MercyOne Clinton Medical Center
1410 N. Fourth St, Clinton, IA · MercyOne · · NPI 1427093962
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 |
|---|---|---|---|---|
| 17-hydroxypregnenolone CPT 84143 | $128.05 | $197.00 | $22.10 – $197.00 | 47 |
| 1st hosp/birthing center care per day nml nb 99460 CPT 99460 | $230.00 | $230.00 | $51.55 – $194.00 | 768 |
| 1st inpatient critical care pr day age 28 days/less than 99468 CPT 99468 | $2,315.00 | $2,315.00 | $604.32 – $1,870.00 | 768 |
| 3-d radiotherapy plan CPT 77295 | $5,969.60 | $9,184.00 | $1,239.00 – $9,184.00 | 118 |
| 3d recon without postprocess indpndt CPT 76376 | $386.10 | $594.00 | $168.10 – $594.00 | 32 |
| Abatacept (with maltose) 250 mg intravenous solution HCPCS J0129 | $7,377.95 | $7,377.95 | $43.87 – $7,377.95 | 118 |
| Abd aorta w/runoff s&i CPT 75630 | $6,659.25 | $10,245.00 | $2,899.34 – $10,245.00 | 118 |
| Abdominal and Pelvic Blood Vessel Ultrasound (complete) CPT 93975 | $1,005.55 | $1,547.00 | $219.72 – $1,547.00 | 118 |
| Abdominal CT scan (with and without contrast) CPT 74170 | $2,189.85 | $3,369.00 | $161.52 – $3,369.00 | 118 |
| Abdominal CT scan (with contrast) CPT 74160 | $2,052.70 | $3,158.00 | $161.52 – $3,158.00 | 118 |
| Abdominal CT scan (without contrast) CPT 74150 | $2,001.35 | $3,079.00 | $96.27 – $3,079.00 | 118 |
| Abdominal MRI (with and without contrast) CPT 74183 | $1,800.50 | $2,770.00 | $321.26 – $2,770.00 | 118 |
| Abdominal MRI (without contrast) CPT 74181 | $1,286.35 | $1,979.00 | $219.72 – $1,979.00 | 118 |
| Abdominal paracentesis w/image guidance CPT 49083 | $1,661.13 | $2,343.00 | $663.07 – $2,343.00 | 117 |
| Abdominal Ultrasound (complete) CPT 76700 | $1,084.20 | $1,668.00 | $96.27 – $1,668.00 | 118 |
| Abdominal Ultrasound (limited) CPT 76705 | $624.00 | $960.00 | $96.27 – $960.00 | 118 |
| Abdominal X-ray (2 views) CPT 74019 | $321.10 | $494.00 | $96.27 – $494.00 | 118 |
| Abdominal X-ray Series (acute, with chest view) CPT 74022 | $358.80 | $552.00 | $96.27 – $552.00 | 118 |
| Abdominal X-ray (single view) CPT 74018 | $234.00 | $360.00 | $80.14 – $360.00 | 118 |
| Abdominoplasty 15830 CPT 15830 | $52,082.48 | $3,823.00 | $15.05 – $14,209.66 | 769 |
| Abd paracentesis/w/o image guide 49082 CPT 49082 | $616.85 | $949.00 | $268.57 – $1,940.91 | 117 |
| Acetaminophen 120 mg rectal suppository HCPCS A9270 | $11,910.01 | $2,532.65 | $0.20 – $4,938.64 | 118 |
| Acetazolamide 500 mg solution for injection HCPCS J1120 | $55.20 | $55.20 | $15.62 – $55.20 | 103 |
| Acetylcholine receptor modulating antibody CPT 86043 | $39.65 | $61.00 | $11.68 – $61.00 | 47 |
| Acetylcysteine 200 mg/ml (20 %) intravenous solution HCPCS J0132 | $244.95 | $244.95 | $22.20 – $244.95 | 103 |
| Aco annual medicare visit (awv), subsq g0439aco HCPCS G0439 | $70.85 | $109.00 | $30.85 – $259.53 | 47 |
| Aco depression screen annual medicare g0444aco HCPCS G0444 | $33.80 | $52.00 | $14.72 – $80.18 | 118 |
| Acute hepatitis panel CPT 80074 | $328.25 | $505.00 | $46.16 – $505.00 | 47 |
| Acyclovir 400 mg tablet HCPCS J8499 | $64.85 | $64.85 | $0.19 – $1.00 | 37 |
| Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr HCPCS J0133 | $20.70 | $20.70 | $0.90 – $4.20 | 103 |
| #acylcarnitineprfl CPT 82017 | $88.40 | $136.00 | $16.35 – $136.00 | 47 |
| Adapter b 8 channel 10cm HCPCS C1883 | $19,860.90 | $30,555.23 | $0.01 – $11.55 | 33 |
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | $695.70 | $695.70 | $2.12 – $7.50 | 33 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $78.60 | $78.60 | $0.22 – $33.87 | 104 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $126.75 | $195.00 | $55.19 – $752.00 | 118 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | $167.70 | $258.00 | $66.30 – $752.00 | 118 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $831.35 | $1,279.00 | $304.16 – $1,279.00 | 118 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | $523.90 | $806.00 | $228.10 – $806.00 | 118 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | $104.00 | $104.00 | $18.11 – $154.08 | 782 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $159.25 | $245.00 | $66.30 – $752.00 | 118 |
| Administration immunization each additional component CPT 90461 | $20.80 | $32.00 | $5.57 – $105.00 | 47 |
| Administration immunization each additional vaccine CPT 90472 | $27.95 | $43.00 | $5.57 – $105.00 | 33 |
| Administration immunization first component each vaccine CPT 90460 | $42.90 | $66.00 | $5.57 – $105.00 | 47 |
| Administration immunization intranasal/oral route 1 vaccine CPT 90473 | $39.65 | $61.00 | $5.57 – $154.08 | 118 |
| Administration immunization intranasal/oral route each additional vaccine CPT 90474 | $23.40 | $36.00 | $5.57 – $105.00 | 33 |
| Administration rsv monoclonal ab seasonal dose im w/counseling CPT 96380 | $39.00 | $60.00 | $5.57 – $105.00 | 47 |
| Administration vaccine hepatitis b HCPCS G0010 | $33,066.51 | $88.00 | $5.57 – $46.00 | 781 |
| Administration vaccine influenza virus HCPCS G0008 | $78.00 | $88.00 | $5.09 – $78.00 | 781 |
| Administration vaccine pneumococcal HCPCS G0009 | $78.00 | $88.00 | $5.09 – $100.21 | 782 |
| Administration vaccine rsv monoclonal ab seasonal dose im CPT 96381 | $36.40 | $56.00 | $5.57 – $105.00 | 47 |
| Ado-trastuzumab emtansine 100 mg intravenous solution HCPCS J9354 | $19,916.25 | $19,916.25 | $38.66 – $12,447.70 | 118 |
| Agalsidase beta 35 mg intravenous solution HCPCS J0180 | $18,756.30 | $18,756.30 | $213.59 – $18,756.30 | 118 |
| Albumin body fluid quantitative each specimen CPT 82042 | $18.20 | $28.00 | $7.54 – $28.00 | 47 |
| Albumin, human 25 % intravenous solution HCPCS P9046 | $2,227.28 | $871.00 | $20.81 – $846.67 | 118 |
| Albumin, human 5 % intravenous solution HCPCS P9041 | $332.50 | $332.50 | $61.55 – $217.50 | 33 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $78.00 | $120.00 | $5.60 – $120.00 | 47 |
| Albumin serum plasma or whole blood CPT 82040 | $555.10 | $81.00 | $4.79 – $81.00 | 47 |
| Albuterol non-comp unit HCPCS J7613 | $1.00 | $1.00 | $0.05 – $1.00 | 767 |
| Alcohol (ethanol) any specimen except urine/breath CPT 82077 | $94.90 | $146.00 | $16.74 – $146.00 | 47 |
| Alemtuzumab 12 mg/1.2 ml intravenous solution HCPCS J0202 | $89,232.75 | $89,232.75 | $2,398.16 – $89,232.75 | 118 |
| Alkaline phosphatase CPT 84075 | $44.20 | $68.00 | $5.02 – $68.00 | 47 |
| Allergen alpha lactalbumin ige CPT 86008 | $91.00 | $140.00 | $17.37 – $65.00 | 47 |
| Allergen egg white ige CPT 86003 | $844.35 | $60.00 | $5.06 – $60.00 | 47 |
| Allograft 160mg placental salera mini membrane HCPCS Q4168 | $43.26 | $66.55 | $12.90 – $66.55 | 40 |
| Allograft allowrap 4x4cm dry 16sqcm HCPCS Q4150 | $424.66 | $653.33 | $44.93 – $231.82 | 40 |
| Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet HCPCS Q4100 | $3,961.09 | $6,093.98 | $22.05 – $113.80 | 40 |
| Allograft dermis 20x25x1mm decell w/matracell arthroflex HCPCS Q4125 | $3,663.49 | $5,636.14 | $7.19 – $37.10 | 40 |
| Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm HCPCS Q4128 | $159.49 | $245.37 | $5.59 – $28.85 | 40 |
| Allograft epieffect 2x3cm-q4186-cost per sq cm HCPCS Q4186 | $2,097.63 | $3,227.12 | $12.20 – $62.95 | 40 |
| Allograft graftjacket 2x12cm-q4107-cost per sq cm HCPCS Q4107 | $238.13 | $366.35 | $38.76 – $200.01 | 40 |
| Allograft membrn amnio 1x2cm hu ambriodry HCPCS V2790 | $5,609.82 | $8,630.50 | $149.76 – $772.75 | 40 |
| Allograft umbil cord+amniotic membrane-q4148-cost per sq cm HCPCS Q4148 | $232.74 | $358.06 | $66.94 – $345.41 | 40 |
| Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm HCPCS Q4187 | $815.54 | $1,254.67 | $116.69 – $602.10 | 40 |
| Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution HCPCS J0256 | $2,450.00 | $2,450.00 | $5.33 – $2,450.00 | 36 |
| Alpha-fetoprotein afp-l3 frac & total CPT 82107 | $188.50 | $290.00 | $62.41 – $290.00 | 47 |
| Alpha-fetoprotein tumor marker CPT 82105 | $155.35 | $239.00 | $16.25 – $184.00 | 47 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | $25,477.05 | $25,477.05 | $74.73 – $264.05 | 107 |
| Alt/sgpt CPT 84460 | $52.65 | $81.00 | $5.14 – $81.00 | 47 |
| Amikacin 4 mg/ml intravitreal injection - cnr HCPCS J0278 | $32.20 | $32.20 | $1.47 – $6.20 | 104 |
| Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr HCPCS J0281 | $49.90 | $49.90 | $7.50 – $27.50 | 104 |
| Aminophylline 25 mg/ml intravenous solution (wrapper) HCPCS J0280 | $101.15 | $101.15 | $5.19 – $18.35 | 33 |
| Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV HCPCS J0283 | $212.00 | $212.00 | $13.05 – $159.50 | 103 |
| Amiodarone 50 mg/ml intravenous solution HCPCS J0282 | $73.00 | $73.00 | $1.10 – $3.90 | 103 |
| Amivantamab-vmjw 50 mg/ml intravenous solution HCPCS J9061 | $11,933.95 | $11,933.95 | $19.77 – $11,933.95 | 118 |
| Ammonia CPT 82140 | $178.10 | $274.00 | $14.12 – $274.00 | 47 |
| Amphetamines 5 or more CPT 80326 | $52.00 | $80.00 | $22.64 – $116.72 | 40 |
| Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J0285 | $8.75 | $8.75 | $2.48 – $34.12 | 103 |
| Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J0289 | $1,507.85 | $1,507.85 | $52.63 – $562.35 | 36 |
| Ampicillin 1 gram solution for injection HCPCS J0290 | $38.85 | $38.85 | $0.49 – $9.70 | 103 |
| Ampicillin-sulbactam 1.5 gram solution for injection HCPCS J0295 | $21.85 | $21.85 | $2.98 – $12.55 | 104 |
| Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis CPT 81515 | $200.20 | $308.00 | $87.16 – $528.61 | 44 |
| Amp metatarsal w/toe single 28810 CPT 28810 | $20,294.75 | $1,460.00 | $126.52 – $7,001.93 | 769 |
| Amputation leg thr tib/fib 27880 CPT 27880 | $3,870.00 | $3,870.00 | $37.48 – $309.60 | 768 |
| Amputation toe interphalangeal joint CPT 28825 | $14,223.27 | $1,194.00 | $2.28 – $7,001.93 | 769 |
| Amputation toe metatarsophalangeal joint CPT 28820 | $1,318.00 | $1,318.00 | $51.55 – $1,042.00 | 768 |
| Amylase CPT 82150 | $84.50 | $130.00 | $6.28 – $26.00 | 47 |
| Analgesics non-opioid definitive assay 1 or 2 acetaminophen CPT 80329 | $274.30 | $422.00 | $110.88 – $422.00 | 43 |
| Analysis gene f2 20210g>a variant CPT 81240 | $446.55 | $687.00 | $63.66 – $364.00 | 47 |
| Analysis gene f5 leiden variant CPT 81241 | $126.10 | $194.00 | $54.90 – $194.00 | 47 |
| Anchor suture 3.5mm pushlock HCPCS C1741 | $2,155.00 | $3,315.38 | $476.54 – $1,683.89 | 33 |
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.