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 |
|---|---|---|---|---|
| Kit trach suct cls 30.5cm HCPCS A4605 | $3,140.14 | $4,830.98 | $11.84 – $41.85 | 33 |
| Knee Arthroscopy (Meniscus Trimming) CPT 29881 | $2,440.00 | $2,440.00 | $25.36 – $195.20 | 768 |
| Knee arthroscopy/surgery CPT 29880 | $20,048.57 | not published | $2.88 – $7,001.93 | 86 |
| Knee arthroscopy/surgery CPT 29883 | $43,121.81 | not published | $4.56 – $15,527.97 | 86 |
| Knee arthroscopy/surgery CPT 29888 | $43,121.81 | not published | $4.56 – $15,527.97 | 86 |
| Knee MRI (with and without contrast) CPT 73723 | $2,603.90 | $4,006.00 | $255.10 – $2,670.00 | 118 |
| Knee MRI (with contrast) CPT 73722 | $2,260.70 | $3,478.00 | $298.64 – $2,318.00 | 118 |
| Knee MRI (without contrast) CPT 73721 | $2,237.30 | $3,442.00 | $219.72 – $2,294.00 | 118 |
| Knee X-ray CPT 73564 | $583.05 | $897.00 | $96.27 – $597.00 | 118 |
| Knee X-ray (1 to 2 views, both knees) CPT 73560 | $321.75 | $495.00 | $80.14 – $330.00 | 118 |
| Knee X-ray (3 views, both knees) CPT 73562 | $466.05 | $717.00 | $80.14 – $478.00 | 118 |
| Knee X-ray (standing, both knees) CPT 73565 | $218.40 | $336.00 | $80.14 – $336.00 | 118 |
| Kyleena, 19.5 mg HCPCS J7296 | $12,724.40 | $12,724.40 | $2,100.00 – $12,724.40 | 535 |
| Labetalol 5 mg/ml IV (wrapper) HCPCS J1920 | $19.45 | $19.45 | $5.50 – $19.45 | 33 |
| Lactate dehydrogenase (ldh) CPT 83615 | $86.45 | $133.00 | $5.85 – $85.00 | 47 |
| Lactated ringers intravenous solution HCPCS J7120 | $17,281.06 | $20.00 | $2.46 – $6,927.30 | 118 |
| Lactic acid CPT 83605 | $551.20 | $112.00 | $9.09 – $112.00 | 118 |
| Lactoferrin fecal qualitative CPT 83630 | $67.60 | $104.00 | $19.09 – $104.00 | 47 |
| Lanreotide 120 mg/0.5 ml subcutaneous syringe HCPCS J1930 | $29,832.00 | $29,832.00 | $34.68 – $18,996.00 | 118 |
| Lanthanum carbonate oral 5mg HCPCS J0607 | $15.86 | $24.40 | $0.04 – $24.40 | 108 |
| Laparo cholecystectomy/graph CPT 47563 | $26,750.76 | $2,574.00 | $2.28 – $12,937.15 | 769 |
| Laparoscopy aspiration CPT 49322 | $1,350.00 | $1,350.00 | $17.34 – $131.36 | 768 |
| Laparoscopy excise lesions CPT 58662 | $30,505.35 | not published | $195.93 – $12,937.15 | 86 |
| Laparoscopy remove adnexa CPT 58661 | $27,984.00 | $3,910.00 | $29.91 – $12,937.15 | 769 |
| Laparo-vag hyst incl t/o CPT 58552 | $32,900.39 | $2,939.00 | $9.09 – $22,747.36 | 769 |
| Lap colectomy/coloproctostomy 44207 CPT 44207 | $6,501.00 | $6,501.00 | $37.48 – $620.48 | 768 |
| Lap colectomy part w/ileum 44205 CPT 44205 | $4,787.00 | $4,787.00 | $37.48 – $459.68 | 768 |
| Lap mobil splenic fl add-on 44213 CPT 44213 | $895.00 | $895.00 | $16.84 – $63.36 | 768 |
| Lap part colectomy w/stoma 44206 CPT 44206 | $6,229.00 | $6,229.00 | $37.48 – $598.24 | 768 |
| Large Joint Injection or Fluid Draw (both sides) CPT 20610 | $488.43 | $383.00 | $12.26 – $656.86 | 783 |
| Laryngoscopy w/bx & op scope CPT 31536 | $16,951.82 | $671.00 | $57.09 – $7,978.49 | 769 |
| Laryngoscopy with biopsy CPT 31576 | $1,009.45 | $1,553.00 | $439.50 – $1,553.00 | 32 |
| Laser surgery of prostate CPT 52648 | $21,572.00 | $5,709.00 | $138.04 – $11,474.00 | 769 |
| Lead acuity x4 spiral l 86cm HCPCS C1900 | $2,873.32 | $4,420.50 | $28.60 – $101.07 | 33 |
| Lead capillary CPT 83655 | $67.60 | $104.00 | $11.73 – $104.00 | 47 |
| Lead ingevity 45cm pfret MRI HCPCS C1898 | $4,159.75 | $6,399.62 | $0.07 – $0.26 | 33 |
| Lead tachy durata sj4 58cm HCPCS C1777 | $8,202.66 | $12,619.48 | $26.44 – $93.42 | 33 |
| Leg Artery Ultrasound (complete, both legs) CPT 93925 | $640.25 | $985.00 | $219.72 – $985.00 | 118 |
| Leg CT Scan (with contrast, both legs) CPT 73701 | $2,701.72 | $3,915.00 | $161.52 – $2,610.00 | 118 |
| Leg CT Scan (without contrast, both legs) CPT 73700 | $2,276.95 | $3,503.00 | $96.27 – $2,335.00 | 118 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $862.55 | $1,327.00 | $219.72 – $1,327.00 | 118 |
| Lens iol 23.0 d 1.5 cyl eyhance toric HCPCS V2787 | $419.25 | $645.00 | $14.15 – $50.00 | 33 |
| Lens iol ant bicnvx 24.0 multi HCPCS V2632 | $692.25 | $1,065.00 | $14.15 – $50.00 | 33 |
| Lens iol ant chamb 10.5 HCPCS V2630 | $354.25 | $545.00 | $14.15 – $50.00 | 33 |
| Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 | $396.40 | $396.40 | $3.89 – $13.75 | 103 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | $37,312.35 | $37,312.35 | $99.23 – $527.00 | 782 |
| Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 | $5,218.50 | $5,218.50 | $1,476.84 – $5,218.50 | 118 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $7.95 | $7.95 | $2.08 – $7.35 | 104 |
| Levetiracetam therapeutic drug level CPT 80177 | $99.45 | $153.00 | $12.84 – $153.00 | 47 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $61.50 | $61.50 | $1.84 – $6.50 | 103 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | $308.15 | $308.15 | $77.00 – $308.15 | 103 |
| Liberta rc ipg HCPCS C1820 | $29,884.39 | $45,975.98 | $19.44 – $68.71 | 33 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | $37.50 | $37.50 | $10.61 – $37.50 | 33 |
| Lidocaine therapeutic drug level CPT 80176 | $98.15 | $151.00 | $14.40 – $151.00 | 13 |
| Lift heel adj small gl60404sm HCPCS L3332 | $38.34 | $58.98 | $16.69 – $58.98 | 33 |
| Lift heel adjustable med HCPCS L3334 | $3.03 | $4.66 | $1.32 – $4.66 | 33 |
| Ligation/major artery/extremity 37618 CPT 37618 | $1,282.00 | $1,282.00 | $117.79 – $846.76 | 768 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $210.00 | $210.00 | $10.41 – $210.00 | 103 |
| Lipase CPT 83690 | $144.95 | $223.00 | $6.68 – $223.00 | 47 |
| Lipoprotein direct measurement hdl CPT 83718 | $94.25 | $145.00 | $7.94 – $145.00 | 47 |
| Lipoprotein direct measurement ldl CPT 83721 | $523.90 | $120.00 | $9.09 – $120.00 | 47 |
| Lithium therapeutic drug level CPT 80178 | $73.45 | $113.00 | $6.41 – $113.00 | 47 |
| Liver Function Test CPT 80076 | $255.45 | $393.00 | $7.92 – $393.00 | 47 |
| Loncastuximab tesirine-lpyl 10 mg intravenous solution HCPCS J9359 | $87,089.35 | $87,089.35 | $197.84 – $87,089.35 | 118 |
| Loop ostmy bridg ster HCPCS A4421 | $45.43 | $69.90 | $0.10 – $0.37 | 33 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $914.87 | $86.05 | $1.50 – $455.17 | 118 |
| Low cost skin substitute app HCPCS C5271 | $2,968.55 | $4,567.00 | $755.08 – $4,567.00 | 42 |
| Low cost skin substitute app HCPCS C5272 | $2,600.00 | $4,000.00 | $1,132.00 – $4,000.00 | 32 |
| Low cost skin substitute app HCPCS C5276 | $2,304.25 | $3,545.00 | $1,003.24 – $3,545.00 | 32 |
| Low-Dose Lung Cancer Screening CT Scan CPT 71271 | $345.15 | $531.00 | $96.27 – $531.00 | 118 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $2,071.55 | $3,187.00 | $321.26 – $3,187.00 | 118 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $2,057.25 | $3,165.00 | $96.27 – $3,165.00 | 118 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $4,882.80 | $7,512.00 | $321.26 – $7,512.00 | 118 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $2,447.90 | $3,766.00 | $321.26 – $3,766.00 | 118 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $2,598.70 | $3,998.00 | $219.72 – $3,998.00 | 118 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $418.60 | $644.00 | $96.27 – $644.00 | 118 |
| Lower Back (Lumbar Spine) X-ray (4 or more views) CPT 72110 | $585.00 | $900.00 | $96.27 – $900.00 | 118 |
| Lower Back (Lumbar Spine) X-ray (with bending views) CPT 72114 | $237.25 | $365.00 | $96.27 – $365.00 | 118 |
| Lower Leg (Shin) X-ray (both sides) CPT 73590 | $335.40 | $516.00 | $80.14 – $343.00 | 118 |
| Lung Function Test Before and After an Inhaler CPT 94060 | $21.00 | $21.00 | $6.60 – $21.00 | 768 |
| Lung perfusion imaging CPT 78580 | $1,290.90 | $1,986.00 | $368.14 – $1,986.00 | 118 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | $25,230.00 | $25,230.00 | $202.23 – $25,230.00 | 118 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | $37,758.50 | $37,758.50 | $39.26 – $12,586.20 | 118 |
| Lvad shower bag heartmate HCPCS Q0501 | $887.68 | $1,365.66 | $386.48 – $1,365.66 | 33 |
| Lymphatics/lymph node imaging CPT 78195 | $1,698.45 | $2,613.00 | $500.00 – $2,613.00 | 118 |
| Macroscopic exam arthropod CPT 87168 | $52.00 | $80.00 | $4.14 – $80.00 | 47 |
| Macroscopic exam parasite CPT 87169 | $45.50 | $70.00 | $4.17 – $70.00 | 47 |
| Magnesium CPT 83735 | $589.55 | $109.00 | $6.50 – $106.00 | 47 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $237.00 | $237.00 | $0.50 – $10.65 | 104 |
| Mammosite ced HCPCS C1728 | $1,437.46 | $2,211.47 | $625.85 – $2,211.47 | 33 |
| Margetuximab-cmkb 25 mg/ml intravenous solution HCPCS J9353 | $8,622.65 | $8,622.65 | $46.45 – $8,622.65 | 118 |
| Marker biop eviva buckle ss HCPCS A4648 | $3,312.87 | $5,096.73 | $0.01 – $0.14 | 33 |
| Marker lymphatic sentimag magtrace 10 vial HCPCS A9697 | $1,262.93 | $1,942.97 | $376.55 – $1,942.97 | 40 |
| Mask full face lg af531 HCPCS A7030 | $47.34 | $72.83 | $20.10 – $71.04 | 33 |
| Mastectomy partial CPT 19301 | $22,031.75 | $2,902.00 | $16.98 – $8,378.85 | 769 |
| Matrix bone cryomatrix 2.0ml HCPCS Q4162 | $6,518.34 | $10,028.22 | $2,837.99 – $10,028.22 | 33 |
| Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm HCPCS Q4166 | $72.92 | $112.19 | $0.70 – $3.61 | 40 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $104.65 | $161.00 | $14.01 – $161.00 | 47 |
| Mayo aathr protein s free CPT 85306 | $169.65 | $261.00 | $14.84 – $261.00 | 47 |
| Mayo activated protein c resistance assay CPT 85307 | $128.05 | $197.00 | $14.84 – $164.00 | 47 |
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.