MercyOne Oelwein Medical Center
201 8th Ave SE, Oelwein, IA · MercyOne · · NPI 1528009511
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 |
|---|---|---|---|---|
| Abatacept (with maltose) 250 mg intravenous solution HCPCS J0129 | $7,377.95 | $7,377.95 | $1,112.25 – $7,377.95 | 115 |
| Abdominal and Pelvic Blood Vessel Ultrasound (limited) CPT 93976 | $762.45 | $1,173.00 | $448.32 – $1,173.00 | 44 |
| Abdominal CT scan (with and without contrast) CPT 74170 | $1,951.30 | $3,002.00 | $1,147.36 – $3,002.00 | 44 |
| Abdominal CT scan (with contrast) CPT 74160 | $1,591.20 | $2,448.00 | $935.63 – $2,448.00 | 44 |
| Abdominal CT scan (without contrast) CPT 74150 | $1,290.90 | $1,986.00 | $759.05 – $1,986.00 | 44 |
| Abdominal MRI (with and without contrast) CPT 74183 | $3,478.15 | $5,351.00 | $2,045.15 – $5,351.00 | 44 |
| Abdominal MRI (without contrast) CPT 74181 | $2,859.35 | $4,399.00 | $1,681.30 – $4,399.00 | 44 |
| Abdominal Ultrasound (complete) CPT 76700 | $692.90 | $1,066.00 | $407.43 – $1,066.00 | 44 |
| Abdominal Ultrasound (limited) CPT 76705 | $556.40 | $856.00 | $327.16 – $856.00 | 44 |
| Abdominal X-ray (2 views) CPT 74019 | $250.90 | $386.00 | $147.53 – $386.00 | 44 |
| Abdominal X-ray Series (acute, with chest view) CPT 74022 | $327.60 | $504.00 | $192.63 – $504.00 | 44 |
| Abdominal X-ray (single view) CPT 74018 | $163.15 | $251.00 | $95.93 – $251.00 | 44 |
| Acetaminophen 120 mg rectal suppository HCPCS A9270 | $11,990.60 | $2,532.65 | $0.38 – $1,377.00 | 115 |
| Acetazolamide 500 mg solution for injection HCPCS J1120 | $55.20 | $55.20 | $17.23 – $55.20 | 115 |
| Acetone qualitative CPT 82009 | $42.25 | $65.00 | $24.84 – $65.00 | 44 |
| Acetylcysteine 200 mg/ml (20 %) intravenous solution HCPCS J0132 | $121.20 | $121.20 | $22.20 – $121.20 | 115 |
| Aco med nutria tx/group, ea 30 min 97804aco CPT 97804 | $94.90 | $146.00 | $55.80 – $146.00 | 44 |
| Acute hepatitis panel CPT 80074 | $1,110.00 | $487.00 | $9.09 – $487.00 | 44 |
| Acyclovir 400 mg tablet HCPCS J8499 | $1.00 | $1.00 | $0.38 – $1.00 | 44 |
| Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr HCPCS J0133 | $10.40 | $10.40 | $0.90 – $4.20 | 115 |
| Adapter b 8 channel 10cm HCPCS C1883 | $19,860.90 | $30,555.23 | $0.01 – $18.84 | 44 |
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | $695.70 | $695.70 | $2.87 – $7.50 | 44 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $56.45 | $56.45 | $0.22 – $1.00 | 115 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $340.60 | $524.00 | $200.27 – $524.00 | 44 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $543.40 | $836.00 | $319.52 – $836.00 | 44 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $271.05 | $417.00 | $159.38 – $417.00 | 44 |
| Administration immunization each additional component CPT 90461 | $27.95 | $43.00 | $7.52 – $19.68 | 44 |
| Administration immunization each additional vaccine CPT 90472 | $65.00 | $100.00 | $7.52 – $19.68 | 44 |
| Administration immunization first component each vaccine CPT 90460 | $42.25 | $65.00 | $7.52 – $19.68 | 44 |
| Administration immunization intranasal/oral route 1 vaccine CPT 90473 | $46.80 | $72.00 | $7.52 – $19.68 | 44 |
| Administration immunization intranasal/oral route each additional vaccine CPT 90474 | $27.95 | $43.00 | $7.52 – $19.68 | 44 |
| Administration rsv monoclonal ab seasonal dose im w/counseling CPT 96380 | $39.00 | $60.00 | $7.52 – $19.68 | 44 |
| Administration vaccine hepatitis b HCPCS G0010 | $57.20 | $88.00 | $7.52 – $19.68 | 44 |
| Administration vaccine influenza virus HCPCS G0008 | $57.20 | $88.00 | $7.52 – $19.68 | 44 |
| Administration vaccine pneumococcal HCPCS G0009 | $57.20 | $88.00 | $7.52 – $19.68 | 44 |
| Administration vaccine rsv monoclonal ab seasonal dose im CPT 96381 | $27.95 | $43.00 | $7.52 – $19.68 | 44 |
| Ado-trastuzumab emtansine 100 mg intravenous solution HCPCS J9354 | $19,916.25 | $19,916.25 | $4,580.00 – $12,447.70 | 115 |
| Agalsidase beta 35 mg intravenous solution HCPCS J0180 | $18,756.30 | $18,756.30 | $7,168.66 – $18,756.30 | 115 |
| Albumin, human 25 % intravenous solution HCPCS P9046 | $435.50 | $435.50 | $166.45 – $435.50 | 44 |
| Albumin, human 5 % intravenous solution HCPCS P9041 | $332.50 | $332.50 | $76.44 – $200.00 | 44 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $57.20 | $88.00 | $5.90 – $88.00 | 44 |
| Albumin serum plasma or whole blood CPT 82040 | $57.85 | $89.00 | $34.02 – $89.00 | 44 |
| Alcohol (ethanol) any specimen except urine/breath CPT 82077 | $94.90 | $146.00 | $55.80 – $146.00 | 44 |
| Alemtuzumab 12 mg/1.2 ml intravenous solution HCPCS J0202 | $89,232.75 | $89,232.75 | $29,288.40 – $89,232.75 | 115 |
| Alkaline phosphatase CPT 84075 | $1,301.00 | $63.00 | $5.08 – $63.00 | 44 |
| Allergen egg white ige CPT 86003 | $28.60 | $44.00 | $16.82 – $44.00 | 44 |
| Allograft 160mg placental salera mini membrane HCPCS Q4168 | $43.26 | $66.55 | $25.44 – $66.55 | 44 |
| Allograft allowrap 4x4cm dry 16sqcm HCPCS Q4150 | $424.66 | $653.33 | $88.60 – $231.82 | 44 |
| Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet HCPCS Q4100 | $3,961.09 | $6,093.98 | $43.49 – $113.80 | 44 |
| Allograft dermis 20x25x1mm decell w/matracell arthroflex HCPCS Q4125 | $3,663.49 | $5,636.14 | $14.18 – $37.10 | 44 |
| Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm HCPCS Q4128 | $159.49 | $245.37 | $11.03 – $28.85 | 44 |
| Allograft epieffect 2x3cm-q4186-cost per sq cm HCPCS Q4186 | $2,097.63 | $3,227.12 | $24.06 – $62.95 | 44 |
| Allograft graftjacket 2x12cm-q4107-cost per sq cm HCPCS Q4107 | $238.13 | $366.35 | $76.44 – $200.01 | 44 |
| Allograft membrn amnio 1x2cm hu ambriodry HCPCS V2790 | $5,609.82 | $8,630.50 | $295.35 – $772.75 | 44 |
| Allograft umbil cord+amniotic membrane-q4148-cost per sq cm HCPCS Q4148 | $3,283.80 | $5,052.00 | $132.02 – $345.41 | 44 |
| Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm HCPCS Q4187 | $815.54 | $1,254.67 | $230.12 – $602.10 | 44 |
| Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution HCPCS J0256 | $2,450.00 | $2,450.00 | $936.39 – $2,450.00 | 44 |
| Alpha-fetoprotein tumor marker CPT 82105 | $129.35 | $199.00 | $76.06 – $199.00 | 44 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | $25,477.05 | $25,477.05 | $94.15 – $264.05 | 114 |
| Alt/sgpt CPT 84460 | $67.60 | $104.00 | $39.75 – $104.00 | 44 |
| Amikacin 4 mg/ml intravitreal injection - cnr HCPCS J0278 | $5.20 | $5.20 | $1.99 – $5.20 | 44 |
| Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr HCPCS J0281 | $27.50 | $27.50 | $7.50 – $27.50 | 115 |
| Aminophylline 25 mg/ml intravenous solution (wrapper) HCPCS J0280 | $101.15 | $101.15 | $7.01 – $18.35 | 44 |
| Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV HCPCS J0283 | $212.00 | $212.00 | $13.05 – $159.50 | 115 |
| Amiodarone 50 mg/ml intravenous solution HCPCS J0282 | $73.00 | $73.00 | $1.49 – $3.90 | 115 |
| Amivantamab-vmjw 50 mg/ml intravenous solution HCPCS J9061 | $11,933.95 | $11,933.95 | $4,252.50 – $11,933.95 | 115 |
| Ammonia CPT 82140 | $154.70 | $238.00 | $14.42 – $238.00 | 44 |
| Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J0285 | $8.75 | $8.75 | $3.34 – $34.12 | 115 |
| Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J0289 | $562.35 | $562.35 | $214.93 – $562.35 | 44 |
| Ampicillin 1 gram solution for injection HCPCS J0290 | $38.85 | $38.85 | $0.98 – $5.90 | 115 |
| Ampicillin-sulbactam 1.5 gram solution for injection HCPCS J0295 | $590.00 | $590.00 | $1.49 – $6.35 | 115 |
| Amylase CPT 82150 | $71.50 | $110.00 | $42.04 – $110.00 | 44 |
| Analgesics non-opioid definitive assay 1 or 2 acetaminophen CPT 80329 | $154.05 | $237.00 | $90.58 – $237.00 | 44 |
| Analysis gene f2 20210g>a variant CPT 81240 | $110.50 | $170.00 | $64.97 – $170.00 | 44 |
| Analysis gene f5 leiden variant CPT 81241 | $379.60 | $584.00 | $223.20 – $584.00 | 44 |
| Anchor suture 3.5mm pushlock HCPCS C1741 | $2,155.00 | $3,315.38 | $643.58 – $1,683.89 | 44 |
| Ankle X-ray CPT 73610 | $407.55 | $627.00 | $159.76 – $418.00 | 44 |
| Ankle X-ray (2 views, both ankles) CPT 73600 | $356.20 | $548.00 | $139.50 – $365.00 | 44 |
| Antibody elution rbc reference CPT 86860 | $85.80 | $132.00 | $50.45 – $132.00 | 28 |
| Antibody identification platelet antibodies heparin-pf4 igg CPT 86022 | $257.40 | $396.00 | $151.35 – $396.00 | 44 |
| Antibody id rbc panel CPT 86870 | $291.85 | $449.00 | $171.61 – $449.00 | 43 |
| Antibody screen rbc CPT 86850 | $85.80 | $132.00 | $50.45 – $132.00 | 44 |
| Anticoag mgmt pt warfarin CPT 93793 | $25.35 | $39.00 | $14.91 – $39.00 | 44 |
| Antihemophilic factor-vwf 250 unit-600 unit intravenous solution HCPCS J7187 | $5,144.60 | $5,144.60 | $894.00 – $2,670.45 | 115 |
| Antineutrophil cytoplasmic antibody screen each antibody CPT 86036 | $147.55 | $227.00 | $86.76 – $227.00 | 44 |
| Antinuclear antibodies CPT 86038 | $105.95 | $163.00 | $62.30 – $163.00 | 44 |
| Antinuclear antibodies titer CPT 86039 | $85.80 | $132.00 | $50.45 – $132.00 | 44 |
| Antistreptolysin o screen CPT 86063 | $48.75 | $75.00 | $28.67 – $75.00 | 44 |
| Antithrombin iii activity CPT 85300 | $135.20 | $208.00 | $79.50 – $208.00 | 44 |
| Anti-thymocyte glob (equine)(1:1000) intradermal test dose HCPCS J7504 | $14,664.50 | $14,664.50 | $5,013.11 – $14,664.50 | 115 |
| Aortic Aneurysm Screening Ultrasound CPT 76706 | $393.90 | $606.00 | $231.61 – $606.00 | 44 |
| Application lower leg splint 29515 CPT 29515 | $222.00 | $222.00 | $13.39 – $111.00 | 768 |
| Applicator tag rfid localizer 12gx7cm HCPCS C1819 | $2,783.02 | $4,281.57 | $1.01 – $2.64 | 44 |
| Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion HCPCS J0185 | $1,185.25 | $1,185.25 | $235.41 – $1,185.25 | 115 |
| Arm CT Scan (without contrast, both arms) CPT 73200 | $1,701.70 | $2,618.00 | $666.94 – $1,745.00 | 44 |
| Arm or Leg Ultrasound (limited, left side) CPT 76882 | $514.15 | $791.00 | $58.20 – $791.00 | 44 |
| Arsenic trioxide 2 mg/ml intravenous solution HCPCS J9017 | $2,478.30 | $2,478.30 | $76.92 – $2,478.30 | 115 |
| Ascenda two piece catheter HCPCS C1772 | $15,324.40 | $23,576.00 | $33.04 – $86.44 | 44 |
| Assay of prostaglandin CPT 84150 | $162.50 | $250.00 | $95.55 – $250.00 | 44 |
| Assessment leukocyte fecal qualitative/semiquantitative CPT 89055 | $43.55 | $67.00 | $4.18 – $67.00 | 44 |
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.