▸ Hospital · OK · CCN 373033
Mercy Rehabilitation Hospital Oklahoma City
5401 W MEMORIAL ROAD, OKLAHOMA CITY, OK, 73142
66 beds5
Compliance grade
A
100/100
Procedures tracked
82
of 209 target codes
Payers
13
with negotiated rates
Rates published
12,075
last crawl 2026-05-24
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 13 | $323.38 | $323.38 | $242.54 | $323.38 | $323.38 |
| CT head with contrast | CPT | 70460 | 13 | $821.93 | $821.93 | $616.45 | $821.93 | $821.93 |
| CT head with and without contrast | CPT | 70470 | 13 | $344.33 | $344.33 | $258.25 | $344.33 | $344.33 |
| CT neck with contrast | CPT | 70491 | 13 | $707.62 | $707.62 | $530.72 | $707.62 | $707.62 |
| MRI brain without contrast | CPT | 70551 | 13 | $709.6 | $709.6 | $532.2 | $709.6 | $709.6 |
| MRI brain with contrast | CPT | 70552 | 13 | $3,712.82 | $3,712.82 | $2,784.62 | $3,712.82 | $3,712.82 |
| MRI brain with and without contrast | CPT | 70553 | 13 | $709.6 | $709.6 | $532.2 | $709.6 | $709.6 |
| Chest X-ray single view | CPT | 71045 | 13 | $263.15 | $263.15 | $46.42 | $129.63 | $263.15 |
| Chest X-ray 2 views | CPT | 71046 | 13 | $294.65 | $294.65 | $200.61 | $267.48 | $294.65 |
| Chest X-ray 3 views | CPT | 71047 | 13 | $463.2 | $463.2 | $347.4 | $463.2 | $463.2 |
| CT chest without contrast | CPT | 71250 | 13 | $323.38 | $323.38 | $242.54 | $323.38 | $323.38 |
| CT chest with contrast | CPT | 71260 | 13 | $323.38 | $323.38 | $242.54 | $323.38 | $323.38 |
| CT chest with and without contrast | CPT | 71270 | 13 | $349.62 | $349.62 | $262.22 | $349.62 | $349.62 |
| MRI chest without contrast | CPT | 71550 | 13 | $707.62 | $707.62 | $530.72 | $707.62 | $707.62 |
| MRI chest with contrast | CPT | 71551 | 13 | $3,208.72 | $3,208.72 | $2,406.54 | $3,208.72 | $3,208.72 |
| MRI chest with and without contrast | CPT | 71552 | 13 | $3,646.76 | $3,646.76 | $2,735.07 | $3,646.76 | $3,646.76 |
| Lumbosacral spine X-ray | CPT | 72100 | 13 | $323.38 | $323.38 | $242.54 | $323.38 | $323.38 |
| CT cervical spine without contrast | CPT | 72125 | 13 | $323.38 | $323.38 | $242.54 | $323.38 | $323.38 |
| CT thoracic spine without contrast | CPT | 72128 | 13 | $323.38 | $323.38 | $242.54 | $323.38 | $323.38 |
| CT lumbar spine without contrast | CPT | 72131 | 13 | $323.38 | $323.38 | $242.54 | $323.38 | $323.38 |
| MRI cervical spine without contrast | CPT | 72141 | 13 | $709.6 | $709.6 | $532.2 | $709.6 | $709.6 |
| MRI thoracic spine without contrast | CPT | 72146 | 13 | $709.6 | $709.6 | $532.2 | $709.6 | $709.6 |
| MRI lumbar spine without contrast | CPT | 72148 | 13 | $709.6 | $709.6 | $532.2 | $709.6 | $709.6 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 13 | $6,029.44 | $6,029.44 | $4,522.08 | $6,029.44 | $6,029.44 |
| MRI cervical spine with and without contrast | CPT | 72156 | 13 | $709.6 | $709.6 | $532.2 | $709.6 | $709.6 |
| MRI lumbar spine with contrast | CPT | 72158 | 13 | $1,113.68 | $1,113.68 | $835.26 | $1,113.68 | $1,113.68 |
| CT pelvis without contrast | CPT | 72192 | 13 | $716.75 | $716.75 | $537.56 | $716.75 | $716.75 |
| CT pelvis with contrast | CPT | 72193 | 13 | $335.07 | $335.07 | $251.3 | $335.07 | $335.07 |
| Shoulder X-ray | CPT | 73030 | 13 | $317.89 | $317.89 | $197.36 | $265.18 | $317.89 |
| Humerus X-ray | CPT | 73060 | 13 | $410.15 | $410.15 | $221.51 | $356.48 | $410.15 |
| Hand X-ray 3 views | CPT | 73130 | 13 | $273.65 | $273.65 | $177.61 | $254.94 | $273.65 |
| MRI upper extremity joint without contrast | CPT | 73221 | 13 | $747.5 | $747.5 | $532.2 | $709.6 | $747.5 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 13 | $1,113.64 | $1,113.64 | $835.23 | $1,113.64 | $1,113.64 |
| Knee X-ray 1-2 views | CPT | 73560 | 13 | $342.52 | $342.52 | $163.7 | $262.87 | $342.52 |
| Ankle X-ray 3 views | CPT | 73610 | 13 | $478.97 | $478.97 | $197.15 | $319.02 | $478.97 |
| MRI lower extremity joint without contrast | CPT | 73721 | 13 | $2,192.06 | $2,192.06 | $537.56 | $1,180.4 | $2,192.06 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 13 | $845.21 | $845.21 | $633.91 | $845.21 | $845.21 |
| CT abdomen without contrast | CPT | 74150 | 13 | $323.38 | $323.38 | $242.54 | $323.38 | $323.38 |
| CT abdomen with contrast | CPT | 74160 | 13 | $821.93 | $821.93 | $616.45 | $821.93 | $821.93 |
| CT abdomen with and without contrast | CPT | 74170 | 13 | $349.62 | $349.62 | $262.22 | $349.62 | $349.62 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 13 | $716.75 | $716.75 | $537.56 | $716.75 | $716.75 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 13 | $1,114.69 | $1,114.69 | $836.02 | $1,114.69 | $1,114.69 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 13 | $323.38 | $323.38 | $242.54 | $323.38 | $323.38 |
| MRI abdomen without contrast | CPT | 74181 | 13 | $716.75 | $716.75 | $537.56 | $716.75 | $716.75 |
| MRI abdomen with and without contrast | CPT | 74183 | 13 | $123.09 | $123.09 | $92.32 | $123.09 | $123.09 |
| Abdominal ultrasound complete | CPT | 76700 | 13 | $323.38 | $323.38 | $242.54 | $323.38 | $323.38 |
| Abdominal ultrasound limited | CPT | 76705 | 13 | $565.48 | $565.48 | $252.49 | $380.38 | $565.48 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 13 | $382.07 | $382.07 | $242.54 | $323.38 | $382.07 |
| Obstetric ultrasound first trimester | CPT | 76801 | 13 | $786.11 | $786.11 | $589.58 | $786.11 | $786.11 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 13 | $903.92 | $903.92 | $677.94 | $903.92 | $903.92 |
| Transvaginal ultrasound | CPT | 76830 | 13 | $963.38 | $963.38 | $722.54 | $963.38 | $963.38 |
| Pelvic ultrasound complete | CPT | 76856 | 13 | $344.33 | $344.33 | $258.25 | $344.33 | $344.33 |
| Scrotal ultrasound | CPT | 76870 | 13 | $339.13 | $339.13 | $254.35 | $339.13 | $339.13 |
| Diagnostic mammography bilateral | CPT | 77066 | 13 | $480.99 | $480.99 | $360.74 | $480.99 | $480.99 |
| Screening mammography bilateral | CPT | 77067 | 13 | $210.99 | $210.99 | $158.24 | $210.99 | $210.99 |
| EKG complete | CPT | 93000 | 13 | $514.29 | $514.29 | $385.72 | $514.29 | $514.29 |
| EKG tracing only | CPT | 93005 | 13 | $1,007.14 | $1,007.14 | $755.36 | $1,007.14 | $1,007.14 |
| Transthoracic echocardiogram complete | CPT | 93306 | 13 | $1,409.03 | $1,409.03 | $1,056.77 | $1,409.03 | $1,409.03 |
| Transthoracic echocardiogram | CPT | 93307 | 13 | $1,259.97 | $1,259.97 | $944.98 | $1,259.97 | $1,259.97 |
| Stress echocardiogram | CPT | 93350 | 13 | $1,332.64 | $1,332.64 | $999.48 | $1,332.64 | $1,332.64 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 13 | $269.85 | $269.85 | $19.99 | $114.52 | $269.85 |
| Electrolyte panel | CPT | 80051 | 13 | $264.31 | $264.31 | $198.23 | $264.31 | $264.31 |
| Comprehensive metabolic panel | CPT | 80053 | 13 | $33.26 | $33.26 | $24.95 | $33.26 | $33.26 |
| Lipid panel | CPT | 80061 | 13 | $163.96 | $163.96 | $15.69 | $71.95 | $163.96 |
| Renal function panel | CPT | 80069 | 13 | $38.75 | $38.75 | $29.06 | $38.75 | $38.75 |
| Hepatic function panel | CPT | 80076 | 13 | $156.96 | $156.96 | $9.57 | $65.24 | $156.96 |
| Urinalysis non-automated | CPT | 81002 | 13 | $92.11 | $92.11 | $69.08 | $92.11 | $92.11 |
| Urinalysis automated | CPT | 81003 | 13 | $10.52 | $10.52 | $7.52 | $10.02 | $10.52 |
| Glucose quantitative | CPT | 82947 | 13 | $75.8 | $75.8 | $9.29 | $34.62 | $75.8 |
| Hemoglobin A1c | CPT | 83036 | 13 | $40.49 | $40.49 | $28.92 | $38.56 | $40.49 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 13 | $78.72 | $78.72 | $56.23 | $74.97 | $78.72 |
| Complete blood count with automated differential | CPT | 85025 | 13 | $36.45 | $36.45 | $18.36 | $25.91 | $36.45 |
| Complete blood count without differential | CPT | 85027 | 13 | $30.33 | $30.33 | $18.36 | $24.48 | $30.33 |
| Urine culture bacterial | CPT | 87086 | 13 | $37.8 | $37.8 | $7.52 | $19.19 | $37.8 |
| Urine culture identification | CPT | 87088 | 13 | $100.8 | $100.8 | $45.26 | $67.97 | $100.8 |
| Tissue exam by pathologist level IV | CPT | 88305 | 13 | $986.49 | $986.49 | $739.87 | $986.49 | $986.49 |
| office | ||||||||
| Office visit, new patient, 45-59 min | CPT | 99204 | 13 | $1,941.5 | $1,941.5 | $1,456.13 | $1,941.5 | $1,941.5 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 13 | $1,904.71 | $1,904.71 | $1,428.53 | $1,904.71 | $1,904.71 |
| Office visit, established patient, 5 min | CPT | 99211 | 13 | $479.59 | $479.59 | $359.69 | $479.59 | $479.59 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 13 | $175.46 | $175.46 | $131.6 | $175.46 | $175.46 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 13 | $767.19 | $767.19 | $575.39 | $767.19 | $767.19 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 13 | $412.91 | $412.91 | $309.68 | $412.91 | $412.91 |
Payer mix (top 13)
| Payer | Codes covered | Median rate |
|---|---|---|
| Aetna | 82 | $323.38 |
| Blue Cross Blue Shield | 82 | $323.38 |
| Centene | 82 | $323.38 |
| Cigna | 82 | $323.38 |
| globalhealth | 82 | $323.38 |
| globalhealth/generations | 82 | $323.38 |
| healthcare highways | 82 | $242.54 |
| healthchoice | 82 | $323.38 |
| healthsmart | 82 | $323.38 |
| Humana | 82 | $323.38 |
| medica | 82 | $323.38 |
| Self-Pay (Cash) | 82 | $323.38 |
| UnitedHealthcare | 82 | $323.38 |