MercyOne Waterloo Medical Center
3421 W. 9th St, Waterloo, IA · MercyOne · · NPI 1700827896
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 |
|---|---|---|---|---|
| Ghs subcutaneous infus. for therapy init 1 hr CPT 96369 | $211.90 | $326.00 | $76.61 – $751.00 | 112 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $803.40 | $1,236.00 | $35.02 – $3,576.15 | 781 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | $702.00 | $1,080.00 | $40.08 – $3,576.15 | 781 |
| Ghs urine, porphyrins quant CPT 84120 | $92.30 | $142.00 | $14.25 – $142.00 | 41 |
| Ghs vaginal delivery only CPT 59409 | $2,587.00 | $2,587.00 | $37.48 – $274.88 | 768 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | $2,720.25 | $4,185.00 | $75.19 – $2,971.35 | 770 |
| Glove finger flexion right lg xl HCPCS L3912 | $53.03 | $81.59 | $13.74 – $58.47 | 25 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $655.40 | $655.40 | $154.02 – $655.40 | 28 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | $567.40 | $567.40 | $133.34 – $567.40 | 28 |
| Glucagon plasma - sendout CPT 82943 | $53.30 | $82.00 | $13.85 – $82.00 | 41 |
| Glucose 1 hr post dose CPT 82950 | $1,917.00 | $69.00 | $4.60 – $106.81 | 112 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $22.75 | $35.00 | $2.30 – $24.85 | 778 |
| Glucose blood quantitative CPT 82947 | $906.00 | $45.00 | $3.80 – $31.95 | 41 |
| Glucose body fluid CPT 82945 | $32.50 | $50.00 | $3.80 – $45.00 | 41 |
| Glucose monitoring continual min 72hr pt CPT 95249 | $211.90 | $326.00 | $41.41 – $284.35 | 777 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $92.30 | $142.00 | $12.47 – $69.00 | 41 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $44.85 | $69.00 | $3.79 – $45.00 | 41 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | $38,998.43 | $7.00 | $1.65 – $6,322.47 | 112 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $5,516.60 | $5,516.60 | $11.40 – $5,516.60 | 99 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $154.05 | $237.00 | $18.00 – $237.00 | 41 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $153.40 | $236.00 | $17.94 – $236.00 | 41 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | $16,064.55 | $16,064.55 | $761.95 – $5,895.10 | 96 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $63.48 | $97.66 | $19.53 – $97.66 | 33 |
| Graft axiofill 1000mg HCPCS J3590 | $6,300.79 | $9,693.53 | $380.36 – $1,618.56 | 25 |
| Graft bone flex 2.5cm x 5cm grafton-cost per sq cm HCPCS Q4205 | $1.41 | $2.17 | $0.51 – $2.17 | 25 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | $1,885.86 | $2,901.33 | $19.26 – $96.28 | 33 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $4,970.86 | $7,647.47 | $0.09 – $0.46 | 33 |
| Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm HCPCS Q4113 | $1,548.87 | $2,382.88 | $559.98 – $2,382.88 | 25 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $16,761.06 | $25,786.25 | $0.10 – $0.43 | 25 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $35,755.20 | $55,008.00 | $0.01 – $0.50 | 25 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | $304.44 | $468.37 | $0.31 – $1.56 | 33 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $410.96 | $632.25 | $47.74 – $238.70 | 33 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $414.05 | $637.00 | $61.18 – $305.89 | 33 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | $476.79 | $733.52 | $16.28 – $81.42 | 33 |
| Graft tis hmatrix dermis 10x5 -cost per sq cm HCPCS Q4134 | $58.05 | $89.31 | $20.99 – $89.31 | 25 |
| Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm HCPCS Q4130 | $1,705.66 | $2,624.09 | $0.01 – $0.04 | 25 |
| Graft viashield 2layer amnion patch 2x2cm-cost per sq cm HCPCS Q4211 | $593.61 | $913.25 | $70.00 – $350.01 | 33 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | $312.02 | $480.03 | $14.59 – $62.10 | 25 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $25,506.74 | $39,241.14 | $0.19 – $0.80 | 25 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $17,074.23 | $26,268.04 | $25.70 – $109.36 | 25 |
| Gstrst open wo constj tube CPT 43830 | $2,524.00 | $2,524.00 | $19.79 – $403.84 | 771 |
| Guided cath fluid drainage 10030 CPT 10030 | $2,451.80 | $3,772.00 | $667.14 – $4,235.59 | 111 |
| Guide endoanchr sg-64 aaa 62cm HCPCS L8670 | $2,547.89 | $3,919.83 | $914.44 – $3,891.24 | 25 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $3,210.97 | $4,939.95 | $0.01 – $0.21 | 25 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $747.95 | $1,150.70 | $0.01 – $20.18 | 25 |
| Guid loc target vol rad tx CPT 77387 | $586.95 | $903.00 | $19.11 – $811.08 | 776 |
| Gw stiffened micro access kit HCPCS C1894 | $115,171.72 | $15,124.43 | $0.01 – $6,264.37 | 112 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | $92.00 | $92.00 | $21.62 – $92.00 | 25 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $3.65 | $3.65 | $0.86 – $3.65 | 25 |
| Handle/convey/speciman/office-lab 99000 CPT 99000 | $16.00 | $16.00 | $2.69 – $16.00 | 535 |
| Handpiece aquabeam hp2000 HCPCS C2596 | $14,876.30 | $22,886.61 | $1,736.58 – $7,389.71 | 25 |
| Hands-On Manual Therapy (each 15 minutes) CPT 97140 | $132.60 | $204.00 | $17.68 – $301.50 | 778 |
| Hand X-ray CPT 73130 | $1,012.00 | $515.00 | $5.54 – $243.53 | 781 |
| Hand X-ray (2 views, both hands) CPT 73120 | $479.05 | $737.00 | $5.11 – $348.61 | 781 |
| Haptoglobin quantitative CPT 83010 | $105.30 | $162.00 | $12.19 – $162.00 | 41 |
| Harvest cultured skin graft 15040 CPT 15040 | $37,827.49 | not published | $31.45 – $11,438.86 | 101 |
| Hba1/hba2 full gene sequence CPT 81259 | $1,537.25 | $2,365.00 | $555.78 – $2,365.00 | 38 |
| Hba1/hba2 gene dup/del vrnts CPT 81269 | $841.10 | $1,294.00 | $198.35 – $1,294.00 | 38 |
| Hbb full gene sequence CPT 81364 | $911.95 | $1,403.00 | $318.09 – $1,403.00 | 38 |
| Hbb gene dup/del variants CPT 81363 | $268.45 | $413.00 | $97.06 – $550.77 | 25 |
| Hc ea ha check monaural CPT 92594 | $26.00 | $40.00 | $9.40 – $355.00 | 25 |
| Hcg qualitative CPT 84703 | $102.70 | $158.00 | $7.28 – $95.00 | 41 |
| Hcg quantitative CPT 84702 | $124.80 | $192.00 | $14.59 – $136.32 | 41 |
| Hc hearing aid chck binaurl CPT 92593 | $109.00 | $109.00 | $15.00 – $175.89 | 780 |
| Hc hearing aid chck monarl CPT 92592 | $67.00 | $75.00 | $15.00 – $107.54 | 780 |
| Hc hearing aid exam both ears CPT 92591 | $212.00 | $212.00 | $30.00 – $341.95 | 777 |
| Hc hearing aid exam one ear CPT 92590 | $167.00 | $167.00 | $30.00 – $268.73 | 777 |
| Head CT scan (with and without contrast) CPT 70470 | $1,914.25 | $2,945.00 | $165.25 – $2,945.00 | 112 |
| Head CT scan (with contrast) CPT 70460 | $1,788.15 | $2,751.00 | $165.25 – $2,751.00 | 112 |
| Head CT scan (without contrast) CPT 70450 | $2,476.00 | $2,476.00 | $98.49 – $2,476.00 | 112 |
| Heel (Calcaneus) X-ray (both feet) CPT 73650 | $384.15 | $591.00 | $4.90 – $279.74 | 781 |
| Helicobacter pylori antibody igm CPT 86677 | $79.95 | $123.00 | $16.33 – $123.00 | 41 |
| Hematocrit CPT 85014 | $1,475.00 | $27.00 | $2.30 – $381.24 | 112 |
| Hemin 350 mg intravenous powder for solution HCPCS J1640 | $34,281.50 | $34,281.50 | $34.60 – $34,281.50 | 96 |
| Hemodialysis one evaluation CPT 90935 | $1,329.90 | $2,046.00 | $39.19 – $1,452.66 | 778 |
| Hemodialysis repeated eval CPT 90937 | $311.00 | $311.00 | $56.45 – $311.00 | 768 |
| Hemoglobin CPT 85018 | $814.00 | $29.00 | $1.90 – $20.59 | 778 |
| Hemoglobin fetal qualitative CPT 83033 | $198.25 | $305.00 | $8.00 – $305.00 | 25 |
| Hemoglobin methemoglobin quantitative CPT 83050 | $60.45 | $93.00 | $7.95 – $93.00 | 41 |
| Hemoglobin-oxygen affinity CPT 82820 | $19,256.81 | $85.00 | $9.09 – $3,312.15 | 112 |
| Hemoglobin plasma CPT 83051 | $59.80 | $92.00 | $7.08 – $92.00 | 41 |
| Hemophilus influenza antibdy CPT 86684 | $34.45 | $53.00 | $12.46 – $53.00 | 41 |
| Heparin assay CPT 85520 | $100.75 | $155.00 | $12.69 – $155.00 | 41 |
| Heparin bolus from bag HCPCS J1644 | $23,476.05 | $53.60 | $0.44 – $6,264.37 | 112 |
| Heparin neutralization CPT 85525 | $83.85 | $129.00 | $11.48 – $129.00 | 41 |
| Heparin, porcine (pf) 10 unit/ml flush (wrapper) HCPCS J1642 | $3.35 | $3.35 | $0.79 – $3.35 | 25 |
| Hepatitis a antibody igm CPT 86709 | $68.90 | $106.00 | $10.91 – $106.00 | 41 |
| Hepatitis b core antibody igm CPT 86705 | $68.90 | $106.00 | $11.40 – $106.00 | 41 |
| Hepatitis b core antibody total CPT 86704 | $120.25 | $185.00 | $11.68 – $185.00 | 41 |
| Hepatitis b immune globulin greater than 1,560 units/5 ml im solution CPT 90371 | $3,148.75 | $3,148.75 | $130.66 – $676.60 | 112 |
| Hepatitis b surface antibody CPT 86706 | $117.65 | $181.00 | $10.40 – $181.00 | 41 |
| Hepatitis c antibody CPT 86803 | $118.95 | $183.00 | $13.83 – $183.00 | 41 |
| Hernia Repair (Inguinal) CPT 49505 | $41,941.94 | $2,314.00 | $0.96 – $6,918.39 | 777 |
| Herpes simplex type 1 antibody igg CPT 86695 | $153.40 | $236.00 | $12.78 – $236.00 | 41 |
| Herpes simplex type 2 antibody igg CPT 86696 | $133.25 | $205.00 | $18.75 – $205.00 | 41 |
| Heterophile antibodies screening CPT 86308 | $57.20 | $88.00 | $4.14 – $62.48 | 778 |
| Hip and Pelvis X-ray (2 views, both hips) CPT 73521 | $450.45 | $693.00 | $6.82 – $492.03 | 781 |
| Hip and Pelvis X-ray (3 to 4 views, both hips) CPT 73522 | $150.00 | $150.00 | $8.95 – $205.67 | 781 |
| Hip and Pelvis X-ray (single view, left side) CPT 73501 | $159.25 | $245.00 | $5.75 – $173.95 | 778 |
| Hip X-ray CPT 73502 | $560.00 | $164.00 | $6.82 – $179.55 | 781 |
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.