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 |
|---|---|---|---|---|
| Part removal of metatarsal CPT 28113 | $1,491.00 | $1,491.00 | $129.61 – $1,241.61 | 768 |
| Part removal of metatarsal 28112 CPT 28112 | $1,367.00 | $1,367.00 | $94.55 – $786.33 | 768 |
| Passy muir valve metal trach HCPCS L8501 | $242.38 | $372.89 | $22.26 – $78.66 | 33 |
| Paste skin barrier .5oz adapt HCPCS A4406 | $0.38 | $0.59 | $0.17 – $0.59 | 33 |
| Pd hl 3.5in 4d med rbr mld 6432 HCPCS L3350 | $94.19 | $144.91 | $41.01 – $144.91 | 33 |
| Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector HCPCS J2506 | $17,709.85 | $17,709.85 | $120.38 – $17,709.85 | 118 |
| Pegfilgrastim-apgf 6 mg/0.6 ml subcutaneous syringe HCPCS Q5122 | $10,830.70 | $10,830.70 | $130.39 – $10,830.70 | 118 |
| Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe HCPCS Q5111 | $19,200.85 | $19,200.85 | $158.75 – $19,200.85 | 118 |
| Pegfilgrastim-fpgk 6 mg/0.6 ml subcutaneous syringe HCPCS Q5127 | $11,866.15 | $11,866.15 | $2,749.32 – $11,866.15 | 104 |
| Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe HCPCS Q5108 | $5,037.30 | $5,037.30 | $96.89 – $5,037.30 | 118 |
| Pegfilgrastim-pbbk 6 mg/0.6 ml subcutaneous syringe HCPCS Q5130 | $11,497.50 | $11,497.50 | $124.68 – $11,497.50 | 118 |
| Pegloticase 8 mg/ml intravenous solution HCPCS J2507 | $95,364.75 | $95,364.75 | $3,610.60 – $95,364.75 | 118 |
| Pelvic CT scan (with contrast) CPT 72193 | $1,805.05 | $2,777.00 | $161.52 – $2,777.00 | 118 |
| Pelvic CT scan (without contrast) CPT 72192 | $1,779.70 | $2,738.00 | $96.27 – $2,738.00 | 118 |
| Pelvic MRI (with and without contrast) CPT 72197 | $2,748.85 | $4,229.00 | $321.26 – $4,229.00 | 118 |
| Pelvic MRI (without contrast) CPT 72195 | $1,777.10 | $2,734.00 | $145.16 – $2,734.00 | 118 |
| Pelvic Ultrasound (complete) CPT 76856 | $795.60 | $1,224.00 | $96.27 – $1,224.00 | 118 |
| Pelvic Ultrasound (limited) CPT 76857 | $357.50 | $550.00 | $96.27 – $550.00 | 118 |
| Pelvis X-ray (1 to 2 views) CPT 72170 | $253.50 | $390.00 | $96.27 – $390.00 | 118 |
| Pelvis X-ray (complete, 4 or more views) CPT 72190 | $420.55 | $647.00 | $96.27 – $647.00 | 118 |
| Pembrolizumab 25 mg/ml intravenous solution HCPCS J9271 | $25,642.86 | $18,047.05 | $57.42 – $18,047.05 | 118 |
| Pemetrexed disodium 100 mg intravenous powder for solution HCPCS J9305 | $5,906.25 | $5,906.25 | $3.52 – $1,181.25 | 118 |
| Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 | $1,928.25 | $1,928.25 | $21.71 – $1,687.20 | 782 |
| Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr HCPCS J2540 | $63.00 | $63.00 | $0.88 – $3.25 | 103 |
| Penile injection CPT 54235 | $271.00 | $290.00 | $21.73 – $534.66 | 783 |
| Penile rear tip xtnd 0.5cm HCPCS C2622 | $13,529.89 | $20,815.21 | $14.15 – $50.00 | 33 |
| Pentamidine 300 mg solution for injection HCPCS J2516 | $792.75 | $792.75 | $224.35 – $792.75 | 33 |
| Pentostatin 10 mg intravenous solution HCPCS J9268 | $14,509.25 | $14,509.25 | $2,486.35 – $14,509.25 | 118 |
| Perc drug-el cor stent sing HCPCS C9600 | $26,971.75 | $41,495.00 | $10,630.56 – $41,495.00 | 117 |
| Pericardial drain w/cath pq w/ct guid CPT 33019 | $743.60 | $1,144.00 | $323.75 – $1,144.00 | 32 |
| Perphenazine 4mg oral HCPCS Q0175 | $1.00 | $1.00 | $0.28 – $1.00 | 103 |
| Perq dev breast 1st strtctc CPT 19283 | $3,510.00 | $5,400.00 | $89.21 – $3,600.00 | 118 |
| Pertuzumab 30 mg/ml desensitization HCPCS J9306 | $20,666.10 | $20,666.10 | $15.59 – $20,666.10 | 118 |
| Pertuzu, trastuzu, 10 mg HCPCS J9316 | $43,628.35 | $43,628.35 | $59.74 – $43,628.35 | 118 |
| Pessary 3.5 in 7 vag sil rng fold HCPCS A4562 | $96.38 | $148.28 | $31.47 – $111.21 | 33 |
| Pet CT skull-mid thgh initial CPT 78815 | $6,347.25 | $9,765.00 | $1,316.78 – $9,765.00 | 118 |
| Pet CT whole body initial CPT 78816 | $6,868.55 | $10,567.00 | $1,316.78 – $10,567.00 | 118 |
| Pfc sigma fem post aug sz3 8mm HCPCS C1776 | $54,744.57 | $84,222.41 | $0.01 – $0.01 | 33 |
| Ph body fluid CPT 83986 | $46.15 | $71.00 | $3.47 – $71.00 | 47 |
| Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr HCPCS J2560 | $201.80 | $201.80 | $18.52 – $65.45 | 103 |
| Phenobarbital therapeutic drug level CPT 80184 | $128.70 | $198.00 | $14.83 – $140.00 | 47 |
| Phentolaine mesylate inj HCPCS J2760 | $2,253.40 | $2,253.40 | $412.15 – $2,253.40 | 118 |
| Phenylephrine 10 mg/ml injection solution HCPCS J2371 | $8.75 | $8.75 | $0.85 – $3.00 | 33 |
| Phenytoin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1165 | $8.25 | $8.25 | $0.66 – $4.95 | 104 |
| Phenytoin total therapeutic drug level CPT 80185 | $122.85 | $189.00 | $12.84 – $159.00 | 47 |
| Phlebotomy therapeutic CPT 99195 | $231.40 | $356.00 | $100.75 – $842.00 | 118 |
| Phosphorus CPT 84100 | $933.40 | $71.00 | $4.59 – $71.00 | 47 |
| Phosphorus 24 hour urine CPT 84105 | $69.55 | $107.00 | $5.60 – $107.00 | 47 |
| Photchmtx tar&uvb/ptrltm&uvb CPT 96910 | $198.90 | $306.00 | $54.32 – $842.00 | 118 |
| Physical Therapy Evaluation (high complexity) CPT 97163 | $190.45 | $293.00 | $74.80 – $461.00 | 47 |
| Physical Therapy Evaluation (low complexity) CPT 97161 | $178.10 | $274.00 | $74.80 – $461.00 | 47 |
| Physical Therapy Evaluation (moderate complexity) CPT 97162 | $820.30 | $287.00 | $74.80 – $461.00 | 47 |
| Physical Therapy Re-Evaluation CPT 97164 | $175.50 | $270.00 | $50.60 – $461.00 | 47 |
| Physician standby services CPT 99360 | $148.00 | $148.00 | $36.38 – $148.00 | 554 |
| Phytonadione (vitamin k1) 10 mg/ml injection solution HCPCS J3430 | $22.60 | $22.60 | $2.84 – $19.80 | 103 |
| Pillow shldr abduc inflat univ HCPCS L3960 | $781.90 | $1,202.93 | $36.12 – $186.36 | 40 |
| Pin caspar distraction 12mm HCPCS C1821 | $24,304.88 | $37,392.12 | $0.01 – $0.33 | 33 |
| Pinworm exam CPT 87172 | $45.50 | $70.00 | $4.14 – $70.00 | 47 |
| Piperacillin-tazobactam 3.375 gram intravenous solution HCPCS J2543 | $89.80 | $89.80 | $2.22 – $22.50 | 103 |
| Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides) CPT 19281 | $1,879.80 | $2,892.00 | $88.76 – $3,534.34 | 117 |
| Placement localization device(s) breast percutaneous mammographic guide ea addl lesion left CPT 19282 | $1,264.25 | $1,945.00 | $44.46 – $1,945.00 | 32 |
| Placement of seton CPT 46020 | $13,376.15 | not published | $2.28 – $5,939.79 | 86 |
| Plasma cryoprecipitate reduced each unit HCPCS P9044 | $247.65 | $381.00 | $107.82 – $381.00 | 33 |
| Platelet aggregation each agent teg CPT 85576 | $73.45 | $113.00 | $24.13 – $113.00 | 47 |
| Platelet automated CPT 85049 | $34.45 | $53.00 | $4.35 – $53.00 | 47 |
| Platelets hla matched leukocytes reduced apheresis/pheresis each unit HCPCS P9052 | $1,996.15 | $3,071.00 | $314.00 – $3,071.00 | 118 |
| Platelets leukocytes reduced each unit HCPCS P9031 | $235.95 | $363.00 | $102.73 – $363.00 | 118 |
| Platelets leukocytes reduced irradiated each unit HCPCS P9033 | $377.00 | $580.00 | $164.14 – $580.00 | 118 |
| Platelets leukoreduced cmv negative apheresis/phresis each unit HCPCS P9055 | $1,787.50 | $2,750.00 | $314.00 – $2,750.00 | 33 |
| Platelets pheresis leukocytes reduced cmv negative irradiated each unit HCPCS P9053 | $1,146.60 | $1,764.00 | $314.00 – $1,764.00 | 118 |
| Platelets pheresis leukocytes reduced each unit HCPCS P9035 | $616.85 | $949.00 | $268.57 – $1,101.30 | 118 |
| Platelets pheresis leukocytes reduced irradiated each unit HCPCS P9037 | $1,098.50 | $1,690.00 | $314.00 – $1,690.00 | 118 |
| Platelets pheresis pathogen-reduced each unit HCPCS P9073 | $724.75 | $1,115.00 | $314.00 – $1,307.62 | 118 |
| Plethysmography lung volumes/airway resistance CPT 94726 | $25.00 | $25.00 | $7.67 – $25.00 | 768 |
| Plug insert indwelling 16f HCPCS L8511 | $153.33 | $235.90 | $66.76 – $235.90 | 33 |
| Poct blood gases ph pco2 po2 arterial calculated o2 CPT 82803 | $26,593.37 | $504.00 | $9.09 – $5,477.93 | 118 |
| Polatuzumab vedotin-piiq 140 mg intravenous solution HCPCS J9309 | $59,184.30 | $59,184.30 | $122.12 – $12,682.40 | 118 |
| Polysom <6 yrs cpap/bilvl CPT 95783 | $2,589.60 | $3,984.00 | $790.78 – $3,984.00 | 118 |
| Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap CPT 95811 | $4,532.45 | $6,973.00 | $79.02 – $6,973.00 | 783 |
| Positioner proc acufex leg acs HCPCS E0190 | $197.14 | $303.30 | $58.78 – $303.30 | 40 |
| Postpartum Care Only CPT 59430 | $384.00 | $384.00 | $37.62 – $384.00 | 768 |
| Potassium 24 hour urine CPT 84133 | $52.00 | $80.00 | $4.58 – $80.00 | 47 |
| Potassium chloride 10 meq/100ml in sterile water intravenous piggyback HCPCS J3480 | $65.00 | $65.00 | $0.17 – $8.40 | 104 |
| Potassium serum/plasma/whole blood CPT 84132 | $102.05 | $56.00 | $4.61 – $56.00 | 47 |
| Pouch high output 2pc 50mm red HCPCS A4413 | $282.29 | $434.29 | $122.90 – $434.29 | 33 |
| Pouch ostmy flat lk n 2.5in roll premier 1pc trnsp HCPCS A4388 | $0.28 | $0.43 | $0.12 – $0.43 | 33 |
| Pouch ostmy nb pouchkin ctf HCPCS A5062 | $0.38 | $0.59 | $0.13 – $0.47 | 33 |
| Pouch uros new (both sides) 2.75in clr HCPCS A4432 | $67.84 | $104.37 | $0.14 – $0.49 | 33 |
| Powder prem protct 1oz HCPCS A4371 | $0.45 | $0.70 | $0.20 – $0.70 | 33 |
| Pralidoxime 1 gram solution for injection HCPCS J2730 | $411.85 | $411.85 | $86.70 – $411.85 | 103 |
| Pr amput fgr/thumb prim/sec any joint/phal sgl incl neurectomies w dir clsr CPT 26951 | $2,445.00 | $2,445.00 | $20.01 – $264.00 | 768 |
| Pr application of long arm splint CPT 29105 | $929.50 | $747.00 | $12.04 – $498.00 | 783 |
| Pr application splint static short arm CPT 29125 | $403.65 | $621.00 | $90.00 – $414.00 | 118 |
| Pr assessment emotional/behavioral per instrument brief CPT 96127 | $71.00 | $71.00 | $3.43 – $11.00 | 767 |
| Pr biopsy skin punch single lesion CPT 11104 | $329.00 | $336.00 | $12.14 – $869.92 | 783 |
| Pr correction hallux valgus (bunionectomy) with sesamoidectomy when performed with first metatarsal and cuneiform joint arthrodesis any method CPT 28297 | $27,478.16 | $2,100.00 | $2.28 – $27,474.19 | 769 |
| Pr correction hammertoe CPT 28285 | $22,389.07 | $1,345.00 | $2.28 – $7,001.93 | 769 |
| Pr counseling smoke/tobacco intermediate greater 3 - 10 minutes CPT 99406 | $33.80 | $52.00 | $6.82 – $80.18 | 783 |
| Pr cystourethroscopy with insertion indwelling ureteral stent CPT 52332 | $21,428.51 | $984.00 | $0.96 – $7,543.30 | 769 |
| Pr discharge day management hospital ip/obs <=30 min on ecounter date CPT 99238 | $174.00 | $174.00 | $47.71 – $173.00 | 768 |
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.