MercyOne Centerville Medical Center
1 Saint Joseph Dr, Centerville, IA · MercyOne · · NPI 1356391635
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| 88334 ap bill cytologic exam each additional site CPT 88334 | $101.00 | $101.00 | $27.82 – $101.00 | 33 |
| 99381 initial comp preventive med less than 1 year new CPT 99381 | $262.00 | $262.00 | $32.15 – $262.00 | 554 |
| 99382 initial comp preventive med 1 to 4 years new CPT 99382 | $274.00 | $274.00 | $32.15 – $274.00 | 554 |
| 99383 initial comp preventive med 5 to 11 years new CPT 99383 | $286.00 | $286.00 | $32.15 – $268.25 | 554 |
| 99391 periodic comp preventive med less than 1 year est CPT 99391 | $236.00 | $236.00 | $32.15 – $169.98 | 554 |
| 99392 periodic comp preventive med 1 to 4 years est CPT 99392 | $252.00 | $252.00 | $32.15 – $252.00 | 554 |
| 99393 periodic comp preventive med 5 to 11 years est CPT 99393 | $251.00 | $251.00 | $32.15 – $238.75 | 554 |
| 99394 periodic comp preventive med 12 to 17 years est CPT 99394 | $470.00 | $276.00 | $32.15 – $167.00 | 555 |
| 99397 periodic comp preventive med 65+ years est CPT 99397 | $323.00 | $323.00 | $42.50 – $237.35 | 554 |
| Abatacept (with maltose) 250 mg intravenous solution HCPCS J0129 | $7,377.95 | $7,377.95 | $1,112.25 – $7,377.95 | 108 |
| Abdominal and Pelvic Blood Vessel Ultrasound (complete) CPT 93975 | $1,295.00 | $1,295.00 | $355.35 – $1,295.00 | 42 |
| Abdominal CT scan (with and without contrast) CPT 74170 | $3,002.00 | $3,002.00 | $823.75 – $3,002.00 | 42 |
| Abdominal CT scan (with contrast) CPT 74160 | $2,448.00 | $2,448.00 | $671.73 – $2,448.00 | 42 |
| Abdominal CT scan (without contrast) CPT 74150 | $1,986.00 | $1,986.00 | $544.96 – $1,986.00 | 42 |
| Abdominal MRI (with and without contrast) CPT 74183 | $5,351.00 | $5,351.00 | $1,468.31 – $5,351.00 | 42 |
| Abdominal MRI (without contrast) CPT 74181 | $4,399.00 | $4,399.00 | $1,207.09 – $4,399.00 | 42 |
| Abdominal paracentesis w/image guidance CPT 49083 | $2,052.00 | $2,052.00 | $563.07 – $2,052.00 | 42 |
| Abdominal Ultrasound (complete) CPT 76700 | $1,066.00 | $1,066.00 | $21.30 – $1,066.00 | 781 |
| Abdominal Ultrasound (limited) CPT 76705 | $856.00 | $856.00 | $17.47 – $856.00 | 781 |
| Abdominal X-ray (2 views) CPT 74019 | $386.00 | $386.00 | $6.82 – $386.00 | 781 |
| Abdominal X-ray Series (acute, with chest view) CPT 74022 | $140.00 | $140.00 | $9.44 – $34.00 | 768 |
| Abdominal X-ray (single view) CPT 74018 | $251.00 | $251.00 | $5.54 – $251.00 | 781 |
| Acetaminophen 120 mg rectal suppository HCPCS A9270 | $8,944.98 | $2,532.65 | $0.27 – $4.92 | 108 |
| Acetone qualitative CPT 82009 | $65.00 | $65.00 | $17.84 – $65.00 | 42 |
| Acetylcysteine 200 mg/ml (20 %) intravenous solution HCPCS J0132 | $244.95 | $244.95 | $22.20 – $244.95 | 108 |
| Aco annual medicare visit (awv), initial g0438aco HCPCS G0438 | $424.00 | $424.00 | $119.30 – $405.34 | 766 |
| Aco annual medicare visit (awv), subsq g0439aco HCPCS G0439 | $386.00 | $386.00 | $47.03 – $386.00 | 780 |
| Aco cont gluc mnt phys/qhp eqp 95250aco CPT 95250 | $549.00 | $549.00 | $150.65 – $549.00 | 42 |
| Aco depression screen annual medicare g0444aco HCPCS G0444 | $52.00 | $52.00 | $5.64 – $43.79 | 766 |
| Acute hepatitis panel CPT 80074 | $487.00 | $487.00 | $133.63 – $487.00 | 42 |
| Acyclovir 400 mg tablet HCPCS J8499 | $1.00 | $1.00 | $0.27 – $1.00 | 42 |
| Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr HCPCS J0133 | $10.40 | $10.40 | $0.90 – $4.20 | 108 |
| Adapter b 8 channel 10cm HCPCS C1883 | $30,555.23 | $30,555.23 | $0.01 – $19.46 | 42 |
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | $695.70 | $695.70 | $2.06 – $7.50 | 42 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $78.60 | $78.60 | $0.22 – $1.00 | 108 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $524.00 | $524.00 | $143.79 – $524.00 | 42 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | $491.00 | $491.00 | $134.73 – $491.00 | 42 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $836.00 | $836.00 | $229.40 – $836.00 | 42 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | $461.00 | $461.00 | $126.50 – $461.00 | 42 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $417.00 | $417.00 | $114.42 – $417.00 | 42 |
| Administration immunization each additional component CPT 90461 | $43.00 | $43.00 | $5.40 – $30.00 | 779 |
| Administration immunization each additional vaccine CPT 90472 | $100.00 | $100.00 | $4.32 – $35.30 | 780 |
| Administration immunization first component each vaccine CPT 90460 | $65.00 | $65.00 | $5.40 – $43.00 | 780 |
| Administration immunization intranasal/oral route 1 vaccine CPT 90473 | $72.00 | $72.00 | $5.40 – $19.68 | 42 |
| Administration immunization intranasal/oral route each additional vaccine CPT 90474 | $43.00 | $43.00 | $5.40 – $23.00 | 780 |
| Administration rsv monoclonal ab seasonal dose im w/counseling CPT 96380 | $60.00 | $60.00 | $5.40 – $42.00 | 780 |
| Administration vaccine hepatitis b HCPCS G0010 | $88.00 | $88.00 | $5.40 – $39.00 | 780 |
| Administration vaccine influenza virus HCPCS G0008 | $88.00 | $88.00 | $5.09 – $39.00 | 780 |
| Administration vaccine pneumococcal HCPCS G0009 | $88.00 | $88.00 | $5.09 – $39.00 | 780 |
| Administration vaccine rsv monoclonal ab seasonal dose im CPT 96381 | $56.46 | $43.00 | $5.40 – $36.00 | 780 |
| Ado-trastuzumab emtansine 100 mg intravenous solution HCPCS J9354 | $19,916.25 | $19,916.25 | $3,415.65 – $12,447.70 | 108 |
| Agalsidase beta 35 mg intravenous solution HCPCS J0180 | $18,756.30 | $18,756.30 | $5,146.73 – $18,756.30 | 108 |
| Albumin body fluid quantitative each specimen CPT 82042 | $73.00 | $73.00 | $7.62 – $73.00 | 42 |
| Albumin, human 25 % intravenous solution HCPCS P9046 | $331.50 | $331.50 | $45.48 – $165.75 | 42 |
| Albumin, human 5 % intravenous solution HCPCS P9041 | $332.50 | $332.50 | $59.68 – $217.50 | 42 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $88.00 | $88.00 | $24.15 – $88.00 | 42 |
| Albumin serum plasma or whole blood CPT 82040 | $89.00 | $89.00 | $24.42 – $89.00 | 42 |
| Albuterol ipratrop non-comp HCPCS J7620 | $2.70 | $1.00 | $0.12 – $1.00 | 766 |
| Albuterol non-comp unit HCPCS J7613 | $1.00 | $1.00 | $0.04 – $1.00 | 766 |
| Alcohol (ethanol) any specimen except urine/breath CPT 82077 | $146.00 | $146.00 | $40.06 – $146.00 | 42 |
| Alemtuzumab 12 mg/1.2 ml intravenous solution HCPCS J0202 | $89,232.75 | $89,232.75 | $24,485.47 – $89,232.75 | 108 |
| Alkaline phosphatase CPT 84075 | $63.00 | $63.00 | $17.29 – $63.00 | 42 |
| Allergen alpha lactalbumin ige CPT 86008 | $48.00 | $48.00 | $13.22 – $48.00 | 42 |
| Allergen egg white ige CPT 86003 | $44.00 | $44.00 | $12.07 – $44.00 | 42 |
| Allergy injections; 2 or more 95117 CPT 95117 | $50.00 | $50.00 | $13.72 – $50.00 | 42 |
| Allergy injection; single 95115 CPT 95115 | $51.00 | $51.00 | $13.99 – $51.00 | 42 |
| Allergy Skin Testing CPT 95004 | $30.00 | $14.00 | $2.55 – $14.00 | 766 |
| Allograft 160mg placental salera mini membrane HCPCS Q4168 | $66.55 | $66.55 | $18.26 – $66.55 | 42 |
| Allograft allowrap 4x4cm dry 16sqcm HCPCS Q4150 | $653.33 | $653.33 | $63.61 – $231.82 | 42 |
| Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet HCPCS Q4100 | $6,093.98 | $6,093.98 | $31.23 – $113.80 | 42 |
| Allograft dermis 20x25x1mm decell w/matracell arthroflex HCPCS Q4125 | $5,636.14 | $5,636.14 | $10.18 – $37.10 | 42 |
| Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm HCPCS Q4128 | $245.37 | $245.37 | $7.92 – $28.85 | 42 |
| Allograft epieffect 2x3cm-q4186-cost per sq cm HCPCS Q4186 | $3,227.12 | $3,227.12 | $17.27 – $62.95 | 42 |
| Allograft graftjacket 2x12cm-q4107-cost per sq cm HCPCS Q4107 | $366.35 | $366.35 | $54.88 – $200.01 | 42 |
| Allograft membrn amnio 1x2cm hu ambriodry HCPCS V2790 | $8,630.50 | $8,630.50 | $212.04 – $772.75 | 42 |
| Allograft umbil cord+amniotic membrane-q4148-cost per sq cm HCPCS Q4148 | $358.06 | $358.06 | $94.78 – $345.41 | 42 |
| Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm HCPCS Q4187 | $1,254.67 | $1,254.67 | $165.22 – $602.10 | 42 |
| Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution HCPCS J0256 | $2,450.00 | $2,450.00 | $672.28 – $2,450.00 | 42 |
| Alpha-fetoprotein tumor marker CPT 82105 | $199.00 | $199.00 | $54.61 – $199.00 | 42 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | $25,477.05 | $25,477.05 | $154.46 – $562.90 | 107 |
| Alt/sgpt CPT 84460 | $481.00 | $104.00 | $9.09 – $104.00 | 42 |
| Amikacin 4 mg/ml intravitreal injection - cnr HCPCS J0278 | $17.05 | $17.05 | $3.10 – $17.05 | 108 |
| Amino acids quant 2-5 CPT 82136 | $145.00 | $145.00 | $39.79 – $145.00 | 42 |
| Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr HCPCS J0281 | $47.20 | $47.20 | $7.50 – $47.20 | 108 |
| Aminophylline 25 mg/ml intravenous solution (wrapper) HCPCS J0280 | $101.15 | $101.15 | $5.04 – $18.35 | 42 |
| Amiodarone 50 mg/ml intravenous solution HCPCS J0282 | $73.00 | $73.00 | $6.00 – $21.85 | 108 |
| Amivantamab-vmjw 50 mg/ml intravenous solution HCPCS J9061 | $11,933.95 | $11,933.95 | $3,274.68 – $11,933.95 | 108 |
| Ammonia CPT 82140 | $238.00 | $238.00 | $65.31 – $238.00 | 42 |
| Amphetamines 5 or more CPT 80326 | $50.00 | $50.00 | $13.72 – $50.00 | 42 |
| Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J0285 | $8.75 | $8.75 | $2.40 – $34.12 | 108 |
| Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J0289 | $1,507.85 | $1,507.85 | $154.31 – $562.35 | 42 |
| Ampicillin 1 gram solution for injection HCPCS J0290 | $38.85 | $38.85 | $0.49 – $3.05 | 108 |
| Ampicillin-sulbactam 1.5 gram solution for injection HCPCS J0295 | $14.55 | $14.55 | $1.74 – $6.35 | 108 |
| Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis CPT 81515 | $789.00 | $789.00 | $216.50 – $789.00 | 42 |
| Amp metatarsal w/toe single 28810 CPT 28810 | $6,888.00 | $6,888.00 | $126.52 – $6,888.00 | 781 |
| Amputation toe interphalangeal joint CPT 28825 | $9,011.63 | $3,850.00 | $5.01 – $1,381.00 | 781 |
| Amputation toe metatarsophalangeal joint CPT 28820 | $11,785.18 | $4,818.00 | $3.36 – $1,444.00 | 781 |
| Amylase CPT 82150 | $125.00 | $125.00 | $30.18 – $110.00 | 42 |
| Analgesics non-opioid definitive assay 1 or 2 acetaminophen CPT 80329 | $237.00 | $237.00 | $65.03 – $237.00 | 42 |
| Analysis gene f2 20210g>a variant CPT 81240 | $170.00 | $170.00 | $46.65 – $170.00 | 42 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.