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 |
|---|---|---|---|---|
| Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution HCPCS A9575 | $229.95 | $229.95 | $12.00 – $229.95 | 44 |
| Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution HCPCS A9581 | $674.30 | $674.30 | $257.72 – $674.30 | 44 |
| Gammaglobulin iga CPT 82784 | $81.90 | $126.00 | $48.16 – $126.00 | 44 |
| Gammaglobulin ige CPT 82785 | $83.85 | $129.00 | $49.30 – $129.00 | 44 |
| Gamma glutamyltransferase CPT 82977 | $60.45 | $93.00 | $35.54 – $93.00 | 44 |
| Gamunex-c/gammaked HCPCS J1561 | $3,559.50 | $3,559.50 | $960.60 – $3,559.50 | 115 |
| Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr HCPCS J1570 | $314.60 | $314.60 | $31.65 – $82.80 | 115 |
| Gemcitabine 1 gram intravenous solution HCPCS J9201 | $540.20 | $540.20 | $16.20 – $50.15 | 115 |
| 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 | 115 |
| General health panel CPT 80050 | $263.25 | $405.00 | $154.79 – $405.00 | 44 |
| Generator barostim neo2 2014 HCPCS C1767 | $44,831.44 | $68,971.44 | $1.28 – $3.36 | 44 |
| Generator emblem MRI sicd subq HCPCS C1722 | $22,347.00 | $34,380.00 | $287.83 – $753.08 | 44 |
| Generator stim baroreceptor neo legacy implant pulse HCPCS C1825 | $37,570.90 | $57,801.38 | $17,082.05 – $44,694.00 | 44 |
| Gentamicin 10 mg/ml liquid compound - enteral use only HCPCS J1580 | $17.40 | $17.40 | $1.66 – $4.35 | 44 |
| Ghs fish cytogen CPT 88271 | $135.85 | $209.00 | $20.99 – $209.00 | 44 |
| Ghs incision thrombosed ext hemorrhoid CPT 46083 | $577.25 | $400.00 | $19.14 – $400.00 | 768 |
| Ghs insertion of needle - bone CPT 36680 | $128.70 | $198.00 | $60.04 – $198.00 | 44 |
| Ghs ot dds rom CPT 95851 | $48.75 | $75.00 | $28.67 – $75.00 | 44 |
| Ghs pr without cont pulse ox CPT 94625 | $157.30 | $242.00 | $92.49 – $242.00 | 44 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $377.65 | $581.00 | $92.25 – $581.00 | 44 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $389.00 | $434.00 | $23.01 – $434.00 | 781 |
| Glove finger flexion right lg xl HCPCS L3912 | $53.03 | $81.59 | $22.35 – $58.47 | 44 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $1,287.75 | $1,287.75 | $492.18 – $1,287.75 | 43 |
| Glucose 1 hr post dose CPT 82950 | $41.60 | $64.00 | $24.46 – $64.00 | 44 |
| Glucose blood quantitative CPT 82947 | $808.00 | $56.00 | $9.09 – $56.00 | 44 |
| Glucose body fluid CPT 82945 | $45.50 | $70.00 | $3.89 – $70.00 | 44 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $92.30 | $142.00 | $21.62 – $142.00 | 44 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $53.95 | $83.00 | $3.84 – $83.00 | 44 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | $3.15 | $3.15 | $1.20 – $3.15 | 44 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $5,516.60 | $5,516.60 | $551.50 – $5,516.60 | 115 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $133.25 | $205.00 | $78.35 – $205.00 | 44 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $135.20 | $208.00 | $79.50 – $208.00 | 44 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | $16,064.55 | $16,064.55 | $803.41 – $5,895.10 | 115 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $93.34 | $143.60 | $54.88 – $143.60 | 44 |
| Graft axiofill 1000mg HCPCS J3590 | $6,300.79 | $9,693.53 | $618.61 – $1,618.56 | 44 |
| Graft bone flex 2.5cm x 5cm grafton-cost per sq cm HCPCS Q4205 | $1.41 | $2.17 | $0.83 – $2.17 | 44 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | $1,885.86 | $2,901.33 | $36.80 – $96.28 | 44 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $4,970.86 | $7,647.47 | $0.18 – $0.46 | 44 |
| Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm HCPCS Q4113 | $1,548.87 | $2,382.88 | $910.74 – $2,382.88 | 44 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $16,761.06 | $25,786.25 | $0.16 – $0.43 | 44 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $35,755.20 | $55,008.00 | $0.01 – $1.00 | 44 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | $304.44 | $468.37 | $0.60 – $1.56 | 44 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $397.96 | $612.24 | $91.23 – $238.70 | 44 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $3,657.34 | $5,626.67 | $116.91 – $305.89 | 44 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | $476.79 | $733.52 | $31.12 – $81.42 | 44 |
| Graft tis hmatrix dermis 10x5 -cost per sq cm HCPCS Q4134 | $58.05 | $89.31 | $34.13 – $89.31 | 44 |
| Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm HCPCS Q4130 | $1,705.66 | $2,624.09 | $0.02 – $0.05 | 44 |
| Graft viashield 2layer amnion patch 2x2cm-cost per sq cm HCPCS Q4211 | $593.61 | $913.25 | $133.77 – $350.01 | 44 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | $312.02 | $480.03 | $23.73 – $62.10 | 44 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $25,506.74 | $39,241.14 | $19.11 – $50.00 | 44 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $17,074.23 | $26,268.04 | $41.80 – $109.36 | 44 |
| Guide endoanchr sg-64 aaa 62cm HCPCS L8670 | $2,547.89 | $3,919.83 | $1,487.23 – $3,891.24 | 44 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $4,580.54 | $7,046.99 | $0.01 – $0.42 | 44 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $747.95 | $1,150.70 | $0.01 – $40.49 | 44 |
| Gw stiffened micro access kit HCPCS C1894 | $9,830.88 | $15,124.43 | $0.01 – $1.10 | 44 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | $92.00 | $92.00 | $35.16 – $92.00 | 44 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $3.65 | $3.65 | $1.40 – $3.65 | 44 |
| Handpiece aquabeam hp2000 HCPCS C2596 | $14,876.30 | $22,886.61 | $2,824.35 – $7,389.71 | 44 |
| Hands-On Manual Therapy (each 15 minutes) CPT 97140 | $128.70 | $198.00 | $75.68 – $198.00 | 44 |
| Hand X-ray CPT 73130 | $305.50 | $470.00 | $119.63 – $313.00 | 44 |
| Hand X-ray (2 views, both hands) CPT 73120 | $235.95 | $363.00 | $92.49 – $242.00 | 44 |
| Haptoglobin quantitative CPT 83010 | $126.10 | $194.00 | $12.58 – $194.00 | 44 |
| Hcg qualitative CPT 84703 | $85.15 | $131.00 | $50.07 – $131.00 | 44 |
| Hcg quantitative CPT 84702 | $109.20 | $168.00 | $15.05 – $168.00 | 44 |
| Head CT scan (with and without contrast) CPT 70470 | $1,747.20 | $2,688.00 | $1,027.35 – $2,688.00 | 44 |
| Head CT scan (with contrast) CPT 70460 | $1,509.30 | $2,322.00 | $887.47 – $2,322.00 | 44 |
| Head CT scan (without contrast) CPT 70450 | $1,368.25 | $2,105.00 | $804.53 – $2,105.00 | 44 |
| Heel (Calcaneus) X-ray (both feet) CPT 73650 | $274.95 | $423.00 | $107.78 – $282.00 | 44 |
| Hematocrit CPT 85014 | $270.00 | $47.00 | $9.09 – $47.00 | 44 |
| Hemin 350 mg intravenous powder for solution HCPCS J1640 | $34,281.50 | $34,281.50 | $11,959.50 – $34,281.50 | 115 |
| Hemoglobin CPT 85018 | $223.00 | $39.00 | $9.09 – $39.00 | 44 |
| Hemoglobin methemoglobin quantitative CPT 83050 | $74.75 | $115.00 | $8.20 – $115.00 | 29 |
| Heparin assay CPT 85520 | $53.95 | $83.00 | $31.72 – $83.00 | 44 |
| Heparin bolus from bag HCPCS J1644 | $22.50 | $22.50 | $2.64 – $6.90 | 114 |
| Heparin, porcine (pf) 10 unit/ml flush (wrapper) HCPCS J1642 | $3.35 | $3.35 | $1.28 – $3.35 | 44 |
| Hepatitis a antibody igm CPT 86709 | $100.10 | $154.00 | $58.86 – $154.00 | 44 |
| Hepatitis b core antibody igm CPT 86705 | $118.95 | $183.00 | $11.77 – $183.00 | 44 |
| Hepatitis b core antibody total CPT 86704 | $96.20 | $148.00 | $56.57 – $148.00 | 44 |
| Hepatitis b immune globulin greater than 1,560 units/5 ml im solution CPT 90371 | $3,148.75 | $3,148.75 | $653.30 – $3,148.75 | 115 |
| Hepatitis b surface antibody CPT 86706 | $107.90 | $166.00 | $10.74 – $166.00 | 44 |
| Hepatitis c antibody CPT 86803 | $126.75 | $195.00 | $13.98 – $195.00 | 44 |
| Herpes simplex type 1 antibody igg CPT 86695 | $85.80 | $132.00 | $50.45 – $132.00 | 29 |
| Herpes simplex type 2 antibody igg CPT 86696 | $57.85 | $89.00 | $34.02 – $89.00 | 29 |
| Heterophile antibodies screening CPT 86308 | $52.00 | $80.00 | $30.58 – $80.00 | 44 |
| Hip and Pelvis X-ray (2 views, both hips) CPT 73521 | $312.65 | $481.00 | $183.84 – $481.00 | 44 |
| Hip and Pelvis X-ray (3 to 4 views, both hips) CPT 73522 | $306.80 | $472.00 | $180.40 – $472.00 | 44 |
| Hip and Pelvis X-ray (single view, left side) CPT 73501 | $187.20 | $288.00 | $110.07 – $288.00 | 44 |
| Hip X-ray CPT 73502 | $222.30 | $342.00 | $130.71 – $342.00 | 44 |
| HIV prep, ftc/tdf 200/300mg HCPCS J0750 | $1.00 | $1.00 | $0.38 – $1.74 | 115 |
| Hldr trach tb tie ad HCPCS A7526 | $1,057.54 | $1,626.99 | $0.23 – $0.59 | 44 |
| Holder tube cath-secure nonstrl lf disp HCPCS A4333 | $0.78 | $1.20 | $0.46 – $1.20 | 44 |
| Homocysteine CPT 83090 | $181.35 | $279.00 | $17.92 – $279.00 | 44 |
| Hopd mntl hlt, 15-29 min HCPCS C7900 | $396.50 | $610.00 | $233.14 – $610.00 | 44 |
| Hopd mntl hlt, grp HCPCS C7903 | $477.75 | $735.00 | $280.92 – $735.00 | 44 |
| Human prothrombin complex concentrate (pcc)-lans 500 unit (400-640 unit) IV solution HCPCS J7165 | $1,829.90 | $1,829.90 | $699.39 – $1,829.90 | 115 |
| Hyaluronidase, human recombinant 150 unit/ml injection solution HCPCS J3473 | $236.10 | $236.10 | $54.00 – $236.10 | 115 |
| Hydralazine 20 mg/ml injection solution HCPCS J0360 | $64.40 | $64.40 | $5.19 – $64.40 | 115 |
| Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J1720 | $243.25 | $243.25 | $16.82 – $44.00 | 115 |
| Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper) HCPCS J1171 | $185.75 | $185.75 | $1.61 – $4.20 | 115 |
| Hydroxyzine hcl 50 mg/ml intramuscular solution HCPCS J3410 | $86.10 | $86.10 | $16.93 – $86.10 | 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.