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 |
|---|---|---|---|---|
| Swallowing Therapy Session CPT 92526 | $221.00 | $340.00 | $72.01 – $340.00 | 45 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $21.45 | $33.00 | $4.26 – $33.00 | 45 |
| System cardiomems hosp electronics HCPCS C2624 | $24,023.02 | $36,958.50 | $10,280.76 – $15,816.55 | 29 |
| System pacing micra av HCPCS C1786 | $16,760.25 | $25,785.00 | $50.38 – $77.51 | 29 |
| System pcmkr dual chamber leadless micra av2 intrdcr cath HCPCS C1785 | $27,099.09 | $41,690.91 | $71.47 – $109.96 | 29 |
| System recell skin grafting/harvesting HCPCS C1832 | $8,955.20 | $13,777.23 | $8,955.20 – $13,777.23 | 29 |
| System sealant biosentry tract HCPCS C2613 | $652.35 | $1,003.62 | $652.35 – $1,003.62 | 29 |
| T3 (triiodothyronine) free CPT 84481 | $122.20 | $188.00 | $16.41 – $188.00 | 45 |
| T3 (triiodothyronine) total CPT 84480 | $96.85 | $149.00 | $13.74 – $149.00 | 45 |
| T4 (thyroxine) free CPT 84439 | $78.65 | $121.00 | $8.74 – $121.00 | 45 |
| T4 (thyroxine) total CPT 84436 | $52.65 | $81.00 | $6.66 – $81.00 | 45 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | $170.70 | $170.70 | $0.15 – $1.00 | 95 |
| Tacrolimus 5 mg/ml intravenous solution HCPCS J7525 | $1,208.10 | $1,208.10 | $262.23 – $1,208.10 | 95 |
| Tacrolimus therapeutic drug level CPT 80197 | $158.60 | $244.00 | $13.30 – $244.00 | 45 |
| Tafasitamab-cxix 200 mg intravenous solution HCPCS J9349 | $4,272.00 | $4,272.00 | $13.52 – $4,272.00 | 111 |
| Tailbone (Sacrum and Coccyx) X-ray CPT 72220 | $221.65 | $341.00 | $82.37 – $341.00 | 111 |
| Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection HCPCS J9325 | $88,021.00 | $88,021.00 | $65.46 – $880.35 | 111 |
| Talquetamab-tgvs 2 mg/ml subcutaneous solution HCPCS J3055 | $35,941.50 | $35,941.50 | $73.42 – $4,492.75 | 108 |
| Tape plstc 1inx5yd hosp tb pk HCPCS A4452 | $3.04 | $4.67 | $3.04 – $4.67 | 29 |
| Target gsa panel hmtlmph neop CPT 81450 | $2,157.35 | $3,319.00 | $735.98 – $3,319.00 | 45 |
| Target gsa panel organ neop CPT 81445 | $1,418.95 | $2,183.00 | $579.37 – $2,183.00 | 45 |
| Tarlatamab-dlle 10 mg intravenous solution HCPCS J9026 | $46,350.00 | $46,350.00 | $1,535.25 – $4,635.00 | 108 |
| Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe HCPCS J1447 | $463.10 | $463.10 | $0.24 – $289.40 | 111 |
| Tbs dxa cal w/i&r fx risk CPT 77089 | $943.00 | not published | $35.69 – $121.75 | 82 |
| Tbs techl calculation only CPT 77091 | $186.55 | $287.00 | $82.37 – $287.00 | 111 |
| Tbs techl prep&transmis data CPT 77090 | $159.25 | $245.00 | $82.37 – $245.00 | 111 |
| Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells CPT 86481 | $221.65 | $341.00 | $96.90 – $341.00 | 45 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $164.45 | $253.00 | $60.06 – $253.00 | 45 |
| Tc-99m apcitide diag HCPCS A9504 | $1,765.30 | $1,765.30 | $1,147.45 – $1,765.30 | 29 |
| Tc-99m arcitumomab HCPCS A9568 | $4,224.15 | $4,224.15 | $844.83 – $4,224.15 | 37 |
| Tc-99m bicisate HCPCS A9557 | $7,128.20 | $7,128.20 | $760.01 – $7,128.20 | 108 |
| Tc-99m depreotide HCPCS A9536 | $1,937.35 | $1,937.35 | $1,259.28 – $1,937.35 | 29 |
| Tc-99m diag per dose HCPCS A4641 | $575.50 | $575.50 | $374.08 – $575.50 | 29 |
| Tc-99m disofenin HCPCS A9510 | $339.80 | $339.80 | $220.87 – $339.80 | 29 |
| Tc-99m exame autol wbc diag per dose HCPCS A9569 | $8,194.15 | $8,194.15 | $915.45 – $8,194.15 | 108 |
| Tc-99m exametazime diag HCPCS A9521 | $7,382.05 | $7,382.05 | $909.16 – $7,382.05 | 108 |
| Tc-99m fanolesomab diag HCPCS A9566 | $17,688.75 | $17,688.75 | $11,497.69 – $17,688.75 | 29 |
| Tc-99m gluceptate HCPCS A9550 | $1,105.40 | $1,105.40 | $718.51 – $1,105.40 | 29 |
| Tc-99m labeled rbc HCPCS A9560 | $857.40 | $857.40 | $557.31 – $857.40 | 29 |
| Tc-99m maa HCPCS A9540 | $760.95 | $760.95 | $494.62 – $760.95 | 29 |
| Tc-99m mebrofenin HCPCS A9537 | $308.25 | $308.25 | $200.36 – $308.25 | 29 |
| Tc-99m medronate HCPCS A9503 | $210.35 | $210.35 | $136.73 – $210.35 | 29 |
| Tc-99m mertiatide HCPCS A9562 | $1,340.90 | $1,340.90 | $871.59 – $1,340.90 | 29 |
| Tc-99m non-heu per study dose HCPCS Q9969 | $1.00 | $1.00 | $0.20 – $1.00 | 37 |
| Tc-99m oxidronate HCPCS A9561 | $199.60 | $199.60 | $129.74 – $199.60 | 29 |
| Tc-99m pentetate dtpa HCPCS A9539 | $627.25 | $627.25 | $407.71 – $627.25 | 29 |
| Tc-99m pentetate dtpa aerosol HCPCS A9567 | $627.25 | $627.25 | $407.71 – $627.25 | 29 |
| Tc-99m pertechnetate per mci HCPCS A9512 | $99.30 | $99.30 | $64.55 – $99.30 | 29 |
| Tc-99m pyroph diag per dose up to 25 mci HCPCS A9538 | $335.80 | $335.80 | $218.27 – $335.80 | 29 |
| Tc-99m sestamibi p study dose HCPCS A9500 | $221.60 | $221.60 | $144.04 – $221.60 | 29 |
| Tc-99m succimer (dmsa) HCPCS A9551 | $2,988.10 | $2,988.10 | $646.73 – $2,988.10 | 108 |
| Tc-99m sulfur colloid HCPCS A9541 | $855.40 | $855.40 | $556.01 – $855.40 | 29 |
| Tc-99m tetrofosmin p study dose HCPCS A9502 | $198.05 | $198.05 | $128.73 – $198.05 | 29 |
| Tc-99m tilmanocept diag HCPCS A9520 | $2,740.00 | $2,740.00 | $1,781.00 – $2,740.00 | 29 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $99.45 | $153.00 | $45.52 – $153.00 | 45 |
| T cells total count CPT 86359 | $91.65 | $141.00 | $36.56 – $141.00 | 45 |
| Tebentafusp-tebn 100 mcg/0.5 ml intravenous solution HCPCS J9274 | $107,550.00 | $107,550.00 | $203.61 – $107,550.00 | 111 |
| Telehealth original site facility fee HCPCS Q3014 | $52.00 | $80.00 | $16.00 – $80.00 | 37 |
| Temozolomide 100 mg intravenous solution HCPCS J9328 | $5,015.55 | $5,015.55 | $1,137.00 – $5,015.55 | 95 |
| Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln HCPCS J9330 | $10,501.70 | $10,501.70 | $53.30 – $10,501.70 | 32 |
| Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) HCPCS J3101 | $23,582.35 | $23,582.35 | $8,597.00 – $23,273.85 | 95 |
| Tenotomy open tndn flxr toe sgl tndn spx CPT 28232 | $8,747.39 | not published | $31.45 – $6,352.30 | 83 |
| Terbutaline 1 mg/ml subcutaneous solution HCPCS J3105 | $90.60 | $90.60 | $58.89 – $90.60 | 29 |
| Test pathogen(s) for platelets reference HCPCS P9100 | $73.45 | $113.00 | $55.84 – $114.53 | 111 |
| Test stress cardiovascular tracing only CPT 93017 | $765.05 | $1,177.00 | $204.38 – $1,177.00 | 111 |
| Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe HCPCS J2356 | $22,937.05 | $22,937.05 | $18.16 – $22,937.05 | 32 |
| Theophylline therapeutic drug level CPT 80198 | $117.00 | $180.00 | $13.70 – $180.00 | 45 |
| Therapy Activity Training (each 15 minutes) CPT 97530 | $128.70 | $198.00 | $31.45 – $198.00 | 45 |
| Therapy Exercise Session (each 15 minutes) CPT 97110 | $3,376.00 | $199.00 | $25.38 – $199.00 | 45 |
| Therapy nutrition individual initial f2f w/patient each 15 minutes CPT 97802 | $94.90 | $146.00 | $15.49 – $146.00 | 45 |
| Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes CPT 97803 | $94.90 | $146.00 | $14.72 – $146.00 | 45 |
| Thiamine hcl (vitamin b1) 100 mg/ml injection solution HCPCS J3411 | $10.30 | $10.30 | $3.58 – $10.30 | 95 |
| Thigh Bone (Femur) X-ray (both sides) CPT 73552 | $403.65 | $621.00 | $82.37 – $414.00 | 111 |
| Thiotepa 15 mg solution for injection HCPCS J9341 | $1,090.00 | $1,090.00 | $708.50 – $1,090.00 | 29 |
| Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides) CPT 32555 | $1,748.50 | $2,690.00 | $593.78 – $1,793.00 | 111 |
| Three-Phase Bone Scan (Nuclear Medicine) CPT 78315 | $1,451.45 | $2,233.00 | $378.41 – $2,233.00 | 111 |
| Thrombin time CPT 85670 | $33.80 | $52.00 | $5.59 – $52.00 | 45 |
| Thromboplastin time partial (ptt) substitution fractions each CPT 85732 | $41.60 | $64.00 | $6.27 – $64.00 | 45 |
| Thyroglobulin antibody CPT 86800 | $122.20 | $188.00 | $15.41 – $188.00 | 45 |
| Thyroid imaging CPT 78013 | $753.35 | $1,159.00 | $378.41 – $1,159.00 | 111 |
| Thyroid (TSH) Test CPT 84443 | $898.00 | $192.00 | $9.09 – $192.00 | 45 |
| Thyroid Ultrasound CPT 76536 | $553.80 | $852.00 | $98.96 – $852.00 | 111 |
| Thyrotropin alfa 0.9 mg intramuscular solution HCPCS J3240 | $10,828.50 | $10,828.50 | $1,992.78 – $10,828.50 | 111 |
| Tibial arthroscopy/surgery CPT 29855 | $22,202.51 | $2,690.00 | $2.88 – $14,087.30 | 769 |
| Tisotumab vedotin-tftv 40 mg intravenous solution HCPCS J9273 | $22,202.40 | $22,202.40 | $170.43 – $22,202.40 | 111 |
| Tissue amnio epifix inj 100mg HCPCS Q4145 | $2,555.89 | $3,932.14 | $1,342.48 – $2,065.35 | 29 |
| Tissue dermagraft 2x3in 37.5sqcm-cost per sq cm HCPCS Q4431 | $67.73 | $104.20 | $67.73 – $104.20 | 29 |
| Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm HCPCS Q4122 | $271.69 | $417.99 | $83.60 – $417.99 | 37 |
| Tissue matrix xcm thk 20x30cm -cost per sq cm HCPCS Q4142 | $49.04 | $75.45 | $15.09 – $75.45 | 37 |
| Tissue surgimend prs meshed 20 cm x 10 cm - cost per 0.5cm HCPCS C9358 | $38.88 | $59.82 | $38.88 – $59.82 | 29 |
| Tissue transglutaminase iga CPT 86364 | $176.80 | $272.00 | $11.17 – $272.00 | 45 |
| Tl-201 thallium diag per mci HCPCS A9505 | $80.10 | $80.10 | $52.07 – $80.10 | 29 |
| Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr HCPCS J3260 | $10.85 | $10.85 | $2.34 – $3.60 | 95 |
| Tobramycin peak therapeutic drug level CPT 80200 | $121.55 | $187.00 | $15.63 – $187.00 | 31 |
| Tocilizumab 162 mg/0.9 ml subcutaneous pen injector HCPCS J3262 | $12,214.20 | $12,214.20 | $5.50 – $2,442.90 | 111 |
| Toe X-ray (both feet) CPT 73660 | $270.40 | $416.00 | $82.37 – $277.00 | 111 |
| Tomosynthesis breast diagnostic left HCPCS G0279 | $221.65 | $341.00 | $11.38 – $227.00 | 42 |
| Tomosynthesis breast screen bilateral CPT 77063 | $830.00 | $120.00 | $20.96 – $80.00 | 45 |
| Tonsillectomy (age 12+) CPT 42826 | $10,688.01 | not published | $2.88 – $6,436.67 | 83 |
| Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution HCPCS J9351 | $188.75 | $188.75 | $74.75 – $115.00 | 29 |
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.