MercyOne Dyersville Medical Center
1111 Third St. SW, Dyersville, IA · MercyOne · · NPI 1205816725
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 |
|---|---|---|---|---|
| Metabolic Blood Panel (Comprehensive) CPT 80053 | $126.10 | $194.00 | $73.33 – $218.37 | 40 |
| Metabolic panel ionized ca CPT 80047 | $10,741.15 | $40.00 | $15.12 – $45.02 | 111 |
| Methacholine chloride 0.0625 mg/ml nebulization soln HCPCS J7674 | $620.95 | $620.95 | $26.08 – $77.67 | 40 |
| Methocarbamol ivpb 250 mg in 50 ml ns - cnr (headpain) HCPCS J2800 | $1,450.00 | $1,450.00 | $4.79 – $80.48 | 111 |
| Methotrexate sodium 2.5 mg tablet HCPCS J8610 | $1.95 | $1.95 | $0.22 – $2.19 | 111 |
| Methotrexate sodium (pf) 1 gram solution for injection HCPCS J9260 | $292.50 | $292.50 | $17.99 – $53.58 | 40 |
| Methotrexate therapeutic drug level CPT 80204 | $128.05 | $197.00 | $74.47 – $221.74 | 40 |
| Methylene blue (antidote) 5 mg/ml intravenous solution HCPCS Q9968 | $620.55 | $620.55 | $234.57 – $698.49 | 40 |
| Methylergonovine 0.2 mg/ml (1 ml) injection solution HCPCS J2210 | $104.35 | $104.35 | $22.06 – $117.46 | 111 |
| Methylnaltrexone 12 mg/0.6 ml subcutaneous injection (wrapper) HCPCS J2212 | $572.60 | $572.60 | $113.60 – $644.52 | 111 |
| Methylprednisolone 4 mg tablet HCPCS J7509 | $1.00 | $1.00 | $0.23 – $1.13 | 111 |
| Methylprednisolone acetate 40 mg/ml suspension for injection HCPCS J1010 | $93.70 | $93.70 | $20.41 – $60.78 | 40 |
| Methylprednisolone sodium succinate 1,000 mg intravenous solution HCPCS J2919 | $317.00 | $317.00 | $2.08 – $10.52 | 111 |
| Metoclopramide in d5w IV syringe 0.2 mg/ml (neo/ped) - cnr HCPCS J2765 | $5.75 | $5.75 | $1.00 – $3.38 | 111 |
| Metoprolol tartrate 5 mg/5 ml intravenous (wrapper) HCPCS J0616 | $4.60 | $4.60 | $0.65 – $5.18 | 111 |
| Metronidazole 500 mg/100 ml in sodium chlor(iso) intravenous piggyback HCPCS J1836 | $14.50 | $14.50 | $5.48 – $16.32 | 40 |
| Micafungin 100 mg intravenous solution HCPCS J2248 | $860.05 | $860.05 | $325.10 – $968.07 | 40 |
| Midazolam 1 mg/ml injection solution HCPCS J2250 | $110.00 | $110.00 | $0.32 – $3.38 | 111 |
| Milrinone 20 mg/100 ml(200 mcg/ml) in 5 % dextrose intravenous piggybk HCPCS J2260 | $110.00 | $110.00 | $10.87 – $32.36 | 40 |
| Mirvetuximab soravtansine-gynx 5 mg/ml intravenous solution HCPCS J9063 | $20,601.45 | $20,601.45 | $7,608.00 – $23,188.99 | 111 |
| Mitomycin 40 mg intravenous solution HCPCS J9280 | $6,967.60 | $6,967.60 | $30.94 – $336.50 | 111 |
| Mitoxantrone 2 mg/ml concentrate,intravenous HCPCS J9293 | $3,514.20 | $3,514.20 | $194.34 – $1,180.14 | 111 |
| Monitor reveal linq ii cardiac HCPCS C1764 | $6,234.66 | $9,591.79 | $36.00 – $107.20 | 40 |
| Morphine 4 mg/ml injection (wrapper) HCPCS J2270 | $207.75 | $207.75 | $1.13 – $4.55 | 111 |
| Morphine 4 mg/ml injection (wrapper)|discarded drug not administered HCPCS J2272 | $10.55 | $10.55 | $8.13 – $8.13 | 71 |
| Morphine (pf) 0.25 mg/0.5 ml injection (neo/ped) - cnr HCPCS J2274 | $45.90 | $45.90 | $1.13 – $10.79 | 111 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain computer-assisted CPT 88361 | $313.95 | $483.00 | $104.85 – $543.66 | 40 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain manual CPT 88360 | $252.20 | $388.00 | $107.52 – $436.73 | 38 |
| Mosunetuzumab-axgb 1 mg/ml intravenous solution HCPCS J9350 | $58,093.20 | $58,093.20 | $714.33 – $2,179.67 | 111 |
| Mumps antibody igg CPT 86735 | $78.00 | $120.00 | $45.36 – $135.07 | 40 |
| Mycophenolate mofetil 250 mg capsule HCPCS J7517 | $1.00 | $1.00 | $0.16 – $1.13 | 111 |
| Mycophenolic acid HCPCS J7518 | $2.20 | $2.20 | $0.37 – $2.48 | 111 |
| Mycoplasma antibody igm CPT 86738 | $73.45 | $113.00 | $42.71 – $127.19 | 40 |
| Myeloperoxidase ab multi step qualitative/semiquantitative CPT 83516 | $115.05 | $177.00 | $66.91 – $199.23 | 40 |
| Nafcillin 2 gram solution for injection HCPCS J2290 | $42.60 | $42.60 | $3.00 – $19.75 | 111 |
| Nalbuphine 10 mg/ml injection solution HCPCS J2300 | $28.50 | $28.50 | $3.51 – $32.08 | 111 |
| Naloxone 0.4 mg/ml injection (wrapper) HCPCS J2312 | $546.10 | $546.10 | $14.00 – $82.00 | 111 |
| Natalizumab 300 mg/15 ml intravenous solution HCPCS J2323 | $26,637.70 | $26,637.70 | $7,239.00 – $29,983.40 | 111 |
| Natriuretic peptide CPT 83880 | $204.10 | $314.00 | $38.86 – $353.44 | 40 |
| Natural killer cells total count CPT 86357 | $99.45 | $153.00 | $36.98 – $153.00 | 40 |
| Ndl round specialty proguide HCPCS C1715 | $1,221.47 | $1,879.19 | $13.40 – $39.90 | 40 |
| Nebulizer Breathing Treatment CPT 94640 | $197.60 | $304.00 | $114.91 – $342.18 | 40 |
| Neck Airway (Soft Tissue) X-ray CPT 70360 | $189.15 | $291.00 | $110.00 – $327.55 | 40 |
| Neck (Cervical Spine) CT scan (with contrast) CPT 72126 | $1,335.75 | $2,055.00 | $776.79 – $2,313.11 | 40 |
| Neck (Cervical Spine) CT scan (without contrast) CPT 72125 | $1,506.05 | $2,317.00 | $875.83 – $2,608.02 | 40 |
| Neck (Cervical Spine) X-ray (2 to 3 views) CPT 72040 | $251.55 | $387.00 | $146.29 – $435.61 | 40 |
| Neck (Cervical Spine) X-ray (4 to 5 views) CPT 72050 | $351.00 | $540.00 | $204.12 – $607.82 | 40 |
| Neck Soft Tissue CT Scan (with contrast) CPT 70491 | $1,603.55 | $2,467.00 | $932.53 – $2,776.86 | 40 |
| Neostigmine methylsulfate 1 mg/ml injection (wrapper) HCPCS J2710 | $9.20 | $9.20 | $3.48 – $10.36 | 40 |
| New Patient Office Visit (level 2) CPT 99202 | $115.70 | $178.00 | $42.93 – $200.36 | 40 |
| New Patient Office Visit (level 3) CPT 99203 | $163.80 | $252.00 | $74.50 – $283.65 | 40 |
| New Patient Office Visit (level 4) CPT 99204 | $250.90 | $386.00 | $121.61 – $434.48 | 40 |
| New Patient Office Visit (level 5) CPT 99205 | $317.20 | $488.00 | $165.20 – $549.29 | 40 |
| Nicardipine 25 mg/10 ml intravenous solution HCPCS J2404 | $27.30 | $27.30 | $10.32 – $30.73 | 111 |
| Nitroglycerin 50 mg/250 ml (200 mcg/ml) in 5 % dextrose intravenous HCPCS J2305 | $112.50 | $112.50 | $14.20 – $126.63 | 111 |
| Nivolumab 10 mg/ml intravenous solution (wrapper) HCPCS J9299 | $24,305.85 | $24,305.85 | $1,444.80 – $4,559.81 | 111 |
| Nivolumab 240 mg-relatlimab-rmbw 80 mg/20 ml intravenous solution HCPCS J9298 | $94,382.55 | $94,382.55 | $34,606.40 – $106,237.00 | 111 |
| Nursing facility discharge management > 30 min 99316 CPT 99316 | $176.80 | $272.00 | $102.82 – $306.16 | 40 |
| Nursing facility discharge management 30 min/less than 99315 CPT 99315 | $129.35 | $199.00 | $75.22 – $223.99 | 40 |
| Nusinersen (pf) 12 mg/5 ml intrathecal solution HCPCS J2326 | $455,355.55 | $455,355.55 | $146,299.20 – $512,548.21 | 111 |
| Obinutuzumab 1,000 mg/40 ml intravenous solution HCPCS J9301 | $28,351.00 | $28,351.00 | $8,586.00 – $31,911.89 | 111 |
| Observation/inpatient hospital care mod severity 99235 CPT 99235 | $302.90 | $466.00 | $176.15 – $524.53 | 40 |
| Observation per hour HCPCS G0378 | $70.20 | $108.00 | $40.82 – $121.56 | 40 |
| Occupational Therapy Evaluation (low complexity) CPT 97165 | $179.40 | $276.00 | $104.33 – $310.67 | 40 |
| Occupational Therapy Evaluation (moderate complexity) CPT 97166 | $198.90 | $306.00 | $115.67 – $344.43 | 40 |
| Ocrelizumab 30 mg/ml intravenous solution HCPCS J2350 | $65,142.90 | $65,142.90 | $24,624.02 – $73,324.85 | 40 |
| Octreotide acetate 100 mcg/ml injection (wrapper) HCPCS J2354 | $17.95 | $17.95 | $0.72 – $2.14 | 111 |
| Octreotide,microspheres ER 20 mg intramuscular susp, extended release HCPCS J2353 | $19,011.30 | $19,011.30 | $4,244.00 – $14,290.62 | 111 |
| Ofatumumab 20 mg/ml intravenous solution (wrapper) HCPCS J9302 | $1,810.15 | $1,810.15 | $684.24 – $2,037.50 | 111 |
| Oil silicone ophth 8.5ml silikon 1000 HCPCS C1814 | $725.10 | $1,115.54 | $421.67 – $1,255.65 | 40 |
| Olanzapine 10 mg intramuscular solution HCPCS J2359 | $64.40 | $64.40 | $24.34 – $72.49 | 40 |
| Omalizumab 150 mg/ml subcutaneous syringe (wrapper) HCPCS J2357 | $7,768.80 | $7,768.80 | $1,216.80 – $8,744.56 | 111 |
| Ondansetron 8 mg disintegrating tablet HCPCS Q0162 | $1.00 | $1.00 | $0.04 – $1.13 | 111 |
| Ondansetron hcl (pf) 2 mg/ml injection (wrapper) HCPCS J2405 | $4.10 | $4.10 | $0.36 – $4.61 | 111 |
| Oral aprepitant HCPCS J8501 | $38.30 | $38.30 | $14.48 – $43.11 | 111 |
| Oritavancin 1,200 mg intravenous solution HCPCS J2406 | $28,018.60 | $28,018.60 | $4,968.00 – $31,537.74 | 111 |
| Oritavancin 400 mg intravenous solution HCPCS J2407 | $5,978.20 | $5,978.20 | $2,259.76 – $6,729.06 | 40 |
| Orthosis lso rigd frm hyperex HCPCS L0472 | $899.04 | $1,383.14 | $522.83 – $1,556.86 | 40 |
| Osmolality blood CPT 83930 | $77.35 | $119.00 | $44.98 – $133.95 | 40 |
| Osmolality urine CPT 83935 | $74.75 | $115.00 | $9.07 – $115.00 | 40 |
| Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes CPT 97763 | $128.70 | $198.00 | $74.84 – $222.87 | 40 |
| Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes CPT 97130 | $133.25 | $205.00 | $77.49 – $230.75 | 40 |
| Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes CPT 97129 | $128.70 | $198.00 | $74.84 – $222.87 | 40 |
| Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr HCPCS J2700 | $14.50 | $14.50 | $3.28 – $16.32 | 111 |
| Oxaliplatin 5 mg/ml desensitization HCPCS J9263 | $1,200.00 | $1,200.00 | $43.47 – $129.44 | 40 |
| Oxytocin 10 unit/ml injection solution HCPCS J2590 | $6.85 | $6.85 | $0.87 – $7.71 | 111 |
| P-32 chromic phos ther per mci HCPCS A9564 | $1,730.00 | $1,730.00 | $653.94 – $1,947.29 | 40 |
| P-32 sod phosphate ther per mci HCPCS A9563 | $1,383.10 | $1,383.10 | $179.12 – $1,556.82 | 111 |
| Pacemaker leadless 19.5f 32.2mm ra HCPCS C1605 | $14,528.90 | $22,352.16 | $12,389.80 – $25,159.59 | 40 |
| Paclitaxel 6 mg/ml concentrate,intravenous HCPCS J9267 | $328.00 | $328.00 | $3.60 – $41.31 | 111 |
| Paclitaxel protein-bound 100 mg intravenous suspension HCPCS J9264 | $4,766.15 | $4,766.15 | $1,327.00 – $5,364.78 | 111 |
| Pad repl cerv collr univ adult HCPCS L0999 | $60.66 | $93.32 | $14.91 – $44.40 | 40 |
| Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution HCPCS J2430 | $136.60 | $136.60 | $11.16 – $48.18 | 111 |
| Panitumumab 20 mg/ml intravenous solution (wrapper) HCPCS J9303 | $20,996.10 | $20,996.10 | $1,888.30 – $5,908.33 | 111 |
| Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr HCPCS J2470 | $10.25 | $10.25 | $1.89 – $11.54 | 111 |
| Papaverin hcl injection HCPCS J2440 | $26.70 | $26.70 | $10.09 – $38.87 | 111 |
| Parathormone (pth) intact CPT 83970 | $238.55 | $367.00 | $138.73 – $413.10 | 40 |
| Paricalcitol HCPCS J2501 | $46.00 | $46.00 | $3.35 – $51.78 | 111 |
| Particle matristem matrix 1000mg micron-q4118-cost per mg HCPCS Q4118 | $221.06 | $340.09 | $0.91 – $2.71 | 40 |
| Passy muir valve metal trach HCPCS L8501 | $242.38 | $372.89 | $29.73 – $88.54 | 40 |
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.