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 |
|---|---|---|---|---|
| Hydroxyzine pamoate 25 mg capsule HCPCS Q0177 | $1.00 | $1.00 | $0.10 – $1.00 | 115 |
| Hzv zoster vacc recombinant adjuvanted im inj CPT 90750 | $169.00 | $260.00 | $99.37 – $260.00 | 115 |
| I-123 iobenguane diag HCPCS A9582 | $24,445.60 | $24,445.60 | $9,343.11 – $24,445.60 | 44 |
| I-123 ioflupane diag HCPCS A9584 | $12,340.00 | $12,340.00 | $4,716.35 – $12,340.00 | 44 |
| I-123 sod iodide diag per 100 uci HCPCS A9516 | $412.50 | $412.50 | $153.36 – $401.25 | 44 |
| I-131 iobenguane sulf diag mibg HCPCS A9508 | $6,709.35 | $6,709.35 | $2,564.31 – $6,709.35 | 44 |
| I-131 sod iodide sol diag per mci HCPCS A9529 | $417.75 | $417.75 | $159.66 – $417.75 | 44 |
| Ibandronate 3 mg/3 ml intravenous syringe HCPCS J1740 | $1,149.75 | $1,149.75 | $92.40 – $1,149.75 | 115 |
| Icd cobalt xt dr MRI is1 df1 HCPCS C1721 | $20,112.30 | $30,942.00 | $0.01 – $1,134.13 | 44 |
| Icd crtd cobalt hf MRI is1 df1 HCPCS C1882 | $27,933.75 | $42,975.00 | $62.21 – $162.77 | 44 |
| Icd crtp serena MRI HCPCS C2621 | $9,235.69 | $14,208.75 | $1,139.40 – $2,981.16 | 44 |
| Icd reliance df4 ib 64cm HCPCS C1895 | $4,621.95 | $7,110.69 | $34.78 – $90.99 | 44 |
| Ifosfamide 1 gram intravenous solution HCPCS J9208 | $494.70 | $494.70 | $25.71 – $169.00 | 115 |
| Imetelstat 188 mg intravenous solution HCPCS J0870 | $31,931.40 | $31,931.40 | $2,679.94 – $7,982.85 | 115 |
| Immob elbow child sm HCPCS L3762 | $29.02 | $44.65 | $1.43 – $3.75 | 44 |
| Immobilizer lwr extrem nylon 20in reinforc 21-35in HCPCS L2999 | $525.01 | $807.71 | $32.72 – $85.60 | 44 |
| Immobilizer shldr cntor adlt HCPCS L3670 | $171.43 | $263.74 | $0.93 – $2.44 | 44 |
| Immobilizer shldr dlx str 24-36in med HCPCS L1830 | $136.42 | $209.88 | $1.54 – $4.02 | 44 |
| Immobilizer shldr sling med HCPCS L3660 | $34.03 | $52.36 | $20.01 – $52.36 | 44 |
| Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution HCPCS J1569 | $10,106.10 | $10,106.10 | $478.00 – $1,684.35 | 115 |
| Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution HCPCS J1566 | $4,576.15 | $4,576.15 | $1,634.00 – $4,576.15 | 115 |
| Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution HCPCS J1568 | $6,381.00 | $6,381.00 | $406.47 – $1,063.50 | 115 |
| Immunoassay tumor antigen quantitative ca 125 CPT 86304 | $131.95 | $203.00 | $20.81 – $203.00 | 44 |
| Immunoassay tumor antigen quantitative ca 19-9 CPT 86301 | $104.65 | $161.00 | $20.81 – $161.00 | 44 |
| Immunofixation electrophoresis serum CPT 86334 | $155.35 | $239.00 | $91.35 – $239.00 | 44 |
| Impl ahmed 6x25x9.6mm glaucoma vlv w/sil ped ster HCPCS L8612 | $5,473.00 | $8,420.00 | $861.33 – $2,253.62 | 44 |
| Implant 11 volt lithium-ion backup battery for controller pocket HCPCS Q0506 | $913.25 | $1,405.00 | $536.99 – $1,405.00 | 44 |
| Implant cartilage 10mm synthetic HCPCS L8699 | $4,241.57 | $6,525.50 | $20.72 – $54.20 | 44 |
| Implant cochlear osia osi300 HCPCS L8690 | $6,357.14 | $9,780.21 | $166.90 – $436.67 | 44 |
| Implant power module patient cable cable 14 volt HCPCS Q0477 | $2,283.12 | $3,512.50 | $1,342.48 – $3,512.50 | 44 |
| Implant pulse generator remede el HCPCS C1823 | $12,314.25 | $18,945.00 | $3,747.77 – $9,805.78 | 44 |
| Implant ureth bulk agent HCPCS L8606 | $2,100.47 | $3,231.50 | $569.75 – $1,490.71 | 44 |
| Impl ear abutment ba300 9mm HCPCS L8693 | $3,704.37 | $5,699.03 | $1,226.86 – $3,210.00 | 44 |
| Impl eye bio-eye 16mm HCPCS L8042 | $1,657.55 | $2,550.08 | $199.96 – $523.17 | 44 |
| In-111 autologous plt stdy dx HCPCS A9571 | $1,494.95 | $1,494.95 | $571.37 – $1,494.95 | 44 |
| In-111 autol wbc diag per dose HCPCS A9570 | $10,776.60 | $10,776.60 | $4,118.82 – $10,776.60 | 44 |
| In-111 capromab pendet HCPCS A9507 | $7,024.00 | $7,024.00 | $2,684.57 – $7,024.00 | 44 |
| In-111 ibritumomab tiux dx HCPCS A9542 | $7,246.75 | $7,246.75 | $2,769.71 – $7,246.75 | 44 |
| In-111 oxyquinolin per 0.5 mci HCPCS A9547 | $10,776.60 | $10,776.60 | $4,118.82 – $10,776.60 | 44 |
| In-111 pentetate dtpa / 0.5 mci HCPCS A9548 | $11,163.95 | $11,163.95 | $4,266.86 – $11,163.95 | 44 |
| In-111 pentetreotide HCPCS A9572 | $15,327.00 | $15,327.00 | $5,857.98 – $15,327.00 | 44 |
| In-111 satumomab pend HCPCS A4642 | $3,524.25 | $3,524.25 | $1,346.97 – $3,524.25 | 44 |
| Incision & drainage hematoma/seroma/fluid collection CPT 10140 | $364.00 | $560.00 | $122.45 – $560.00 | 44 |
| Incision tendon sheath CPT 26055 | $666.90 | $1,026.00 | $392.14 – $1,026.00 | 44 |
| Infect ag eia influenza a or b ea CPT 87400 | $466.00 | $50.00 | $19.11 – $50.00 | 44 |
| Infect ag na resp virus 12-25 targets CPT 87633 | $812.50 | $1,250.00 | $477.75 – $1,250.00 | 44 |
| Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin CPT 87324 | $68.25 | $105.00 | $40.13 – $105.00 | 44 |
| Infectious agent antigen immunoassay ql/sq multi step cryptosporidium CPT 87328 | $103.35 | $159.00 | $60.77 – $159.00 | 44 |
| Infectious agent antigen immunoassay ql/sq multi step giardia CPT 87329 | $100.10 | $154.00 | $58.86 – $154.00 | 44 |
| Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool CPT 87338 | $210.60 | $324.00 | $14.38 – $324.00 | 44 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn CPT 87340 | $94.25 | $145.00 | $55.42 – $145.00 | 44 |
| Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies CPT 87389 | $123.50 | $190.00 | $72.62 – $190.00 | 44 |
| Infectious agent antigen immunoassay ql/sq multi step legionella urine CPT 87449 | $53.30 | $82.00 | $31.34 – $82.00 | 44 |
| Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin CPT 87427 | $63.70 | $98.00 | $37.46 – $98.00 | 44 |
| Infectious agent nucleic acid amplified probe CPT 87798 | $213.85 | $329.00 | $125.74 – $329.00 | 44 |
| Infectious agent nucleic acid amplified probe chlamydia trachomatis CPT 87491 | $200.85 | $309.00 | $118.10 – $309.00 | 44 |
| Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s) CPT 87493 | $126.10 | $194.00 | $74.15 – $194.00 | 44 |
| Infectious agent nucleic acid amplified probe hsv-1 CPT 87529 | $193.70 | $298.00 | $113.90 – $298.00 | 44 |
| Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus CPT 87641 | $181.35 | $279.00 | $106.63 – $279.00 | 44 |
| Infectious agent nucleic acid amplified probe neisseria gonorrhoeae CPT 87591 | $193.05 | $297.00 | $113.51 – $297.00 | 44 |
| Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 CPT 87635 | $807.00 | $288.00 | $50.28 – $288.00 | 44 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b CPT 87636 | $361.40 | $556.00 | $212.50 – $556.00 | 44 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv CPT 87637 | $298.35 | $459.00 | $175.43 – $459.00 | 44 |
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | $202.15 | $311.00 | $118.86 – $311.00 | 44 |
| Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae CPT 87494 | $137.15 | $211.00 | $80.64 – $211.00 | 44 |
| Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance CPT 87564 | $209.95 | $323.00 | $123.45 – $323.00 | 44 |
| Infectious agent nucleic acid joint space pathogens multiplex amplified probe >= 26 targets CPT 87627 | $1,325.35 | $2,039.00 | $779.31 – $2,039.00 | 44 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | $579.80 | $892.00 | $340.92 – $892.00 | 44 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets CPT 87505 | $313.95 | $483.00 | $184.60 – $483.00 | 44 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | $231.40 | $356.00 | $42.84 – $356.00 | 44 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $308.10 | $474.00 | $42.84 – $474.00 | 44 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $219.05 | $337.00 | $85.10 – $337.00 | 44 |
| Infliximab 100 mg intravenous solution HCPCS J1745 | $3,222.55 | $3,222.55 | $311.80 – $3,222.55 | 115 |
| Infliximab-axxq 100 mg intravenous solution HCPCS Q5121 | $1,379.70 | $1,379.70 | $358.80 – $1,379.70 | 115 |
| Infliximab-dyyb 100 mg intravenous solution HCPCS Q5103 | $2,739.55 | $2,739.55 | $405.00 – $2,739.55 | 115 |
| Initial nursing facility care/day 35 minutes CPT 99305 | $224.25 | $345.00 | $130.76 – $345.00 | 44 |
| Initial nursing facility care/day low severity 99304 CPT 99304 | $216.00 | $216.00 | $45.37 – $216.00 | 781 |
| Injection, renflexis HCPCS Q5104 | $1,933.40 | $1,933.40 | $250.50 – $1,933.40 | 115 |
| Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s) CPT 20552 | $156.00 | $156.00 | $11.40 – $78.00 | 768 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 | $145.60 | $224.00 | $85.61 – $224.00 | 44 |
| Inj hydroxocobalamin IV 25mg HCPCS J3424 | $4,819.80 | $4,819.80 | $998.00 – $4,819.80 | 115 |
| Inj, nithiodote, 3mg / 125mg HCPCS J0211 | $984.90 | $984.90 | $157.00 – $984.90 | 115 |
| Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln HCPCS J9229 | $73,182.85 | $73,182.85 | $26,573.31 – $73,182.85 | 115 |
| Insertion catheter bladder non indwelling CPT 51701 | $250.90 | $386.00 | $147.53 – $386.00 | 44 |
| Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years CPT 36569 | $2,022.15 | $3,111.00 | $1,189.02 – $3,111.00 | 44 |
| Insole orthotic freedom sz6 6816 HCPCS L3060 | $44.30 | $68.15 | $26.05 – $68.15 | 44 |
| Insulin total CPT 83525 | $85.80 | $132.00 | $50.45 – $132.00 | 44 |
| Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm HCPCS Q4114 | $2,333.79 | $3,590.44 | $1,372.27 – $3,590.44 | 44 |
| Integra os putty 2.5cc - cost per 0.5cc HCPCS C9359 | $146.76 | $225.79 | $86.30 – $225.79 | 44 |
| Interferon beta-1a 30 mcg/0.5 ml im injection (wrapper) HCPCS Q3027 | $10,427.90 | $10,427.90 | $2,159.40 – $10,427.90 | 115 |
| Intrinsic factor antibody CPT 86340 | $122.20 | $188.00 | $14.78 – $188.00 | 44 |
| Intubation endotracheal emergency procedure CPT 31500 | $450.00 | $450.00 | $84.77 – $450.00 | 781 |
| Iopamidol 300 mg iodine/ml (61 %) intravenous solution HCPCS Q9967 | $227.50 | $227.50 | $4.49 – $11.75 | 44 |
| Ipilimumab 5 mg/ml intravenous solution (wrapper) HCPCS J9228 | $110,829.85 | $110,829.85 | $10,036.00 – $27,707.50 | 115 |
| Irinotecan 20 mg/ml intravenous solution (wrapper) HCPCS J9206 | $522.90 | $522.90 | $24.44 – $63.95 | 44 |
| Irinotecan liposomal 4.3 mg/ml intravenous HCPCS J9205 | $9,268.95 | $9,268.95 | $3,070.63 – $9,268.95 | 115 |
| Iron CPT 83540 | $53.30 | $82.00 | $31.34 – $82.00 | 44 |
| Iron binding capacity CPT 83550 | $63.05 | $97.00 | $37.07 – $97.00 | 44 |
| Iron dextran 50 mg/ml injection solution HCPCS J1750 | $185.90 | $185.90 | $71.05 – $185.90 | 44 |
| Iron sucrose 20 mg iron/ml intravenous solution (wrapper) HCPCS J1756 | $158.45 | $158.45 | $22.00 – $158.45 | 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.