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 |
|---|---|---|---|---|
| Toripalimab-tpzi 240 mg/6 ml (40 mg/ml) intravenous solution HCPCS J3263 | $48,786.25 | $48,786.25 | $9,480.00 – $48,786.25 | 95 |
| Total Hip Replacement CPT 27130 | $34,016.02 | $5,650.00 | $9.09 – $24,925.18 | 769 |
| Total Knee Replacement CPT 27447 | $33,085.71 | $5,642.00 | $9.09 – $24,925.18 | 769 |
| Toxoplasma antibody igg CPT 86777 | $79.30 | $122.00 | $13.94 – $122.00 | 45 |
| Toxoplasma antibody igm CPT 86778 | $62.40 | $96.00 | $13.96 – $96.00 | 45 |
| Trabectedin 1 mg intravenous solution HCPCS J9352 | $11,842.80 | $11,842.80 | $332.90 – $11,842.80 | 111 |
| Training self management diabetes individual outpatient department per 30 minutes HCPCS G0108 | $242.00 | $242.00 | $21.28 – $242.00 | 45 |
| Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution HCPCS J3290 | $18.85 | $18.85 | $2.00 – $18.85 | 100 |
| Transferrin CPT 84466 | $109.85 | $169.00 | $12.36 – $169.00 | 45 |
| Transvaginal Pelvic Ultrasound (not pregnancy) CPT 76830 | $558.35 | $859.00 | $98.96 – $859.00 | 111 |
| Transvaginal Pregnancy Ultrasound CPT 76817 | $589.55 | $907.00 | $22.58 – $907.00 | 781 |
| Trastuzumab 150 mg intravenous solution HCPCS J9355 | $4,708.00 | $4,708.00 | $72.01 – $4,675.30 | 111 |
| Trastuzumab-anns 150 mg intravenous solution HCPCS Q5117 | $10,508.35 | $10,508.35 | $50.41 – $2,766.05 | 111 |
| Trastuzumab-qyyp 150 mg intravenous solution HCPCS Q5116 | $9,357.40 | $9,357.40 | $8.04 – $3,365.30 | 111 |
| Trauma partial team response w/critical care services level 4 HCPCS G0390 | $2,798.25 | $4,305.00 | $2,238.60 – $3,444.00 | 29 |
| Tray bonemarrw oncontrol 102mm HCPCS C1830 | $699.55 | $1,076.23 | $39.65 – $61.00 | 29 |
| Tray trach basic clean/care ster HCPCS A4626 | $0.51 | $0.78 | $0.51 – $0.78 | 29 |
| Treat fracture of ulna CPT 25535 | $1,604.00 | $1,604.00 | $115.72 – $1,604.00 | 768 |
| Treat lower leg joint CPT 27829 | $34,203.50 | not published | $1.92 – $14,087.30 | 83 |
| Treatment fx radial distal open w/internal fixation 2 frag left (restricted method ii cah) CPT 25608 | $24,054.57 | $2,860.00 | $0.96 – $14,087.30 | 769 |
| Treatment fx radial distal open w/internal fixation left (restricted method ii cah) CPT 25607 | $2,562.00 | $2,562.00 | $29.61 – $268.32 | 768 |
| Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour CPT 94645 | $158.60 | $244.00 | $158.60 – $244.00 | 29 |
| Treatment of ankle fracture CPT 27792 | $32,472.99 | not published | $0.96 – $14,087.30 | 83 |
| Treat metacarpal fracture CPT 26615 | $1,999.00 | $1,999.00 | $174.66 – $1,311.00 | 768 |
| Treat metatarsal fracture CPT 28485 | $16,279.50 | not published | $3.84 – $14,087.30 | 83 |
| Treat wrist dislocation CPT 25675 | $1,445.00 | $1,445.00 | $96.89 – $999.33 | 768 |
| Tremelimumab-actl 20 mg/ml intravenous solution HCPCS J9347 | $127,265.40 | $127,265.40 | $134.29 – $10,605.45 | 111 |
| Treponema pallidum antibody CPT 86780 | $130.00 | $200.00 | $12.83 – $200.00 | 45 |
| Triamcinolone acetonide 40 mg/ml suspension for injection HCPCS J3301 | $39.10 | $39.10 | $25.42 – $39.10 | 29 |
| Triglycerides CPT 84478 | $50.05 | $77.00 | $5.56 – $77.00 | 45 |
| Trilaciclib 300 mg intravenous solution HCPCS J1448 | $8,065.15 | $8,065.15 | $5.24 – $8,065.15 | 111 |
| Trnsfr/rearrngmnt adjcnt tiss trnk 10.1-30sqcm CPT 14001 | $2,131.00 | $2,131.00 | $191.92 – $1,473.00 | 768 |
| Troponin quantitative CPT 84484 | $124.80 | $192.00 | $12.09 – $192.00 | 45 |
| Tube drain vert dev st 5-40f HCPCS A5200 | $17.68 | $27.20 | $17.68 – $27.20 | 29 |
| Tube trach disp innr can 5 xlt HCPCS A7521 | $416.99 | $641.52 | $2.20 – $3.39 | 29 |
| Tube trach disp innr can 6 xlt HCPCS A4623 | $2.78 | $4.27 | $1.28 – $1.97 | 29 |
| Tube trach fen sz 6 uncuffed HCPCS A7520 | $128.12 | $197.11 | $0.72 – $1.10 | 29 |
| Tx open dstl phlngl fx f/t internal fixation ea CPT 26765 | $9,299.53 | not published | $3,097.14 – $6,352.30 | 82 |
| Tx phalangeal shaft fx open prox/middle ea CPT 26735 | $2,066.00 | $2,066.00 | $179.99 – $1,370.00 | 768 |
| Ublituximab-xiiy 25 mg/ml intravenous solution HCPCS J2329 | $35,496.45 | $35,496.45 | $67.73 – $35,496.45 | 111 |
| Ultrasound breast unilateral limited (both sides) CPT 76642 | $729.30 | $1,122.00 | $75.49 – $748.00 | 111 |
| Ultrasound doppler velocimetry fetal umbilical artery CPT 76820 | $228.80 | $352.00 | $98.96 – $352.00 | 111 |
| Ultrasound fetal biophysical profile without non-stress testing CPT 76819 | $534.95 | $823.00 | $98.96 – $823.00 | 111 |
| Ultrasound Guidance for a Needle Procedure CPT 76942 | $534.95 | $823.00 | $10.90 – $823.00 | 780 |
| Ultrasound joint complete left CPT 76881 | $642.85 | $989.00 | $98.96 – $989.00 | 111 |
| Ultrasound pregnant uterus < 14 weeks each additional gestation CPT 76802 | $407.55 | $627.00 | $357.39 – $627.00 | 29 |
| Ultrasound pregnant uterus detailed fetal exam single/1st gestation CPT 76811 | $579.80 | $892.00 | $57.72 – $892.00 | 781 |
| Ultrasound pregnant uterus follow up per fetus CPT 76816 | $446.55 | $687.00 | $98.96 – $687.00 | 111 |
| Ultrasound transabd ea addl gest CPT 76812 | $683.15 | $1,051.00 | $599.07 – $1,051.00 | 29 |
| Unit mobile power mpu HCPCS Q0479 | $11,821.68 | $18,187.20 | $11,821.68 – $18,187.20 | 29 |
| Unlisted procedure microbiology CPT 87999 | $2,388.75 | $3,675.00 | $2,094.75 – $3,675.00 | 29 |
| Upper Arm (Humerus) X-ray (left side) CPT 73060 | $201.50 | $310.00 | $82.37 – $310.00 | 111 |
| Upper Back (Thoracic Spine) CT Scan (without contrast) CPT 72128 | $1,330.55 | $2,047.00 | $98.96 – $2,047.00 | 111 |
| Upper Back (Thoracic Spine) MRI (with and without contrast) CPT 72157 | $4,634.50 | $7,130.00 | $330.23 – $7,130.00 | 111 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | $2,551.90 | $3,926.00 | $225.85 – $3,926.00 | 111 |
| Upper Back (Thoracic Spine) X-ray (2 views) CPT 72070 | $261.30 | $402.00 | $98.96 – $402.00 | 111 |
| Upper Back (Thoracic Spine) X-ray (3 views) CPT 72072 | $333.45 | $513.00 | $98.96 – $513.00 | 111 |
| Upper Endoscopy (EGD, diagnostic) CPT 43235 | $10,242.70 | not published | $858.52 – $1,760.83 | 82 |
| Upper Endoscopy (EGD, with biopsy) CPT 43239 | $7,375.40 | $503.00 | $39.41 – $1,760.83 | 769 |
| Upper GI Barium X-ray (barium and gas) CPT 74246 | $458.90 | $706.00 | $166.03 – $706.00 | 111 |
| Upper GI Barium X-ray (barium only) CPT 74240 | $331.50 | $510.00 | $166.03 – $510.00 | 111 |
| Urea nitrogen CPT 84520 | $521.00 | $65.00 | $3.83 – $65.00 | 45 |
| Urea nitrogen 24 hour urine CPT 84540 | $54.60 | $84.00 | $5.39 – $84.00 | 45 |
| Uric acid blood CPT 84550 | $57.85 | $89.00 | $4.38 – $89.00 | 45 |
| Uric acid urine CPT 84560 | $66.30 | $102.00 | $4.93 – $102.00 | 45 |
| Urinalysis microscopic only CPT 81015 | $31.85 | $49.00 | $2.96 – $49.00 | 45 |
| Urinalysis (with microscopy) CPT 81001 | $721.00 | $68.00 | $3.07 – $68.00 | 45 |
| Urinalysis (without microscopy) CPT 81003 | $385.00 | $61.00 | $2.18 – $61.00 | 45 |
| Urine Culture Test CPT 87086 | $313.00 | $90.00 | $7.82 – $90.00 | 45 |
| Urine pregnancy test CPT 81025 | $42.25 | $65.00 | $8.34 – $65.00 | 45 |
| Ustekinumab 130 mg/26 ml intravenous solution HCPCS J3358 | $6,677.00 | $6,677.00 | $12.24 – $6,677.00 | 111 |
| Ustekinumab 45 mg/0.5 ml subcutaneous solution HCPCS J3357 | $45,913.60 | $45,913.60 | $3,644.10 – $45,913.60 | 103 |
| Vaccine Administration (one shot) CPT 90471 | $95.55 | $147.00 | $12.79 – $139.78 | 111 |
| Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml CPT 91322 | $273.00 | $420.00 | $111.13 – $420.00 | 111 |
| Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml CPT 91321 | $533.00 | $820.00 | $147.06 – $820.00 | 111 |
| Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im CPT 91320 | $98.15 | $151.00 | $39.95 – $168.37 | 111 |
| Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im CPT 91319 | $65.65 | $101.00 | $26.72 – $101.00 | 111 |
| Vaccine covid-19 pfizer tris-sucrose 6mos-4yrs 3mcg/0.3ml im CPT 91318 | $49.40 | $76.00 | $20.11 – $76.00 | 111 |
| Vaccine dtap < 7 years im CPT 90700 | $33.15 | $51.00 | $29.59 – $51.00 | 95 |
| Vaccine dtap-hep b-ipv im CPT 90723 | $95.55 | $147.00 | $29.40 – $147.00 | 103 |
| Vaccine dtap-ipv 4-6 years im CPT 90696 | $54.60 | $84.00 | $54.60 – $84.00 | 95 |
| Vaccine dtap-ipv-hib-hepb im CPT 90697 | $128.70 | $198.00 | $39.60 – $198.00 | 103 |
| Vaccine dtap-ipv/hib im CPT 90698 | $98.15 | $151.00 | $98.15 – $151.00 | 95 |
| Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im CPT 90647 | $37.05 | $57.00 | $30.58 – $57.00 | 95 |
| Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im CPT 90648 | $35.10 | $54.00 | $13.17 – $54.00 | 95 |
| Vaccine hepatitis a (hepa) adult im CPT 90632 | $135.85 | $209.00 | $72.68 – $209.00 | 95 |
| Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im CPT 90636 | $118.95 | $183.00 | $118.95 – $183.00 | 95 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im CPT 90633 | $43.55 | $67.00 | $38.85 – $67.00 | 95 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 3 dose im CPT 90634 | $45.50 | $70.00 | $45.50 – $70.00 | 29 |
| Vaccine hepatitis b (hepb) adolescent 2 dose im CPT 90743 | $54.60 | $84.00 | $22.23 – $84.00 | 111 |
| Vaccine hepatitis b (hepb) adult 3 dose im CPT 90746 | $345.70 | $345.70 | $55.57 – $210.00 | 111 |
| Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im CPT 90739 | $310.70 | $478.00 | $126.48 – $478.00 | 111 |
| Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 | $138.80 | $138.80 | $23.81 – $90.00 | 111 |
| Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im CPT 90651 | $245.05 | $377.00 | $75.40 – $377.00 | 103 |
| Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im CPT 90649 | $215.15 | $331.00 | $66.20 – $331.00 | 37 |
| Vaccine influenza (iiv) preservative free antigen content im CPT 90662 | $142.35 | $219.00 | $57.95 – $219.00 | 111 |
| Vaccine influenza inactivated adjuvant im CPT 90653 | $303.40 | $303.40 | $21.96 – $98.16 | 111 |
| Vaccine influenza nos 0.5ml dose im CPT 90658 | $20.15 | $31.00 | $6.20 – $31.00 | 108 |
| Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im CPT 90656 | $102.45 | $102.45 | $7.94 – $30.00 | 111 |
| Vaccine influenza quadrivalent (iiv4) 0.5ml dose im CPT 90688 | $40.95 | $63.00 | $16.67 – $63.00 | 111 |
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.