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 |
|---|---|---|---|---|
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $122.85 | $189.00 | $12.47 – $142.00 | 47 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $31.85 | $49.00 | $3.79 – $45.00 | 47 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | $7.00 | $7.00 | $1.98 – $7.00 | 33 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $5,516.60 | $5,516.60 | $11.40 – $5,516.60 | 118 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $172.90 | $266.00 | $18.00 – $266.00 | 47 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $176.80 | $272.00 | $17.94 – $272.00 | 47 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | $16,064.55 | $16,064.55 | $195.87 – $5,895.10 | 118 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $100.11 | $154.01 | $29.85 – $154.01 | 40 |
| Graft axiofill 1000mg HCPCS J3590 | $6,300.79 | $9,693.53 | $458.05 – $1,618.56 | 33 |
| Graft bone flex 2.5cm x 5cm grafton-cost per sq cm HCPCS Q4205 | $1.41 | $2.17 | $0.61 – $2.17 | 33 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | $1,885.86 | $2,901.33 | $18.66 – $96.28 | 40 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $4,970.86 | $7,647.47 | $0.09 – $0.46 | 40 |
| Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm HCPCS Q4113 | $1,548.87 | $2,382.88 | $674.36 – $2,382.88 | 33 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $16,761.06 | $25,786.25 | $0.12 – $0.43 | 33 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $35,755.20 | $55,008.00 | $0.01 – $0.62 | 33 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | $304.44 | $468.37 | $0.30 – $1.56 | 40 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $397.50 | $611.54 | $46.26 – $238.70 | 40 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $414.05 | $637.00 | $59.28 – $305.89 | 40 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | $476.79 | $733.52 | $15.78 – $81.42 | 40 |
| Graft tis hmatrix dermis 10x5 -cost per sq cm HCPCS Q4134 | $58.05 | $89.31 | $25.27 – $89.31 | 33 |
| Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm HCPCS Q4130 | $1,705.66 | $2,624.09 | $0.01 – $0.05 | 33 |
| Graft viashield 2layer amnion patch 2x2cm-cost per sq cm HCPCS Q4211 | $593.61 | $913.25 | $67.83 – $350.01 | 40 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | $312.02 | $480.03 | $17.57 – $62.10 | 33 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $25,506.74 | $39,241.14 | $14.15 – $50.00 | 33 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $17,074.23 | $26,268.04 | $30.95 – $109.36 | 33 |
| Gstrst open wo constj tube CPT 43830 | $2,524.00 | $2,524.00 | $23.28 – $246.88 | 768 |
| G-tube reposition CPT 43761 | $378.00 | $378.00 | $28.23 – $227.00 | 768 |
| Guide endoanchr sg-64 aaa 62cm HCPCS L8670 | $2,547.89 | $3,919.83 | $1,101.22 – $3,891.24 | 33 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $4,925.86 | $7,578.25 | $0.01 – $0.26 | 33 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $747.95 | $1,150.70 | $0.01 – $24.82 | 33 |
| Guid loc target vol rad tx CPT 77387 | $793.65 | $1,221.00 | $345.54 – $1,239.00 | 33 |
| Gw stiffened micro access kit HCPCS C1894 | $9,830.88 | $15,124.43 | $0.01 – $0.68 | 33 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $3.65 | $3.65 | $1.03 – $3.65 | 33 |
| Handpiece aquabeam hp2000 HCPCS C2596 | $14,876.30 | $22,886.61 | $2,089.33 – $7,382.80 | 33 |
| Hands-On Manual Therapy (each 15 minutes) CPT 97140 | $1,696.50 | $145.00 | $23.75 – $195.00 | 47 |
| Hand X-ray CPT 73130 | $780.00 | $583.00 | $80.14 – $389.00 | 118 |
| Hand X-ray (2 views, both hands) CPT 73120 | $352.95 | $543.00 | $96.27 – $362.00 | 118 |
| Haptoglobin quantitative CPT 83010 | $151.45 | $233.00 | $12.19 – $233.00 | 47 |
| Hbot, full body chamber, 30m HCPCS G0277 | $48,249.50 | $816.00 | $74.50 – $1,093.00 | 118 |
| Hcg qualitative CPT 84703 | $94.25 | $145.00 | $7.28 – $145.00 | 47 |
| Hcg quantitative CPT 84702 | $170.95 | $263.00 | $14.59 – $167.00 | 47 |
| Head CT scan (with and without contrast) CPT 70470 | $2,089.75 | $3,215.00 | $161.52 – $3,215.00 | 118 |
| Head CT scan (with contrast) CPT 70460 | $2,063.75 | $3,175.00 | $161.52 – $3,175.00 | 118 |
| Head CT scan (without contrast) CPT 70450 | $1,633.45 | $2,513.00 | $96.27 – $2,513.00 | 118 |
| Heel (Calcaneus) X-ray (both feet) CPT 73650 | $319.15 | $491.00 | $80.14 – $328.00 | 118 |
| Helicobacter pylori antibody igm CPT 86677 | $79.95 | $123.00 | $16.33 – $123.00 | 47 |
| Hematocrit CPT 85014 | $522.60 | $58.00 | $2.30 – $58.00 | 47 |
| Hemin 350 mg intravenous powder for solution HCPCS J1640 | $34,281.50 | $34,281.50 | $34.60 – $34,281.50 | 115 |
| Hemodialysis one evaluation CPT 90935 | $2,447.90 | $3,766.00 | $544.00 – $3,766.00 | 118 |
| Hemoglobin CPT 85018 | $593.45 | $58.00 | $2.30 – $58.00 | 47 |
| Hemoglobin fetal qualitative CPT 83033 | $198.25 | $305.00 | $8.00 – $305.00 | 33 |
| Hemoglobin methemoglobin quantitative CPT 83050 | $256.10 | $394.00 | $7.95 – $236.00 | 32 |
| Hemoglobin plasma CPT 83051 | $59.80 | $92.00 | $7.08 – $92.00 | 47 |
| Hemorrhoidectomy intrnl lig rbbr band ligations CPT 46221 | $2,236.00 | $3,440.00 | $38.89 – $3,440.00 | 783 |
| Heparin assay CPT 85520 | $55.25 | $85.00 | $12.69 – $85.00 | 47 |
| Heparin bolus from bag HCPCS J1644 | $32,957.24 | $38.75 | $1.98 – $69.85 | 107 |
| Heparin neutralization CPT 85525 | $83.85 | $129.00 | $11.48 – $129.00 | 47 |
| Heparin, porcine (pf) 10 unit/ml flush (wrapper) HCPCS J1642 | $3.00 | $3.00 | $0.85 – $3.00 | 33 |
| Hepatectomy removal of liver 47120 CPT 47120 | $8,322.00 | $8,322.00 | $37.48 – $809.28 | 768 |
| Hepatitis a antibody igm CPT 86709 | $146.25 | $225.00 | $10.91 – $225.00 | 47 |
| Hepatitis b core antibody igm CPT 86705 | $128.05 | $197.00 | $11.40 – $197.00 | 47 |
| Hepatitis b core antibody total CPT 86704 | $240.50 | $370.00 | $11.68 – $370.00 | 47 |
| Hepatitis b immune globulin greater than 1,560 units/5 ml im solution CPT 90371 | $3,148.75 | $3,148.75 | $135.07 – $3,148.75 | 118 |
| Hepatitis b surface antibody CPT 86706 | $87.10 | $134.00 | $10.40 – $134.00 | 47 |
| Hepatitis c antibody CPT 86803 | $191.10 | $294.00 | $13.83 – $294.00 | 47 |
| Hepb vacc 3 dose immunsup im CPT 90740 | $565.15 | $565.15 | $159.94 – $565.15 | 115 |
| Hernia Repair (Inguinal) CPT 49505 | $18,665.79 | $2,314.00 | $2.28 – $7,661.89 | 769 |
| Herpes simplex type 1 antibody igg CPT 86695 | $61.75 | $95.00 | $12.78 – $95.00 | 47 |
| Herpes simplex type 2 antibody igg CPT 86696 | $96.20 | $148.00 | $18.75 – $148.00 | 47 |
| Heterophile antibodies screening CPT 86308 | $57.20 | $88.00 | $5.02 – $88.00 | 47 |
| Hip and Pelvis X-ray (2 views, both hips) CPT 73521 | $280.80 | $432.00 | $96.27 – $432.00 | 118 |
| Hip and Pelvis X-ray (3 to 4 views, both hips) CPT 73522 | $308.75 | $475.00 | $96.27 – $475.00 | 118 |
| Hip and Pelvis X-ray (single view, left side) CPT 73501 | $167.70 | $258.00 | $73.01 – $258.00 | 118 |
| Hip X-ray CPT 73502 | $224.25 | $345.00 | $80.14 – $345.00 | 118 |
| Histamine CPT 83088 | $125.45 | $193.00 | $28.61 – $193.00 | 47 |
| HIV prep, ftc/tdf 200/300mg HCPCS J0750 | $56.50 | $56.50 | $1.24 – $56.50 | 113 |
| Hldr trach tb tie ad HCPCS A7526 | $1,057.54 | $1,626.99 | $0.17 – $0.59 | 33 |
| Holder tube cath-secure nonstrl lf disp HCPCS A4333 | $0.78 | $1.20 | $0.34 – $1.20 | 33 |
| Home health re-certification physician g0179 HCPCS G0179 | $94.00 | $94.00 | $29.74 – $94.00 | 767 |
| Home sleep test/type 3 porta HCPCS G0399 | $1,077.39 | $603.00 | $36.62 – $534.00 | 556 |
| Homocysteine CPT 83090 | $156.00 | $240.00 | $17.36 – $240.00 | 47 |
| Homogenization tissue CPT 87176 | $327.60 | $504.00 | $5.70 – $504.00 | 47 |
| Human prothrombin complex concentrate (pcc)-lans 500 unit (400-640 unit) IV solution HCPCS J7165 | $1,829.90 | $1,829.90 | $1.67 – $1,829.90 | 115 |
| Hyaluronidase 150 unit/ml injection solution HCPCS J3470 | $154.70 | $154.70 | $31.55 – $154.70 | 103 |
| Hyaluronidase, human recombinant 150 unit/ml injection solution HCPCS J3473 | $236.10 | $236.10 | $54.00 – $236.10 | 103 |
| Hydralazine 20 mg/ml injection solution HCPCS J0360 | $69.00 | $69.00 | $5.19 – $69.00 | 103 |
| Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J1720 | $243.25 | $243.25 | $12.45 – $57.33 | 104 |
| Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper) HCPCS J1171 | $25,355.67 | $185.75 | $1.80 – $12,937.15 | 118 |
| Hydroxyzine hcl 50 mg/ml intramuscular solution HCPCS J3410 | $105.00 | $105.00 | $29.72 – $105.00 | 33 |
| Hydroxyzine pamoate 25 mg capsule HCPCS Q0177 | $1.00 | $1.00 | $0.10 – $1.00 | 103 |
| Hyperbaric oxygen therapy CPT 99183 | $322.00 | $322.00 | $38.06 – $296.74 | 768 |
| Hysterosalpingography s&i CPT 74740 | $821.60 | $1,264.00 | $219.72 – $1,264.00 | 118 |
| Hysteroscopy ablation CPT 58563 | $25,185.06 | $1,047.00 | $11.08 – $10,705.01 | 769 |
| Hysteroscopy biopsy CPT 58558 | $18,285.77 | $819.00 | $3.21 – $6,927.30 | 769 |
| Hysteroscopy dx sep proc CPT 58555 | $574.00 | $574.00 | $6.87 – $52.64 | 768 |
| Hzv zoster vacc recombinant adjuvanted im inj CPT 90750 | $1,079.35 | $1,079.35 | $54.60 – $273.00 | 110 |
| I-123 iobenguane diag HCPCS A9582 | $24,445.60 | $24,445.60 | $17.29 – $24,445.60 | 117 |
| I-123 ioflupane diag HCPCS A9584 | $12,340.00 | $12,340.00 | $1,359.99 – $12,340.00 | 115 |
| I-123 sod iodide diag per 100 uci HCPCS A9516 | $412.50 | $412.50 | $113.55 – $401.25 | 33 |
| I-131 iobenguane sulf diag mibg HCPCS A9508 | $6,709.35 | $6,709.35 | $1,898.75 – $6,709.35 | 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.