Mercy Hospital Healdton Menu
| Items | |||||
|---|---|---|---|---|---|
| Treatment Room - Established Patient Office Or Other Outpatient Visit, Typically 5 Minutes (350001098) | $138.00 |
N/A
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||
| Therapeutic Services - Respiratory Inhaled Pressure Or Nonpressure Treatment To Relieve Airway Obstruction Or For Sputum Specimen (100001469) | $105.00 |
N/A
|
|
||
| Therapeutic Services - Insertion Of Indwelling Bladder Catheter (100001351) | $230.00 |
N/A
|
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||
| Therapeutic Services - Injection Therapy For Diagnosis Or Prevention, Under The Skin Or Into Muscle (100001420) | $135.00 |
N/A
|
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||
| Therapeutic Services - Injection Therapy For Diagnosis Or Prevention, Into Vein (100001422) | $167.00 |
N/A
|
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| Therapeutic Services - Injection Therapy For Diagnosis Or Prevention, Additional Sequential Injection Of Same Substance Into Vein (100001541) | $167.00 |
N/A
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| Therapeutic Services - Injection Therapy For Diagnosis Or Prevention, Additional Sequential Injection Of New Substance Into Vein (100001493) | $167.00 |
N/A
|
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| Supplies - Splint (400000681) | $15.00 |
N/A
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| Supplies (100001109) | $318.00 |
N/A
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| Supplies (400031090) | $138.00 |
N/A
|
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| Supplies (400001091) | $40.00 |
N/A
|
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| Supplies (400001094) | $35.00 |
N/A
|
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| Supplies (400053388) | $32.00 |
N/A
|
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| Supplies (400002910) | $31.00 |
N/A
|
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| Supplies (400051848) | $28.00 |
N/A
|
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| Supplies (400055912) | $23.00 |
N/A
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| Supplies (400016175) | $20.00 |
N/A
|
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| Supplies (400002909) | $15.00 |
N/A
|
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| Supplies (400037191) | $13.00 |
N/A
|
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| Supplies (400021415) | $11.00 |
N/A
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| Supplies (400021419) | $10.00 |
N/A
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| Supplies (400021421) | $9.00 |
N/A
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| Supplies (400021418) | $9.00 |
N/A
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| Supplies (400021420) | $9.00 |
N/A
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| Supplies (400014363) | $8.00 |
N/A
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| Supplies (400019087) | $5.00 |
N/A
|
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| Sterile Supplies - Ostomy Skin Barrier (400006834) | $9.00 |
N/A
|
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||
| Sterile Supplies (400051751) | $80.00 |
N/A
|
|
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| Sterile Supplies (400035732) | $46.00 |
N/A
|
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| Sterile Supplies (400046436) | $36.00 |
N/A
|
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| Sterile Supplies (400055121) | $33.00 |
N/A
|
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| Sterile Supplies (400014154) | $33.00 |
N/A
|
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| Sterile Supplies (400014987) | $29.00 |
N/A
|
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| Sterile Supplies (400003635) | $11.00 |
N/A
|
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| Sterile Supplies (400005627) | $11.00 |
N/A
|
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| Sterile Supplies (400041135) | $10.00 |
N/A
|
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| Sterile Supplies (400020788) | $9.00 |
N/A
|
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| Sterile Supplies (400005626) | $9.00 |
N/A
|
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| Sterile Supplies (400006147) | $8.00 |
N/A
|
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| Sterile Supplies (400041036) | $5.00 |
N/A
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| Sterile Supplies (400036506) | $5.00 |
N/A
|
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| Sterile Supplies (400003133) | $3.00 |
N/A
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| Room & Board - Semi-Private (140000002) | $700.00 |
N/A
|
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| Room & Board - Semi-Private (140000090) | $650.00 |
N/A
|
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| Room & Board - Private (140000089) | $690.00 |
N/A
|
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| Respiratory Services - Respiratory Inhaled Pressure Or Nonpressure Treatment To Relieve Airway Obstruction Or For Sputum Specimen (100001536) | $105.00 |
N/A
|
|
||
| Respiratory Services - Respiratory Inhaled Pressure Or Nonpressure Treatment To Relieve Airway Obstruction Or For Sputum Specimen (100001535) | $105.00 |
N/A
|
|
||
| Respiratory Services - Multiple Measurements Of Oxygen Saturation In Blood Using Ear Or Finger Device (100001538) | $190.00 |
N/A
|
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||
| Respiratory Services - Multiple Measurements Of Oxygen Saturation In Blood Using Ear Or Finger Device (100001461) | $190.00 |
N/A
|
|
||
| Respiratory Services - Measurement Of Oxygen Saturation In Blood Using Ear Or Finger Device (100001460) | $94.00 |
N/A
|
|
||
| Prosthetic/orthotic Supplies - Shoulder Brace (400015812) | $24.00 |
N/A
|
|
||
| Professional Services - Subsequent Nursing Facility Visit, Typically 15 Minutes Per Day (350002034) | $145.00 |
N/A
|
|
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| Professional Services - Subsequent Nursing Facility Visit, Typically 10 Minutes Per Day (350002033) | $97.00 |
N/A
|
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| Professional Services - Simple Wound Repair Of The Face, Ears, Eyelids, Nose, Lips, Or Mucous Membranes (200002501) | $339.00 |
N/A
|
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| Professional Services - Hospital Observation Care On Day Of Discharge (200003143) | $176.00 |
N/A
|
|
||
| Professional Services - Emergency Department Visit, Self Limited Or Minor Problem (200003151) | $108.00 |
N/A
|
|
||
| Professional Services - Emergency Department Visit, Problem With Significant Threat To Life Or Function (200003159) | $645.00 |
N/A
|
|
||
| Professional Services - Emergency Department Visit, Problem With Significant Threat To Life Or Function (200003158) | $548.00 |
N/A
|
|
||
| Professional Services - Emergency Department Visit, Problem Of High Severity (200003157) | $431.00 |
N/A
|
|
||
| Professional Services - Emergency Department Visit, Problem Of High Severity (200003156) | $366.00 |
N/A
|
|
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| Professional Services - Emergency Department Visit, Moderately Severe Problem (200003155) | $280.00 |
N/A
|
|
||
| Professional Services - Emergency Department Visit, Moderately Severe Problem (200003154) | $238.00 |
N/A
|
|
||
| Professional Services - Emergency Department Visit, Low To Moderately Severe Problem (200003153) | $176.00 |
N/A
|
|
||
| Professional Services - Emergency Department Visit, Low To Moderately Severe Problem (200003152) | $150.00 |
N/A
|
|
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| Professional Services - Critical Care Delivery Critically Ill Or Injured Patient, First 30-74 Minutes (200003160) | $714.00 |
N/A
|
|
||
| Preventive Services - Administration Of Vaccine By Injection, 1 Vaccine (100001548) | $94.00 |
N/A
|
|
||
| Physical Therapy - Walking Training To 1 Or More Areas, Each 15 Minutes (370001311) | $84.00 |
N/A
|
|
||
| Physical Therapy - Therapeutic Procedures In A Group Setting (370002041) | $50.00 |
N/A
|
|
||
| Physical Therapy - Therapeutic Exercise To Develop Strength, Endurance, Range Of Motion, And Flexibility, Each 15 Minutes (370001262) | $105.00 |
N/A
|
|
||
| Physical Therapy - Therapeutic Activities To Improve Function With One-On-One Contact Between Patient And Provider, Each 15 Minutes (370001355) | $100.00 |
N/A
|
|
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| Physical Therapy - Re-Evaluation Of Physical Therapy, Typically 20 Minutes (370002430) | $125.00 |
N/A
|
|
||
| Physical Therapy - Manual Therapy Techniques To 1 Or More Regions, Each 15 Minutes (370001332) | $132.00 |
N/A
|
|
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| Physical Therapy - Evaluation Of Physical Therapy, Typically 30 Minutes (370002412) | $210.00 |
N/A
|
|
||
| Physical Therapy - Evaluation Of Physical Therapy, Typically 20 Minutes (370002404) | $210.00 |
N/A
|
|
||
| Physical Therapy - Evaluation Of Physical Therapy, Typically 20 Minutes (370002403) | $170.00 |
N/A
|
|
||
| Physical Therapy - Evaluation Of Physical Therapy, Typically 20 Minutes (370002402) | $130.00 |
N/A
|
|
||
| Physical Therapy - Application Of Ultrasound To 1 Or More Areas, Each 15 Minutes (370001243) | $105.00 |
N/A
|
|
||
| Physical Therapy - Application Of Electrical Stimulation To 1 Or More Areas, Each 15 Minutes (370001231) | $110.00 |
N/A
|
|
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| Occupational Therapy - Wheelchair Management, Each 15 Minutes (370001393) | $90.00 |
N/A
|
|
||
| Occupational Therapy - Therapeutic Procedures In A Group Setting (370002049) | $50.00 |
N/A
|
|
||
| Occupational Therapy - Therapeutic Exercise To Develop Strength, Endurance, Range Of Motion, And Flexibility, Each 15 Minutes (370001276) | $105.00 |
N/A
|
|
||
| Occupational Therapy - Therapeutic Activities To Improve Function With One-On-One Contact Between Patient And Provider, Each 15 Minutes (370001357) | $100.00 |
N/A
|
|
||
| Occupational Therapy - Self-Care Or Home Management Training, Each 15 Minutes (370001374) | $115.00 |
N/A
|
|
||
| Occupational Therapy - Manual Therapy Techniques To 1 Or More Regions, Each 15 Minutes (370001334) | $132.00 |
N/A
|
|
||
| Occupational Therapy - Evaluation Of Occupational Therapy, Typically 30 Minutes (370002442) | $210.00 |
N/A
|
|
||
| Occupational Therapy - Evaluation Of Occupational Therapy, Typically 30 Minutes (370002441) | $170.00 |
N/A
|
|
||
| Occupational Therapy - Evaluation Of Occupational Therapy, Typically 30 Minutes (370002440) | $130.00 |
N/A
|
|
||
| Lab - Vitamin D-3 Level (800000287) | $237.00 |
N/A
|
|
||
| Lab - Vitamin B-12 Level (Cyanocobalamin Level) (800000378) | $119.00 |
N/A
|
|
||
| Lab - Vitamin B-1 Level (800000798) | $188.00 |
N/A
|
|
||
| Lab - Vancomycin Level (800000120) | $179.00 |
N/A
|
|
||
| Lab - Urine Pregnancy Test (800003123) | $100.00 |
N/A
|
|
||
| Lab - Urine Pregnancy Test (800000196) | $100.00 |
N/A
|
|
||
| Lab - Uric Acid Level In Blood (800000835) | $51.00 |
N/A
|
|
||
| Lab - Troponin Protein Level (800002233) | $180.00 |
N/A
|
|
||
| Lab - Thyroxine Level (Free) (800000805) | $131.00 |
N/A
|
|
||
| Lab - Thyroid Stimulating Hormone Level (800000811) | $175.00 |
N/A
|
|
||
| Lab - Thyroid Hormone Level (T3 Free) (800000823) | $167.00 |
N/A
|
|
||
| Lab - Testosterone Level (Total) (800000797) | $179.00 |
N/A
|
|
||
| Lab - Testosterone Level (Free) (800000795) | $153.00 |
N/A
|
|
||
| Lab - Susceptibility Study Of Specific Antimicrobial Agent (Mic Or Breakpoint, Per Plate, Each Multi-Antimicrobial Agent) (800001494) | $120.00 |
N/A
|
|
||
| Lab - Susceptibility Study Of Specific Antimicrobial Agent (Disk Method, Per Plate With 12 Or Fewer Drugs) (800001491) | $101.00 |
N/A
|
|
||
| Lab - Susceptibility Study Of Specific Antimicrobial Agent (Agar Dilution Method, Per Drug) (800001488) | $36.00 |
N/A
|
|
||
| Lab - Specimen Analysis For Strep Group A Bacteria (Immunoassay With Direct Optical Observation) (800003987) | $105.00 |
N/A
|
|
||
| Lab - Specimen Analysis For Strep Group A Bacteria (Immunoassay With Direct Optical Observation) (800001625) | $105.00 |
N/A
|
|
||
| Lab - Specimen Analysis For Rotavirus (Immunoassay Technique) (800001569) | $162.00 |
N/A
|
|
||
| Lab - Specimen Analysis For Identification Of Organism (Immunoassay With Direct Optical Observation) (800003264) | $91.00 |
N/A
|
|
||
| Lab - Specimen Analysis For Identification Of Organism (Immunoassay With Direct Optical Observation) (800003263) | $91.00 |
N/A
|
|
||
| Lab - Smear With Special Stain For Microorganisms (Gram Or Giemsa Stain) (800001504) | $84.00 |
N/A
|
|
||
| Lab - Skin Test For Tuberculosis Bacterial Infection (800001170) | $47.00 |
N/A
|
|
||
| Lab - Screening Culture For Pathogenic Organisms Without Colony Count (800001446) | $110.00 |
N/A
|
|
||
| Lab - Red Blood Cell Volume Count (Electronic Hematocrit) (800000880) | $47.00 |
N/A
|
|
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| Lab - Red Blood Cell Sedimentation Rate (Non-Automated) (800000968) | $71.00 |
N/A
|
|
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| Lab - Puncture Of Skin For Collection Of Blood Sample (800001763) | $6.00 |
N/A
|
|
||
| Lab - Prostate Specific Antigen Level (Psa, Total) (800000738) | $135.00 |
N/A
|
|
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| Lab - Phosphate Level In Blood (800000708) | $68.00 |
N/A
|
|
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| Lab - Phenytoin Level (Total) (800000105) | $151.00 |
N/A
|
|
||
| Lab - Parathyroid Hormone Level (800001939) | $274.00 |
N/A
|
|
||
| Lab - Natriuretic Peptide Protein Level (800000604) | $192.00 |
N/A
|
|
||
| Lab - Microsomal Antibodies Measurement (800001131) | $120.00 |
N/A
|
|
||
| Lab - Magnesium Level (800000579) | $72.00 |
N/A
|
|
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| Lab - Lipid Panel (800000010) | $165.00 |
N/A
|
|
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| Lab - Lipase Enzyme Level (800000572) | $105.00 |
N/A
|
|
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| Lab - Lactic Acid Level (800000551) | $100.00 |
N/A
|
|
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| Lab - Kidney Function Panel (800000012) | $197.00 |
N/A
|
|
||
| Lab - Iron Level (800000544) | $89.00 |
N/A
|
|
||
| Lab - Iron Binding Capacity (800000546) | $89.00 |
N/A
|
|
||
| Lab - Insulin Measurement (Total) (800000541) | $110.00 |
N/A
|
|
||
| Lab - Insertion Of Needle Into Vein For Collection Of Blood Sample (800001762) | $18.00 |
N/A
|
|
||
| Lab - Initial Drug Testing (Presumptive And Read By Instrument Assisted Direct Optical Observation) (800000028) | $125.00 |
N/A
|
|
||
| Lab - Hidden Blood Identification In Stool (Qualitative For Colorectal Cancer Screening) (800000284) | $47.00 |
N/A
|
|
||
| Lab - Hemoglobin Count (800000882) | $51.00 |
N/A
|
|
||
| Lab - Hemoglobin A1C Level (800000496) | $107.00 |
N/A
|
|
||
| Lab - Glucose Level Using Fda Approved Home Device (800000470) | $38.00 |
N/A
|
|
||
| Lab - Glucose Level In Blood Except With Reagent Strip (800000459) | $53.00 |
N/A
|
|
||
| Lab - Folic Acid Level (Serum) (800000422) | $113.00 |
N/A
|
|
||
| Lab - Ferritin Protein Level (800000417) | $117.00 |
N/A
|
|
||
| Lab - Drug Testing For Analgesics Levels (1 Or 2 Non-Opiod Drugs) (800000201) | $200.00 |
N/A
|
|
||
| Lab - Drug Testing For Analgesics Levels (1 Or 2 Non-Opiod Drugs) (800000111) | $141.00 |
N/A
|
|
||
| Lab - Drug Test For Alcohols Levels (Excluding Biomarkers) (800000221) | $152.00 |
N/A
|
|
||
| Lab - Detection Test For Respiratory Syncytial Virus (Immunoassay With Direct Optical Observation) (800001620) | $125.00 |
N/A
|
|
||
| Lab - Detection Test For Respiratory Syncytial Virus (Immunoassay With Direct Optical Observation) (800003940) | $125.00 |
N/A
|
|
||
| Lab - Detection Test For Influenza Virus (Immunoassay With Direct Optical Observation) (800001619) | $92.00 |
N/A
|
|
||
| Lab - Detection Test For Influenza Virus (Immunoassay With Direct Optical Observation) (800003291) | $83.00 |
N/A
|
|
||
| Lab - Detection Test For Influenza Virus (Immunoassay With Direct Optical Observation) (800003290) | $83.00 |
N/A
|
|
||
| Lab - Detection Test For Clostridium Difficile (Amplified Probe Technique) (800002978) | $212.00 |
N/A
|
|
||
| Lab - Culture Organism Identification By Immunologic Method (Culture Typing Method Other Than Immunofluorescence) (800002302) | $63.00 |
N/A
|
|
||
| Lab - Culture Organism Identification By Immunologic Method (Culture Typing Method Other Than Immunofluorescence) (800001473) | $61.00 |
N/A
|
|
||
| Lab - Culture Organism Identification By Immunologic Method (Culture Typing Method Other Than Immunofluorescence) (800001475) | $61.00 |
N/A
|
|
||
| Lab - Culture Organism Identification By Immunologic Method (Culture Typing Method Other Than Immunofluorescence) (800001478) | $60.00 |
N/A
|
|
||
| Lab - Culture Organism Identification By Immunologic Method (Culture Typing Method Other Than Immunofluorescence) (800001476) | $60.00 |
N/A
|
|
||
| Lab - Culture Organism Identification By Immunologic Method (Culture Typing Method Other Than Immunofluorescence) (800001474) | $60.00 |
N/A
|
|
||
| Lab - Creatinine Level In Other Source (800000371) | $84.00 |
N/A
|
|
||
| Lab - Creatinine Level In Blood (800000367) | $50.00 |
N/A
|
|
||
| Lab - Comprehensive Group Of Blood Chemicals (800000006) | $225.00 |
N/A
|
|
||
| Lab - Clotting Time Test (Prothrombin Time) (800000957) | $64.00 |
N/A
|
|
||
| Lab - Clotting Time Test (Partial Thromboplastin Time, Plasma Or Whole Blood) (800000982) | $111.00 |
N/A
|
|
||
| Lab - Catheterization For Collection Of Specimen (100001666) | $82.00 |
N/A
|
|
||
| Lab - C-Reactive Protein Measurement (800001036) | $64.00 |
N/A
|
|
||
| Lab - C-Peptide Protein Level (800000858) | $174.00 |
N/A
|
|
||
| Lab - Blood Gas Levels Without Direct Oxygen Saturation Measurement (800002822) | $247.00 |
N/A
|
|
||
| Lab - Blood Clotting Function Measurement (Quantitative D-Dimer) (800000932) | $174.00 |
N/A
|
|
||
| Lab - Bilirubin Level In Blood (Direct) (800000278) | $51.00 |
N/A
|
|
||
| Lab - Basic Group Of Blood Chemicals (With Total Calcium) (800000000) | $175.00 |
N/A
|
|
||
| Lab - Bacterial Urine Culture With Colony Count (800001457) | $120.00 |
N/A
|
|
||
| Lab - Bacterial Stool Culture With Preliminary Examination For Salmonella And Shigella Species (Aerobic) (800001409) | $180.00 |
N/A
|
|
||
| Lab - Bacterial Stool Culture For Additional Pathogens (Aerobic) (800001414) | $76.00 |
N/A
|
|
||
| Lab - Bacterial Stool Culture For Additional Pathogens (Aerobic) (800001410) | $75.00 |
N/A
|
|
||
| Lab - Bacterial Stool Culture For Additional Pathogens (Aerobic) (800001411) | $75.00 |
N/A
|
|
||
| Lab - Bacterial Stool Culture For Additional Pathogens (Aerobic) (800001412) | $75.00 |
N/A
|
|
||
| Lab - Bacterial Culture Verification Through Additional Testing (Aerobic) (800001443) | $97.00 |
N/A
|
|
||
| Lab - Bacterial Culture Using Source Other Than Urine, Blood, Or Stool (Aerobic) (800001428) | $176.00 |
N/A
|
|
||
| Lab - Bacterial Culture Using Source Other Than Urine, Blood, Or Stool (Aerobic) (800001431) | $176.00 |
N/A
|
|
||
| Lab - Bacterial Blood Culture (Aerobic) (800001408) | $180.00 |
N/A
|
|
||
| Lab - Automated Blood Cell Count With Automated White Cell Differential Count (800000886) | $100.00 |
N/A
|
|
||
| Lab - Analysis Of Urine, Non-Automated Without Miscroscope (800002695) | $34.00 |
N/A
|
|
||
| Lab - Analysis Of Urine, Microscope Only (800000193) | $38.00 |
N/A
|
|
||
| Lab - Analysis Of Urine, Automated Without Microscope (800003433) | $62.00 |
N/A
|
|
||
| Lab - Analysis Of Urine, Automated Without Microscope (800000187) | $62.00 |
N/A
|
|
||
| Lab - Analysis Of Urine, Automated With Microscope (800000172) | $80.00 |
N/A
|
|
||
| Lab - Amylase Enzyme Level (800000255) | $105.00 |
N/A
|
|
||
| Lab - Albumin Protein Level In Urine (Quantitative) (800000217) | $105.00 |
N/A
|
|
||
| Infusion Therapy - Infusion Into A Vein For Therapy, Prevention, Or Diagnosis, Up To 1 Hour (100001256) | $248.00 |
N/A
|
|
||
| Infusion Therapy - Infusion Into A Vein For Therapy, Prevention, Or Diagnosis, Additional Hour (100001518) | $248.00 |
N/A
|
|
||
| Infusion Therapy - Hydration Infusion Into A Vein, Additional Hour (200001006) | $189.00 |
N/A
|
|
||
| Infusion Therapy - Hydration Infusion Into A Vein, 31 Minutes To 1 Hour (100001477) | $189.00 |
N/A
|
|
||
| Heart Monitoring - Routine Ekg Using At Least 12 Leads, Tracing Only (600000243) | $225.00 |
N/A
|
|
||
| Emergency Room - Insertion Of Indwelling Bladder Catheter (200003295) | $230.00 |
N/A
|
|
||
| Emergency Room - Emergency Department Visit, Self Limited Or Minor Problem (200003327) | $233.00 |
N/A
|
|
||
| Emergency Room - Emergency Department Visit, Problem With Significant Threat To Life Or Function (200001021) | $1,532.00 |
N/A
|
|
||
| Emergency Room - Emergency Department Visit, Problem Of High Severity (200001020) | $950.00 |
N/A
|
|
||
| Emergency Room - Emergency Department Visit, Moderately Severe Problem (200001019) | $580.00 |
N/A
|
|
||
| Emergency Room - Emergency Department Visit, Low To Moderately Severe Problem (200001018) | $335.00 |
N/A
|
|
||
| Emergency Room (200003560) | $672.00 |
N/A
|
|
||
| Emergency Room (200003559) | $315.00 |
N/A
|
|
||
| Diagnostic Services - Ultrasound Scan Of Veins Of One Arm Or Leg Or Limited (600000287) | $831.00 |
N/A
|
|
||
| Diagnostic Services - Ultrasound Scan Of Head And Neck Blood Vessels On Both Sides (600000266) | $1,363.00 |
N/A
|
|
||
| Diagnostic Services - Ultrasound Scan Of Arteries And Arterial Grafts Of Both Legs (600000274) | $789.00 |
N/A
|
|
||
| Diagnostic Services - Ultrasound Measurement Of Bladder Capacity After Voiding (100000028) | $259.00 |
N/A
|
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| Diagnostic Imaging - X-Ray Of Wrist, 3 Or More Views (700000112) | $382.00 |
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