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 |
|---|---|---|---|---|
| Troponin quantitative CPT 84484 | $679.25 | $298.00 | $9.09 – $298.00 | 118 |
| Tube drain vert dev st 5-40f HCPCS A5200 | $17.68 | $27.20 | $7.70 – $27.20 | 33 |
| Tube trach disp innr can 5 xlt HCPCS A7521 | $425.24 | $654.22 | $0.96 – $3.39 | 33 |
| Tube trach disp innr can 6 xlt HCPCS A4623 | $2.78 | $4.28 | $0.56 – $1.97 | 33 |
| Tube trach fen sz 6 uncuffed HCPCS A7520 | $128.15 | $197.15 | $0.31 – $1.10 | 33 |
| Tx closed tib shaft fx without manip CPT 27750 | $1,137.00 | $1,137.00 | $97.72 – $1,027.00 | 768 |
| Tx open dstl phlngl fx f/t internal fixation ea CPT 26765 | $1,752.00 | $1,752.00 | $149.67 – $1,265.38 | 768 |
| Tx phalangeal shaft fx open prox/middle ea CPT 26735 | $2,066.00 | $2,066.00 | $179.99 – $1,370.00 | 768 |
| Tympanostomy/ven tube/loc/top anes 69433 CPT 69433 | $944.00 | $944.00 | $30.56 – $1,154.14 | 783 |
| Ublituximab-xiiy 25 mg/ml intravenous solution HCPCS J2329 | $35,496.45 | $35,496.45 | $67.73 – $35,496.45 | 118 |
| Ultrasound breast unilateral limited (both sides) CPT 76642 | $553.15 | $851.00 | $75.49 – $567.00 | 118 |
| Ultrasound doppler velocimetry fetal umbilical artery CPT 76820 | $284.70 | $438.00 | $96.27 – $438.00 | 118 |
| Ultrasound encephalogram CPT 76506 | $329.55 | $507.00 | $96.27 – $507.00 | 118 |
| Ultrasound fetal biophysical profile without non-stress testing CPT 76819 | $466.70 | $718.00 | $96.27 – $718.00 | 118 |
| Ultrasound Guidance for a Needle Procedure CPT 76942 | $2,284.75 | $989.00 | $10.90 – $989.00 | 783 |
| Ultrasound guidance for vascular access CPT 76937 | $2,489.62 | $490.00 | $1.40 – $944.09 | 783 |
| Ultrasound hips infant dynamic CPT 76885 | $391.30 | $602.00 | $80.14 – $602.00 | 118 |
| Ultrasound joint complete left CPT 76881 | $825.50 | $1,270.00 | $96.27 – $1,270.00 | 118 |
| Ultrasound pregnant uterus < 14 weeks each additional gestation CPT 76802 | $234.65 | $361.00 | $102.16 – $361.00 | 32 |
| Ultrasound pregnant uterus follow up per fetus CPT 76816 | $326.30 | $502.00 | $96.27 – $502.00 | 118 |
| Ultrasound prostate/transrectal CPT 76872 | $570.00 | $570.00 | $20.24 – $223.72 | 783 |
| Ultrasound spinal canal and contents CPT 76800 | $385.45 | $593.00 | $96.27 – $593.00 | 118 |
| Unit mobile power mpu HCPCS Q0479 | $11,821.68 | $18,187.20 | $5,146.98 – $18,187.20 | 33 |
| Unlisted chemotherapy px CPT 96549 | $85.80 | $132.00 | $37.36 – $752.00 | 118 |
| Unlisted dialysis procedure CPT 90999 | $33,066.51 | $3,766.00 | $137.80 – $3,587.00 | 107 |
| Unlisted procedure microbiology CPT 87999 | $507.00 | $780.00 | $220.74 – $780.00 | 33 |
| Upper Arm (Humerus) X-ray (left side) CPT 73060 | $269.10 | $414.00 | $80.14 – $414.00 | 118 |
| Upper Back (Thoracic Spine) CT Scan (with contrast) CPT 72129 | $1,623.05 | $2,497.00 | $161.52 – $2,497.00 | 118 |
| Upper Back (Thoracic Spine) CT Scan (without contrast) CPT 72128 | $2,057.25 | $3,165.00 | $96.27 – $3,165.00 | 118 |
| Upper Back (Thoracic Spine) MRI (with and without contrast) CPT 72157 | $3,595.15 | $5,531.00 | $321.26 – $5,531.00 | 118 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | $2,717.65 | $4,181.00 | $219.72 – $4,181.00 | 118 |
| Upper Back (Thoracic Spine) X-ray (2 views) CPT 72070 | $874.25 | $491.00 | $9.09 – $491.00 | 118 |
| Upper Back (Thoracic Spine) X-ray (3 views) CPT 72072 | $418.60 | $644.00 | $96.27 – $644.00 | 118 |
| Upper Endoscopy (EGD, diagnostic) CPT 43235 | $10,152.54 | $446.00 | $2.28 – $1,940.91 | 769 |
| Upper Endoscopy (EGD, with biopsy) CPT 43239 | $11,677.09 | $503.00 | $39.41 – $1,940.91 | 769 |
| Upper GI Barium X-ray (barium and gas) CPT 74246 | $627.25 | $965.00 | $161.52 – $965.00 | 118 |
| Upper GI Barium X-ray (barium only) CPT 74240 | $496.60 | $764.00 | $161.52 – $764.00 | 118 |
| Urea nitrogen CPT 84520 | $29.25 | $45.00 | $3.83 – $45.00 | 47 |
| Urea nitrogen 24 hour urine CPT 84540 | $66.95 | $103.00 | $5.39 – $103.00 | 47 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | $787.80 | $1,212.00 | $219.72 – $1,212.00 | 118 |
| Uric acid blood CPT 84550 | $45.50 | $70.00 | $4.38 – $70.00 | 47 |
| Uric acid urine CPT 84560 | $163.15 | $251.00 | $4.93 – $251.00 | 47 |
| Urinalysis microscopic only CPT 81015 | $48.75 | $75.00 | $2.96 – $75.00 | 47 |
| Urinalysis (with microscopy) CPT 81001 | $406.90 | $79.00 | $3.07 – $79.00 | 47 |
| Urinalysis (without microscopy) CPT 81003 | $46.15 | $71.00 | $2.18 – $71.00 | 47 |
| Urine Culture Test CPT 87086 | $411.45 | $135.00 | $7.82 – $135.00 | 47 |
| Urine pregnancy test CPT 81025 | $36.40 | $56.00 | $8.34 – $56.00 | 47 |
| Ustekinumab 130 mg/26 ml intravenous solution HCPCS J3358 | $6,677.00 | $6,677.00 | $12.24 – $6,677.00 | 118 |
| Ustekinumab 45 mg/0.5 ml subcutaneous solution HCPCS J3357 | $45,913.60 | $45,913.60 | $3,644.10 – $45,913.60 | 111 |
| Vaccine Administration (one shot) CPT 90471 | $39.65 | $61.00 | $5.57 – $105.00 | 107 |
| Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml CPT 91322 | $286.65 | $441.00 | $124.80 – $441.00 | 118 |
| Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml CPT 91321 | $559.65 | $861.00 | $147.06 – $861.00 | 118 |
| Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im CPT 91320 | $103.35 | $159.00 | $45.00 – $168.37 | 118 |
| Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im CPT 91319 | $68.90 | $106.00 | $30.00 – $106.00 | 118 |
| Vaccine covid-19 pfizer tris-sucrose 6mos-4yrs 3mcg/0.3ml im CPT 91318 | $52.00 | $80.00 | $22.64 – $80.00 | 118 |
| Vaccine dtap < 7 years im CPT 90700 | $142.05 | $142.05 | $15.28 – $54.00 | 103 |
| Vaccine dtap-hep b-ipv im CPT 90723 | $513.00 | $513.00 | $30.80 – $154.00 | 110 |
| Vaccine dtap-ipv 4-6 years im CPT 90696 | $301.15 | $301.15 | $24.90 – $88.00 | 103 |
| Vaccine dtap-ipv-hib-hepb im CPT 90697 | $135.20 | $208.00 | $41.60 – $208.00 | 110 |
| Vaccine dtap-ipv/hib im CPT 90698 | $103.35 | $159.00 | $45.00 – $159.00 | 103 |
| Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im CPT 90647 | $39.00 | $60.00 | $16.98 – $60.00 | 103 |
| Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im CPT 90648 | $62.60 | $62.60 | $13.17 – $57.00 | 103 |
| Vaccine hepatitis a (hepa) adult im CPT 90632 | $412.25 | $412.25 | $61.98 – $219.00 | 103 |
| Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im CPT 90636 | $124.80 | $192.00 | $54.34 – $192.00 | 103 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im CPT 90633 | $185.55 | $185.55 | $19.81 – $70.00 | 103 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 3 dose im CPT 90634 | $48.10 | $74.00 | $20.94 – $74.00 | 32 |
| Vaccine hepatitis b (hepb) adolescent 2 dose im CPT 90743 | $57.20 | $88.00 | $24.90 – $88.00 | 118 |
| Vaccine hepatitis b (hepb) adult 3 dose im CPT 90746 | $33,066.51 | $345.70 | $62.54 – $221.00 | 118 |
| Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im CPT 90739 | $326.30 | $502.00 | $142.07 – $502.00 | 118 |
| Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 | $138.80 | $138.80 | $26.89 – $95.00 | 118 |
| Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im CPT 90651 | $1,547.80 | $1,547.80 | $79.20 – $396.00 | 110 |
| Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im CPT 90649 | $226.20 | $348.00 | $69.60 – $348.00 | 39 |
| Vaccine influenza (iiv) preservative free antigen content im CPT 90662 | $149.50 | $230.00 | $65.09 – $230.00 | 118 |
| Vaccine influenza inactivated adjuvant im CPT 90653 | $303.40 | $303.40 | $24.62 – $98.16 | 118 |
| Vaccine influenza nos 0.5ml dose im CPT 90658 | $21.45 | $33.00 | $6.60 – $33.00 | 114 |
| Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im CPT 90656 | $102.45 | $102.45 | $9.06 – $71.00 | 782 |
| Vaccine influenza quadrivalent (iiv4) 0.5ml dose im CPT 90688 | $42.90 | $66.00 | $18.44 – $66.00 | 118 |
| Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im CPT 90694 | $157.95 | $243.00 | $67.98 – $243.00 | 118 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.25ml dose im CPT 90685 | $20.80 | $32.00 | $9.06 – $32.00 | 115 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im CPT 90686 | $45.50 | $70.00 | $19.73 – $70.00 | 118 |
| Vaccine influenza quadrivalent (iiv4) split virus 0.25 ml im CPT 90687 | $22.10 | $34.00 | $9.22 – $34.00 | 115 |
| Vaccine influenza quadrivalent live (laiv4) intranasal CPT 90672 | $56.55 | $87.00 | $24.50 – $87.00 | 115 |
| Vaccine influenza quadrivalent (riv4) rdna antibiotic/preservative free im CPT 90682 | $149.50 | $230.00 | $64.51 – $230.00 | 118 |
| Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im CPT 90661 | $524.55 | $807.00 | $33.39 – $807.00 | 118 |
| Vaccine influenza trivalent (iiv3) 0.25ml dose im CPT 90657 | $32.50 | $50.00 | $11.03 – $50.00 | 115 |
| Vaccine mengingoccocal serogroup b 2 dose im CPT 90620 | $1,156.10 | $1,156.10 | $58.40 – $292.00 | 110 |
| Vaccine mengingoccocal serogroup b 2 or 3 dose im CPT 90621 | $169.00 | $260.00 | $73.58 – $260.00 | 103 |
| Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im CPT 90619 | $149.50 | $230.00 | $46.00 – $230.00 | 110 |
| Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im CPT 90734 | $813.00 | $813.00 | $123.40 – $617.00 | 110 |
| Vaccine mmr live subcutaneous CPT 90707 | $466.05 | $466.05 | $36.22 – $156.00 | 552 |
| Vaccine mmrv live subcutaneous CPT 90710 | $1,445.85 | $1,445.85 | $130.40 – $652.00 | 111 |
| Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im CPT 90732 | $556.15 | $556.15 | $118.29 – $418.00 | 118 |
| Vaccine pneumococcal conjugate 13 valent (pcv13) im CPT 90670 | $524.55 | $807.00 | $228.38 – $807.00 | 118 |
| Vaccine pneumonococcal conjugate 15 valent (pcv15) im CPT 90671 | $501.15 | $771.00 | $218.19 – $771.00 | 118 |
| Vaccine pneumonococcal conjugate 20 valent (pcv20) im CPT 90677 | $1,376.55 | $1,376.55 | $255.55 – $903.00 | 118 |
| Vaccine polio (ipv) subcutaneous/im CPT 90713 | $220.20 | $220.20 | $16.70 – $59.00 | 103 |
| Vaccine rabies im CPT 90675 | $1,998.80 | $1,998.80 | $290.92 – $1,028.00 | 118 |
| Vaccine respiratory syncytial virus bivalent subunit/preservative free im CPT 90678 | $1,467.45 | $1,467.45 | $81.20 – $406.00 | 110 |
| Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im CPT 90380 | $2,736.70 | $2,736.70 | $136.20 – $681.00 | 110 |
| Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im CPT 90381 | $2,736.70 | $2,736.70 | $136.20 – $681.00 | 110 |
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.