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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
Medicare Rate
$24
Insurance Negotiated Rates
Blue Cross Blue Shield$19
Chest X-Ray 2 Views
71046Cash Price
(No Insurance)
$120
Gross Charge
$150
Medicare Rate
$31
Insurance Negotiated Rates
Blue Cross Blue Shield$19
Cash Price
(No Insurance)
$1,736
Gross Charge
$2,170
Medicare Rate
$356
Insurance Negotiated Rates
Humana$651
Cash Price
(No Insurance)
$2,574
Gross Charge
$3,217
Medicare Rate
$450
Insurance Negotiated Rates
Humana$965
Cash Price
(No Insurance)
$1,736
Gross Charge
$2,170
Medicare Rate
$471
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
Medicare Rate
$280
Insurance Negotiated Rates
Blue Cross Blue Shield$106
Cash Price
(No Insurance)
$1,202
Gross Charge
$1,503
Medicare Rate
$172
Insurance Negotiated Rates
Blue Cross Blue Shield$106
Cash Price
(No Insurance)
$87
Gross Charge
$109
Medicare Rate
$156
Insurance Negotiated Rates
Humana$33
ER Visit Level 3
99283Cash Price
(No Insurance)
$606
Gross Charge
$757
Medicare Rate
$69
Insurance Negotiated Rates
Humana$227
ER Visit Level 4
99284Cash Price
(No Insurance)
$990
Gross Charge
$1,238
Medicare Rate
$117
Insurance Negotiated Rates
Humana$371
ER Visit Level 5
99285Cash Price
(No Insurance)
$1,562
Gross Charge
$1,952
Medicare Rate
$170
Insurance Negotiated Rates
Humana$586
Cash Price
(No Insurance)
$378
Gross Charge
$473
Medicare Rate
$48
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
Medicare Rate
$495
Insurance Negotiated Rates
Bsa-All Plans$3,000
Knee X-Ray
73560Cash Price
(No Insurance)
$33
Gross Charge
$41
Medicare Rate
$32
Insurance Negotiated Rates
Humana$8
Cash Price
(No Insurance)
$11,258
Gross Charge
$14,073
Medicare Rate
$615
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
Medicare Rate
$146
Insurance Negotiated Rates
Blue Cross Blue Shield$16
Mammogram Screening
77067Cash Price
(No Insurance)
$245
Gross Charge
$306
Medicare Rate
$118
Insurance Negotiated Rates
Blue Cross Blue Shield$16
MRI Brain
70551Cash Price
(No Insurance)
$1,916
Gross Charge
$2,395
Medicare Rate
$183
Insurance Negotiated Rates
Healthchoice-All Plans$690
Cash Price
(No Insurance)
$2,827
Gross Charge
$3,534
Medicare Rate
$296
Insurance Negotiated Rates
Blue Cross Blue Shield$783
MRI Cervical Spine
72141Cash Price
(No Insurance)
$1,716
Gross Charge
$2,145
Medicare Rate
$179
Insurance Negotiated Rates
Humana$644
MRI Knee
73721Cash Price
(No Insurance)
$1,174
Gross Charge
$1,467
Medicare Rate
$191
Insurance Negotiated Rates
Blue Cross Blue Shield$83
MRI Lumbar Spine
72148Cash Price
(No Insurance)
$1,757
Gross Charge
$2,196
Medicare Rate
$180
Insurance Negotiated Rates
Humana$659
MRI Shoulder
73221Cash Price
(No Insurance)
$1,235
Gross Charge
$1,544
Medicare Rate
$191
Insurance Negotiated Rates
Blue Cross Blue Shield$83
Office Visit Level 3
99213Cash Price
(No Insurance)
$195
Gross Charge
$244
Medicare Rate
$91
Insurance Negotiated Rates
Humana$73
Office Visit Level 4
99214Cash Price
(No Insurance)
$256
Gross Charge
$320
Medicare Rate
$130
Insurance Negotiated Rates
Humana$96
Shoulder X-Ray
73030Cash Price
(No Insurance)
$42
Gross Charge
$52
Medicare Rate
$33
Insurance Negotiated Rates
Humana$9
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
Medicare Rate
$107
Insurance Negotiated Rates
Blue Cross Blue Shield$36
Ultrasound Pelvis
76856Cash Price
(No Insurance)
$817
Gross Charge
$1,021
Medicare Rate
$98
Insurance Negotiated Rates
Blue Cross Blue Shield$36
Cash Price
(No Insurance)
$370
Gross Charge
$462
Medicare Rate
$109
Insurance Negotiated Rates
Blue Cross Blue Shield$36
Cash Price
(No Insurance)
$2,092
Gross Charge
$2,615
Medicare Rate
$301
Insurance Negotiated Rates
Blue Cross Blue Shield$326
Cash Price
(No Insurance)
$2,316
Gross Charge
$2,895
Medicare Rate
$390
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