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Memorial Hospital Of Texas County Authority
Guymon, OK · CMS ID: 371340
This hospital has pricing data for 37 procedures ranging from $10 to $11,258.
Procedures (37)
Chest X-Ray 1 View
71045Cash Price
(No Insurance)
$80
Gross Charge
$100
Insurance Negotiated Rates
Blue Cross Blue Shield$19
Chest X-Ray 2 Views
71046Cash Price
(No Insurance)
$120
Gross Charge
$150
Insurance Negotiated Rates
Blue Cross Blue Shield$19
Cash Price
(No Insurance)
$1,736
Gross Charge
$2,170
Insurance Negotiated Rates
Humana$651
Cash Price
(No Insurance)
$2,574
Gross Charge
$3,217
Insurance Negotiated Rates
Humana$965
Cash Price
(No Insurance)
$1,736
Gross Charge
$2,170
Insurance Negotiated Rates
Humana$651
Cash Price
(No Insurance)
$10
Gross Charge
$13
Insurance Negotiated Rates
UnitedHealthcare$1
Cash Price
(No Insurance)
$10
Gross Charge
$13
Insurance Negotiated Rates
UnitedHealthcare$1
Cash Price
(No Insurance)
$1,630
Gross Charge
$2,037
Insurance Negotiated Rates
Blue Cross Blue Shield$106
Cash Price
(No Insurance)
$1,202
Gross Charge
$1,503
Insurance Negotiated Rates
Blue Cross Blue Shield$106
Cash Price
(No Insurance)
$87
Gross Charge
$109
Insurance Negotiated Rates
Humana$33
ER Visit Level 3
99283Cash Price
(No Insurance)
$606
Gross Charge
$757
Insurance Negotiated Rates
Humana$227
ER Visit Level 4
99284Cash Price
(No Insurance)
$990
Gross Charge
$1,238
Insurance Negotiated Rates
Humana$371
ER Visit Level 5
99285Cash Price
(No Insurance)
$1,562
Gross Charge
$1,952
Insurance Negotiated Rates
Humana$586
Cash Price
(No Insurance)
$378
Gross Charge
$473
Insurance Negotiated Rates
Blue Cross Blue Shield$63
Hemoglobin A1C
83036Cash Price
(No Insurance)
$12
Gross Charge
$15
Insurance Negotiated Rates
UnitedHealthcare$1
Knee Arthroscopy
29881Cash Price
(No Insurance)
$10,753
Gross Charge
$13,441
Insurance Negotiated Rates
Bsa-All Plans$3,000
Cash Price
(No Insurance)
$11,258
Gross Charge
$14,073
Insurance Negotiated Rates
Bsa-All Plans$3,000
Lipid Panel
80061Cash Price
(No Insurance)
$143
Gross Charge
$178
Insurance Negotiated Rates
UnitedHealthcare$2
Mammogram Diagnostic
77066Cash Price
(No Insurance)
$446
Gross Charge
$557
Insurance Negotiated Rates
Blue Cross Blue Shield$16
Mammogram Screening
77067Cash Price
(No Insurance)
$245
Gross Charge
$306
Insurance Negotiated Rates
Blue Cross Blue Shield$16
MRI Brain
70551Cash Price
(No Insurance)
$1,916
Gross Charge
$2,395
Insurance Negotiated Rates
Healthchoice-All Plans$690
Cash Price
(No Insurance)
$2,827
Gross Charge
$3,534
Insurance Negotiated Rates
Blue Cross Blue Shield$783
MRI Cervical Spine
72141Cash Price
(No Insurance)
$1,716
Gross Charge
$2,145
Insurance Negotiated Rates
Humana$644
MRI Knee
73721Cash Price
(No Insurance)
$1,174
Gross Charge
$1,467
Insurance Negotiated Rates
Blue Cross Blue Shield$83
MRI Lumbar Spine
72148Cash Price
(No Insurance)
$1,757
Gross Charge
$2,196
Insurance Negotiated Rates
Humana$659
MRI Shoulder
73221Cash Price
(No Insurance)
$1,235
Gross Charge
$1,544
Insurance Negotiated Rates
Blue Cross Blue Shield$83
Office Visit Level 3
99213Cash Price
(No Insurance)
$195
Gross Charge
$244
Insurance Negotiated Rates
Humana$73
Office Visit Level 4
99214Cash Price
(No Insurance)
$256
Gross Charge
$320
Insurance Negotiated Rates
Humana$96
TSH (Thyroid)
84443Cash Price
(No Insurance)
$10
Gross Charge
$13
Insurance Negotiated Rates
UnitedHealthcare$2
Ultrasound Abdomen
76700Cash Price
(No Insurance)
$637
Gross Charge
$796
Insurance Negotiated Rates
Blue Cross Blue Shield$36
Ultrasound Pelvis
76856Cash Price
(No Insurance)
$817
Gross Charge
$1,021
Insurance Negotiated Rates
Blue Cross Blue Shield$36
Cash Price
(No Insurance)
$370
Gross Charge
$462
Insurance Negotiated Rates
Blue Cross Blue Shield$36
Cash Price
(No Insurance)
$2,092
Gross Charge
$2,615
Insurance Negotiated Rates
Blue Cross Blue Shield$326
Cash Price
(No Insurance)
$2,316
Gross Charge
$2,895
Insurance Negotiated Rates
Blue Cross Blue Shield$326
Urinalysis
81001Cash Price
(No Insurance)
$462
Gross Charge
$577
Insurance Negotiated Rates
Blue Cross Blue Shield$1