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 |
|---|---|---|---|---|
| Injection during cath supravalvular aortography CPT 93567 | $315.25 | $485.00 | $137.26 – $485.00 | 32 |
| Injection epidural blood patch or clot CPT 62273 | $1,832.35 | $2,819.00 | $650.02 – $2,819.00 | 117 |
| Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides) CPT 23350 | $892.45 | $1,373.00 | $259.23 – $916.00 | 32 |
| Injection, fulvestrant HCPCS J9395 | $328.60 | $328.60 | $92.99 – $328.60 | 33 |
| Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides) HCPCS G0260 | $3,372.20 | $5,188.00 | $92.05 – $3,459.00 | 117 |
| Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides) CPT 64450 | $4,245.93 | $3,568.00 | $650.02 – $2,378.00 | 117 |
| Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides) CPT 64483 | $3,047.85 | $4,689.00 | $814.47 – $3,126.00 | 117 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level CPT 64491 | $1,023.75 | $1,575.00 | $297.15 – $1,050.00 | 32 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level CPT 64490 | $2,281.50 | $3,510.00 | $662.22 – $2,340.00 | 117 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance CPT 64494 | $4,972.21 | $1,917.00 | $361.67 – $1,892.73 | 117 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level CPT 64493 | $4,972.21 | $3,834.00 | $723.35 – $2,556.00 | 117 |
| Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance CPT 62321 | $2,675.76 | $2,162.00 | $611.85 – $2,162.00 | 117 |
| Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance CPT 62323 | $2,582.71 | $1,989.00 | $562.89 – $1,989.00 | 117 |
| Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 | $272.00 | $387.00 | $9.16 – $656.86 | 783 |
| Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s) CPT 20552 | $167.70 | $258.00 | $11.40 – $656.86 | 783 |
| Injection(s) trigger point(s) single/multiple >= 3 muscle(s) CPT 20553 | $170.30 | $262.00 | $74.15 – $656.86 | 117 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 | $12,791.19 | $198.00 | $9.09 – $533.00 | 118 |
| Injection treatment of nose CPT 30200 | $329.55 | $507.00 | $143.48 – $507.00 | 32 |
| Inj, etelcalcetide, 0.1 mg HCPCS J0606 | $1,083.90 | $1,083.90 | $66.52 – $541.95 | 104 |
| Inj gemcitabine hcl (accord) HCPCS J9196 | $485.70 | $485.70 | $137.45 – $485.70 | 33 |
| Inj heparin, pfizer, 1000u HCPCS J1643 | $55.10 | $55.10 | $6.02 – $55.10 | 104 |
| Inj intralesional <= 7 lsn(s) CPT 11900 | $196.95 | $303.00 | $85.75 – $429.35 | 117 |
| Inj lwr xtr fscl pln blk uni w/wo image CPT 64473 | $1,095.90 | $1,686.00 | $318.09 – $1,124.00 | 32 |
| Inj, nithiodote, 3mg / 125mg HCPCS J0211 | $984.90 | $984.90 | $157.00 – $984.90 | 104 |
| Inj nivolumab 2 mg hyaluron HCPCS J9289 | $48,611.65 | $48,611.65 | $27.24 – $48,611.65 | 115 |
| Inj non-compmd foam sclrsnt sgl trncl vein CPT 36465 | $1,606.80 | $2,472.00 | $466.10 – $4,415.33 | 117 |
| Inj pantoprazole(hikma) 40mg HCPCS J2471 | $16.80 | $16.80 | $4.75 – $16.80 | 103 |
| Inj retacrit esrd on dialysi HCPCS Q5105 | $33,902.60 | not published | $86.75 – $774.56 | 77 |
| Inj testosterone cypionate HCPCS J1071 | $208.65 | $208.65 | $0.02 – $101.05 | 781 |
| Inj, vegzelma, 10 mg HCPCS Q5129 | $981.40 | $981.40 | $277.74 – $981.40 | 104 |
| Inj w/fluor eval cv device CPT 36598 | $588.90 | $906.00 | $170.93 – $604.00 | 117 |
| Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln HCPCS J9229 | $73,182.85 | $73,182.85 | $2,514.57 – $73,182.85 | 118 |
| Ins cerv dilator (sep proc) CPT 59200 | $570.70 | $878.00 | $15.94 – $878.00 | 782 |
| Insert drug delivery implant CPT 11981 | $135.00 | $135.00 | $2.79 – $21.60 | 768 |
| Insert intrauterine device iud CPT 58300 | $20,142.43 | $150.00 | $4.46 – $6,927.30 | 557 |
| Insertion catheter bladder non indwelling CPT 51701 | $145.60 | $224.00 | $4.37 – $284.72 | 783 |
| Insertion catheter pleural indwelling tunneled with cuff CPT 32550 | $1,320.00 | $1,320.00 | $18.51 – $68.64 | 768 |
| Insertion intra aortic balloon assist device percutaneous CPT 33967 | $3,781.05 | $5,817.00 | $1,646.21 – $5,817.00 | 32 |
| Insertion nontunneled centrally inserted central venous catheter >= 5 years old CPT 36556 | $7,634.22 | $6,505.00 | $39.86 – $6,756.86 | 783 |
| Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular CPT 33208 | $14,561.95 | $22,403.00 | $6,340.05 – $22,403.00 | 117 |
| Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years CPT 36569 | $7,634.22 | $3,298.00 | $933.33 – $3,368.62 | 117 |
| Insertion/replacement temporary single chamber electrode/pacemaker catheter CPT 33210 | $4,957.55 | $7,627.00 | $2,158.44 – $17,708.96 | 117 |
| Insertion subcutaneous cardiac rhythm monitor CPT 33285 | $20,074.60 | $30,884.00 | $7,620.46 – $30,884.00 | 117 |
| Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides) CPT 36561 | $17,139.64 | $11,573.00 | $2.28 – $7,715.00 | 783 |
| Insert pessary/other device CPT 57160 | $137.00 | $205.00 | $12.89 – $432.64 | 783 |
| In situ hybridization per specimen each additional single probe stain CPT 88364 | $192.40 | $296.00 | $83.77 – $296.00 | 33 |
| In situ hybridization per specimen initial single probe stain CPT 88365 | $204.10 | $314.00 | $88.86 – $364.58 | 118 |
| Insole orthotic freedom sz6 6816 HCPCS L3060 | $44.30 | $68.15 | $19.29 – $68.15 | 33 |
| Instillation anticarcinogenic agent bladder CPT 51720 | $447.20 | $317.00 | $12.14 – $1,492.18 | 783 |
| Ins tun cv cath wo subq prt/pm CPT 36558 | $1,102.00 | $1,102.00 | $6.57 – $88.16 | 768 |
| Insulin total CPT 83525 | $87.75 | $135.00 | $11.08 – $119.00 | 47 |
| Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm HCPCS Q4114 | $2,333.79 | $3,590.44 | $695.83 – $3,590.44 | 40 |
| Integra os putty 2.5cc - cost per 0.5cc HCPCS C9359 | $146.76 | $225.79 | $63.90 – $225.79 | 33 |
| Interferon beta-1a 30 mcg/0.5 ml im injection (wrapper) HCPCS Q3027 | $10,427.90 | $10,427.90 | $1,816.42 – $10,427.90 | 104 |
| Interrog evl pm/ldls pm ip CPT 93288 | $97.50 | $150.00 | $34.37 – $150.00 | 117 |
| Intro cath dialysis circuit w/pta CPT 36902 | $8,717.80 | $13,412.00 | $3,795.60 – $13,412.00 | 117 |
| Intro catheter aorta CPT 36200 | $1,367.60 | $2,104.00 | $397.05 – $1,403.00 | 32 |
| Intubation endotracheal emergency procedure CPT 31500 | $25,535.62 | $546.00 | $2.88 – $546.00 | 117 |
| Iopamidol 250 mg iodine/ml (51 %) intravenous solution HCPCS Q9966 | $2,675.76 | $46.90 | $13.27 – $1,510.55 | 118 |
| Iopamidol 300 mg iodine/ml (61 %) intravenous solution HCPCS Q9967 | $431.50 | $431.50 | $3.33 – $11.75 | 33 |
| Ipilimumab 5 mg/ml intravenous solution (wrapper) HCPCS J9228 | $110,829.85 | $110,829.85 | $172.83 – $27,707.50 | 118 |
| Irinotecan 20 mg/ml intravenous solution (wrapper) HCPCS J9206 | $522.90 | $522.90 | $18.10 – $63.95 | 33 |
| Irinotecan liposomal 4.3 mg/ml intravenous HCPCS J9205 | $9,268.95 | $9,268.95 | $64.64 – $9,268.95 | 118 |
| Iron CPT 83540 | $624.00 | $70.00 | $6.27 – $70.00 | 47 |
| Iron binding capacity CPT 83550 | $48.75 | $75.00 | $8.47 – $75.00 | 47 |
| Iron dextran 50 mg/ml injection solution HCPCS J1750 | $185.90 | $185.90 | $17.46 – $185.90 | 36 |
| Iron sucrose 20 mg iron/ml intravenous solution (wrapper) HCPCS J1756 | $33,187.02 | $82.80 | $9.05 – $544.00 | 107 |
| Irradiation of blood product each unit reference CPT 86945 | $137.15 | $211.00 | $33.96 – $211.00 | 47 |
| Irrigation implantable venous access device for drug delivery systems CPT 96523 | $201.50 | $310.00 | $16.88 – $310.00 | 782 |
| Isatuximab-irfc 20 mg/ml intravenous solution HCPCS J9227 | $2,779.35 | $2,779.35 | $77.83 – $2,779.35 | 118 |
| IV Fluids (each additional hour) CPT 96361 | $17,824.85 | $159.00 | $2.28 – $533.00 | 118 |
| IV Fluids (first hour) CPT 96360 | $10,692.27 | $736.00 | $88.83 – $736.00 | 118 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $14,932.25 | $230.00 | $25.28 – $957.20 | 118 |
| IV Medicine Infusion (additional drug) CPT 96367 | $25,115.80 | $238.00 | $2.28 – $533.00 | 118 |
| IV Medicine Infusion (each additional hour) CPT 96366 | $9,550.97 | $160.00 | $43.12 – $533.00 | 118 |
| IV Medicine Infusion (first hour) CPT 96365 | $3,301.41 | $736.00 | $9.09 – $736.00 | 118 |
| IV Push Injection (each additional drug) CPT 96375 | $20,671.49 | $198.00 | $0.90 – $533.00 | 118 |
| IV Push Injection (first drug) CPT 96374 | $2,555.15 | $736.00 | $195.87 – $736.00 | 118 |
| Ixabepilone 15 mg intravenous solution HCPCS J9207 | $18,131.05 | $18,131.05 | $127.12 – $6,043.70 | 118 |
| Jak2 targeted sequence analysis CPT 81279 | $455.65 | $701.00 | $181.50 – $701.00 | 44 |
| Jaw Joint (TMJ) X-ray (both sides, open and closed) CPT 70330 | $466.05 | $717.00 | $80.14 – $717.00 | 118 |
| Jaw (Mandible) X-ray (complete) CPT 70110 | $413.40 | $636.00 | $96.27 – $636.00 | 118 |
| Jkt lso inter HCPCS L0560 | $41.27 | $63.49 | $17.97 – $63.49 | 33 |
| John cunningham antibody CPT 86711 | $39.65 | $61.00 | $16.55 – $61.00 | 44 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $39.00 | $60.00 | $7.92 – $60.00 | 47 |
| Ketorolac (Toradol) Pain Shot, 15 mg HCPCS J1885 | $17.20 | $17.20 | $0.30 – $9.66 | 781 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $1,005.55 | $1,508.00 | $96.27 – $1,508.00 | 118 |
| Kidney (Retroperitoneal) Ultrasound (limited) CPT 76775 | $414.05 | $637.00 | $96.27 – $637.00 | 118 |
| Kit case 4.2mm spinejack HCPCS C1062 | $5,937.40 | $9,134.46 | $829.81 – $2,932.18 | 33 |
| Kit cast tcc 3in w/2reg boots total contact cast HCPCS Q4038 | $257.21 | $395.71 | $96.42 – $340.71 | 33 |
| Kit cath f 8f w/glv + wipe ster HCPCS A4353 | $1.31 | $2.02 | $0.38 – $1.33 | 33 |
| Kit cath ivl 2.5x40mm 135cm shockwave s4 HCPCS C1761 | $6,430.77 | $9,893.50 | $1,638.22 – $5,788.75 | 33 |
| Kit hfx iq ipg bundle HCPCS C1822 | $26,541.53 | $40,833.13 | $11,133.03 – $39,339.32 | 33 |
| Kit ipg optimizer smart HCPCS C1824 | $29,051.10 | $44,694.00 | $11,188.97 – $39,537.00 | 33 |
| Kit irrigator stoma cone 7721 HCPCS A4398 | $2.05 | $3.16 | $0.89 – $3.16 | 33 |
| Kit lead specify 5-6-5 HCPCS C1778 | $13,454.45 | $20,699.16 | $40.56 – $143.33 | 33 |
| Kit monitr cath camino icp w/integratd licox bolt fitting HCPCS A9279 | $1,313.77 | $2,021.18 | $571.99 – $2,021.18 | 33 |
| Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set HCPCS C1878 | $1,391.79 | $2,141.22 | $576.54 – $2,037.25 | 33 |
| Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm HCPCS Q4105 | $234.08 | $360.12 | $40.86 – $210.83 | 40 |
| Kit sound processor cochlear osia 2 HCPCS L8691 | $6,106.28 | $9,394.28 | $1,233.64 – $6,365.52 | 40 |
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.