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 |
|---|---|---|---|---|
| Red blood cells frozen/deglycerolized/washed leukocytes reduced irradiated each unit HCPCS P9057 | $787.15 | $1,211.00 | $314.00 – $1,211.00 | 33 |
| Red blood cells leukocytes reduced cmv negative irradiated each unit HCPCS P9058 | $877.50 | $1,350.00 | $224.79 – $1,350.00 | 118 |
| Red blood cells leukocytes reduced each unit HCPCS P9016 | $256.10 | $394.00 | $111.50 – $398.06 | 118 |
| Red blood cells leukocytes reduced irradiated each unit HCPCS P9040 | $1,085.50 | $1,670.00 | $239.22 – $1,670.00 | 118 |
| Red blood cells washed each unit HCPCS P9022 | $604.50 | $930.00 | $263.19 – $930.00 | 118 |
| Regadenoson 0.4 mg/5 ml intravenous syringe HCPCS J2785 | $92.00 | $92.00 | $11.56 – $92.00 | 103 |
| Remdesivir 100 mg intravenous powder for solution HCPCS J0248 | $3,543.15 | $3,543.15 | $5.91 – $3,543.15 | 118 |
| Removal central venous catheter tunneled without port/pump CPT 36589 | $1,692.60 | $2,604.00 | $6.39 – $2,604.00 | 783 |
| Removal central venous device tunneled w/port/pump central/peripheral insertion CPT 36590 | $11,930.78 | $632.00 | $8.81 – $3,368.62 | 769 |
| Removal cerumen impacted (both sides) CPT 69210 | $232.00 | $232.00 | $8.63 – $126.24 | 783 |
| Removal devitalized tissue non-selective debridement without anesthesia per session CPT 97602 | $4,300.07 | $571.00 | $88.83 – $571.00 | 118 |
| Removal foreign body foot subcutaneous right CPT 28190 | $3,868.15 | $5,951.00 | $30.44 – $3,967.00 | 783 |
| Removal of adenoids CPT 42830 | $18,459.89 | $785.00 | $0.96 – $7,094.93 | 769 |
| Removal of adenoids CPT 42831 | $856.50 | $855.00 | $67.84 – $855.00 | 768 |
| Removal of bone for graft CPT 20900 | $1,346.00 | $1,346.00 | $8.10 – $62.56 | 768 |
| Removal of bone for graft CPT 20902 | $34,469.09 | not published | $0.96 – $27,474.19 | 86 |
| Removal of foot lesion CPT 28080 | $1,330.46 | $1,318.00 | $102.93 – $1,318.00 | 768 |
| Removal of foot lesion CPT 28090 | $1,079.00 | $1,079.00 | $93.94 – $1,079.00 | 768 |
| Removal of foot lesion CPT 28104 | $1,291.50 | $1,233.00 | $108.21 – $1,233.00 | 768 |
| Removal of gallbladder 47600 CPT 47600 | $3,825.00 | $3,825.00 | $34.18 – $374.24 | 768 |
| Removal of heel bone CPT 28118 | $1,463.00 | $1,463.00 | $129.40 – $974.27 | 768 |
| Removal of heel spur CPT 28119 | $25,905.49 | not published | $2.28 – $7,001.93 | 86 |
| Removal of hydrocele CPT 55040 | $18,841.48 | not published | $0.96 – $7,661.89 | 86 |
| Removal of implant deep CPT 20680 | $20,270.38 | $1,446.00 | $2.28 – $6,215.96 | 769 |
| Removal of intranasal lesion CPT 30117 | $1,073.00 | $1,073.00 | $32.83 – $704.17 | 768 |
| Removal of metatarsal CPT 28140 | $1,715.00 | $1,715.00 | $126.31 – $870.00 | 768 |
| Removal of ovary(s) 58940 CPT 58940 | $1,673.00 | $1,673.00 | $23.28 – $195.36 | 768 |
| Removal of sesamoid bone CPT 28315 | $1,144.00 | $1,144.00 | $90.77 – $757.44 | 768 |
| Removal of stomachpartial 43632 CPT 43632 | $7,239.00 | $7,239.00 | $37.48 – $704.32 | 768 |
| Removal of testis CPT 54520 | $1,440.00 | $1,440.00 | $97.45 – $720.00 | 768 |
| Removal/replacement ppm generator dual lead system CPT 33228 | $16,807.05 | $25,857.00 | $7,317.53 – $25,857.00 | 117 |
| Removal skin tags fibrocutaneous any area <= 15 lesions CPT 11200 | $253.00 | $253.00 | $21.66 – $429.35 | 783 |
| Removal sutr and stapl no anes CPT 15854 | $33.00 | $33.00 | $10.25 – $33.00 | 767 |
| Removal sutr or stapl no anes CPT 15853 | $37.00 | $37.00 | $7.36 – $26.00 | 781 |
| Remove anal fist complex CPT 46280 | $1,760.00 | $1,760.00 | $153.90 – $1,206.45 | 768 |
| Remove anal fist inter CPT 46275 | $13,376.15 | not published | $2.28 – $5,939.79 | 86 |
| Remove anal fist subq CPT 46270 | $1,462.00 | $1,462.00 | $95.63 – $970.13 | 768 |
| Remove bladder stone CPT 52317 | $22,325.62 | $1,097.00 | $0.96 – $7,543.30 | 769 |
| Remove bladder stone CPT 52318 | $23,855.60 | not published | $0.96 – $7,543.30 | 86 |
| Remove in/ex hem groups 2+ CPT 46260 | $17,529.45 | $1,756.00 | $2.28 – $5,939.79 | 769 |
| Remove int/ext hem 1 group CPT 46255 | $1,297.00 | $1,297.00 | $111.83 – $925.15 | 768 |
| Remove pilonidal cyst compl CPT 11772 | $18,803.60 | $1,886.00 | $2.88 – $6,215.96 | 769 |
| Remove pilonidal cyst exten CPT 11771 | $1,460.00 | $1,460.00 | $140.90 – $1,168.06 | 768 |
| Remove tonsils and adenoids CPT 42820 | $17,294.97 | $1,077.00 | $2.28 – $12,668.17 | 769 |
| Remove tonsils and adenoids CPT 42821 | $17,058.85 | $1,126.00 | $2.28 – $7,094.93 | 769 |
| Remove ventilating tube CPT 69424 | $15,027.35 | not published | $3,053.07 – $7,094.93 | 85 |
| Remove wrist tendon lesion CPT 25111 | $1,134.00 | $1,134.00 | $102.35 – $752.00 | 768 |
| Renal function panel CPT 80069 | $103.35 | $159.00 | $8.42 – $159.00 | 47 |
| Reopening of recent laparotomy 49002 CPT 49002 | $3,723.00 | $3,723.00 | $30.90 – $361.92 | 768 |
| Repair bladder defect CPT 57288 | $21,356.00 | $2,223.00 | $0.96 – $10,705.01 | 769 |
| Repair bowel-bladder fistula 44661 CPT 44661 | $5,535.00 | $5,535.00 | $37.48 – $530.88 | 768 |
| Repair bowel fistula 44650 CPT 44650 | $5,152.00 | $5,152.00 | $408.46 – $3,292.00 | 768 |
| Repair defect of artery 35011 CPT 35011 | $3,252.00 | $3,252.00 | $37.48 – $349.60 | 768 |
| Repair eardrum structures CPT 69631 | $3,189.00 | $3,189.00 | $254.86 – $2,613.87 | 768 |
| Repair nasal stenosis CPT 30465 | $23,485.67 | $3,323.00 | $0.96 – $12,668.17 | 769 |
| Repair of achilles tendon CPT 27654 | $2,485.00 | $2,485.00 | $215.56 – $1,959.76 | 768 |
| Repair of foot tendon CPT 28200 | $25,905.49 | not published | $2.28 – $7,001.93 | 86 |
| Repair of hydrocele 55060 CPT 55060 | $1,372.00 | $1,372.00 | $112.89 – $943.56 | 768 |
| Repair of kneecap tendon CPT 27380 | $1,402.00 | $1,402.00 | $27.28 – $224.32 | 768 |
| Repair of leg tendon each CPT 27658 | $1,608.00 | $1,608.00 | $113.85 – $984.86 | 768 |
| Repair of metatarsals CPT 28322 | $2,129.50 | $2,008.00 | $117.85 – $2,008.00 | 768 |
| Repair of nasal septum CPT 30520 | $24,057.05 | $2,184.00 | $1.92 – $7,094.93 | 769 |
| Repair of thigh muscle CPT 27385 | $2,742.00 | $2,742.00 | $29.44 – $219.36 | 768 |
| Repair oronasal fistula 30600 CPT 30600 | $1,246.00 | $1,246.00 | $122.90 – $1,246.00 | 768 |
| Repair tendon extensor foot 1/2 each tendon CPT 28208 | $1,123.00 | $1,123.00 | $66.50 – $995.83 | 768 |
| Replace duod/jej tube perc CPT 49451 | $5,653.65 | not published | $2.28 – $1,940.91 | 86 |
| Replace g-j tube perc CPT 49452 | $502.00 | $502.00 | $5.96 – $45.28 | 768 |
| Reptilase test CPT 85635 | $79.95 | $123.00 | $9.55 – $123.00 | 47 |
| Reremove wrist tendon lesion CPT 25112 | $1,361.00 | $1,361.00 | $120.24 – $1,094.50 | 768 |
| Rerepair ing hernia blocked CPT 49521 | $20,081.00 | $2,570.00 | $2.28 – $13,853.68 | 769 |
| Resect inferior turbinate CPT 30140 | $24,057.05 | $2,256.00 | $0.96 – $7,094.93 | 769 |
| Reslizumab 10 mg/ml intravenous solution HCPCS J2786 | $5,680.00 | $5,680.00 | $10.84 – $5,680.00 | 36 |
| Respirator motion mgmt simul CPT 77293 | $727.35 | $1,119.00 | $316.68 – $1,239.00 | 33 |
| Resuscitation delivery/birthing room CPT 99465 | $942.50 | $1,450.00 | $78.81 – $1,450.00 | 782 |
| Reticulated platelet assay CPT 85055 | $169.00 | $260.00 | $34.63 – $260.00 | 47 |
| Reticulocyte automated CPT 85045 | $42.90 | $66.00 | $3.87 – $66.00 | 47 |
| Reticulocyte direct measurement automated CPT 85046 | $53.30 | $82.00 | $5.40 – $82.00 | 47 |
| Retifanlimab-dlwr 500 mg/20 ml intravenous solution HCPCS J9345 | $45,114.00 | $45,114.00 | $29.43 – $45,114.00 | 118 |
| Revasc intravasc lithotripsy HCPCS C9764 | $12,210.25 | $18,785.00 | $5,316.16 – $24,704.04 | 114 |
| Revise/remove sling repair CPT 57287 | $2,224.00 | $2,224.00 | $32.87 – $259.68 | 768 |
| Revision of bladder neck CPT 52500 | $1,574.00 | $1,574.00 | $112.36 – $1,223.94 | 768 |
| Revision of calf tendon CPT 27687 | $25,535.62 | $1,581.00 | $2.88 – $7,001.93 | 769 |
| Rezafungin 200 mg intravenous solution HCPCS J0349 | $10,657.15 | $10,657.15 | $10.60 – $10,657.15 | 115 |
| Rheumatoid factor qualitative CPT 86430 | $26.00 | $40.00 | $6.14 – $40.00 | 33 |
| Rheumatoid factor quantitative CPT 86431 | $66.95 | $103.00 | $5.50 – $103.00 | 47 |
| Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe HCPCS J2791 | $294.95 | $294.95 | $63.30 – $294.95 | 781 |
| Rho d immune globulin inj HCPCS J2790 | $615.00 | $615.00 | $72.03 – $615.00 | 767 |
| Rho(d) immune globulin (rhig) human full dose im CPT 90384 | $159.25 | $245.00 | $69.34 – $245.00 | 103 |
| Rib and Chest X-ray (3 views, left side) CPT 71101 | $668.85 | $1,029.00 | $96.27 – $1,029.00 | 118 |
| Rib and Chest X-ray (4 or more views, both sides) CPT 71111 | $819.00 | $1,260.00 | $96.27 – $1,260.00 | 118 |
| Rib X-ray (3 views, both sides) CPT 71110 | $305.50 | $470.00 | $96.27 – $470.00 | 118 |
| Rifampin in ns IV syringe 3 mg/ml (neo/ped) - cnr HCPCS J2804 | $82.10 | $82.10 | $9.60 – $82.10 | 104 |
| Ring barrier skin cx 1 9/16 adapt HCPCS A4411 | $0.66 | $1.01 | $0.29 – $1.01 | 33 |
| Ring fx reform 11-13x17mm HCPCS L8610 | $1,052.12 | $1,618.64 | $32.26 – $114.00 | 33 |
| Ring ostmy barr adapt 48mm HCPCS A4385 | $0.33 | $0.51 | $0.14 – $0.51 | 33 |
| Risankizumab-rzaa 60 mg/ml intravenous solution HCPCS J2327 | $30,071.50 | $30,071.50 | $14.63 – $30,071.50 | 118 |
| Risperidone microspheres 12.5 mg/2 ml inj HCPCS J2794 | $4,735.80 | $4,735.80 | $10.96 – $4,735.80 | 118 |
| Rituximab 10 mg/ml concentrate,intravenous HCPCS J9312 | $14,092.80 | $14,092.80 | $73.27 – $14,092.80 | 118 |
| Rituximab 1,400 mg/11.7 ml (120 mg/ml)-hyaluronidase subcutaneous soln HCPCS J9311 | $31,203.09 | $22,548.30 | $9.09 – $19,729.75 | 118 |
| Rituximab-abbs 10 mg/ml intravenous solution HCPCS Q5115 | $12,035.25 | $12,035.25 | $29.54 – $2,407.05 | 118 |
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.