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $1,546.29 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $3,861 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $1,588.87 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $246.57 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $252.40 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $252.40 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $1,344.60 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $1,344.60 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $347.34
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED Visit Care Level 4	$6,027.34	$3,917.77	$366.15 – $868.10
Emergency room visit (moderately high): 10 of 125 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $4,590 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $3,861 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $379.20 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $385.81 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $385.81 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $530.93 AMERICAN HEALTH ADVANTAGE OF OK MEDICARE [20019] — HB OKLC MANAGED MEDICARE: $385.81 AMG SPEC HOSP EDMOND [20034] — HB OKLC LTAC MCR 105%: $412.95 BCBS MEDICARE ADVANTAGE [20047] — HB OKLC MANAGED MEDICARE: $385.81 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB OKLC MANAGED MEDICARE: $385.81
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED Visit Care Level 5	$4,929	$3,203.85	$545.97 – $858.16
Emergency room visit (high): 10 of 125 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $4,590 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $3,861 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $545.97 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $550.64 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $550.64 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $757.77 AMERICAN HEALTH ADVANTAGE OF OK MEDICARE [20019] — HB OKLC MANAGED MEDICARE: $550.64 AMG SPEC HOSP EDMOND [20034] — HB OKLC LTAC MCR 105%: $589.37 BCBS MEDICARE ADVANTAGE [20047] — HB OKLC MANAGED MEDICARE: $550.64 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB OKLC MANAGED MEDICARE: $550.64

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	$29	$18.85	$11.31 – $29
Basic metabolic panel (blood test): 10 of 119 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $11.89 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $20.01 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $6.89 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $20.56 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $7.53 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $8.30 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $8.30 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $17.40 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $17.40 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $11.42
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POC Bmp W Calcium Total	$602	$391.30	$234.78 – $602
Basic metabolic panel (blood test): 10 of 119 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $11.89 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $415.38 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $6.89 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $426.82 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $7.53 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $8.30 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $8.30 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $361.20 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $361.20 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $11.42
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Comprehensive Metabolic Panel	$36	$23.40	$8.59 – $86.60
Comprehensive metabolic panel (blood test): 10 of 119 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $14.84 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $24.84 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $8.59 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $25.52 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $9.39 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $10.36 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $10.36 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $21.60 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $21.60 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $14.26
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Obstetric Panel	$519	$337.35	$202.41 – $519
Obstetric blood test panel: 10 of 116 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $67.22 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $358.11 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $38.92 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $367.97 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $42.53 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $46.90 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $46.90 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $311.40 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $311.40 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $64.54
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Lipid Panel	$74	$48.10	$28.86 – $74
Cholesterol panel (lipid panel): 10 of 119 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $18.83 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $51.06 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $10.90 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $52.47 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $11.91 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $13.14 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $13.14 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $44.40 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $44.40 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $18.08
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POC Lipid Panel	$238	$154.70	$92.82 – $238
Cholesterol panel (lipid panel): 10 of 119 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $18.83 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $164.22 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $10.90 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $168.74 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $11.91 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $13.14 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $13.14 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $142.80 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $142.80 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $18.08
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Renal Function Panel	$237	$154.05	$7.06 – $74.01
Kidney function panel: 10 of 119 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $12.20 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $163.53 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $7.06 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $168.03 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $7.72 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $8.52 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $8.52 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $142.20 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $142.20 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $11.72
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hepatic Function Panel	$153	$99.45	$6.66 – $60.62
Liver function panel: 10 of 119 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $11.50 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $105.57 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $6.66 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $108.48 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $7.27 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $8.01 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $8.01 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $91.80 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $91.80 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $11.03
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis Automated W Micro	$17	$11.05	$2.59 – $28.34
Urine test (automated, with microscope): 10 of 119 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $4.47 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $11.73 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $2.59 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $12.05 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $2.82 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $3.11 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $3.11 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $10.20 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $10.20 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $4.28
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POC Urinalysis Non-Auto	$41	$26.65	$2.84 – $7.68
Urine test (manual, without microscope): 10 of 120 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $4.90 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $28.29 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $2.84 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $29.07 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $3.10 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $3.41 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $3.41 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $24.60 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $24.60 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $4.70
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis Non Automated WO Micro	$44	$28.60	$2.84 – $7.68
Urine test (manual, without microscope): 10 of 120 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $4.90 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $30.36 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $2.84 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $31.20 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $3.10 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $3.41 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $3.41 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $26.40 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $26.40 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $4.70
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urine Ketones Nonautomated	$41	$26.65	$15.99 – $41
Urine test (manual, without microscope): 10 of 120 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $4.90 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $28.29 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $2.84 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $29.07 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $3.10 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $3.41 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $3.41 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $24.60 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $24.60 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $4.70
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POC Urinalysis Automated W/O Micro	$132	$85.80	$1.84 – $14.96
Urine test (automated, without microscope): 10 of 119 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $3.17 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $91.08 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $1.84 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $93.59 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $2 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $2.21 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $2.21 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $79.20 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $79.20 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $3.04
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis Automated W/O Micro	$12	$7.80	$4.68 – $12
Urine test (automated, without microscope): 10 of 119 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $3.17 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $8.28 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $1.84 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $8.51 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $2 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $2.21 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $2.21 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $7.20 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $7.20 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $3.04
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urine Ketones Automated	$142	$92.30	$1.84 – $14.96
Urine test (automated, without microscope): 10 of 119 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $3.17 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $97.98 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $1.84 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $100.68 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $2 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $2.21 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $2.21 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $85.20 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $85.20 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $3.04
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psa Total Diagnostic	$101	$65.65	$39.39 – $101
PSA (prostate specific antigen) blood test: 10 of 119 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $25.86 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $69.69 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $14.97 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $71.61 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $16.36 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $18.04 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $18.04 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $60.60 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $60.60 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $24.83
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psa Ultrasensitive	$151	$98.15	$58.89 – $151
PSA (prostate specific antigen) blood test: 10 of 119 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $25.86 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $104.19 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $14.97 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $107.06 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $16.36 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $18.04 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $18.04 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $90.60 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $90.60 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $24.83
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Tsh Newborn	$17	$11.05	$6.63 – $17
Thyroid stimulating hormone (TSH) test: 10 of 119 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $23.62 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $11.73 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $13.67 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $12.05 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $14.94 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $16.48 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $16.48 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $10.20 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $10.20 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $22.68
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Tsh Thyroid Stimulating Hormone	$92	$59.80	$13.67 – $101.20
Thyroid stimulating hormone (TSH) test: 10 of 119 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $23.62 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $63.48 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $13.67 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $65.23 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $14.94 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $16.48 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $16.48 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $55.20 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $55.20 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $22.68
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Cbc W Auto Diff	$27	$17.55	$6.33 – $51.17
Complete blood count (CBC) with differential: 10 of 119 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $10.93 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $18.63 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $6.33 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $19.14 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $6.91 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $7.62 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $7.62 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $16.20 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $16.20 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $10.49
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Cbc Automated WO Diff	$89	$57.85	$5.27 – $41.73
Complete blood count (CBC), automated: 10 of 119 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $9.10 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $61.41 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $5.27 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $63.10 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $5.75 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $6.35 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $6.35 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $53.40 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $53.40 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $8.73
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prothrombin Time	$22	$14.30	$3.49 – $28.34
Blood clotting time test (prothrombin time, PT): 10 of 119 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $6.02 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $15.18 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $3.49 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $15.60 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $3.82 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $4.21 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $4.21 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $13.20 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $13.20 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $5.79
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prothrombin Time Mixing Test	$56	$36.40	$21.84 – $56
Blood clotting time test (prothrombin time, PT): 10 of 119 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $6.02 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $38.64 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $3.49 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $39.70 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $3.82 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $4.21 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $4.21 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $33.60 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $33.60 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $5.79
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POC Prothrombin Time	$56	$36.40	$21.84 – $56
Blood clotting time test (prothrombin time, PT): 10 of 119 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $6.02 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $38.64 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $3.49 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $39.70 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $3.82 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $4.21 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $4.21 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $33.60 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $33.60 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $5.79
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ptt Mixing	$132	$85.80	$4.90 – $53.54
Blood clotting test (partial thromboplastin time, PTT): 10 of 119 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $8.46 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $91.08 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $4.90 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $93.59 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $5.35 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $5.90 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $5.90 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $79.20 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $79.20 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $8.11
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ptt Partial Thromboplastin Time	$41	$26.65	$4.90 – $53.54
Blood clotting test (partial thromboplastin time, PTT): 10 of 119 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $8.46 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $28.29 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $4.90 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $29.07 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $5.35 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $5.90 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $5.90 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $24.60 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $24.60 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $8.11

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	$2,298	$1,493.70	$469 – $470
CT scan of the head or brain, without contrast: 10 of 124 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $63.91 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $1,585.62 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $63.91 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $1,629.28 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $57.46 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $96.67 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $96.67 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $1,378.80 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $1,378.80 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $133.03
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	$4,534	$2,947.10	$520 – $749
MRI of the brain, before and after contrast: 10 of 124 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $229.35 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $3,128.46 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $229.35 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $3,214.61 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $183.49 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $322.58 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $322.58 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $2,720.40 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $2,720.40 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $443.91
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Xr Chest 2 Views	$633	$411.45	$76.36 – $181.05
Chest X-ray, 2 views: 10 of 123 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $394.99 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $436.77 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $382.33 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $448.80 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $19.41 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $80.47 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $80.47 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $379.80 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $379.80 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $110.73
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	$708	$460.20	$224.44 – $708
X-ray of the lower spine, at least 4 views: 10 of 124 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $171 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $488.52 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $152.48 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $501.97 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $33.02 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $96.67 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $96.67 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $424.80 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $424.80 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $133.03
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	$3,304	$2,147.60	$520 – $749
MRI of the lower back (lumbar spine), without contrast: 10 of 124 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $128.77 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $2,279.76 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $128.77 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $2,342.54 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $105.76 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $220.62 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $220.62 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $1,982.40 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $1,982.40 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $303.60
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT Pelvis W Cont	$2,488	$1,617.20	$146.32 – $1,206.14
CT scan of the pelvis, with contrast: 10 of 124 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $146.32 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $1,716.72 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $146.32 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $1,763.99 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $158.53 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $162.18 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $162.18 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $1,492.80 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $1,492.80 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $223.18
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	$4,704	$3,057.60	$209.37 – $496.40
MRI of a leg joint (such as the knee), without contrast: 10 of 124 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $146.01 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $3,245.76 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $146.01 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $3,335.14 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $120.47 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $220.62 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $220.62 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $2,822.40 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $2,822.40 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $303.60
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	$3,136	$2,038.40	$120.47 – $1,358.88
MRI of a leg joint (such as the knee), without contrast: 10 of 124 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $146.01 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $2,163.84 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $146.01 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $2,223.42 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $120.47 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $220.62 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $220.62 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $1,881.60 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $1,881.60 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $303.60
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	$3,136	$2,038.40	$520 – $749
MRI of a leg joint (such as the knee), without contrast: 10 of 124 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $146.01 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $2,163.84 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $146.01 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $2,223.42 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $120.47 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $220.62 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $220.62 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $1,881.60 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $1,881.60 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $303.60
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	$4,794	$3,116.10	$188.51 – $752.18
CT scan of the abdomen and pelvis, with contrast: 10 of 124 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $192.07 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $3,307.86 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $192.07 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $3,398.95 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $188.51 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $322.58 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $322.58 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $2,876.40 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $2,876.40 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $443.91
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US Abdomen Complete	$1,164	$756.60	$91.74 – $217.50
Ultrasound of the abdomen, complete: 10 of 124 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $72.69 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $803.16 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $72.69 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $825.28 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $65.49 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $96.67 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $96.67 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $698.40 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $698.40 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $133.03
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US Preg Uter 14 Wks Or>	$1,212	$787.80	$91.74 – $217.50
Pregnancy ultrasound (after the first trimester): 10 of 124 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $484.98 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $836.28 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $432.44 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $859.31 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $94.70 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $96.67 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $96.67 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $727.20 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $727.20 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $133.03
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US Transvaginal Non OB	$1,353	$879.45	$130
Transvaginal ultrasound: 10 of 124 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $462.42 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $933.57 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $412.32 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $959.28 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $72.43 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $96.67 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $96.67 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $811.80 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $811.80 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $133.03
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mamm Diagnostic Unilat Rt W Cad	$311	$202.15	$98.59 – $326.55
Diagnostic mammogram, one breast: 10 of 118 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $194.06 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $214.59 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $187.84 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $220.50 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $72.73 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $75.83 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $75.83 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $186.60 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $186.60 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $104.36
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mamm Diagnostic Unilat Lt W Cad	$311	$202.15	$71.97 – $259.08
Diagnostic mammogram, one breast: 10 of 118 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $194.06 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $214.59 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $187.84 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $220.50 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $72.73 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $75.83 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $75.83 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $186.60 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $186.60 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $104.36
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mamm Diagnostic Bilat W Cad	$630	$409.50	$92.30 – $327.99
Diagnostic mammogram, both breasts: 10 of 118 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $393.12 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $434.70 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $380.52 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $446.67 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $93.26 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $97.26 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $97.26 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $378 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $378 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $133.84
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mamm Scrn Left W Cad	$475	$308.75	$76.15 – $264.60
Screening mammogram, both breasts: 10 of 118 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $296.40 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $327.75 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $286.90 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $336.78 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $76.90 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $80.24 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $80.24 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $285 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $285 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $110.42
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mamm Scrn Right W Cad	$475	$308.75	$76.15 – $264.60
Screening mammogram, both breasts: 10 of 118 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $296.40 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $327.75 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $286.90 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $336.78 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $76.90 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $80.24 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $80.24 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $285 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $285 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $110.42
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mamm Scrn Bilat Implant W Cad	$610	$396.50	$76.15 – $264.60
Screening mammogram, both breasts: 10 of 118 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $380.64 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $420.90 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $368.44 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $432.49 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $76.90 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $80.24 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $80.24 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $366 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $366 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $110.42

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Lt Heart Cath Including Inj Lt Ventriculography, S/I	$20,782	$13,508.30	$134.65 – $5,961.87
Left heart catheterization (diagnostic): 10 of 119 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $9,109 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $14,339.58 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $7,171 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $14,734.44 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $749.56 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $2,997.57 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $2,997.57 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $12,469.20 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $12,469.20 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $4,125.10
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Comp Eval WO Induction	$19,164	$12,456.60	$383 – $14,343.48
Heart rhythm study (electrophysiology evaluation): 10 of 116 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $13,223.16 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $13,587.28 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $6,757.32 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $7,211.77 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $7,211.77 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $11,498.40 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $11,498.40 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $9,924.46 AMERICAN HEALTH ADVANTAGE OF OK MEDICARE [20019] — HB OKLC MANAGED MEDICARE: $7,211.77 AMG SPEC HOSP EDMOND [20034] — HB OKLC LTAC MCR 105%: $7,719.02
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Comp Ep Eval Pvi W/3d Mapping	$50,769	$32,999.85	$22,935.96 – $54,378.67
Heart rhythm study with ablation for atrial fibrillation: 10 of 117 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $35,030.61 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $35,995.22 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $817.30 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $24,167.75 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $24,167.75 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $30,461.40 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $30,461.40 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $33,258.37 AMERICAN HEALTH ADVANTAGE OF OK MEDICARE [20019] — HB OKLC MANAGED MEDICARE: $24,167.75 AMG SPEC HOSP EDMOND [20034] — HB OKLC LTAC MCR 105%: $25,867.62
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	$5,430	$3,529.50	$1,476 – $2,214
Sleep study (overnight, in a sleep lab): 10 of 124 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $969.03 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $3,746.70 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $889.75 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $3,849.87 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $527.77 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $794.01 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $794.01 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $3,258 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $3,258 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $1,092.68
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 <6 Hrs	$8,306	$5,398.90	$1,476 – $2,214
Sleep study (overnight, in a sleep lab): 10 of 124 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $969.03 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $5,731.14 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $889.75 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $5,888.95 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $527.77 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $794.01 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $794.01 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $4,983.60 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $4,983.60 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $1,092.68

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 Ther Exer 1 or > Area Ea 15m	$136	$88.40	$96 – $144
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 119 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $55.01 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $93.84 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $49.51 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $96.42 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $25.94 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $27.13 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $27.13 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $81.60 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $81.60 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $37.34
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ot Ther Exer 1or> Area Ea 15m Chl Dev	$329	$213.85	$104.29 – $329
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 119 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $55.01 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $227.01 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $49.51 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $233.26 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $25.94 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $27.13 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $27.13 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $197.40 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $197.40 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $37.34
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Ther Exer 1 or > Area Ea 15m	$136	$88.40	$21.76 – $68.56
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 119 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $55.01 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $93.84 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $49.51 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $96.42 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $25.94 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $27.13 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $27.13 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $81.60 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $81.60 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $37.34
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval Level I 105 Min	$659	$428.35	$208.90 – $659
Physical therapy evaluation (low complexity): 10 of 118 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $411.22 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $454.71 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $398.04 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $467.23 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $88.72 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $91.55 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $91.55 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $395.40 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $395.40 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $125.98
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval Level I 15 Min	$174	$113.10	$86.88 – $205.99
Physical therapy evaluation (low complexity): 10 of 118 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $108.58 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $120.06 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $105.10 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $123.37 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $88.72 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $91.55 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $91.55 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $104.40 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $104.40 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $125.98
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval Level I 150 Min	$659	$428.35	$96 – $144
Physical therapy evaluation (low complexity): 10 of 118 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $411.22 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $454.71 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $398.04 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $467.23 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $88.72 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $91.55 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $91.55 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $395.40 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $395.40 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $125.98
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval Level II 105 Min	$497	$323.05	$157.55 – $497
Physical therapy evaluation (moderate complexity): 10 of 118 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $310.13 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $342.93 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $300.19 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $352.37 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $88.72 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $91.55 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $91.55 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $298.20 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $298.20 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $125.98
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval Level II 135 Min	$627	$407.55	$96 – $144
Physical therapy evaluation (moderate complexity): 10 of 118 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $391.25 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $432.63 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $378.71 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $444.54 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $88.72 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $91.55 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $91.55 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $376.20 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $376.20 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $125.98
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval Level II 90 Min	$486	$315.90	$86.88 – $205.99
Physical therapy evaluation (moderate complexity): 10 of 118 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $303.26 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $335.34 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $293.54 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $344.57 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $88.72 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $91.55 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $91.55 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $291.60 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $291.60 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $125.98
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval Level III 150 Min	$738	$479.70	$233.95 – $738
Physical therapy evaluation (high complexity): 10 of 118 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $460.51 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $509.22 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $445.75 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $523.24 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $88.72 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $91.55 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $91.55 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $442.80 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $442.80 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $125.98
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval Level III 30 Min	$288	$187.20	$91.30 – $288
Physical therapy evaluation (high complexity): 10 of 118 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $179.71 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $198.72 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $173.95 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $204.19 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $88.72 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $91.55 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $91.55 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $172.80 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $172.80 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $125.98
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval Level III 45 Min	$327	$212.55	$96 – $144
Physical therapy evaluation (high complexity): 10 of 118 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $204.05 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $225.63 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $197.51 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $231.84 AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $88.72 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $91.55 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $91.55 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $196.20 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $196.20 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $125.98

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Surgical Arthroscopy Sho W/Coracoacrm Ligm Rls	$20,397.24	$13,258.21	$6,367.32 – $15,096.24
Shoulder arthroscopy: shaving of shoulder bone: 10 of 115 insurance plan rates AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $6,361.60 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $6,709.29 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $6,709.29 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $9,232.96 AMERICAN HEALTH ADVANTAGE OF OK MEDICARE [20019] — HB OKLC MANAGED MEDICARE: $6,709.29 AMG SPEC HOSP EDMOND [20034] — HB OKLC LTAC MCR 105%: $7,181.19 BCBS MEDICARE ADVANTAGE [20047] — HB OKLC MANAGED MEDICARE: $6,709.29 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB OKLC MANAGED MEDICARE: $6,709.29 BLUE CROSS AND BLUE SHIELD [20053] — HB OKLC BCBS OF OK NATIVEBLUE MCR 103%: $142.31 BLUE CROSS AND BLUE SHIELD [20053] — HB OKLC BLUE CHOICE: $7,413.38
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Arthrs Knee Surg W/Meniscectomy Med/Lat W/Shvg	$10,336.78	$6,718.91	$297 – $6,017.17
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 116 insurance plan rates AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $2,889.37 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $3,025.38 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $3,025.38 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $4,163.36 AMERICAN HEALTH ADVANTAGE OF OK MEDICARE [20019] — HB OKLC MANAGED MEDICARE: $3,025.38 AMG SPEC HOSP EDMOND [20034] — HB OKLC LTAC MCR 105%: $3,238.17 BCBS MEDICARE ADVANTAGE [20047] — HB OKLC MANAGED MEDICARE: $3,025.38 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB OKLC MANAGED MEDICARE: $3,025.38 BLUE CROSS AND BLUE SHIELD [20053] — HB OKLC BCBS OF OK NATIVEBLUE MCR 103%: $487.28 BLUE CROSS AND BLUE SHIELD [20053] — HB OKLC BLUE CHOICE: $3,342.87
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Tonsillectomy & Adenoidectomy <Age 12	$6,719.55	$4,367.71	$249.29 – $10,886.49
Removal of tonsils and adenoids (under age 12): 10 of 114 insurance plan rates AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $5,267.98 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $5,473.63 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $5,473.63 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $7,532.52 AMERICAN HEALTH ADVANTAGE OF OK MEDICARE [20019] — HB OKLC MANAGED MEDICARE: $5,473.63 AMG SPEC HOSP EDMOND [20034] — HB OKLC LTAC MCR 105%: $5,858.63 BCBS MEDICARE ADVANTAGE [20047] — HB OKLC MANAGED MEDICARE: $5,473.63 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB OKLC MANAGED MEDICARE: $5,473.63 BLUE CROSS AND BLUE SHIELD [20053] — HB OKLC BCBS OF OK NATIVEBLUE MCR 103%: $249.29 BLUE CROSS AND BLUE SHIELD [20053] — HB OKLC BLUE CHOICE: $6,048.05
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: GI Upper Endoscopy Complex	$2,177	$1,415.05	$217.70 – $2,177
Upper GI endoscopy (diagnostic): 10 of 120 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $1,358.45 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $1,502.13 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $1,314.91 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $1,543.49 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $313.49 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $838.62 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $1,306.20 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $1,306.20 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $653.10 AMERICAN HEALTH ADVANTAGE OF OK MEDICARE [20019] — HB OKLC MANAGED MEDICARE: $838.62
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: GI Egd W/Biopsy Pf	$5,635.33	$3,662.96	$48.18 – $1,886.94
Upper GI endoscopy with biopsy: 10 of 110 insurance plan rates AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $838.62 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $838.62 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $1,154.07 AMERICAN HEALTH ADVANTAGE OF OK MEDICARE [20019] — HB OKLC MANAGED MEDICARE: $838.62 AMG SPEC HOSP EDMOND [20034] — HB OKLC LTAC MCR 105%: $897.61 BCBS MEDICARE ADVANTAGE [20047] — HB OKLC MANAGED MEDICARE: $838.62 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB OKLC MANAGED MEDICARE: $838.62 BLUE CROSS AND BLUE SHIELD [20053] — HB OKLC BCBS OF OK NATIVEBLUE MCR 103%: $119.53 BLUE CROSS AND BLUE SHIELD [20053] — HB OKLC BLUE CHOICE: $926.63 BLUE CROSS AND BLUE SHIELD [20053] — HB OKLC BLUE CROSS ADVANTAGE PPO: $926.63
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: GI Colonoscopy	$4,078.99	$2,651.34	$236 – $2,360
Colonoscopy (diagnostic): 10 of 120 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $1,472.64 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $1,628.40 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $1,425.44 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $1,673.24 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $339.84 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $859.86 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $1,416 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $1,416 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $708 AMERICAN HEALTH ADVANTAGE OF OK MEDICARE [20019] — HB OKLC MANAGED MEDICARE: $859.86
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: GI Colo Biopsy Cold Pf	$5,125.64	$3,331.67	$48.18 – $2,489.56
Colonoscopy with biopsy: 10 of 111 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $1,275 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $1,106.45 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $1,106.45 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $1,522.63 AMERICAN HEALTH ADVANTAGE OF OK MEDICARE [20019] — HB OKLC MANAGED MEDICARE: $1,106.45 AMG SPEC HOSP EDMOND [20034] — HB OKLC LTAC MCR 105%: $1,184.27 BCBS MEDICARE ADVANTAGE [20047] — HB OKLC MANAGED MEDICARE: $1,106.45 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB OKLC MANAGED MEDICARE: $1,106.45 BLUE CROSS AND BLUE SHIELD [20053] — HB OKLC BCBS OF OK NATIVEBLUE MCR 103%: $172.17 BLUE CROSS AND BLUE SHIELD [20053] — HB OKLC BLUE CHOICE: $1,222.56
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: GI Colo Biopsy Snare Pf	$5,154.03	$3,350.12	$1,275
Colonoscopy with removal of polyps (snare): 10 of 111 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $1,275 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $1,106.45 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $1,106.45 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $1,522.63 AMERICAN HEALTH ADVANTAGE OF OK MEDICARE [20019] — HB OKLC MANAGED MEDICARE: $1,106.45 AMG SPEC HOSP EDMOND [20034] — HB OKLC LTAC MCR 105%: $1,184.27 BCBS MEDICARE ADVANTAGE [20047] — HB OKLC MANAGED MEDICARE: $1,106.45 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB OKLC MANAGED MEDICARE: $1,106.45 BLUE CROSS AND BLUE SHIELD [20053] — HB OKLC BCBS OF OK NATIVEBLUE MCR 103%: $216.93 BLUE CROSS AND BLUE SHIELD [20053] — HB OKLC BLUE CHOICE: $1,222.56
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Lap,Cholecystectomy Pf	$13,556.37	$8,811.64	$363 – $11,117.65
Gallbladder removal by laparoscope: 10 of 116 insurance plan rates AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $5,195.58 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $5,589.85 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $5,589.85 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $7,692.46 AMERICAN HEALTH ADVANTAGE OF OK MEDICARE [20019] — HB OKLC MANAGED MEDICARE: $5,589.85 AMG SPEC HOSP EDMOND [20034] — HB OKLC LTAC MCR 105%: $5,983.02 BCBS MEDICARE ADVANTAGE [20047] — HB OKLC MANAGED MEDICARE: $5,589.85 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB OKLC MANAGED MEDICARE: $5,589.85 BLUE CROSS AND BLUE SHIELD [20053] — HB OKLC BCBS OF OK NATIVEBLUE MCR 103%: $599.95 BLUE CROSS AND BLUE SHIELD [20053] — HB OKLC BLUE CHOICE: $6,176.47
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Rx Ing Hernia,5+Y/O,Reducibl Pf	$12,161.20	$7,904.78	$363 – $6,584.31
Groin (inguinal) hernia repair, age 5 or older: 10 of 113 insurance plan rates AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $3,142.68 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $3,310.53 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $3,310.53 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $4,555.78 AMERICAN HEALTH ADVANTAGE OF OK MEDICARE [20019] — HB OKLC MANAGED MEDICARE: $3,310.53 AMG SPEC HOSP EDMOND [20034] — HB OKLC LTAC MCR 105%: $3,543.38 BCBS MEDICARE ADVANTAGE [20047] — HB OKLC MANAGED MEDICARE: $3,310.53 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB OKLC MANAGED MEDICARE: $3,310.53 BLUE CROSS AND BLUE SHIELD [20053] — HB OKLC BCBS OF OK NATIVEBLUE MCR 103%: $481.05 BLUE CROSS AND BLUE SHIELD [20053] — HB OKLC BLUE CHOICE: $3,657.95
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Bx Prostate Needle/Punch	$9,386.18	$6,101.02	$53.24 – $1,824.23
Prostate biopsy: 10 of 115 insurance plan rates AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $1,824.23 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $331.43 AMERICAN HEALTH ADVANTAGE OF OK MEDICARE [20019] — HB OKLC MANAGED MEDICARE: $331.43 AMG SPEC HOSP EDMOND [20034] — HB OKLC LTAC MCR 105%: $51.57 BCBS MEDICARE ADVANTAGE [20047] — HB OKLC MANAGED MEDICARE: $331.43 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB OKLC MANAGED MEDICARE: $331.43 BLUE CROSS AND BLUE SHIELD [20053] — HB OKLC BCBS OF OK NATIVEBLUE MCR 103%: $222.50 BLUE CROSS AND BLUE SHIELD [20053] — HB OKLC BLUE CHOICE: $53.24 BLUE CROSS AND BLUE SHIELD [20053] — HB OKLC BLUE CROSS ADVANTAGE PPO: $53.24 BLUE CROSS AND BLUE SHIELD [20053] — HB OKLC BLUE CROSS PREFERRED: $53.24
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Laps Surg Prst8ect Rpbic Rad W/Nerve Sparing	$31,696.63	$20,602.81	$363 – $19,548.13
Prostate removal by laparoscope (radical prostatectomy): 10 of 117 insurance plan rates AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $1,056.31 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $9,828.62 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $9,828.62 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $13,525.63 AMERICAN HEALTH ADVANTAGE OF OK MEDICARE [20019] — HB OKLC MANAGED MEDICARE: $9,828.62 AMG SPEC HOSP EDMOND [20034] — HB OKLC LTAC MCR 105%: $10,519.93 BCBS MEDICARE ADVANTAGE [20047] — HB OKLC MANAGED MEDICARE: $9,828.62 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB OKLC MANAGED MEDICARE: $9,828.62 BLUE CROSS AND BLUE SHIELD [20053] — HB OKLC BCBS OF OK NATIVEBLUE MCR 103%: $1,049.97 BLUE CROSS AND BLUE SHIELD [20053] — HB OKLC BLUE CHOICE: $10,860.07
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hysteroscopy Bx Endometrium&/Polypc W/WO D&C	$11,101.11	$7,215.72	$197.42 – $5,953.03
Hysteroscopy with biopsy of the uterus lining: 10 of 114 insurance plan rates AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $2,831.42 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $2,993.13 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $2,993.13 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $4,118.99 AMERICAN HEALTH ADVANTAGE OF OK MEDICARE [20019] — HB OKLC MANAGED MEDICARE: $2,993.13 AMG SPEC HOSP EDMOND [20034] — HB OKLC LTAC MCR 105%: $3,203.66 BCBS MEDICARE ADVANTAGE [20047] — HB OKLC MANAGED MEDICARE: $2,993.13 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB OKLC MANAGED MEDICARE: $2,993.13 BLUE CROSS AND BLUE SHIELD [20053] — HB OKLC BCBS OF OK NATIVEBLUE MCR 103%: $197.42 BLUE CROSS AND BLUE SHIELD [20053] — HB OKLC BLUE CHOICE: $3,307.24
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Inject Interlaminar Lumbar or Sacral W Imag	$3,484.54	$2,264.95	$619.41 – $1,468.55
Spinal injection, lower back (epidural), with imaging guidance: 10 of 119 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $992.16 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $960.36 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $652.68 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $652.68 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $898.18 AMERICAN HEALTH ADVANTAGE OF OK MEDICARE [20019] — HB OKLC MANAGED MEDICARE: $652.68 AMG SPEC HOSP EDMOND [20034] — HB OKLC LTAC MCR 105%: $698.58 BCBS MEDICARE ADVANTAGE [20047] — HB OKLC MANAGED MEDICARE: $652.68 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB OKLC MANAGED MEDICARE: $652.68 BLUE CROSS AND BLUE SHIELD [20053] — HB OKLC BCBS OF OK NATIVEBLUE MCR 103%: $86.63
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Inj Transforminal Epi/Lumb/Sacral Sngl Level	$4,554.40	$2,960.36	$194.70 – $1,947
Nerve root injection, lower back, with imaging guidance: 10 of 121 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $1,214.93 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $1,175.99 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $280.37 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $817.81 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $584.10 AMERICAN HEALTH ADVANTAGE OF OK MEDICARE [20019] — HB OKLC MANAGED MEDICARE: $817.81 AMG SPEC HOSP EDMOND [20034] — HB OKLC LTAC MCR 105%: $875.33 BCBS MEDICARE ADVANTAGE [20047] — HB OKLC MANAGED MEDICARE: $817.81 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB OKLC MANAGED MEDICARE: $817.81 BLUE CROSS AND BLUE SHIELD [20053] — HB OKLC BCBS OF OK NATIVEBLUE MCR 103%: $96.36
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Bilat Inj Epi/Lumb/Sacral Sngl Level	$2,828	$1,838.20	$297
Nerve root injection, lower back, with imaging guidance: 10 of 71 insurance plan rates AETNA CONTRACTED [320008] — HB OKLC AETNA POS HMO GATED: $1,764.67 AETNA CONTRACTED [320008] — HB OKLC AETNA PPO NON-GATED: $1,951.32 AETNA CONTRACTED [320008] — HB OKLC AETNA PREFERRED COX & NBD: $1,708.11 AETNA CONTRACTED [320008] — HB OKLC AETNA SIGNATURE ASA: $2,005.05 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $407.23 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM LACLEDE CHAIN DEC: $1,696.80 AITHER HEALTH CONTRACTED [320449] — HB OKLC ADA ARDM WOODARD DEC NEW 040124: $1,696.80 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $848.40 AUXIANT CONTRACTED [320462] — HB ARDM, OKLC NETWORK AFFILIATION AGREEMENT: $1,838.20 AUXIANT CONTRACTED [320462] — HB OKLC ADA ARDM BUCHHEIT DEC: $1,696.80
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Neuroplas/ Tranposit Median Nerve at Carp Tiunn Pf	$9,370.95	$6,091.12	$320 – $3,591.04
Carpal tunnel release: 10 of 115 insurance plan rates AETNA MEDICAID CONTRACTED [320009] — HB OKLC OK MEDICAID (SOONERCARE): $1,738.97 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC AETNA MCR: $1,805.54 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB OKLC MANAGED MEDICARE: $1,805.54 AMBETTER CONTRACTED [320452] — HB OKLC AMBETTER EXCHANGE MEDICARE: $2,484.69 AMERICAN HEALTH ADVANTAGE OF OK MEDICARE [20019] — HB OKLC MANAGED MEDICARE: $1,805.54 AMG SPEC HOSP EDMOND [20034] — HB OKLC LTAC MCR 105%: $1,932.54 BCBS MEDICARE ADVANTAGE [20047] — HB OKLC MANAGED MEDICARE: $1,805.54 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB OKLC MANAGED MEDICARE: $1,805.54 BLUE CROSS AND BLUE SHIELD [20053] — HB OKLC BCBS OF OK NATIVEBLUE MCR 103%: $397.69 BLUE CROSS AND BLUE SHIELD [20053] — HB OKLC BLUE CHOICE: $1,995.02

Source: Mercy Hospital Oklahoma City, Inc’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 12, 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	Acute Care Hospital
Address	4300 West Memorial Road, Oklahoma City, OK 73120
County	Oklahoma County
State	Oklahoma
Phone	(405) 755‑1515
Emergency services	Yes
Ownership	Voluntary non-profit - Church
Medicare overall rating	4 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	370013
Name in Medicare records	MERCY HOSPITAL OKLAHOMA CITY, INC
Profile level	Medicare data + hospital website
Name on the hospital’s website	Mercy Hospital Oklahoma City
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 Oklahoma City — mercy.net
Mercy Hospital Oklahoma City — mercy.net
Mercy Birthing Center - Love Family Women's Center | Mercy — mercy.net
Mercy Therapy Services - Love Family Women's Center | Mercy — mercy.net