Mercy Hospital Tishomingo INC

1000 South Byrd St, Tishomingo, OK 73460 · (580) 371-2327

Critical Access HospitalsVoluntary non-profit - ChurchPart of Mercy Health · 28 hospitals Website ↗Website taken from the domain of its price file

Price file

Prices published

File dated 2026-06-11

431 price rows for 24 procedures

Published prices

cash · negotiated range · list

Basic metabolic panel (blood test)

CPT 80048

$86

cash

$8 to $11

5 negotiated rates

$133

list

CT scan of the abdomen and pelvis, with contrast

CPT 74177

$2,871

cash

$189 to $802

5 negotiated rates

$4,417

list

CT scan of the head, no contrast

CPT 70450

$1,446

cash

$57 to $294

5 negotiated rates

$2,225

list

CT scan of the pelvis, with contrast

CPT 72193

$2,122

cash

$159 to $493

5 negotiated rates

$3,264

list

Chlamydia test (DNA)

CPT 87491 · lowest of 2 lines

$83

cash

$31 to $47

14 negotiated rates

$128

list

Complete blood count (CBC) with differential

CPT 85025

$72

cash

$7 to $13

50 negotiated rates

$110

list

Comprehensive metabolic panel (blood test)

CPT 80053

$120

cash

$9 to $17

51 negotiated rates

$185

list

Established patient office visit (about 40 minutes)

CPT 99215

$227

cash

$159 to $308

5 negotiated rates

$349

list

Gonorrhea test (DNA)

CPT 87591 · lowest of 2 lines

$83

cash

$31 to $47

14 negotiated rates

$128

list

Hospital stay for digestive disorders, no complications

MS-DRG 392

$8,097

cash

$2,395 to $10,080

48 negotiated rates

$12,457

list

Lipid panel (cholesterol test)

CPT 80061 · lowest of 2 lines

$105

cash

$12 to $17

10 negotiated rates

$161

list

Liver function panel

CPT 80076

$146

cash

$7 to $10

5 negotiated rates

$225

list

New patient office visit (about 30 minutes)

CPT 99203

$177

cash

$98 to $187

5 negotiated rates

$273

list

New patient office visit (about 45 minutes)

CPT 99204

$226

cash

$148 to $283

5 negotiated rates

$347

list

New patient office visit (about 60 minutes)

CPT 99205

$295

cash

$195 to $378

5 negotiated rates

$454

list

PSA test (prostate)

CPT 84153 · lowest of 2 lines

$101

cash

$16 to $25

20 negotiated rates

$156

list

Partial thromboplastin time (blood clotting test)

CPT 85730

$85

cash

$5 to $8

5 negotiated rates

$130

list

Physical therapy, therapeutic exercise (15 minutes)

CPT 97110 · lowest of 3 lines

$83

cash

$26 to $47

15 negotiated rates

$127

list

Prothrombin time (blood clotting test)

CPT 85610

$46

cash

$4 to $5

5 negotiated rates

$71

list

TSH test (thyroid)

CPT 84443 · lowest of 2 lines

$16

cash

$15 to $21

10 negotiated rates

$24

list

Transvaginal ultrasound

CPT 76830

$532

cash

$72 to $240

5 negotiated rates

$819

list

Ultrasound of the abdomen (complete)

CPT 76700

$283

cash

$65 to $240

5 negotiated rates

$435

list

Urinalysis with microscope

CPT 81001

$57

cash

$3 to $4

5 negotiated rates

$87

list

X-ray of the lower spine (4 or more views)

CPT 72110

$358

cash

$33 to $240

5 negotiated rates

$551

list

Source files

The machine-readable files this hospital lists in its cms-hpt.txt. Every price above comes from one of them.

https://www.mercy.net/content/dam/mercy/en/web-assets/charge-files/274433830_mercy-hospital-tishomingo_standardcharges.zip
Mercy Hospital Tishomingo · discovered · tall v3.0.0 · file dated 2026-06-11 · 2.7 MB · 431 price rows read · read Oct 2026