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 |
|---|---|---|---|---|
| Splint extn xsm w sof-stretch rolyan HCPCS L3925 | $50.38 | $77.51 | $15.10 – $39.50 | 44 |
| Splint finger 4 prong foam sm HCPCS A4570 | $0.55 | $0.85 | $0.26 – $0.67 | 44 |
| Splint finger fold over sm HCPCS L3924 | $0.44 | $0.67 | $0.26 – $0.67 | 44 |
| Splint finger frog med HCPCS L3927 | $0.54 | $0.83 | $0.15 – $0.39 | 44 |
| Splint fing stax assort 1-7in HCPCS Q4049 | $1.04 | $1.60 | $0.61 – $1.60 | 44 |
| Splint func pos polyflex ii med HCPCS L3999 | $33.60 | $51.70 | $19.76 – $51.70 | 44 |
| Splint rstrc wrst/cmc right med HCPCS L3923 | $101.18 | $155.66 | $18.48 – $48.35 | 44 |
| Sr-89 stront chlor ther / mci HCPCS A9600 | $40,862.00 | $40,862.00 | $15,000.00 – $40,862.00 | 115 |
| Staph a dna amp probe CPT 87640 | $100.10 | $154.00 | $58.86 – $154.00 | 44 |
| St cognitve performance testing healthcare professional each hour CPT 96125 | $408.85 | $629.00 | $240.40 – $629.00 | 44 |
| Stent axios caut enh 15x10mm electrocaut HCPCS C1874 | $32,403.15 | $49,851.00 | $0.01 – $15.37 | 44 |
| Stent bili dbl pgtl 10fx5cm HCPCS C2617 | $6,063.30 | $9,328.16 | $11.37 – $29.75 | 44 |
| Stent bili rx wallflx 10x80 uncvr HCPCS C1876 | $18,714.49 | $28,791.53 | $0.89 – $2.32 | 44 |
| Stent bronch dumon sil 10x40mm HCPCS C1875 | $4,918.86 | $7,567.48 | $322.19 – $843.00 | 44 |
| St evaluate speech sound production CPT 92522 | $336.70 | $518.00 | $197.98 – $518.00 | 44 |
| Strap chin dlx f/cpap HCPCS A7036 | $34.90 | $53.70 | $20.52 – $53.70 | 44 |
| Strap montgmry ns 8 hl sht 7.25 x 11.25in HCPCS A4461 | $0.25 | $0.39 | $0.15 – $0.39 | 44 |
| Succinylcholine chloride 20 mg/ml injection solution (wrapper) HCPCS J0330 | $77.20 | $77.20 | $29.51 – $77.20 | 44 |
| Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution HCPCS J2865 | $23.00 | $23.00 | $8.79 – $23.00 | 44 |
| Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 | $55.20 | $55.20 | $21.10 – $55.20 | 115 |
| Support clav 29.6-40.5in med HCPCS L3650 | $94.19 | $144.91 | $1.25 – $3.26 | 44 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $122.20 | $188.00 | $71.85 – $188.00 | 42 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $178.10 | $274.00 | $65.31 – $274.00 | 41 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $14.30 | $22.00 | $8.41 – $22.00 | 44 |
| Susceptibility mic per plate CPT 87186 | $89.70 | $138.00 | $52.74 – $138.00 | 44 |
| Swallowing Evaluation (Bedside) CPT 92610 | $293.15 | $451.00 | $172.37 – $451.00 | 44 |
| System cardiomems hosp electronics HCPCS C2624 | $24,023.02 | $36,958.50 | $6,045.09 – $15,816.55 | 44 |
| System pacing micra av HCPCS C1786 | $16,760.25 | $25,785.00 | $29.62 – $77.51 | 44 |
| System pcmkr dual chamber leadless micra av2 intrdcr cath HCPCS C1785 | $27,099.09 | $41,690.91 | $42.03 – $109.96 | 44 |
| System recell skin grafting/harvesting HCPCS C1832 | $8,955.20 | $13,777.23 | $5,265.66 – $13,777.23 | 44 |
| System sealant biosentry tract HCPCS C2613 | $652.35 | $1,003.62 | $383.58 – $1,003.62 | 44 |
| T3 (triiodothyronine) free CPT 84481 | $122.20 | $188.00 | $16.77 – $188.00 | 44 |
| T3 (triiodothyronine) total CPT 84480 | $96.85 | $149.00 | $56.95 – $149.00 | 44 |
| T4 (thyroxine) free CPT 84439 | $738.00 | $121.00 | $9.09 – $121.00 | 44 |
| T4 (thyroxine) total CPT 84436 | $52.65 | $81.00 | $30.96 – $81.00 | 44 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | $170.70 | $170.70 | $0.15 – $1.00 | 115 |
| Tacrolimus 5 mg/ml intravenous solution HCPCS J7525 | $1,208.10 | $1,208.10 | $262.23 – $1,208.10 | 115 |
| Tacrolimus therapeutic drug level CPT 80197 | $158.60 | $244.00 | $93.26 – $244.00 | 44 |
| Tafasitamab-cxix 200 mg intravenous solution HCPCS J9349 | $4,272.00 | $4,272.00 | $1,540.00 – $4,272.00 | 115 |
| Tailbone (Sacrum and Coccyx) X-ray CPT 72220 | $221.65 | $341.00 | $130.33 – $341.00 | 44 |
| Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection HCPCS J9325 | $88,021.00 | $88,021.00 | $321.96 – $880.35 | 115 |
| Talquetamab-tgvs 2 mg/ml subcutaneous solution HCPCS J3055 | $35,941.50 | $35,941.50 | $868.80 – $4,492.75 | 115 |
| Tape plstc 1inx5yd hosp tb pk HCPCS A4452 | $3.04 | $4.67 | $1.81 – $4.67 | 34 |
| Tarlatamab-dlle 10 mg intravenous solution HCPCS J9026 | $46,350.00 | $46,350.00 | $1,715.37 – $4,635.00 | 115 |
| Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe HCPCS J1447 | $463.10 | $463.10 | $90.00 – $289.40 | 115 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $164.45 | $253.00 | $96.70 – $253.00 | 44 |
| Tc-99m apcitide diag HCPCS A9504 | $1,765.30 | $1,765.30 | $674.70 – $1,765.30 | 44 |
| Tc-99m arcitumomab HCPCS A9568 | $4,224.15 | $4,224.15 | $1,614.47 – $4,224.15 | 44 |
| Tc-99m bicisate HCPCS A9557 | $7,128.20 | $7,128.20 | $2,724.40 – $7,128.20 | 44 |
| Tc-99m depreotide HCPCS A9536 | $1,937.35 | $1,937.35 | $740.46 – $1,937.35 | 44 |
| Tc-99m diag per dose HCPCS A4641 | $575.50 | $575.50 | $219.96 – $575.50 | 44 |
| Tc-99m disofenin HCPCS A9510 | $339.80 | $339.80 | $129.87 – $339.80 | 44 |
| Tc-99m exame autol wbc diag per dose HCPCS A9569 | $8,194.15 | $8,194.15 | $3,131.80 – $8,194.15 | 44 |
| Tc-99m exametazime diag HCPCS A9521 | $7,382.05 | $7,382.05 | $2,821.42 – $7,382.05 | 44 |
| Tc-99m fanolesomab diag HCPCS A9566 | $17,688.75 | $17,688.75 | $6,760.64 – $17,688.75 | 44 |
| Tc-99m gluceptate HCPCS A9550 | $1,105.40 | $1,105.40 | $422.48 – $1,105.40 | 44 |
| Tc-99m labeled rbc HCPCS A9560 | $857.40 | $857.40 | $327.70 – $857.40 | 44 |
| Tc-99m maa HCPCS A9540 | $760.95 | $760.95 | $290.84 – $760.95 | 44 |
| Tc-99m mebrofenin HCPCS A9537 | $308.25 | $308.25 | $117.81 – $308.25 | 44 |
| Tc-99m medronate HCPCS A9503 | $210.35 | $210.35 | $80.40 – $210.35 | 44 |
| Tc-99m mertiatide HCPCS A9562 | $1,340.90 | $1,340.90 | $512.49 – $1,340.90 | 44 |
| Tc-99m non-heu per study dose HCPCS Q9969 | $1.00 | $1.00 | $0.38 – $1.00 | 44 |
| Tc-99m oxidronate HCPCS A9561 | $199.60 | $199.60 | $76.29 – $199.60 | 44 |
| Tc-99m pentetate dtpa HCPCS A9539 | $627.25 | $627.25 | $239.73 – $627.25 | 44 |
| Tc-99m pentetate dtpa aerosol HCPCS A9567 | $627.25 | $627.25 | $239.73 – $627.25 | 44 |
| Tc-99m pertechnetate per mci HCPCS A9512 | $99.30 | $99.30 | $37.95 – $99.30 | 44 |
| Tc-99m pyroph diag per dose up to 25 mci HCPCS A9538 | $335.80 | $335.80 | $128.34 – $335.80 | 44 |
| Tc-99m sestamibi p study dose HCPCS A9500 | $221.60 | $221.60 | $84.70 – $221.60 | 44 |
| Tc-99m succimer (dmsa) HCPCS A9551 | $2,988.10 | $2,988.10 | $1,142.05 – $2,988.10 | 44 |
| Tc-99m sulfur colloid HCPCS A9541 | $855.40 | $855.40 | $326.93 – $855.40 | 44 |
| Tc-99m tetrofosmin p study dose HCPCS A9502 | $198.05 | $198.05 | $75.69 – $198.05 | 44 |
| Tc-99m tilmanocept diag HCPCS A9520 | $2,740.00 | $2,740.00 | $1,047.23 – $2,740.00 | 44 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $99.45 | $153.00 | $46.98 – $153.00 | 44 |
| T cells total count CPT 86359 | $91.65 | $141.00 | $36.98 – $141.00 | 44 |
| Tebentafusp-tebn 100 mcg/0.5 ml intravenous solution HCPCS J9274 | $107,550.00 | $107,550.00 | $23,757.00 – $107,550.00 | 115 |
| Telehealth original site facility fee HCPCS Q3014 | $52.00 | $80.00 | $30.58 – $80.00 | 44 |
| Temozolomide 100 mg intravenous solution HCPCS J9328 | $5,015.55 | $5,015.55 | $1,137.00 – $5,015.55 | 115 |
| Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln HCPCS J9330 | $10,501.70 | $10,501.70 | $4,013.75 – $10,501.70 | 44 |
| Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) HCPCS J3101 | $23,582.35 | $23,582.35 | $8,597.00 – $23,273.85 | 115 |
| Terbutaline 1 mg/ml subcutaneous solution HCPCS J3105 | $6.90 | $6.90 | $2.64 – $6.90 | 44 |
| Test pathogen(s) for platelets reference HCPCS P9100 | $73.45 | $113.00 | $43.19 – $113.00 | 44 |
| Test stress cardiovascular tracing only CPT 93017 | $765.05 | $1,177.00 | $449.85 – $1,177.00 | 44 |
| Tetanus immune globulin inj HCPCS J1670 | $2,622.15 | $2,622.15 | $577.05 – $2,622.15 | 115 |
| Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe HCPCS J2356 | $22,937.05 | $22,937.05 | $8,766.54 – $22,937.05 | 44 |
| Theophylline therapeutic drug level CPT 80198 | $117.00 | $180.00 | $68.80 – $180.00 | 44 |
| Therapy activity per session >= 45 minutes HCPCS G0176 | $422.50 | $650.00 | $248.43 – $650.00 | 44 |
| Therapy Activity Training (each 15 minutes) CPT 97530 | $128.70 | $198.00 | $75.68 – $198.00 | 44 |
| Therapy Exercise Session (each 15 minutes) CPT 97110 | $129.35 | $199.00 | $76.06 – $199.00 | 44 |
| Therapy nutrition individual initial f2f w/patient each 15 minutes CPT 97802 | $94.90 | $146.00 | $55.80 – $146.00 | 44 |
| Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes CPT 97803 | $94.90 | $146.00 | $55.80 – $146.00 | 44 |
| Thiamine hcl (vitamin b1) 100 mg/ml injection solution HCPCS J3411 | $10.30 | $10.30 | $3.58 – $10.30 | 115 |
| Thigh Bone (Femur) X-ray (both sides) CPT 73552 | $403.65 | $621.00 | $158.23 – $414.00 | 44 |
| Thiotepa 15 mg solution for injection HCPCS J9341 | $1,090.00 | $1,090.00 | $416.60 – $1,090.00 | 44 |
| Thrombin time CPT 85670 | $33.80 | $52.00 | $5.65 – $52.00 | 44 |
| Thromboplastin time partial (ptt) substitution fractions each CPT 85732 | $41.60 | $64.00 | $24.46 – $64.00 | 44 |
| Thyroglobulin antibody CPT 86800 | $122.20 | $188.00 | $15.91 – $188.00 | 44 |
| Thyroid (TSH) Test CPT 84443 | $810.00 | $192.00 | $9.09 – $192.00 | 44 |
| Thyroid Ultrasound CPT 76536 | $553.80 | $852.00 | $325.63 – $852.00 | 44 |
| Thyrotropin alfa 0.9 mg intramuscular solution HCPCS J3240 | $10,828.50 | $10,828.50 | $2,113.24 – $10,828.50 | 115 |
| Tisotumab vedotin-tftv 40 mg intravenous solution HCPCS J9273 | $22,202.40 | $22,202.40 | $8,257.60 – $22,202.40 | 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.