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 |
|---|---|---|---|---|
| Graft axiofill 1000mg HCPCS J3590 | $6,300.79 | $9,693.53 | $1,052.06 – $1,618.56 | 29 |
| Graft bone flex 2.5cm x 5cm grafton-cost per sq cm HCPCS Q4205 | $1.41 | $2.17 | $1.41 – $2.17 | 29 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | $1,885.86 | $2,901.33 | $19.26 – $96.28 | 37 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $4,970.86 | $7,647.47 | $0.09 – $0.46 | 37 |
| Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm HCPCS Q4113 | $1,548.87 | $2,382.88 | $1,548.87 – $2,382.88 | 29 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $16,761.06 | $25,786.25 | $0.28 – $0.43 | 29 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $35,755.20 | $55,008.00 | $0.01 – $0.01 | 29 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | $304.44 | $468.37 | $0.31 – $1.56 | 37 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $397.96 | $612.24 | $47.74 – $238.70 | 37 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $414.05 | $637.00 | $61.18 – $305.89 | 37 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | $476.79 | $733.52 | $16.28 – $81.42 | 37 |
| Graft tis hmatrix dermis 10x5 -cost per sq cm HCPCS Q4134 | $58.05 | $89.31 | $58.05 – $89.31 | 29 |
| Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm HCPCS Q4130 | $1,705.66 | $2,624.09 | $0.03 – $0.05 | 29 |
| Graft viashield 2layer amnion patch 2x2cm-cost per sq cm HCPCS Q4211 | $593.61 | $913.25 | $70.00 – $350.01 | 37 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | $312.02 | $480.03 | $40.37 – $62.10 | 29 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $25,506.74 | $39,241.14 | $2.76 – $4.24 | 29 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $17,074.23 | $26,268.04 | $71.08 – $109.36 | 29 |
| Guide endoanchr sg-64 aaa 62cm HCPCS L8670 | $2,547.89 | $3,919.83 | $2,529.31 – $3,891.24 | 29 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $4,580.54 | $7,046.99 | $0.01 – $0.01 | 29 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $747.95 | $1,150.70 | $0.01 – $0.01 | 29 |
| Gw stiffened micro access kit HCPCS C1894 | $9,830.88 | $15,124.43 | $0.01 – $0.01 | 29 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $3.65 | $3.65 | $2.37 – $3.65 | 29 |
| Handpiece aquabeam hp2000 HCPCS C2596 | $14,876.30 | $22,886.61 | $4,803.31 – $7,389.71 | 29 |
| Hands-On Manual Therapy (each 15 minutes) CPT 97140 | $128.70 | $198.00 | $23.75 – $198.00 | 45 |
| Hand X-ray CPT 73130 | $313.00 | $470.00 | $82.37 – $313.00 | 111 |
| Hand X-ray (2 views, both hands) CPT 73120 | $235.95 | $363.00 | $98.96 – $242.00 | 111 |
| Haptoglobin quantitative CPT 83010 | $126.10 | $194.00 | $12.19 – $194.00 | 45 |
| Hcg qualitative CPT 84703 | $85.15 | $131.00 | $7.28 – $131.00 | 45 |
| Hcg quantitative CPT 84702 | $109.20 | $168.00 | $14.59 – $168.00 | 45 |
| Hc nm kidney imaging with flow CPT 78701 | $783.90 | $1,206.00 | $378.41 – $1,206.00 | 111 |
| Head CT scan (with and without contrast) CPT 70470 | $1,747.20 | $2,688.00 | $166.03 – $2,688.00 | 111 |
| Head CT scan (with contrast) CPT 70460 | $1,509.30 | $2,322.00 | $166.03 – $2,322.00 | 111 |
| Head CT scan (without contrast) CPT 70450 | $2,105.00 | $2,105.00 | $98.96 – $2,105.00 | 111 |
| Heel (Calcaneus) X-ray (both feet) CPT 73650 | $274.95 | $423.00 | $82.37 – $282.00 | 111 |
| Helicobacter pylori antibody igm CPT 86677 | $79.95 | $123.00 | $16.33 – $123.00 | 45 |
| Hematocrit CPT 85014 | $603.00 | $47.00 | $2.30 – $88.91 | 111 |
| Hemin 350 mg intravenous powder for solution HCPCS J1640 | $34,281.50 | $34,281.50 | $34.60 – $34,281.50 | 108 |
| Hemoglobin CPT 85018 | $603.00 | $39.00 | $2.30 – $88.91 | 111 |
| Hemoglobin fetal qualitative CPT 83033 | $128.70 | $198.00 | $112.86 – $198.00 | 29 |
| Hemoglobin methemoglobin quantitative CPT 83050 | $74.75 | $115.00 | $7.95 – $115.00 | 31 |
| Hemoglobin plasma CPT 83051 | $83.85 | $129.00 | $7.08 – $129.00 | 45 |
| Heparin assay CPT 85520 | $53.95 | $83.00 | $12.69 – $83.00 | 45 |
| Heparin bolus from bag HCPCS J1644 | $45.00 | $45.00 | $2.20 – $7.60 | 95 |
| Heparin neutralization CPT 85525 | $47.45 | $73.00 | $11.48 – $73.00 | 45 |
| Heparin, porcine (pf) 10 unit/ml flush (wrapper) HCPCS J1642 | $3.00 | $3.00 | $1.95 – $3.00 | 29 |
| Hepatitis a antibody igm CPT 86709 | $100.10 | $154.00 | $10.91 – $154.00 | 45 |
| Hepatitis b core antibody igm CPT 86705 | $118.95 | $183.00 | $11.40 – $183.00 | 45 |
| Hepatitis b core antibody total CPT 86704 | $96.20 | $148.00 | $11.68 – $148.00 | 45 |
| Hepatitis b surface antibody CPT 86706 | $107.90 | $166.00 | $10.40 – $166.00 | 45 |
| Hepatitis c antibody CPT 86803 | $126.75 | $195.00 | $13.83 – $195.00 | 45 |
| Hernia Repair (Inguinal) CPT 49505 | $23,230.87 | not published | $0.96 – $6,951.03 | 83 |
| Herpes simplex type 1 antibody igg CPT 86695 | $85.80 | $132.00 | $12.78 – $132.00 | 31 |
| Herpes simplex type 2 antibody igg CPT 86696 | $57.85 | $89.00 | $18.75 – $89.00 | 31 |
| Heterophile antibodies screening CPT 86308 | $52.00 | $80.00 | $5.02 – $80.00 | 45 |
| Hip and Pelvis X-ray (2 views, both hips) CPT 73521 | $312.65 | $481.00 | $98.96 – $481.00 | 111 |
| Hip and Pelvis X-ray (3 to 4 views, both hips) CPT 73522 | $306.80 | $472.00 | $98.96 – $472.00 | 111 |
| Hip and Pelvis X-ray (single view, left side) CPT 73501 | $187.20 | $288.00 | $82.37 – $288.00 | 111 |
| Hip X-ray CPT 73502 | $222.30 | $342.00 | $82.37 – $342.00 | 111 |
| Hla class i high defin qual CPT 86832 | $631.15 | $971.00 | $313.71 – $971.00 | 45 |
| Hla class ii high defin qual CPT 86833 | $635.70 | $978.00 | $315.70 – $978.00 | 45 |
| Hldr trach tb tie ad HCPCS A7526 | $1,057.54 | $1,626.99 | $0.38 – $0.59 | 29 |
| Holder tube cath-secure nonstrl lf disp HCPCS A4333 | $0.78 | $1.20 | $0.78 – $1.20 | 29 |
| Home sleep test/type 3 porta HCPCS G0399 | $447.20 | $688.00 | $204.38 – $688.00 | 108 |
| Homocysteine CPT 83090 | $181.35 | $279.00 | $17.36 – $279.00 | 45 |
| Homogenization tissue CPT 87176 | $29.90 | $46.00 | $5.70 – $46.00 | 45 |
| Human prothrombin complex concentrate (pcc)-lans 500 unit (400-640 unit) IV solution HCPCS J7165 | $1,829.90 | $1,829.90 | $1.67 – $1,829.90 | 108 |
| Hyaluronidase 150 unit/ml injection solution HCPCS J3470 | $154.70 | $154.70 | $31.55 – $154.70 | 95 |
| Hyaluronidase, human recombinant 150 unit/ml injection solution HCPCS J3473 | $236.10 | $236.10 | $54.00 – $236.10 | 95 |
| Hydralazine 20 mg/ml injection solution HCPCS J0360 | $64.40 | $64.40 | $5.19 – $64.40 | 95 |
| Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J1720 | $243.25 | $243.25 | $21.20 – $44.00 | 95 |
| Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper) HCPCS J1171 | $185.75 | $185.75 | $1.80 – $3.65 | 95 |
| Hydroxyzine hcl 50 mg/ml intramuscular solution HCPCS J3410 | $105.00 | $105.00 | $68.25 – $105.00 | 29 |
| Hydroxyzine pamoate 25 mg capsule HCPCS Q0177 | $1.00 | $1.00 | $0.10 – $1.00 | 95 |
| Hzv zoster vacc recombinant adjuvanted im inj CPT 90750 | $169.00 | $260.00 | $52.00 – $260.00 | 103 |
| I-123 iobenguane diag HCPCS A9582 | $24,445.60 | $24,445.60 | $17.29 – $24,445.60 | 111 |
| I-123 ioflupane diag HCPCS A9584 | $12,340.00 | $12,340.00 | $1,359.99 – $12,340.00 | 108 |
| I-123 sod iodide diag per 100 uci HCPCS A9516 | $412.50 | $412.50 | $260.81 – $401.25 | 29 |
| I-131 iobenguane sulf diag mibg HCPCS A9508 | $6,709.35 | $6,709.35 | $4,361.08 – $6,709.35 | 29 |
| I-131 sod iodide sol diag per mci HCPCS A9529 | $417.75 | $417.75 | $271.54 – $417.75 | 29 |
| Ibandronate 3 mg/3 ml intravenous syringe HCPCS J1740 | $1,149.75 | $1,149.75 | $92.40 – $1,149.75 | 95 |
| Icd cobalt xt dr MRI is1 df1 HCPCS C1721 | $20,112.30 | $30,942.00 | $0.01 – $0.01 | 29 |
| Icd crtd cobalt hf MRI is1 df1 HCPCS C1882 | $27,933.75 | $42,975.00 | $105.80 – $162.77 | 29 |
| Icd crtp serena MRI HCPCS C2621 | $9,235.69 | $14,208.75 | $1,937.75 – $2,981.16 | 29 |
| Icd reliance df4 ib 64cm HCPCS C1895 | $4,621.95 | $7,110.69 | $59.14 – $90.99 | 29 |
| Ifosfamide 1 gram intravenous solution HCPCS J9208 | $494.70 | $494.70 | $25.71 – $169.00 | 95 |
| Igh@ var region somatic mutation analy CPT 81263 | $301.60 | $464.00 | $264.48 – $591.99 | 42 |
| Ihc/icc per specimen each additional single antibody stain CPT 88341 | $14,884.70 | $204.00 | $86.77 – $1,805.43 | 111 |
| Ihc/icc per specimen each multiplex antibody stain CPT 88344 | $378.95 | $583.00 | $332.31 – $695.89 | 111 |
| Ihc/icc per specimen initial single antibody stain CPT 88342 | $11,096.40 | $354.00 | $69.55 – $354.00 | 111 |
| Imetelstat 188 mg intravenous solution HCPCS J0870 | $31,931.40 | $31,931.40 | $57.14 – $7,982.85 | 108 |
| Immob elbow child sm HCPCS L3762 | $29.02 | $44.65 | $0.75 – $3.75 | 37 |
| Immobilizer lwr extrem nylon 20in reinforc 21-35in HCPCS L2999 | $525.01 | $807.71 | $55.64 – $85.60 | 29 |
| Immobilizer shldr cntor adlt HCPCS L3670 | $171.43 | $263.74 | $0.49 – $2.44 | 37 |
| Immobilizer shldr dlx str 24-36in med HCPCS L1830 | $136.42 | $209.88 | $0.85 – $4.02 | 37 |
| Immobilizer shldr sling med HCPCS L3660 | $34.03 | $52.36 | $34.03 – $52.36 | 29 |
| Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution HCPCS J1569 | $10,106.10 | $10,106.10 | $46.34 – $1,684.35 | 111 |
| Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution HCPCS J1566 | $4,576.15 | $4,576.15 | $77.31 – $4,576.15 | 111 |
| Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution HCPCS J1568 | $6,381.00 | $6,381.00 | $46.44 – $1,063.50 | 111 |
| Immunoassay tumor antigen quantitative ca 125 CPT 86304 | $131.95 | $203.00 | $20.17 – $203.00 | 45 |
| Immunoassay tumor antigen quantitative ca 19-9 CPT 86301 | $104.65 | $161.00 | $20.17 – $161.00 | 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.