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 |
|---|---|---|---|---|
| Rituximab-arrx 10 mg/ml intravenous solution HCPCS Q5123 | $8,300.55 | $8,300.55 | $74.05 – $1,660.15 | 36 |
| Rituximab-pvvr 10 mg/ml intravenous solution HCPCS Q5119 | $9,889.65 | $9,889.65 | $13.00 – $1,978.00 | 118 |
| Rmv implant contraceptive capsule 11976 CPT 11976 | $723.45 | $1,113.00 | $25.56 – $1,515.37 | 783 |
| Rmvl ninfct mesh hernia rpr 49623 CPT 49623 | $709.00 | $709.00 | $8.35 – $69.60 | 768 |
| Romidepsin 10 mg/2 ml intravenous powder for solution HCPCS J9319 | $8,826.40 | $8,826.40 | $30.29 – $8,826.40 | 118 |
| Romiplostim 125 mcg subcutaneous solution HCPCS J2802 | $17,344.00 | $17,344.00 | $10.83 – $4,336.10 | 115 |
| Romosozumab-aqqg 105 mg/1.17 ml subcutaneous syringe (wrapper) HCPCS J3111 | $13,801.85 | $13,801.85 | $11.40 – $13,801.85 | 118 |
| Ropivacaine 0.2 % epidural pca - 1 hour dose limit HCPCS J2795 | $188.50 | $188.50 | $0.60 – $14.58 | 104 |
| Rozanolixizumab-noli 140 mg/ml subcutaneous solution HCPCS J9333 | $56,796.70 | $56,796.70 | $22.32 – $56,796.70 | 118 |
| Rp loclzj tum spect w/ct 1 CPT 78830 | $3,118.05 | $4,797.00 | $1,192.19 – $4,797.00 | 118 |
| Rpr aa hrn 1st > 10 ncr/strn CPT 49596 | $3,648.00 | $3,648.00 | $21.23 – $353.76 | 768 |
| Rpr aa hrn 1st 3-10 ncr/strn CPT 49594 | $21,593.36 | $2,655.00 | $4.56 – $12,937.15 | 769 |
| Rpr aa hrn 1st 3-10 rdc CPT 49593 | $20,966.06 | $2,041.00 | $2.88 – $13,853.68 | 769 |
| Rpr aa hrn 1st < 3 ncr/strn CPT 49592 | $18,152.52 | not published | $65.31 – $12,937.15 | 86 |
| Rpr aa hrn rcr > 10 ncr/strn CPT 49618 | $4,418.00 | $4,418.00 | $26.27 – $437.76 | 768 |
| Rpr aa hrn rcr > 10 rdc CPT 49617 | $3,156.00 | $3,156.00 | $18.37 – $306.24 | 768 |
| Rpr aa hrn rcr 3-10 ncr/strn CPT 49616 | $3,057.00 | $3,057.00 | $17.75 – $295.84 | 768 |
| Rpr fem hernia init blocked CPT 49553 | $2,271.00 | $2,271.00 | $23.55 – $222.88 | 768 |
| Rubella antibody igg CPT 86762 | $77.35 | $119.00 | $13.94 – $119.00 | 47 |
| Rubeola antibody igg CPT 86765 | $128.05 | $197.00 | $12.48 – $197.00 | 47 |
| Russell viper venom diluted CPT 85613 | $349.70 | $538.00 | $9.28 – $162.00 | 47 |
| Sacituzumab govitecan-hziy 180 mg intravenous solution HCPCS J9317 | $7,844.35 | $7,844.35 | $33.65 – $7,844.35 | 118 |
| Sacroiliac Joint X-ray (3 or more views) CPT 72202 | $295.10 | $454.00 | $96.27 – $454.00 | 118 |
| Sbsq nurs facil care/day unstabl/new prob 35 min 99310 CPT 99310 | $321.00 | $321.00 | $30.80 – $321.00 | 769 |
| Sbsq nursing facil care/day minor complj 15 min CPT 99308 | $165.00 | $165.00 | $30.80 – $165.00 | 769 |
| Sbsq nursing facil care/day new problem 25 min CPT 99309 | $221.00 | $221.00 | $66.13 – $221.00 | 769 |
| Sbsq nursing facility care/day e/m stable 10 min CPT 99307 | $105.00 | $105.00 | $24.50 – $105.00 | 768 |
| Scan duplex extracranial arteries unilateral/limited study CPT 93882 | $692.90 | $1,066.00 | $96.27 – $1,066.00 | 118 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $650.00 | $1,000.00 | $96.27 – $1,000.00 | 118 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $514.80 | $792.00 | $96.27 – $792.00 | 118 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $486.20 | $748.00 | $96.27 – $748.00 | 118 |
| Scan proc cranial extra CPT 61782 | $26,150.60 | $538.00 | $2.28 – $15,102.64 | 769 |
| Scope uretscp lithovue dig disp HCPCS C1747 | $2,514.76 | $3,868.86 | $513.34 – $1,813.91 | 33 |
| Screening Colonoscopy (average risk) HCPCS G0121 | $8,660.27 | $870.00 | $2.28 – $1,990.07 | 769 |
| Screening Colonoscopy (high risk) HCPCS G0105 | $8,635.22 | $869.00 | $2.28 – $1,990.07 | 769 |
| Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations HCPCS G0328 | $141.05 | $217.00 | $17.69 – $217.00 | 44 |
| Screening hepatitis b non-obstetric high risk HCPCS G0499 | $89.70 | $138.00 | $27.70 – $138.00 | 44 |
| Screening hepatitis c antibody high risk HCPCS G0472 | $85.80 | $132.00 | $37.36 – $132.00 | 47 |
| Screening HIV antigen/antibody combination assay HCPCS G0475 | $96.85 | $149.00 | $23.60 – $90.00 | 44 |
| Screening Mammogram CPT 77067 | $352.95 | $543.00 | $81.59 – $515.00 | 47 |
| Screening prostate cancer PSA HCPCS G0103 | $118.30 | $182.00 | $18.92 – $182.00 | 44 |
| Screw cortex 2.0 x 10mm HCPCS C1713 | $776,558.25 | $1,194,705.00 | $0.01 – $0.07 | 33 |
| Scrotal (Testicle) Ultrasound CPT 76870 | $857.35 | $1,319.00 | $96.27 – $1,319.00 | 118 |
| Sedation moderate same physician performing a gastrointestinal endoscopic service >= 5 years initial 15 minutes intra-service time HCPCS G0500 | $194.35 | $299.00 | $84.62 – $299.00 | 33 |
| Sedimentation rate erythrocyte automated CPT 85652 | $44.20 | $68.00 | $2.62 – $68.00 | 47 |
| Self-Care and Home Skills Training (each 15 minutes) CPT 97535 | $1,515.80 | $106.00 | $28.47 – $195.00 | 47 |
| Semen analysis presence/motility CPT 89321 | $41.60 | $64.00 | $11.68 – $64.00 | 47 |
| Sertraline (zoloft) - sendout CPT 80332 | $222.95 | $343.00 | $97.07 – $343.00 | 43 |
| Set radiation therapy field CPT 77280 | $1,110.85 | $1,709.00 | $123.77 – $1,709.00 | 118 |
| Set radiation therapy field CPT 77290 | $1,728.35 | $2,659.00 | $344.79 – $2,659.00 | 118 |
| Sevelamer carbonate 800 mg tablet HCPCS J0601 | $0.01 | $0.01 | $0.01 – $0.01 | 101 |
| Sevelamer carbonate pdr 20mg HCPCS J0602 | $0.03 | $0.04 | $0.01 – $0.05 | 104 |
| Sheath gldlight lasr 12fx50cm HCPCS C2629 | $4,725.71 | $7,270.33 | $206.76 – $730.60 | 33 |
| Sheath laser cavaclear 14f HCPCS C1603 | $5,815.06 | $8,946.25 | $1,881.46 – $6,648.28 | 33 |
| Shoe post-op mens m HCPCS L3260 | $42.87 | $65.95 | $0.56 – $2.90 | 40 |
| Shot (Injection into Muscle or Under the Skin) CPT 96372 | $235.95 | $158.00 | $3.28 – $158.00 | 782 |
| Shoulder AC Joint X-ray (both sides) CPT 73050 | $169.00 | $260.00 | $73.58 – $260.00 | 118 |
| Shoulder Blade (Scapula) X-ray (both sides) CPT 73010 | $408.85 | $629.00 | $96.27 – $419.00 | 118 |
| Shoulder MRI (with and without contrast) CPT 73223 | $4,715.10 | $7,254.00 | $321.26 – $4,836.00 | 118 |
| Shoulder MRI (with contrast) CPT 73222 | $3,125.85 | $4,809.00 | $721.88 – $3,206.00 | 118 |
| Shoulder MRI (without contrast) CPT 73221 | $2,237.30 | $3,442.00 | $219.72 – $2,294.00 | 118 |
| Shoulder X-ray CPT 73030 | $741.00 | $652.00 | $80.14 – $435.00 | 118 |
| Shoulder X-ray (single view, both shoulders) CPT 73020 | $315.25 | $485.00 | $80.14 – $323.00 | 118 |
| Shrinker prosth above knee HCPCS L8460 | $230.16 | $354.09 | $100.21 – $354.09 | 33 |
| Shrinker prosth below knee HCPCS L8440 | $178.39 | $274.45 | $77.67 – $274.45 | 33 |
| Shunt glaucoma baerveldt 350mm HCPCS C1783 | $3,209.23 | $4,937.28 | $50.55 – $178.61 | 33 |
| Shuntogram nonvascular supervision & interpretation CPT 75809 | $361.40 | $556.00 | $96.27 – $556.00 | 118 |
| Sickling rbc CPT 85660 | $85.80 | $132.00 | $5.33 – $132.00 | 47 |
| Sincalide 5 mcg solution for injection HCPCS J2805 | $651.10 | $651.10 | $135.97 – $651.10 | 103 |
| Sinus CT scan (with contrast) CPT 70487 | $1,847.30 | $2,842.00 | $161.52 – $2,842.00 | 118 |
| Sinus CT scan (without contrast) CPT 70486 | $1,461.85 | $2,249.00 | $96.27 – $2,249.00 | 118 |
| Sinus X-ray (complete) CPT 70220 | $347.10 | $534.00 | $80.14 – $534.00 | 118 |
| Sinus X-ray (limited) CPT 70210 | $165.10 | $254.00 | $71.88 – $254.00 | 118 |
| Sirolimus-protein bound 100 mg intravenous suspension HCPCS J9331 | $42,938.50 | $42,938.50 | $9,250.00 – $42,938.50 | 104 |
| Skull X-ray (1 to 3 views) CPT 70250 | $272.35 | $419.00 | $96.27 – $419.00 | 118 |
| Skull X-ray (complete) CPT 70260 | $423.15 | $651.00 | $96.27 – $651.00 | 118 |
| Sleep Study (Polysomnography) CPT 95810 | $4,249.70 | $6,538.00 | $76.25 – $6,538.00 | 783 |
| Sleep study unattended CPT 95806 | $565.00 | $565.00 | $28.54 – $560.00 | 783 |
| Sleeve fing rolyan med HCPCS L3933 | $37.65 | $57.93 | $16.39 – $57.93 | 33 |
| Sleeve irr assura 1pc disp HCPCS A4397 | $0.65 | $1.00 | $0.28 – $1.00 | 33 |
| Sling arm deluxe w/pad xs HCPCS A4565 | $529.06 | $813.94 | $0.61 – $460.33 | 40 |
| Sling pelv split sam med HCPCS L0621 | $165.55 | $254.70 | $49.36 – $254.70 | 40 |
| Sling suprapubic suburetheral HCPCS C1771 | $9,679.96 | $14,892.24 | $577.82 – $2,041.75 | 33 |
| Slp pure tone screening CPT 92551 | $34.45 | $53.00 | $10.60 – $163.00 | 40 |
| Sm-153 lexidron ther HCPCS A9604 | $57,456.00 | $57,456.00 | $4,314.91 – $57,456.00 | 104 |
| Small Bowel Barium X-ray (Follow-Through) CPT 74250 | $532.35 | $819.00 | $161.52 – $819.00 | 118 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $61.75 | $95.00 | $5.22 – $95.00 | 47 |
| Smear gram stain CPT 87205 | $55.90 | $86.00 | $4.14 – $86.00 | 47 |
| Smear nasal eosinophil CPT 89190 | $27.30 | $42.00 | $5.61 – $42.00 | 47 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $44.20 | $68.00 | $5.80 – $68.00 | 47 |
| Smear wet mount CPT 87210 | $56.55 | $87.00 | $5.64 – $87.00 | 47 |
| Sock wool above knee HCPCS L8430 | $158.68 | $244.12 | $69.09 – $244.12 | 33 |
| Sodium 24 hour urine CPT 84300 | $46.15 | $71.00 | $4.91 – $71.00 | 47 |
| Sodium chloride 0.9 % intravenous solution HCPCS J7030 | $11,906.96 | $20.00 | $2.28 – $4,938.64 | 118 |
| Sodium chloride 0.9 % IV bolus HCPCS J7040 | $22.50 | $22.50 | $4.95 – $17.50 | 33 |
| Sodium chloride 0.9 % IV bolus HCPCS J7050 | $34.50 | $34.50 | $3.89 – $13.75 | 33 |
| Sodium chloride 3 % ivpb HCPCS J7131 | $35.00 | $35.00 | $8.49 – $75.00 | 104 |
| Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous HCPCS J2916 | $40.85 | $40.85 | $10.90 – $40.85 | 103 |
| Sodium serum/plasma/whole blood CPT 84295 | $53.30 | $46.00 | $4.66 – $46.00 | 47 |
| Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution HCPCS J0209 | $495.00 | $495.00 | $0.86 – $495.00 | 114 |
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.