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 |
|---|---|---|---|---|
| Irradiation of blood product each unit reference CPT 86945 | $202.15 | $311.00 | $118.86 – $311.00 | 44 |
| Irrigation implantable venous access device for drug delivery systems CPT 96523 | $163.15 | $251.00 | $95.93 – $251.00 | 44 |
| Isatuximab-irfc 20 mg/ml intravenous solution HCPCS J9227 | $2,779.35 | $2,779.35 | $906.80 – $2,779.35 | 115 |
| IV Fluids (each additional hour) CPT 96361 | $1,628.00 | $152.00 | $2.28 – $152.00 | 115 |
| IV Fluids (first hour) CPT 96360 | $11,569.50 | $369.00 | $2.28 – $369.00 | 115 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $113.10 | $174.00 | $66.50 – $174.00 | 44 |
| IV Medicine Infusion (additional drug) CPT 96367 | $191.10 | $294.00 | $112.37 – $294.00 | 44 |
| IV Medicine Infusion (each additional hour) CPT 96366 | $11,422.50 | $149.00 | $56.95 – $2,881.80 | 115 |
| IV Medicine Infusion (first hour) CPT 96365 | $5,720.75 | $445.00 | $170.08 – $855.00 | 115 |
| IV Push Injection (each additional drug) CPT 96375 | $28,219.85 | $192.00 | $9.09 – $192.00 | 115 |
| IV Push Injection (first drug) CPT 96374 | $1,919.50 | $310.00 | $26.00 – $310.00 | 115 |
| Ixabepilone 15 mg intravenous solution HCPCS J9207 | $18,131.05 | $18,131.05 | $2,276.25 – $6,043.70 | 115 |
| Jkt lso inter HCPCS L0560 | $41.27 | $63.49 | $24.27 – $63.49 | 44 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $72.80 | $112.00 | $42.81 – $112.00 | 44 |
| Ketorolac (Toradol) Pain Shot, 15 mg HCPCS J1885 | $9.20 | $9.20 | $3.08 – $8.05 | 44 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $603.85 | $929.00 | $355.06 – $929.00 | 44 |
| Kidney (Retroperitoneal) Ultrasound (limited) CPT 76775 | $443.95 | $683.00 | $261.04 – $683.00 | 44 |
| Kit case 4.2mm spinejack HCPCS C1062 | $5,934.85 | $9,130.54 | $1,120.68 – $2,932.18 | 44 |
| Kit cast tcc 3in w/2reg boots total contact cast HCPCS Q4038 | $257.21 | $395.71 | $130.22 – $340.71 | 44 |
| Kit cath f 8f w/glv + wipe ster HCPCS A4353 | $1.31 | $2.02 | $0.51 – $1.33 | 44 |
| Kit cath ivl 2.5x40mm 135cm shockwave s4 HCPCS C1761 | $6,430.77 | $9,893.50 | $2,212.46 – $5,788.75 | 44 |
| Kit hfx iq ipg bundle HCPCS C1822 | $26,541.53 | $40,833.13 | $14,969.79 – $39,167.42 | 44 |
| Kit ipg optimizer smart HCPCS C1824 | $29,051.10 | $44,694.00 | $15,111.04 – $39,537.00 | 44 |
| Kit irrigator stoma cone 7721 HCPCS A4398 | $2.05 | $3.16 | $1.21 – $3.16 | 44 |
| Kit lead specify 5-6-5 HCPCS C1778 | $13,454.45 | $20,699.16 | $54.78 – $143.33 | 44 |
| Kit monitr cath camino icp w/integratd licox bolt fitting HCPCS A9279 | $1,313.77 | $2,021.18 | $772.49 – $2,021.18 | 44 |
| Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set HCPCS C1878 | $1,391.79 | $2,141.22 | $786.10 – $2,056.78 | 44 |
| Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm HCPCS Q4105 | $234.08 | $360.12 | $80.58 – $210.83 | 44 |
| Kit sound processor cochlear osia 2 HCPCS L8691 | $6,106.28 | $9,394.28 | $2,432.90 – $6,365.52 | 44 |
| Kit trach suct cls 30.5cm HCPCS A4605 | $3,140.14 | $4,830.98 | $16.00 – $41.85 | 44 |
| Knee MRI (with and without contrast) CPT 73723 | $4,938.70 | $7,598.00 | $1,935.84 – $5,065.00 | 43 |
| Knee MRI (without contrast) CPT 73721 | $3,903.25 | $6,005.00 | $1,529.95 – $4,003.00 | 44 |
| Knee X-ray CPT 73564 | $483.60 | $744.00 | $189.57 – $496.00 | 44 |
| Knee X-ray (1 to 2 views, both knees) CPT 73560 | $266.50 | $410.00 | $104.34 – $273.00 | 44 |
| Knee X-ray (3 views, both knees) CPT 73562 | $319.15 | $491.00 | $124.98 – $327.00 | 44 |
| Knee X-ray (standing, both knees) CPT 73565 | $337.35 | $519.00 | $198.36 – $519.00 | 44 |
| Labetalol 5 mg/ml IV (wrapper) HCPCS J1920 | $19.45 | $19.45 | $7.43 – $19.45 | 44 |
| Lacosamide 200 mg/20 ml intravenous solution HCPCS C9254 | $53.80 | $53.80 | $20.56 – $53.80 | 44 |
| Lactate dehydrogenase (ldh) CPT 83615 | $48.75 | $75.00 | $28.67 – $75.00 | 44 |
| Lactated ringers intravenous solution HCPCS J7120 | $20.00 | $20.00 | $7.64 – $20.00 | 44 |
| Lactic acid CPT 83605 | $432.00 | $126.00 | $11.34 – $126.00 | 44 |
| Lactoferrin fecal qualitative CPT 83630 | $126.75 | $195.00 | $19.31 – $195.00 | 44 |
| Lanreotide 120 mg/0.5 ml subcutaneous syringe HCPCS J1930 | $29,832.00 | $29,832.00 | $11,401.79 – $29,832.00 | 44 |
| Lead acuity x4 spiral l 86cm HCPCS C1900 | $2,873.32 | $4,420.50 | $38.63 – $101.07 | 44 |
| Lead capillary CPT 83655 | $90.35 | $139.00 | $53.13 – $139.00 | 44 |
| Lead ingevity 45cm pfret MRI HCPCS C1898 | $4,159.75 | $6,399.62 | $0.10 – $0.26 | 44 |
| Lead tachy durata sj4 58cm HCPCS C1777 | $8,202.66 | $12,619.48 | $35.71 – $93.42 | 44 |
| Leg CT Scan (with contrast, both legs) CPT 73701 | $2,269.15 | $3,491.00 | $889.38 – $2,327.00 | 44 |
| Leg CT Scan (without contrast, both legs) CPT 73700 | $2,120.95 | $3,263.00 | $831.29 – $2,175.00 | 44 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $987.35 | $1,519.00 | $580.56 – $1,519.00 | 44 |
| Lens iol 23.0 d 1.5 cyl eyhance toric HCPCS V2787 | $419.25 | $645.00 | $19.11 – $50.00 | 44 |
| Lens iol ant bicnvx 24.0 multi HCPCS V2632 | $692.25 | $1,065.00 | $19.11 – $50.00 | 44 |
| Lens iol ant chamb 10.5 HCPCS V2630 | $354.25 | $545.00 | $19.11 – $50.00 | 44 |
| Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 | $396.40 | $396.40 | $3.95 – $13.75 | 115 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | $37,312.35 | $37,312.35 | $134.02 – $350.65 | 115 |
| Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 | $5,218.50 | $5,218.50 | $1,737.10 – $5,218.50 | 115 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $13.80 | $13.80 | $2.25 – $7.95 | 115 |
| Levetiracetam therapeutic drug level CPT 80177 | $130.00 | $200.00 | $76.44 – $200.00 | 44 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $61.50 | $61.50 | $1.96 – $15.50 | 115 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | $422.25 | $422.25 | $77.00 – $422.25 | 115 |
| Liberta rc ipg HCPCS C1820 | $29,884.39 | $45,975.98 | $26.26 – $68.71 | 44 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | $37.50 | $37.50 | $14.33 – $37.50 | 44 |
| Lift heel adj small gl60404sm HCPCS L3332 | $38.34 | $58.98 | $22.54 – $58.98 | 44 |
| Lift heel adjustable med HCPCS L3334 | $3.03 | $4.66 | $1.78 – $4.66 | 44 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $36.00 | $36.00 | $10.41 – $36.00 | 115 |
| Lipase CPT 83690 | $83.20 | $128.00 | $48.92 – $128.00 | 44 |
| Lipoprotein direct measurement hdl CPT 83718 | $62.40 | $96.00 | $8.03 – $96.00 | 44 |
| Lipoprotein direct measurement ldl CPT 83721 | $62.40 | $96.00 | $10.50 – $96.00 | 44 |
| Lithium therapeutic drug level CPT 80178 | $61.10 | $94.00 | $6.61 – $94.00 | 44 |
| Liver Function Test CPT 80076 | $110.50 | $170.00 | $64.97 – $170.00 | 44 |
| Loncastuximab tesirine-lpyl 10 mg intravenous solution HCPCS J9359 | $87,089.35 | $87,089.35 | $31,546.27 – $87,089.35 | 115 |
| Loop ostmy bridg ster HCPCS A4421 | $45.43 | $69.90 | $0.14 – $0.36 | 34 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $60.90 | $60.90 | $1.80 – $4.70 | 115 |
| Low-Dose Lung Cancer Screening CT Scan CPT 71271 | $1,402.05 | $2,157.00 | $824.41 – $2,157.00 | 44 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $1,517.10 | $2,334.00 | $892.05 – $2,334.00 | 44 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $3,803.15 | $5,851.00 | $2,236.25 – $5,851.00 | 43 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $2,598.70 | $3,998.00 | $1,528.04 – $3,998.00 | 44 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $286.00 | $440.00 | $168.17 – $440.00 | 44 |
| Lower Back (Lumbar Spine) X-ray (4 or more views) CPT 72110 | $369.20 | $568.00 | $217.09 – $568.00 | 44 |
| Lower Back (Lumbar Spine) X-ray (with bending views) CPT 72114 | $559.65 | $861.00 | $329.07 – $861.00 | 44 |
| Lower Leg (Shin) X-ray (both sides) CPT 73590 | $295.75 | $455.00 | $115.81 – $303.00 | 44 |
| Lung Function Test Before and After an Inhaler CPT 94060 | $453.05 | $697.00 | $266.39 – $697.00 | 44 |
| Lung Function Test (Spirometry) CPT 94010 | $221.65 | $341.00 | $130.33 – $341.00 | 44 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | $25,230.00 | $25,230.00 | $9,022.80 – $25,230.00 | 115 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | $37,758.50 | $37,758.50 | $4,196.00 – $12,586.20 | 115 |
| Lvad shower bag heartmate HCPCS Q0501 | $887.68 | $1,365.66 | $521.96 – $1,365.66 | 44 |
| Magnesium CPT 83735 | $871.00 | $107.00 | $9.09 – $107.00 | 44 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $522.50 | $522.50 | $0.50 – $11.90 | 115 |
| Mammosite ced HCPCS C1728 | $1,437.46 | $2,211.47 | $845.22 – $2,211.47 | 44 |
| Margetuximab-cmkb 25 mg/ml intravenous solution HCPCS J9353 | $8,622.65 | $8,622.65 | $2,760.50 – $8,622.65 | 115 |
| Marker biop eviva buckle ss HCPCS A4648 | $3,312.87 | $5,096.73 | $0.01 – $0.23 | 44 |
| Marker lymphatic sentimag magtrace 10 vial HCPCS A9697 | $1,283.48 | $1,974.59 | $754.69 – $1,974.59 | 44 |
| Mask full face lg af531 HCPCS A7030 | $47.34 | $72.83 | $27.15 – $71.04 | 44 |
| Matrix bone cryomatrix 2.0ml HCPCS Q4162 | $6,518.34 | $10,028.22 | $3,832.79 – $10,028.22 | 44 |
| Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm HCPCS Q4166 | $72.92 | $112.19 | $1.38 – $3.61 | 44 |
| Mayo aathr protein s free CPT 85306 | $153.40 | $236.00 | $90.20 – $236.00 | 44 |
| Mayo activated protein c resistance assay CPT 85307 | $128.05 | $197.00 | $15.01 – $197.00 | 44 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $305.50 | $470.00 | $37.80 – $470.00 | 44 |
| Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation CPT 80321 | $97.50 | $150.00 | $57.33 – $150.00 | 44 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $108.55 | $167.00 | $63.83 – $167.00 | 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.