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 |
|---|---|---|---|---|
| Fetal hemoglobin (kleihauer betke) CPT 85460 | $48.75 | $75.00 | $7.49 – $75.00 | 45 |
| Fetal hemoglobin rosette CPT 85461 | $81.90 | $126.00 | $9.07 – $126.00 | 45 |
| Fetal non stress test CPT 59025 | $336.70 | $518.00 | $191.37 – $518.00 | 111 |
| Fibrin degradation d dimer quantitative CPT 85379 | $145.60 | $224.00 | $9.86 – $125.00 | 45 |
| Fibrinogen activity CPT 85384 | $67.60 | $104.00 | $9.41 – $104.00 | 45 |
| Fibrinolysins/coagulopathy screen interpretation/report CPT 85390 | $222.30 | $342.00 | $15.00 – $342.00 | 45 |
| Filgrastim-aafi 300 mcg/0.5 ml subcutaneous syringe HCPCS Q5110 | $1,611.50 | $1,611.50 | $0.27 – $1,007.20 | 111 |
| Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr HCPCS J1442 | $1,447.95 | $1,447.95 | $0.98 – $1,447.95 | 111 |
| Filgrastim-sndz 300 mcg/0.5 ml injection syringe HCPCS Q5101 | $2,018.90 | $2,018.90 | $0.34 – $1,261.80 | 111 |
| Filter spider fx 3mmx320cm HCPCS C1884 | $17,509.15 | $26,937.16 | $1,737.00 – $2,672.31 | 29 |
| Filter vena cava fem denali HCPCS C1880 | $23,327.77 | $35,888.87 | $235.95 – $363.00 | 29 |
| Finger joint sz00 swanson w/grommets HCPCS L8630 | $2,105.74 | $3,239.60 | $575.35 – $885.15 | 29 |
| Finger X-ray (both hands) CPT 73140 | $282.75 | $435.00 | $82.37 – $290.00 | 111 |
| Flow cytometry marker each additional CPT 88185 | $85.15 | $131.00 | $74.67 – $131.00 | 29 |
| Flow cytometry one marker technical component CPT 88184 | $248.95 | $383.00 | $218.31 – $695.89 | 111 |
| Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback HCPCS J1450 | $74.00 | $74.00 | $12.03 – $18.50 | 29 |
| Fludarabine 50 mg intravenous solution HCPCS J9185 | $434.65 | $434.65 | $78.41 – $434.65 | 95 |
| Fluorescent antibody titer dna CPT 86256 | $79.95 | $123.00 | $11.81 – $123.00 | 45 |
| Fluoroguide for spine inject 77003-26 CPT 77003 | $8,329.15 | $618.00 | $0.96 – $1,717.13 | 111 |
| Fluoroguide needle placement CPT 77002 | $5,709.33 | $766.00 | $17.25 – $766.00 | 781 |
| Fluoroscopy (Live X-ray Guidance, up to 1 hour) CPT 76000 | $24,225.64 | $693.00 | $0.96 – $693.00 | 111 |
| Fluorouracil 50 mg/ml intravenous solution (wrapper) HCPCS J9190 | $24.90 | $24.90 | $3.76 – $24.90 | 95 |
| Folic acid CPT 82746 | $94.25 | $145.00 | $14.25 – $145.00 | 45 |
| Folic acid 5 mg/ml injection solution HCPCS J1808 | $161.00 | $161.00 | $30.00 – $161.00 | 95 |
| Fomepizole 1 gram/ml intravenous solution HCPCS J1451 | $6,898.50 | $6,898.50 | $1,243.00 – $6,898.50 | 95 |
| Foot drp splt w/exp heel lg HCPCS L4398 | $275.11 | $423.24 | $15.45 – $77.24 | 37 |
| Foot X-ray CPT 73630 | $339.30 | $522.00 | $82.37 – $348.00 | 111 |
| Foot X-ray (2 views, both feet) CPT 73620 | $270.40 | $416.00 | $82.37 – $277.00 | 111 |
| Forearm X-ray (both sides) CPT 73090 | $358.00 | $537.00 | $82.37 – $358.00 | 111 |
| Fosaprepitant 150 mg intravenous powder for solution HCPCS J1453 | $378.00 | $378.00 | $16.50 – $115.00 | 95 |
| Fosphenytoin 50 mg pe/ml injection (wrapper) HCPCS Q2009 | $54.75 | $54.75 | $1.31 – $54.75 | 108 |
| Fresh frozen plasma 8-24 hours collection each unit HCPCS P9059 | $337.35 | $519.00 | $72.29 – $519.00 | 111 |
| Fresh frozen plasma frozen within 8 hours of collection each unit HCPCS P9017 | $144.95 | $223.00 | $84.26 – $223.00 | 111 |
| Fresh frozen plasma thawing ea un CPT 86927 | $53.30 | $82.00 | $46.74 – $82.00 | 29 |
| Fructosamine glycated protein CPT 82985 | $69.55 | $107.00 | $16.24 – $107.00 | 45 |
| Full Spine X-ray (Scoliosis Survey) CPT 72082 | $230.10 | $354.00 | $98.96 – $354.00 | 111 |
| Furosemide 10 mg/ml injection solution HCPCS J1938 | $8.30 | $8.30 | $0.80 – $8.30 | 95 |
| Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr HCPCS J1940 | $48.25 | $48.25 | $1.35 – $6.75 | 37 |
| Fusion of big toe joint CPT 28750 | $29,270.20 | not published | $0.96 – $14,087.30 | 83 |
| Ga-67 gallium 0.1 mci HCPCS A9556 | $253.10 | $253.10 | $164.52 – $253.10 | 29 |
| Ga-68 gallium 68 dotatate HCPCS A9587 | $15,600.00 | $15,600.00 | $48.64 – $15,600.00 | 108 |
| Gadobutrol 1 mmol/ml intravenous solution (wrapper) HCPCS A9585 | $591.40 | $591.40 | $19.76 – $591.40 | 29 |
| Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper) HCPCS A9579 | $231.00 | $231.00 | $7.35 – $231.00 | 29 |
| Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution HCPCS A9575 | $99.80 | $99.80 | $24.00 – $99.80 | 29 |
| Gallbladder and Bile Duct Scan (HIDA Scan) CPT 78226 | $1,046.50 | $1,610.00 | $378.41 – $1,610.00 | 111 |
| Gallbladder Function Scan (HIDA with Medication) CPT 78227 | $1,440.40 | $2,216.00 | $513.95 – $2,216.00 | 111 |
| Gallbladder Removal (Laparoscopic) CPT 47562 | $18,286.06 | not published | $0.96 – $11,736.86 | 83 |
| Gammaglobulin iga CPT 82784 | $81.90 | $126.00 | $9.02 – $126.00 | 45 |
| Gammaglobulin ige CPT 82785 | $83.85 | $129.00 | $15.95 – $129.00 | 45 |
| Gamma glutamyltransferase CPT 82977 | $60.45 | $93.00 | $6.98 – $93.00 | 45 |
| Gamunex-c/gammaked HCPCS J1561 | $14,238.00 | $14,238.00 | $48.09 – $1,779.75 | 111 |
| Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr HCPCS J1570 | $138.00 | $138.00 | $39.62 – $82.80 | 95 |
| Gemcitabine 1 gram intravenous solution HCPCS J9201 | $540.20 | $540.20 | $16.20 – $50.15 | 95 |
| Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln HCPCS J9203 | $31,504.65 | $31,504.65 | $11,652.30 – $31,504.65 | 95 |
| General health panel CPT 80050 | $263.25 | $405.00 | $52.41 – $405.00 | 37 |
| Generator barostim neo2 2014 HCPCS C1767 | $44,831.44 | $68,971.44 | $2.18 – $3.36 | 29 |
| Generator emblem MRI sicd subq HCPCS C1722 | $22,347.00 | $34,380.00 | $489.50 – $753.08 | 29 |
| Generator stim baroreceptor neo legacy implant pulse HCPCS C1825 | $37,570.90 | $57,801.38 | $29,051.10 – $44,694.00 | 29 |
| Gentamicin 10 mg/ml liquid compound - enteral use only HCPCS J1580 | $17.40 | $17.40 | $2.83 – $4.35 | 29 |
| Gentamicin peak therapeutic drug level CPT 80170 | $97.50 | $150.00 | $15.87 – $150.00 | 45 |
| G-esoph reflx tst w/electrod CPT 91035 | $1,103.70 | $1,698.00 | $812.85 – $1,698.00 | 111 |
| Ghs block ilioinguinal/gentitofemoral CPT 64425 | $1,407.25 | $2,165.00 | $668.16 – $1,443.00 | 111 |
| Ghs chemo >8 hrs CPT 96416 | $471.25 | $725.00 | $312.65 – $725.00 | 111 |
| Ghs chemo IV push, ea addtl CPT 96411 | $312.65 | $481.00 | $68.15 – $481.00 | 111 |
| Ghs fish cytogen CPT 88271 | $135.85 | $209.00 | $20.76 – $209.00 | 45 |
| Ghs histoplasma antigen CPT 87385 | $208.65 | $321.00 | $12.84 – $321.00 | 45 |
| Ghs HIV antibody CPT 86703 | $64.35 | $99.00 | $13.28 – $99.00 | 45 |
| Ghs inj transforaminal cerv single bil CPT 64479 | $2,252.25 | $3,465.00 | $837.21 – $2,310.00 | 111 |
| Ghs layer closure 2.6 - 7.5 cm - 12042 CPT 12042 | $11,181.60 | $646.00 | $0.36 – $3,206.43 | 769 |
| Ghs layer closure 7.6 - 12.5 cm - 12034 CPT 12034 | $13,669.23 | not published | $0.96 – $3,206.43 | 83 |
| Ghs myocardial strain img spckl track CPT 93356 | $123.00 | $123.00 | $6.39 – $70.00 | 780 |
| Ghs nailbed repair/nail removal CPT 11760 | $490.00 | $459.00 | $30.19 – $348.44 | 768 |
| Ghs nerve blk intercostal, ea addtl level CPT 64421 | $1,502.80 | $2,312.00 | $837.21 – $1,717.13 | 111 |
| Ghs nerve blk intercostal, single level CPT 64420 | $2,237.95 | $3,443.00 | $668.16 – $2,295.00 | 111 |
| Ghs nerve block axillary nerve CPT 64417 | $236.50 | $200.00 | $19.60 – $200.00 | 768 |
| Ghs nerve block brachial plexus CPT 64415 | $221.00 | $221.00 | $21.20 – $221.00 | 768 |
| Ghs nerve block celiac plexus CPT 64530 | $2,224.95 | $3,423.00 | $837.21 – $3,423.00 | 111 |
| Ghs nerve block lumbar or thoracic symp CPT 64520 | $1,762.80 | $2,712.00 | $837.21 – $1,808.00 | 111 |
| Ghs nerve block sciatic nerve CPT 64445 | $34,203.50 | $229.00 | $1.92 – $14,087.30 | 769 |
| Ghs ot prosthetic training/15 min CPT 97761 | $68.90 | $106.00 | $24.86 – $106.00 | 45 |
| Ghs ot sensory integrative tech/15min CPT 97533 | $62.40 | $96.00 | $23.21 – $114.77 | 45 |
| Ghs paravert facet/nerve lumb ea add bil CPT 64495 | $4,078.75 | $6,275.00 | $2,718.95 – $4,183.00 | 29 |
| Ghs sp train/fitting sp device - kx CPT 92609 | $185.25 | $285.00 | $49.33 – $285.00 | 45 |
| Ghs st - re-eval for alt comm CPT 92597 | $213.85 | $329.00 | $67.21 – $329.00 | 45 |
| Gi trc img intral colon i&r CPT 91113 | $1,378.00 | $2,120.00 | $880.26 – $2,120.00 | 111 |
| Glassia injection HCPCS J0257 | $2,200.00 | $2,200.00 | $5.58 – $2,200.00 | 111 |
| Glove finger flexion right lg xl HCPCS L3912 | $53.03 | $81.59 | $38.01 – $58.47 | 29 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $655.40 | $655.40 | $177.28 – $655.40 | 32 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | $567.40 | $567.40 | $228.98 – $567.40 | 32 |
| Glucose 1 hr post dose CPT 82950 | $41.60 | $64.00 | $4.60 – $64.00 | 45 |
| Glucose blood quantitative CPT 82947 | $355.00 | $56.00 | $3.80 – $56.00 | 45 |
| Glucose body fluid CPT 82945 | $45.50 | $70.00 | $3.80 – $70.00 | 45 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $92.30 | $142.00 | $12.47 – $142.00 | 45 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $53.95 | $83.00 | $3.79 – $83.00 | 45 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | $10,644.80 | $20.60 | $0.36 – $1,805.43 | 111 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $5,516.60 | $5,516.60 | $11.40 – $5,516.60 | 111 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $133.25 | $205.00 | $18.00 – $205.00 | 45 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $135.20 | $208.00 | $17.94 – $208.00 | 45 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | $16,064.55 | $16,064.55 | $761.95 – $5,895.10 | 108 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $93.34 | $143.60 | $28.72 – $143.60 | 37 |
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.