MercyOne Newton Medical Center
204 N. 4th Ave E, Newton, IA · MercyOne · · NPI 1003296179
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 |
|---|---|---|---|---|
| Scope uretscp lithovue dig disp HCPCS C1747 | $2,514.76 | $3,868.86 | $1,179.04 – $1,813.91 | 29 |
| Screening Colonoscopy (average risk) HCPCS G0121 | $8,052.75 | $870.00 | $52.61 – $1,805.43 | 769 |
| Screening Colonoscopy (high risk) HCPCS G0105 | $8,148.95 | $869.00 | $0.32 – $1,805.43 | 769 |
| Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations HCPCS G0328 | $61.75 | $95.00 | $17.69 – $95.00 | 42 |
| Screening hepatitis b non-obstetric high risk HCPCS G0499 | $56.55 | $87.00 | $27.70 – $87.00 | 42 |
| Screening hepatitis c antibody high risk HCPCS G0472 | $85.80 | $132.00 | $44.91 – $132.00 | 45 |
| Screening HIV antigen/antibody combination assay HCPCS G0475 | $96.85 | $149.00 | $23.60 – $149.00 | 42 |
| Screening Mammogram CPT 77067 | $830.00 | $710.00 | $81.59 – $473.00 | 45 |
| Screening prostate cancer PSA HCPCS G0103 | $129.35 | $199.00 | $18.92 – $199.00 | 42 |
| Screw cortex 2.0 x 10mm HCPCS C1713 | $776,558.25 | $1,194,705.00 | $0.01 – $0.01 | 29 |
| Scrotal (Testicle) Ultrasound CPT 76870 | $542.75 | $835.00 | $98.96 – $835.00 | 111 |
| Sedation moderate same physician performing a gastrointestinal endoscopic service >= 5 years initial 15 minutes intra-service time HCPCS G0500 | $558.35 | $859.00 | $558.35 – $859.00 | 29 |
| Sedimentation rate erythrocyte automated CPT 85652 | $44.20 | $68.00 | $2.62 – $68.00 | 45 |
| Self-Care and Home Skills Training (each 15 minutes) CPT 97535 | $93.60 | $144.00 | $28.47 – $144.00 | 45 |
| Semen analysis presence/motility CPT 89321 | $100.75 | $155.00 | $11.68 – $155.00 | 45 |
| Sheath gldlight lasr 12fx50cm HCPCS C2629 | $4,730.47 | $7,277.64 | $474.89 – $730.60 | 29 |
| Sheath laser cavaclear 14f HCPCS C1603 | $5,815.06 | $8,946.25 | $4,321.38 – $6,648.28 | 29 |
| Sho arthrs srg bicp tenodsis CPT 29828 | $29,911.68 | $3,150.00 | $0.96 – $14,087.30 | 769 |
| Sho arthrs srg xtnsv dbrdmt CPT 29823 | $27,866.36 | $2,048.00 | $0.96 – $14,087.30 | 769 |
| Shoe post-op mens m HCPCS L3260 | $42.87 | $65.95 | $0.58 – $2.90 | 37 |
| Shot (Injection into Muscle or Under the Skin) CPT 96372 | $9,042.85 | $159.00 | $68.15 – $159.00 | 111 |
| Shoulder AC Joint X-ray (both sides) CPT 73050 | $249.60 | $384.00 | $82.37 – $384.00 | 111 |
| Shoulder Arthroscopy (Rotator Cuff Repair) CPT 29827 | $29,101.52 | $3,671.00 | $0.36 – $14,087.30 | 769 |
| Shoulder Blade (Scapula) X-ray (both sides) CPT 73010 | $622.05 | $957.00 | $98.96 – $638.00 | 111 |
| Shoulder MRI (with and without contrast) CPT 73223 | $6,159.40 | $9,476.00 | $330.23 – $6,317.00 | 111 |
| Shoulder MRI (with contrast) CPT 73222 | $5,245.50 | $8,070.00 | $742.03 – $5,380.00 | 111 |
| Shoulder MRI (without contrast) CPT 73221 | $3,858.40 | $5,936.00 | $225.85 – $3,957.00 | 111 |
| Shoulder X-ray CPT 73030 | $396.00 | $594.00 | $82.37 – $396.00 | 111 |
| Shoulder X-ray (single view, both shoulders) CPT 73020 | $299.65 | $461.00 | $82.37 – $307.00 | 111 |
| Shrinker prosth above knee HCPCS L8460 | $230.16 | $354.09 | $230.16 – $354.09 | 29 |
| Shrinker prosth below knee HCPCS L8440 | $178.63 | $274.82 | $178.63 – $274.82 | 29 |
| Shunt glaucoma baerveldt 350mm HCPCS C1783 | $3,209.23 | $4,937.28 | $116.10 – $178.61 | 29 |
| Shuntogram nonvascular supervision & interpretation CPT 75809 | $659.10 | $1,014.00 | $98.96 – $1,014.00 | 111 |
| Sickling rbc CPT 85660 | $50.70 | $78.00 | $5.33 – $78.00 | 45 |
| Sincalide 5 mcg solution for injection HCPCS J2805 | $628.40 | $628.40 | $135.97 – $628.40 | 95 |
| Sinus CT scan (with and without contrast) CPT 70488 | $1,218.10 | $1,874.00 | $166.03 – $1,874.00 | 111 |
| Sinus CT scan (with contrast) CPT 70487 | $2,102.10 | $3,234.00 | $166.03 – $3,234.00 | 111 |
| Sinus CT scan (without contrast) CPT 70486 | $1,962.00 | $1,962.00 | $98.96 – $1,962.00 | 111 |
| Sirolimus-protein bound 100 mg intravenous suspension HCPCS J9331 | $42,938.50 | $42,938.50 | $9,250.00 – $42,938.50 | 95 |
| Skull X-ray (1 to 3 views) CPT 70250 | $193.05 | $297.00 | $98.96 – $297.00 | 111 |
| Skull X-ray (complete) CPT 70260 | $301.60 | $464.00 | $98.96 – $464.00 | 111 |
| Sleep Study (Polysomnography) CPT 95810 | $3,901.30 | $6,002.00 | $812.85 – $6,002.00 | 111 |
| Sleeve fing rolyan med HCPCS L3933 | $37.65 | $57.93 | $37.65 – $57.93 | 29 |
| Sleeve irr assura 1pc disp HCPCS A4397 | $0.65 | $1.00 | $0.65 – $1.00 | 29 |
| Sling arm deluxe w/pad xs HCPCS A4565 | $529.06 | $813.94 | $1.35 – $460.33 | 37 |
| Sling pelv split sam med HCPCS L0621 | $165.55 | $254.70 | $50.94 – $254.70 | 37 |
| Sling suprapubic suburetheral HCPCS C1771 | $9,671.50 | $14,879.23 | $1,327.14 – $2,041.75 | 29 |
| Sm-153 lexidron ther HCPCS A9604 | $57,456.00 | $57,456.00 | $4,314.91 – $57,456.00 | 95 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $50.70 | $78.00 | $5.22 – $78.00 | 45 |
| Smear gram stain CPT 87205 | $393.00 | $55.00 | $4.14 – $55.00 | 45 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $64.35 | $99.00 | $5.80 – $99.00 | 45 |
| Sock wool above knee HCPCS L8430 | $158.68 | $244.12 | $158.68 – $244.12 | 29 |
| Sodium 24 hour urine CPT 84300 | $74.10 | $114.00 | $4.91 – $114.00 | 45 |
| Sodium chloride 0.9 % intravenous solution HCPCS J7030 | $25.00 | $25.00 | $13.00 – $20.00 | 29 |
| Sodium chloride 0.9 % IV bolus HCPCS J7040 | $22.50 | $22.50 | $13.00 – $20.00 | 29 |
| Sodium chloride 0.9 % IV bolus HCPCS J7050 | $34.50 | $34.50 | $8.94 – $13.75 | 29 |
| Sodium chloride 3 % ivpb HCPCS J7131 | $30.00 | $30.00 | $19.50 – $75.00 | 95 |
| Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous HCPCS J2916 | $292.60 | $292.60 | $10.90 – $40.85 | 95 |
| Sodium serum/plasma/whole blood CPT 84295 | $11,028.10 | $61.00 | $4.66 – $1,687.37 | 111 |
| Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution HCPCS J0209 | $495.00 | $495.00 | $0.86 – $495.00 | 108 |
| Specific gravity body fluid CPT 84315 | $30.55 | $47.00 | $3.18 – $47.00 | 45 |
| Speech and Language Evaluation (comprehensive) CPT 92523 | $428.35 | $659.00 | $178.58 – $659.00 | 45 |
| Speech Therapy Session (one-on-one) CPT 92507 | $245.70 | $378.00 | $72.09 – $378.00 | 45 |
| Splint arm vnyl coated padded lft med HCPCS Q4051 | $16.25 | $25.00 | $16.25 – $25.00 | 29 |
| Splint dorsal bloc wh med perf 3.2mm lf polyflex ii HCPCS L3906 | $43.09 | $66.30 | $5.84 – $29.20 | 37 |
| Splint extn xsm w sof-stretch rolyan HCPCS L3925 | $50.38 | $77.51 | $7.90 – $39.50 | 37 |
| Splint finger 4 prong foam sm HCPCS A4570 | $0.55 | $0.85 | $0.44 – $0.67 | 29 |
| Splint finger fold over sm HCPCS L3924 | $0.44 | $0.67 | $0.44 – $0.67 | 29 |
| Splint finger frog med HCPCS L3927 | $0.54 | $0.83 | $0.08 – $0.39 | 37 |
| Splint fing stax assort 1-7in HCPCS Q4049 | $1.04 | $1.60 | $1.04 – $1.60 | 29 |
| Splint func pos polyflex ii med HCPCS L3999 | $33.60 | $51.70 | $10.34 – $51.70 | 37 |
| Splint rstrc wrst/cmc right med HCPCS L3923 | $101.18 | $155.66 | $9.67 – $48.35 | 37 |
| Sr-89 stront chlor ther / mci HCPCS A9600 | $40,862.00 | $40,862.00 | $4,063.41 – $40,862.00 | 108 |
| St analysis behavior qualitative voice/resonance CPT 92524 | $286.65 | $441.00 | $88.93 – $441.00 | 45 |
| St cognitve performance testing healthcare professional each hour CPT 96125 | $408.85 | $629.00 | $75.75 – $629.00 | 45 |
| Stent axios caut enh 15x10mm electrocaut HCPCS C1874 | $32,403.15 | $49,851.00 | $0.01 – $0.01 | 29 |
| Stent bili dbl pgtl 10fx5cm HCPCS C2617 | $6,063.30 | $9,328.16 | $19.34 – $29.75 | 29 |
| Stent bili rx wallflx 10x80 uncvr HCPCS C1876 | $18,714.49 | $28,791.53 | $1.51 – $2.32 | 29 |
| Stent bronch dumon sil 10x40mm HCPCS C1875 | $4,918.86 | $7,567.48 | $547.95 – $843.00 | 29 |
| St evaluate speech sound production CPT 92522 | $336.70 | $518.00 | $86.24 – $518.00 | 45 |
| St evaluation motion fluoroscopic swallow function cine/video CPT 92611 | $312.65 | $481.00 | $84.86 – $481.00 | 45 |
| Stomach Emptying Scan (Nuclear Medicine) CPT 78264 | $1,238.25 | $1,905.00 | $378.41 – $1,905.00 | 111 |
| Strap chin dlx f/cpap HCPCS A7036 | $34.90 | $53.70 | $34.91 – $53.70 | 29 |
| Strap montgmry ns 8 hl sht 7.25 x 11.25in HCPCS A4461 | $0.25 | $0.39 | $0.25 – $0.39 | 29 |
| Stress test pulmonary CPT 94618 | $273.65 | $421.00 | $125.94 – $421.00 | 111 |
| Stress tte complete CPT 93351 | $1,578.85 | $2,429.00 | $517.21 – $2,429.00 | 111 |
| Succinylcholine chloride 20 mg/ml injection solution (wrapper) HCPCS J0330 | $82.50 | $82.50 | $53.63 – $82.50 | 29 |
| Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution HCPCS J2865 | $9.20 | $9.20 | $5.98 – $9.20 | 29 |
| Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 | $17.70 | $17.70 | $3.54 – $65.71 | 103 |
| Support clav 29.6-40.5in med HCPCS L3650 | $94.19 | $144.91 | $0.65 – $3.26 | 37 |
| Surgical pathology level 1 gross examination only CPT 88300 | $72.15 | $111.00 | $27.38 – $111.00 | 111 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $116.35 | $179.00 | $35.35 – $179.00 | 111 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $122.20 | $188.00 | $49.33 – $188.00 | 111 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $178.10 | $274.00 | $31.45 – $274.00 | 111 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $321.10 | $494.00 | $183.41 – $695.89 | 111 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $531.05 | $817.00 | $465.69 – $1,564.16 | 111 |
| Susceptibility agar dilution per agent CPT 87181 | $54.60 | $84.00 | $4.60 – $84.00 | 45 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $14.30 | $22.00 | $4.60 – $22.00 | 45 |
| Susceptibility mic per plate CPT 87186 | $324.00 | $138.00 | $8.38 – $138.00 | 45 |
| Swallowing Evaluation (Bedside) CPT 92610 | $293.15 | $451.00 | $55.26 – $451.00 | 45 |
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.