MercyOne North Iowa Medical Center
1000 4th St. SW, Mason City, IA · MercyOne · · NPI 1467537886
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 |
|---|---|---|---|---|
| Skull X-ray (1 to 3 views) CPT 70250 | $182.00 | $280.00 | $71.68 – $280.00 | 119 |
| Skull X-ray (complete) CPT 70260 | $338.00 | $520.00 | $101.16 – $520.00 | 119 |
| Sleep Study (Polysomnography) CPT 95810 | $3,779.10 | $5,814.00 | $73.91 – $5,814.00 | 782 |
| Sleep study unattended CPT 95806 | $653.00 | $653.00 | $27.48 – $653.00 | 780 |
| Sleeve fing rolyan med HCPCS L3933 | $37.65 | $57.93 | $14.83 – $57.93 | 31 |
| Sleeve irr assura 1pc disp HCPCS A4397 | $0.65 | $1.00 | $0.26 – $1.00 | 31 |
| Sling arm deluxe w/pad xs HCPCS A4565 | $529.06 | $813.94 | $0.55 – $460.33 | 39 |
| Sling pelv split sam med HCPCS L0621 | $165.55 | $254.70 | $50.94 – $254.70 | 39 |
| Sling suprapubic suburetheral HCPCS C1771 | $9,679.96 | $14,892.24 | $522.69 – $2,041.75 | 31 |
| Sm-153 lexidron ther HCPCS A9604 | $57,456.00 | $57,456.00 | $4,314.91 – $57,456.00 | 102 |
| Small Bowel Barium X-ray (Follow-Through) CPT 74250 | $365.95 | $563.00 | $144.13 – $563.00 | 119 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $50.70 | $78.00 | $5.22 – $78.00 | 48 |
| Smear gram stain CPT 87205 | $1,050.00 | $89.00 | $4.14 – $136.02 | 119 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $100.10 | $154.00 | $5.80 – $154.00 | 48 |
| Smear wet mount CPT 87210 | $70.20 | $108.00 | $4.66 – $108.00 | 780 |
| Sock wool above knee HCPCS L8430 | $158.68 | $244.12 | $62.49 – $244.12 | 31 |
| Sodium 24 hour urine CPT 84300 | $44.85 | $69.00 | $4.91 – $69.00 | 48 |
| Sodium chloride 0.9 % intravenous solution HCPCS J7030 | $23,334.26 | $25.00 | $1.28 – $7,023.57 | 119 |
| Sodium chloride 0.9 % IV bolus HCPCS J7040 | $23,203.65 | $20.00 | $1.38 – $75.07 | 119 |
| Sodium chloride 0.9 % IV bolus HCPCS J7050 | $24,687.86 | $34.50 | $0.71 – $7,023.57 | 119 |
| Sodium chloride 3 % ivpb HCPCS J7131 | $30.00 | $30.00 | $7.68 – $75.00 | 102 |
| Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous HCPCS J2916 | $40.85 | $40.85 | $10.46 – $40.85 | 101 |
| Sodium serum/plasma/whole blood CPT 84295 | $260.00 | $37.00 | $4.66 – $136.02 | 119 |
| Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution HCPCS J0209 | $495.00 | $495.00 | $0.86 – $495.00 | 115 |
| Sp bone agrft morsel add-on CPT 20937 | $75,121.10 | not published | $9.09 – $37,986.64 | 89 |
| Sp bone agrft struct add-on CPT 20938 | $72,062.62 | not published | $3.84 – $27,814.73 | 89 |
| Sp bone algrft morsel add-on CPT 20930 | $86,480.76 | $399.00 | $0.96 – $27,814.73 | 542 |
| Special radiation dosimetry CPT 77331 | $415.35 | $639.00 | $130.06 – $1,055.00 | 119 |
| Special radiation treatment CPT 77470 | $1,960.40 | $3,016.00 | $534.63 – $3,016.00 | 119 |
| Special teletx port plan CPT 77321 | $1,037.40 | $1,596.00 | $362.29 – $1,596.00 | 119 |
| Specific gravity body fluid CPT 84315 | $39.00 | $60.00 | $3.18 – $60.00 | 48 |
| Speech and Language Evaluation (comprehensive) CPT 92523 | $276.25 | $425.00 | $108.80 – $440.25 | 48 |
| Speech Therapy Session (one-on-one) CPT 92507 | $216.45 | $333.00 | $72.09 – $350.00 | 48 |
| Spinal bone allograftstructural 20931 CPT 20931 | $94,507.40 | $364.00 | $3.84 – $27,814.73 | 768 |
| Spinal bone autograftlocal 20936 CPT 20936 | $86,113.86 | not published | $1.92 – $58,785.27 | 89 |
| Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance CPT 62328 | $1,785.55 | $2,747.00 | $683.01 – $2,747.00 | 118 |
| Spine X-ray (single view, one level) CPT 72020 | $60,206.23 | $305.00 | $2.28 – $305.00 | 119 |
| Splint arm vnyl coated padded lft med HCPCS Q4051 | $16.25 | $25.00 | $6.40 – $25.00 | 31 |
| Splint dorsal bloc wh med perf 3.2mm lf polyflex ii HCPCS L3906 | $43.09 | $66.30 | $5.84 – $29.20 | 39 |
| Splint extn xsm w sof-stretch rolyan HCPCS L3925 | $50.38 | $77.51 | $7.90 – $39.50 | 39 |
| Splint finger 4 prong foam sm HCPCS A4570 | $0.55 | $0.85 | $0.17 – $0.67 | 31 |
| Splint finger fold over sm HCPCS L3924 | $0.44 | $0.67 | $0.17 – $0.67 | 31 |
| Splint finger frog med HCPCS L3927 | $0.54 | $0.83 | $0.08 – $0.39 | 39 |
| Splint fing stax assort 1-7in HCPCS Q4049 | $1.04 | $1.60 | $0.41 – $1.60 | 31 |
| Splint func pos polyflex ii med HCPCS L3999 | $33.60 | $51.70 | $10.34 – $51.70 | 39 |
| Splint rstrc wrst/cmc right med HCPCS L3923 | $101.18 | $155.66 | $9.67 – $48.35 | 39 |
| Sr-89 stront chlor ther / mci HCPCS A9600 | $40,862.00 | $40,862.00 | $4,063.41 – $40,862.00 | 116 |
| St analysis behavior qualitative voice/resonance CPT 92524 | $228.80 | $352.00 | $88.93 – $352.00 | 48 |
| Staph a dna amp probe CPT 87640 | $100.10 | $154.00 | $34.01 – $154.00 | 48 |
| Stent/athrectomy/fem/pop/unilat 37227 CPT 37227 | $45,431.10 | $69,894.00 | $9,319.20 – $46,596.00 | 38 |
| Stent axios caut enh 15x10mm electrocaut HCPCS C1874 | $32,403.15 | $49,851.00 | $0.01 – $8.35 | 31 |
| Stent bili dbl pgtl 10fx5cm HCPCS C2617 | $6,063.30 | $9,328.16 | $7.62 – $29.75 | 31 |
| Stent bili rx wallflx 10x80 uncvr HCPCS C1876 | $18,714.49 | $28,791.53 | $0.59 – $2.32 | 31 |
| Stent bronch dumon sil 10x40mm HCPCS C1875 | $4,918.86 | $7,567.48 | $215.81 – $843.00 | 31 |
| Stent iliac/open or perc/uni/init 37221 CPT 37221 | $91,192.46 | $44,146.00 | $0.96 – $29,430.00 | 118 |
| Stent iliac/open/perc/ea ad/ipsila 37223 CPT 37223 | $7,801.95 | $12,003.00 | $1,600.40 – $8,002.00 | 38 |
| Stereoscopic x-ray guidance HCPCS G6002 | $236.00 | $236.00 | $13.21 – $67.00 | 766 |
| St evaluate speech sound production CPT 92522 | $228.80 | $352.00 | $86.24 – $352.00 | 48 |
| St evaluation motion fluoroscopic swallow function cine/video CPT 92611 | $1,412.00 | $446.00 | $84.86 – $446.00 | 119 |
| Stomach Emptying Scan (Nuclear Medicine) CPT 78264 | $1,120.60 | $1,724.00 | $386.82 – $1,724.00 | 119 |
| Strap chin dlx f/cpap HCPCS A7036 | $34.90 | $53.70 | $13.75 – $53.70 | 31 |
| Strap montgmry ns 8 hl sht 7.25 x 11.25in HCPCS A4461 | $0.25 | $0.39 | $0.10 – $0.39 | 31 |
| Strapping of hand or finger CPT 29280 | $105.00 | $105.00 | $6.29 – $77.00 | 766 |
| Stress test pulmonary CPT 94618 | $202.15 | $311.00 | $13.85 – $311.00 | 782 |
| Stress tte complete CPT 93351 | $945.10 | $1,454.00 | $372.22 – $1,454.00 | 119 |
| Str markers specimen anal CPT 81265 | $1,240.85 | $1,909.00 | $228.41 – $1,909.00 | 45 |
| Subq i/p critical care pr day age 28 days/less than 99469 CPT 99469 | $1,002.00 | $1,002.00 | $261.27 – $883.03 | 767 |
| Subsequent intensive care infant 1500-2500 grams 99479 CPT 99479 | $316.00 | $316.00 | $81.91 – $227.00 | 766 |
| Subsequent intensive care infant 2501-5000 grams 99480 CPT 99480 | $304.00 | $304.00 | $79.04 – $218.00 | 766 |
| Succinylcholine chloride 20 mg/ml injection solution (wrapper) HCPCS J0330 | $77.20 | $77.20 | $19.76 – $77.20 | 31 |
| Suction lipectomy trunk CPT 15877 | $53,854.76 | not published | $0.96 – $7,677.40 | 89 |
| Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution HCPCS C9399 | $3,881.35 | $3,881.35 | $776.27 – $3,881.35 | 36 |
| Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution HCPCS J2865 | $57.70 | $57.70 | $14.77 – $57.70 | 31 |
| Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 | $148.93 | $148.93 | $6.51 – $55.20 | 552 |
| Support clav 29.6-40.5in med HCPCS L3650 | $94.19 | $144.91 | $0.65 – $3.26 | 39 |
| Surgical pathology level 1 gross examination only CPT 88300 | $87.10 | $134.00 | $24.96 – $134.00 | 119 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $181.35 | $279.00 | $24.96 – $279.00 | 119 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $202.80 | $312.00 | $50.14 – $312.00 | 119 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $9,342.77 | $362.00 | $31.45 – $362.00 | 119 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $324.35 | $499.00 | $127.74 – $776.57 | 119 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $445.90 | $686.00 | $175.62 – $1,745.49 | 119 |
| Susceptibility agar dilution per agent CPT 87181 | $55.25 | $85.00 | $4.60 – $85.00 | 48 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $28.60 | $44.00 | $4.60 – $44.00 | 48 |
| Susceptibility mic per plate CPT 87186 | $1,050.00 | $133.00 | $8.38 – $136.02 | 119 |
| Svc venogram s&i CPT 75827 | $1,990.95 | $3,063.00 | $784.13 – $3,410.37 | 119 |
| Swallowing Evaluation (Bedside) CPT 92610 | $731.00 | $414.00 | $55.26 – $414.00 | 48 |
| Swallowing Therapy Session CPT 92526 | $206.05 | $317.00 | $72.01 – $350.00 | 48 |
| Synch audio-only est low 20 CPT 98013 | $160.00 | $160.00 | $36.38 – $160.00 | 556 |
| Synch audio-only est mod 30 CPT 98014 | $235.00 | $235.00 | $53.05 – $235.00 | 556 |
| Synvisc or synvisc-one HCPCS J7325 | $272.00 | $21.00 | $6.61 – $21.00 | 765 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $44.85 | $69.00 | $4.26 – $69.00 | 48 |
| System cardiomems hosp electronics HCPCS C2624 | $24,023.02 | $36,958.50 | $4,049.04 – $15,816.55 | 31 |
| System pacing micra av HCPCS C1786 | $16,760.25 | $25,785.00 | $19.84 – $77.51 | 31 |
| System pcmkr dual chamber leadless micra av2 intrdcr cath HCPCS C1785 | $27,099.09 | $41,690.91 | $28.15 – $109.96 | 31 |
| System recell skin grafting/harvesting HCPCS C1832 | $8,955.20 | $13,777.23 | $3,526.97 – $13,777.23 | 31 |
| System sealant biosentry tract HCPCS C2613 | $652.35 | $1,003.62 | $256.93 – $1,003.62 | 31 |
| T3 (triiodothyronine) free CPT 84481 | $109.85 | $169.00 | $16.41 – $169.00 | 48 |
| T3 (triiodothyronine) total CPT 84480 | $813.00 | $97.00 | $9.09 – $97.00 | 48 |
| T4 (thyroxine) free CPT 84439 | $1,030.00 | $148.00 | $8.74 – $148.00 | 119 |
| T4 (thyroxine) total CPT 84436 | $55.25 | $85.00 | $6.66 – $85.00 | 48 |
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.