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 |
|---|---|---|---|---|
| Phenytoin total therapeutic drug level CPT 80185 | $100.10 | $154.00 | $58.86 – $154.00 | 44 |
| Phlebotomy therapeutic CPT 99195 | $306.80 | $472.00 | $180.40 – $472.00 | 44 |
| Phosphorus CPT 84100 | $52.00 | $80.00 | $30.58 – $80.00 | 44 |
| Physical Therapy Evaluation (low complexity) CPT 97161 | $222.95 | $343.00 | $131.09 – $343.00 | 44 |
| Physical Therapy Evaluation (moderate complexity) CPT 97162 | $194.35 | $299.00 | $114.28 – $299.00 | 44 |
| Physical Therapy Re-Evaluation CPT 97164 | $162.50 | $250.00 | $95.55 – $250.00 | 44 |
| Phytonadione (vitamin k1) 10 mg/ml injection solution HCPCS J3430 | $24.85 | $24.85 | $2.84 – $19.80 | 115 |
| Pillow shldr abduc inflat univ HCPCS L3960 | $781.90 | $1,202.93 | $71.23 – $186.36 | 44 |
| Pin caspar distraction 12mm HCPCS C1821 | $24,304.88 | $37,392.12 | $0.01 – $0.54 | 44 |
| Pinworm exam CPT 87172 | $33.80 | $52.00 | $4.18 – $52.00 | 44 |
| Piperacillin-tazobactam 3.375 gram intravenous solution HCPCS J2543 | $89.80 | $89.80 | $2.22 – $10.15 | 115 |
| Plasma cryoprecipitate reduced each unit HCPCS P9044 | $247.65 | $381.00 | $145.62 – $381.00 | 44 |
| Platelet aggregation each agent teg CPT 85576 | $134.55 | $207.00 | $79.12 – $207.00 | 44 |
| Platelet automated CPT 85049 | $32.50 | $50.00 | $4.39 – $50.00 | 44 |
| Platelets hla matched leukocytes reduced apheresis/pheresis each unit HCPCS P9052 | $1,504.10 | $2,314.00 | $884.41 – $2,314.00 | 44 |
| Platelets leukocytes reduced each unit HCPCS P9031 | $245.05 | $377.00 | $144.09 – $377.00 | 44 |
| Platelets leukocytes reduced irradiated each unit HCPCS P9033 | $397.15 | $611.00 | $233.52 – $611.00 | 44 |
| Platelets leukoreduced cmv negative apheresis/phresis each unit HCPCS P9055 | $1,001.00 | $1,540.00 | $588.59 – $1,540.00 | 44 |
| Platelets pheresis leukocytes reduced cmv negative irradiated each unit HCPCS P9053 | $1,170.65 | $1,801.00 | $688.34 – $1,801.00 | 44 |
| Platelets pheresis leukocytes reduced each unit HCPCS P9035 | $953.55 | $1,467.00 | $560.69 – $1,467.00 | 44 |
| Platelets pheresis leukocytes reduced irradiated each unit HCPCS P9037 | $1,231.75 | $1,895.00 | $724.27 – $1,895.00 | 44 |
| Platelets pheresis pathogen-reduced each unit HCPCS P9073 | $1,053.00 | $1,620.00 | $619.16 – $1,620.00 | 44 |
| Plug insert indwelling 16f HCPCS L8511 | $153.33 | $235.90 | $90.16 – $235.90 | 44 |
| Polatuzumab vedotin-piiq 140 mg intravenous solution HCPCS J9309 | $59,184.30 | $59,184.30 | $4,472.40 – $12,682.40 | 115 |
| Positioner proc acufex leg acs HCPCS E0190 | $197.14 | $303.30 | $115.92 – $303.30 | 44 |
| Potassium 24 hour urine CPT 84133 | $53.95 | $83.00 | $4.64 – $83.00 | 44 |
| Potassium chloride 10 meq/100ml in sterile water intravenous piggyback HCPCS J3480 | $60.00 | $60.00 | $0.17 – $3.00 | 115 |
| Potassium serum/plasma/whole blood CPT 84132 | $112.00 | $67.00 | $9.09 – $67.00 | 44 |
| Pouch high output 2pc 50mm red HCPCS A4413 | $282.29 | $434.29 | $168.33 – $434.29 | 34 |
| Pouch ostmy flat lk n 2.5in roll premier 1pc trnsp HCPCS A4388 | $0.28 | $0.43 | $0.16 – $0.43 | 44 |
| Pouch ostmy nb pouchkin ctf HCPCS A5062 | $0.38 | $0.59 | $0.18 – $0.47 | 44 |
| Pouch uros new (both sides) 2.75in clr HCPCS A4432 | $51.37 | $79.03 | $0.19 – $0.49 | 34 |
| Powder prem protct 1oz HCPCS A4371 | $0.45 | $0.70 | $0.27 – $0.70 | 44 |
| Pr application of long arm splint CPT 29105 | $278.85 | $429.00 | $12.04 – $286.00 | 781 |
| Pr application splint static short arm CPT 29125 | $325.00 | $500.00 | $10.08 – $333.00 | 781 |
| Pr discharge day management hospital ip/obs <=30 min on ecounter date CPT 99238 | $174.00 | $240.00 | $47.71 – $240.00 | 781 |
| Pr discharge day management hospital ip/obs > 30 min on encounter date CPT 99239 | $256.00 | $256.00 | $67.95 – $256.00 | 781 |
| Prealbumin CPT 84134 | $73.45 | $113.00 | $14.30 – $113.00 | 44 |
| Pr ecg 12 lead report only CPT 93010 | $26.00 | $26.00 | $2.67 – $17.00 | 768 |
| Pr ecg external < 48 hours continuous recording/storage r&i by a phys/qhp CPT 93227 | $83.00 | $83.00 | $11.29 – $65.47 | 768 |
| Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution HCPCS J7510 | $5.90 | $5.90 | $0.81 – $4.40 | 115 |
| Prednisone 1 mg tablet HCPCS J7512 | $1.00 | $1.00 | $0.38 – $1.00 | 44 |
| Pregnancy Ultrasound (limited) CPT 76815 | $632.45 | $973.00 | $371.88 – $973.00 | 44 |
| Pretreatment serum by diff red cell adsorption patient rbc/known phenotype each adsorption ref CPT 86977 | $129.35 | $199.00 | $76.06 – $199.00 | 28 |
| Pretreat rbc absorption reference CPT 86978 | $118.95 | $183.00 | $70.93 – $183.00 | 34 |
| Pretreat rbc density gradient separation reference CPT 86972 | $75.40 | $116.00 | $44.34 – $116.00 | 44 |
| Pretreat rbc w chem/drugs reference CPT 86970 | $88.40 | $136.00 | $51.98 – $136.00 | 28 |
| Pr hospital ip/obs care initial high level per day CPT 99223 | $483.00 | $536.00 | $99.68 – $536.00 | 781 |
| Pr hospital ip/obs care initial moderate level per day CPT 99222 | $328.00 | $402.00 | $74.55 – $402.00 | 781 |
| Pr hospital ip/obs care initial straightforward or low level per day CPT 99221 | $241.00 | $277.00 | $47.50 – $277.00 | 781 |
| Pr hospital ip/obs care subsequent high level per day CPT 99233 | $209.95 | $323.00 | $116.73 – $323.00 | 44 |
| Pr hospital ip/obs care subsequent moderate level per day CPT 99232 | $173.00 | $239.00 | $44.94 – $239.00 | 781 |
| Pr hospital ip/obs care subsequent straightforward or low level per day CPT 99231 | $106.00 | $115.00 | $28.12 – $115.00 | 781 |
| Pr incision & drainage abscess complicated/multiple CPT 10061 | $607.00 | $607.00 | $5.92 – $470.00 | 781 |
| Pr incision & drainage abscess simple/single CPT 10060 | $350.00 | $417.00 | $26.46 – $417.00 | 781 |
| Pr incision & removal foreign body subcutaneous tissues simple CPT 10120 | $371.15 | $571.00 | $27.42 – $571.00 | 781 |
| Pr moderate sedation same physician >= 5 years initial 15 minutes CPT 99152 | $37.00 | $37.00 | $5.94 – $26.00 | 768 |
| Probe cryo 1150mm endo flex ster disp HCPCS C2618 | $4,097.91 | $6,304.48 | $161.10 – $421.50 | 44 |
| Procainamide 100 mg/ml injection (wrapper) HCPCS J2690 | $2,889.60 | $2,889.60 | $72.04 – $194.32 | 115 |
| Procalcitonin CPT 84145 | $258.70 | $398.00 | $26.68 – $398.00 | 44 |
| Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution HCPCS J0780 | $24.40 | $24.40 | $2.52 – $24.40 | 115 |
| Prochlorperazine maleate 5 mg tablet HCPCS Q0164 | $1.00 | $1.00 | $0.35 – $1.00 | 115 |
| Progesterone CPT 84144 | $107.25 | $165.00 | $63.06 – $165.00 | 44 |
| Prolactin CPT 84146 | $149.50 | $230.00 | $87.91 – $230.00 | 44 |
| Promethazine 25 mg tablet HCPCS Q0169 | $1.00 | $1.00 | $0.12 – $1.00 | 115 |
| Propofol infusion 10 mg/ml HCPCS J2704 | $46.50 | $46.50 | $7.61 – $19.90 | 44 |
| Propranolol in ns IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J1800 | $9.20 | $9.20 | $3.52 – $9.20 | 115 |
| Prosthesis voc advantage 20f 14mm HCPCS L8509 | $2,365.32 | $3,638.95 | $0.34 – $0.89 | 44 |
| Prosthesis voc lopres 20f 22mm HCPCS L8507 | $462.69 | $711.83 | $23.21 – $60.73 | 44 |
| Protamine 10 mg/ml intravenous solution HCPCS J2720 | $150.50 | $150.50 | $41.00 – $150.50 | 115 |
| Protector nerve neurawrap 4cm HCPCS C9353 | $3,580.71 | $5,508.79 | $2,086.43 – $5,459.00 | 44 |
| Protein c activity CPT 85303 | $119.60 | $184.00 | $70.32 – $184.00 | 44 |
| Protein electrophoretic fractionation & quantitation serum CPT 84165 | $74.75 | $115.00 | $43.95 – $115.00 | 44 |
| Protein total 24 hour urine CPT 84156 | $707.00 | $75.00 | $9.09 – $75.00 | 44 |
| Protein total body fluid CPT 84157 | $46.15 | $71.00 | $3.96 – $71.00 | 44 |
| Protein total serum plasma whole blood CPT 84155 | $55.25 | $85.00 | $32.49 – $85.00 | 44 |
| Prothrombin time substitution plasma fractions each CPT 85611 | $126.75 | $195.00 | $3.86 – $195.00 | 44 |
| Provox xtraflange 17fr HCPCS L8499 | $84.23 | $129.58 | $39.65 – $103.73 | 44 |
| Pr removal foreign body external auditory canal without anesthesia CPT 69200 | $181.29 | $168.00 | $11.76 – $168.00 | 768 |
| Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm CPT 12032 | $655.20 | $1,008.00 | $44.29 – $1,008.00 | 781 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm CPT 12011 | $265.00 | $370.00 | $17.36 – $370.00 | 781 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm CPT 12013 | $351.00 | $386.00 | $17.79 – $386.00 | 781 |
| Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm CPT 12001 | $256.00 | $309.00 | $14.06 – $309.00 | 781 |
| Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm CPT 12002 | $330.00 | $374.00 | $18.32 – $374.00 | 781 |
| PSA (Prostate) Test CPT 84153 | $122.20 | $188.00 | $71.85 – $188.00 | 44 |
| Psychoeducation 45 min + HCPCS G0177 | $422.50 | $650.00 | $248.43 – $650.00 | 44 |
| Psychotherapy group therapy CPT 90853 | $501.80 | $772.00 | $295.06 – $772.00 | 44 |
| Psychotherapy patient individual therapy 30 minutes CPT 90832 | $396.50 | $610.00 | $233.14 – $610.00 | 44 |
| Psychotherapy patient individual therapy 45 minutes CPT 90834 | $490.75 | $755.00 | $288.56 – $755.00 | 44 |
| Psychotherapy patient individual therapy 60 minutes CPT 90837 | $500.50 | $770.00 | $294.29 – $770.00 | 44 |
| Psychthrp grp 45-50min mcr HCPCS G0410 | $503.10 | $774.00 | $295.82 – $774.00 | 44 |
| Pt application of modality >=1 area hot/cold packs CPT 97010 | $63.05 | $97.00 | $37.07 – $97.00 | 44 |
| Pt application of modality >=1 area ultrasound each 15 minutes CPT 97035 | $87.75 | $135.00 | $51.60 – $135.00 | 44 |
| Pt repositioning canalith procedure(s) per day CPT 95992 | $213.20 | $328.00 | $127.13 – $328.00 | 36 |
| Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan HCPCS G0283 | $74.75 | $115.00 | $43.95 – $115.00 | 44 |
| Pulse ox continuous overnight monitoring CPT 94762 | $291.85 | $449.00 | $171.61 – $449.00 | 44 |
| Pulse ox single CPT 94760 | $50.70 | $78.00 | $29.81 – $78.00 | 44 |
| Pump on-q 100mlx2ml/hr 2 day delivery HCPCS C9804 | $367.13 | $564.81 | $85.65 – $224.11 | 44 |
| Puncture arterial withdrawal blood for diagnosis CPT 36600 | $113.75 | $175.00 | $66.89 – $175.00 | 44 |
| Rabies immune globulin (pf) 300 unit/ml intramuscular solution CPT 90375 | $3,213.80 | $3,213.80 | $532.88 – $3,213.80 | 115 |
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.