Mercy Health Services-Iowa Corp.
Mercy Health Services-Iowa Corp. in Mason City, IA publishes cash prices for 65 common procedures listed here, from its own machine-readable price file updated Mar 31, 2026. Click a procedure to compare it with other hospitals nearby.
1000 4th St. SW, Mason City, IA 50401 Collected Sep 23, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT Abdomen & Pelvis W/Contrast | $4,436.90 | $6,826.00 | 35% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT Abdomen & Pelvis W/Contrast | $4,436.90 | $6,826.00 | 35% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT Head/Brain W/O Contrast | $1,578.85 | $2,429.00 | 35% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT Head/Brain W/O Contrast | $2,574.00 | — | — |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT Head/Brain W/O Contrast | $1,578.85 | $2,429.00 | 35% |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT Pelvis W/Contrast | $1,706.25 | $2,625.00 | 35% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT Pelvis W/Contrast | $1,706.25 | $2,625.00 | 35% |
| Diagnostic mammogram, both breasts both sides CPT 77066 HC Mammography Diagnostic Bilateral | $421.20 | $648.00 | 35% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC Mammography Diagnostic Bilateral | $421.20 | $648.00 | 35% |
| Diagnostic mammogram, one breast one side CPT 77065 HC Mammography Diagnostic Unilateral Lt | $295.10 | $454.00 | 35% |
| Diagnostic mammogram, one breast one side CPT 77065 HC Mammography Diagnostic Unilateral Rt | $295.10 | $454.00 | 35% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 HC Mammography Diagnostic Unilateral Lt | $295.10 | $454.00 | 35% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 HC Mammography Diagnostic Unilateral Rt | $295.10 | $454.00 | 35% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI Lower Extremity Joint W/O Contrast Bl | $1,550.25 | $2,385.00 | 35% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI Lower Extremity Joint W/O Contrast Lt | $1,033.50 | $1,590.00 | 35% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI Lower Extremity Joint W/O Contrast Rt | $1,033.50 | $1,590.00 | 35% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI Lower Extremity Joint W/O Contrast Bl | $1,550.25 | $2,385.00 | 35% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI Lower Extremity Joint W/O Contrast Rt | $1,033.50 | $1,590.00 | 35% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI Lower Extremity Joint W/O Contrast Lt | $1,033.50 | $1,590.00 | 35% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI Lower Extremity Joint W/O & W/Contrast Bl | $2,465.45 | $3,793.00 | 35% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI Lower Extremity Joint W/O & W/Contrast Lt | $1,643.20 | $2,528.00 | 35% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI Lower Extremity Joint W/O & W/Contrast Rt | $1,643.20 | $2,528.00 | 35% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI Lower Extremity Joint W/O & W/Contrast Bl | $2,465.45 | $3,793.00 | 35% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MRI Lower Extremity Joint W/O & W/Contrast Lt | $1,643.20 | $2,528.00 | 35% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MRI Lower Extremity Joint W/O & W/Contrast Rt | $1,643.20 | $2,528.00 | 35% |
| MRI of the brain, no contrast dye CPT 70551 HC MRI Brain W/O Contrast | $1,643.20 | $2,528.00 | 35% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI Brain W/O Contrast | $1,643.20 | $2,528.00 | 35% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI Brain W/O & W/Contrast | $1,643.20 | $2,528.00 | 35% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI Brain W/O & W/Contrast | $2,987.90 | — | — |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI Brain W/O & W/Contrast | $1,643.20 | $2,528.00 | 35% |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI Lumbar Spine W/O Contrast | $1,033.50 | $1,590.00 | 35% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI Lumbar Spine W/O Contrast | $1,033.50 | $1,590.00 | 35% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US Pregnant Uterus >= 14 Weeks Single/1st Gestation | $677.30 | $1,042.00 | 35% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US Pregnant Uterus >= 14 Weeks Single/1st Gestation | $677.30 | $1,042.00 | 35% |
| Screening mammogram, both breasts both sides CPT 77067 HC Mammography Screen Bilateral | $281.45 | $433.00 | 35% |
| Screening mammogram, both breasts one side CPT 77067 HC Mammography Screen Bl Reduced Service Unilateral Only Completed | $217.10 | $334.00 | 35% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 HC Mammography Screen Bilateral | $281.45 | $433.00 | 35% |
| Screening mammogram, both breasts inpatient one side CPT 77067 HC Mammography Screen Bl Reduced Service Unilateral Only Completed | $217.10 | $334.00 | 35% |
| Sleep study in a lab (polysomnography) CPT 95810 PR Polysomnography Sleep Staging >=4 Parameters Age >=6 Years | $1,785.00 | $1,785.00 | — |
| Sleep study in a lab (polysomnography) CPT 95810 HC Polysomnography Sleep Staging >=4 Parameters Age >=6 Years | $3,779.10 | $5,814.00 | 35% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 PR Polysomnography Sleep Staging >=4 Parameters Age >=6 Years | $1,785.00 | $1,785.00 | — |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 HC Polysomnography Sleep Staging >=4 Parameters Age >=6 Years | $3,779.10 | $5,814.00 | 35% |
| Transvaginal pelvic ultrasound CPT 76830 PR US Transvaginal Non Obstetric | $275.82 | — | — |
| Transvaginal pelvic ultrasound CPT 76830 HC US Transvaginal Non Obstetric | $678.60 | $1,044.00 | 35% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 PR US Transvaginal Non Obstetric | $341.00 | $341.00 | — |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC US Transvaginal Non Obstetric | $678.60 | $1,044.00 | 35% |
| Ultrasound of the abdomen, complete CPT 76700 HC US Abdomen Complete | $954.85 | $1,469.00 | 35% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HC US Abdomen Complete | $954.85 | $1,469.00 | 35% |
| X-ray of the lower back, 4 or more views CPT 72110 HC Xr Lumbosacral Spine >= 4 Views | $374.40 | $576.00 | 35% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC Xr Lumbosacral Spine >= 4 Views | $374.40 | $576.00 | 35% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 HC Basic Metabolic Panel (Calcium Total) | $99.45 | $153.00 | 35% |
| Basic metabolic panel (blood test) CPT 80048 HC Basic Metabolic Panel (Calcium Total) | $500.00 | — | — |
| Basic metabolic panel (blood test) inpatient CPT 80048 HC Basic Metabolic Panel (Calcium Total) | $99.45 | $153.00 | 35% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC Mayo Lmpp Lipid Panel | $55.90 | $86.00 | 35% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC Lipid Panel | $92.30 | $142.00 | 35% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC Mayo Lmpp Lipid Panel | $55.90 | $86.00 | 35% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC Lipid Panel | $92.30 | $142.00 | 35% |
| Complete blood count (CBC) with differential CPT 85025 HC Cbc Automated/Differential Wbc Automated | $89.05 | $137.00 | 35% |
| Complete blood count (CBC) with differential CPT 85025 HC Cbc Automated/Differential Wbc Automated | $809.00 | — | — |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC Cbc Automated/Differential Wbc Automated | $89.05 | $137.00 | 35% |
| Complete blood count (CBC), no differential CPT 85027 HC Cbc Automated | $68.90 | $106.00 | 35% |
| Complete blood count (CBC), no differential CPT 85027 HC Cbc Automated | $750.00 | — | — |
| Complete blood count (CBC), no differential inpatient CPT 85027 HC Cbc Automated | $68.90 | $106.00 | 35% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC Comprehensive Metabolic Panel | $150.15 | $231.00 | 35% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC Comprehensive Metabolic Panel | $855.00 | — | — |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC Comprehensive Metabolic Panel | $150.15 | $231.00 | 35% |
| Kidney function blood test panel CPT 80069 HC Renal Function Panel | $108.55 | $167.00 | 35% |
| Kidney function blood test panel CPT 80069 HC Renal Function Panel | $800.00 | — | — |
| Kidney function blood test panel inpatient CPT 80069 HC Renal Function Panel | $108.55 | $167.00 | 35% |
| Liver function blood test panel CPT 80076 HC Hepatic Function Panel | $255.45 | $393.00 | 35% |
| Liver function blood test panel inpatient CPT 80076 HC Hepatic Function Panel | $255.45 | $393.00 | 35% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC Mayo Psaft Prostate Specific Antigen Free | $82.55 | $127.00 | 35% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC Mayo Psaft Prostate Specific Antigen Free | $82.55 | $127.00 | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC Prostate Specific Antigen Total | $84.50 | $130.00 | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC Warde 1012090 Prostate Specific Antigen Total | $84.50 | $130.00 | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC Mayo Prostate Specific Antigen Total Ultrasensitive | $84.50 | $130.00 | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC Mayo Psaft Prostate Specific Antigen Total | $131.30 | $202.00 | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC Prostate Specific Antigen Total | $669.00 | — | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC Mayo Prostate Specific Antigen Total Ultrasensitive | $84.50 | $130.00 | 35% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC Prostate Specific Antigen Total | $84.50 | $130.00 | 35% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC Warde 1012090 Prostate Specific Antigen Total | $84.50 | $130.00 | 35% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC Mayo Psaft Prostate Specific Antigen Total | $131.30 | $202.00 | 35% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC Mayo Albld Thromboplastin Time Partial (Ptt) | $64.35 | $99.00 | 35% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC Mayo Aathr Thromboplastin Time Partial (Ptt) | $64.35 | $99.00 | 35% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC Mayo Luppr Thromboplastin Time Partial (Ptt) | $64.35 | $99.00 | 35% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC Thromboplastin Time Partial (Ptt) | $64.35 | $99.00 | 35% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC Thromboplastin Time Partial (Ptt) | $1,933.00 | — | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC Thromboplastin Time Partial (Ptt) | $64.35 | $99.00 | 35% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC Mayo Luppr Thromboplastin Time Partial (Ptt) | $64.35 | $99.00 | 35% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC Mayo Aathr Thromboplastin Time Partial (Ptt) | $64.35 | $99.00 | 35% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC Mayo Albld Thromboplastin Time Partial (Ptt) | $64.35 | $99.00 | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PR Prothrombin Time | $9.00 | $9.00 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC POCT Prothrombin Time | $29.90 | $46.00 | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC Mayo Aathr Prothrombin Time | $35.10 | $54.00 | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC Mayo Albld Prothrombin Time | $35.10 | $54.00 | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC Prothrombin Time | $35.10 | $54.00 | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC Mayo Luppr Prothrombin Time | $35.10 | $54.00 | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC Prothrombin Time | $189.00 | — | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PR Prothrombin Time | $23.88 | — | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC POCT Prothrombin Time | $29.90 | $46.00 | 35% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC Mayo Luppr Prothrombin Time | $35.10 | $54.00 | 35% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC Mayo Aathr Prothrombin Time | $35.10 | $54.00 | 35% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC Prothrombin Time | $35.10 | $54.00 | 35% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC Mayo Albld Prothrombin Time | $35.10 | $54.00 | 35% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC Mayo Thyroid Stimulating Hormone | $92.95 | $143.00 | 35% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC Thyroid Stimulating Hormone | $123.50 | $190.00 | 35% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC Mayo Fcuip Thyroid Stimulating Hormone | $123.50 | $190.00 | 35% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC Thyroid Stimulating Hormone | $884.00 | — | — |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC Mayo Thyroid Stimulating Hormone | $92.95 | $143.00 | 35% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC Thyroid Stimulating Hormone | $123.50 | $190.00 | 35% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC Mayo Fcuip Thyroid Stimulating Hormone | $123.50 | $190.00 | 35% |
| Urinalysis with microscope exam, automated CPT 81001 HC Urinalysis With Microscopy Automated | $51.35 | $79.00 | 35% |
| Urinalysis with microscope exam, automated CPT 81001 HC Urinalysis With Microscopy Automated | $659.00 | — | — |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HC Urinalysis With Microscopy Automated | $51.35 | $79.00 | 35% |
| Urinalysis with microscope exam, manual CPT 81000 HC Urinalysis With Microscopy Nonautomated | $7.80 | $12.00 | 35% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 HC Urinalysis With Microscopy Nonautomated | $7.80 | $12.00 | 35% |
| Urinalysis without microscope exam, automated CPT 81003 PR Urinalysis Without Microscopy Automated | $10.00 | $10.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 HC Urinalysis Without Microscopy Automated | $32.50 | $50.00 | 35% |
| Urinalysis without microscope exam, automated CPT 81003 HC Urinalysis Without Microscopy Automated | $599.00 | — | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 PR Urinalysis Without Microscopy Automated | $7.48 | — | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC Urinalysis Without Microscopy Automated | $32.50 | $50.00 | 35% |
| Urinalysis without microscope exam, manual CPT 81002 PR Urinalysis Without Microscopy Non-Automated | $7.00 | $7.00 | — |
| Urinalysis without microscope exam, manual CPT 81002 HC Urinalysis Without Microscopy Nonautomated | $13.65 | $21.00 | 35% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 PR Urinalysis Without Microscopy Non-Automated | $9.12 | — | — |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HC Urinalysis Without Microscopy Nonautomated | $13.65 | $21.00 | 35% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Cesarean delivery, including prenatal and postpartum care CPT 59510 PR Routine Obstetric Care Incl Antepartum Care/C-Section & Postpartum Care | $5,860.00 | $5,860.00 | — |
| Cesarean delivery, including prenatal and postpartum care inpatient CPT 59510 PR Routine Obstetric Care Incl Antepartum Care/C-Section & Postpartum Care | $8,236.00 | $8,236.00 | — |
| Colonoscopy with polyp removal CPT 45385 HC Colon Flex W/Rem Tumor(S)/Polyp(S)/Other Lesion(S) by Snare Tech (Restricted Method II CAH) | $14,370.45 | — | — |
| Colonoscopy with tissue sample CPT 45380 HC Colonoscopy Flexible With Biopsy Single/Multiple (Restricted Method II CAH) | $20,520.45 | — | — |
| Colonoscopy, diagnostic CPT 45378 HC Colon Flexible Dx W/Collection of Specimen(S) by Brushing/Washing (Restricted Method II CAH) | $13,152.95 | — | — |
| Gallbladder removal, laparoscopic CPT 47562 HC Cholecystectomy W/Laparoscopy (Restricted Method II CAH) | $59,346.65 | — | — |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 HC Repr Hernia Ing Init >=5yr Bl (Restricted Method II CAH) | $35,260.90 | — | — |
| Knee arthroscopy with meniscus trim one side CPT 29881 HC Arthro Knee W/Mnsc Med or Lat Incl/Chndrplsty Same/Sep Compart Lt (Rest Method II CAH) | $45,685.12 | — | — |
| Left heart catheterization, diagnostic one side CPT 93452 HC Cath Lt Heart/Lv Gram | $5,206.50 | $8,010.00 | 35% |
| Left heart catheterization, diagnostic one side CPT 93452 HC Cath Lt Heart/Lv Gram | $49,209.40 | — | — |
| Left heart catheterization, diagnostic inpatient one side CPT 93452 HC Cath Lt Heart/Lv Gram | $5,206.50 | $8,010.00 | 35% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC Injection(S) Epidural/Subarachnoid Lumbar/Sacral Needle Placement W/Guidance | $2,872.35 | $4,419.00 | 35% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC Injection(S) Epidural/Subarachnoid Lumbar/Sacral Needle Placement W/Guidance | $2,872.35 | $4,419.00 | 35% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC Injection(S) Anesthetic Agent(S)/Steroid Lumb/S Transforaminal Epidural W/Img Single Bl | $3,916.90 | $6,026.00 | 35% |
| Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 HC Injection(S) Anesthetic Agent(S)/Steroid Lumb/S Transforaminal Epidural W/Img Single Rt | $2,611.05 | $4,017.00 | 35% |
| Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 HC Injection(S) Anesthetic Agent(S)/Steroid Lumb/S Transforaminal Epidural W/Img Single Lt | $2,611.05 | $4,017.00 | 35% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC Injection(S) Anesthetic Agent(S)/Steroid Lumb/S Transforaminal Epidural W/Img Single Bl | $3,916.90 | $6,026.00 | 35% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 HC Injection(S) Anesthetic Agent(S)/Steroid Lumb/S Transforaminal Epidural W/Img Single Rt | $2,611.05 | $4,017.00 | 35% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 HC Injection(S) Anesthetic Agent(S)/Steroid Lumb/S Transforaminal Epidural W/Img Single Lt | $2,611.05 | $4,017.00 | 35% |
| Prostate biopsy CPT 55700 HC Biopsy Prostate Needle/Punch Single/Multiple Any Approach | $1,332.50 | $2,050.00 | 35% |
| Prostate biopsy CPT 55700 HC Biopsy Prostate Needle/Punch Single/Multiple Any Approach | $22,560.46 | — | — |
| Prostate biopsy inpatient CPT 55700 HC Biopsy Prostate Needle/Punch Single/Multiple Any Approach | $1,332.50 | $2,050.00 | 35% |
| Removal of a breast lump, open surgery one side CPT 19120 HC Excision Cyst/Fibroadenoma/Other Benign/Malignant Tumor Open Male/Female >= 1 Lesion Lt | $29,514.35 | — | — |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) one side CPT 29826 HC Arth Shld Srg Decompr Subacrml Sp W/Prt Acrmplsty W/Crccrml Sep Proc Lt(Rest Method II CAH) | $66,795.64 | — | — |
| Tonsil and adenoid removal, child under 12 CPT 42820 PR Tonsillectomy & Adenoidectomy Younger Than Age 12 | $27,164.21 | — | — |
| Total hip replacement one side CPT 27130 HC Arthoplasty Acetabular & Proximal Femoral Prosthetic Repl Rt (Restricted Method II CAH) | $81,256.87 | — | — |
| Total knee replacement one side CPT 27447 HC Arthro Knee/Condyle/Plateau Med/Lat W/or W/O Patella Resurf (Tka) Lt(Rest Method II CAH) | $76,625.63 | — | — |
| Upper endoscopy (EGD) with biopsy CPT 43239 HC Egd Flexible Transoral W/Bx Single/Mult (Restricted Method II CAH) | $17,156.61 | — | — |
| Upper endoscopy (EGD), diagnostic CPT 43235 PR Egd Flexible Transoral Dx Incl Coll Spec by Brushing/Washing | $10,469.95 | — | — |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 PR Routine OB Care Incl Antepartum Care Vag Del & Pp Care After Prev C/S | $5,847.47 | — | — |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care inpatient CPT 59610 PR Routine OB Care Incl Antepartum Care Vag Del & Pp Care After Prev C/S | $7,792.00 | $7,792.00 | — |
| Vaginal delivery, including prenatal and postpartum care CPT 59400 PR Routine Obstetric Care Incl Antepartum Care Vaginal Delivery and Pp Care | $5,277.00 | $5,277.00 | — |
| Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 PR Routine Obstetric Care Incl Antepartum Care Vaginal Delivery and Pp Care | $7,499.00 | $7,499.00 | — |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 PR Ecg 12 Lead Interpretation & Report | $63.00 | $63.00 | — |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 HC Ecg 12 Lead Interpretation & Report | $150.80 | $232.00 | 35% |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 PR Ecg 12 Lead Interpretation & Report | $49.00 | — | — |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 HC Ecg 12 Lead Interpretation & Report | $150.80 | $232.00 | 35% |
| Family therapy with the patient, 50 minutes CPT 90847 HC Psychotherapy Family W/Patient 50 Minutes | $302.90 | $466.00 | 35% |
| Family therapy with the patient, 50 minutes CPT 90847 PR Psychotherapy Family W/Patient 50 Minutes | $315.00 | $315.00 | — |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC Psychotherapy Family W/Patient 50 Minutes | $302.90 | $466.00 | 35% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 PR Psychotherapy Family W/Patient 50 Minutes | $315.00 | $315.00 | — |
| Family therapy without the patient, 50 minutes CPT 90846 HC Psychotherapy Family W/O Patient 50 Minutes | $249.60 | $384.00 | 35% |
| Family therapy without the patient, 50 minutes CPT 90846 PR Psychotherapy Family W/O Patient 50 Minutes | $303.00 | $303.00 | — |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HC Psychotherapy Family W/O Patient 50 Minutes | $249.60 | $384.00 | 35% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 PR Psychotherapy Family W/O Patient 50 Minutes | $303.00 | $303.00 | — |
| Group psychotherapy session CPT 90853 PR Psychotherapy Group | $75.00 | $75.00 | — |
| Group psychotherapy session CPT 90853 HC Psychotherapy Group Therapy | $167.70 | $258.00 | 35% |
| Group psychotherapy session inpatient CPT 90853 PR Psychotherapy Group | $75.00 | $75.00 | — |
| Group psychotherapy session inpatient CPT 90853 HC Psychotherapy Group Therapy | $167.70 | $258.00 | 35% |
| New patient office visit, about 30 minutes CPT 99203 PR Visit Office Outpatient New Low Level | $180.00 | $180.00 | — |
| New patient office visit, about 30 minutes CPT 99203 PR Visit Office Outpatient New Low Level | $180.00 | $180.00 | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 PR Visit Office Outpatient New Low Level | $180.00 | $180.00 | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 PR Visit Office Outpatient New Low Level | $180.00 | $180.00 | — |
| New patient office visit, about 45 minutes CPT 99204 PR Visit Office Outpatient New Moderate Level | $307.00 | $307.00 | — |
| New patient office visit, about 45 minutes CPT 99204 PR Visit Office Outpatient New Moderate Level | $307.00 | $307.00 | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 PR Visit Office Outpatient New Moderate Level | $307.00 | $307.00 | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 PR Visit Office Outpatient New Moderate Level | $307.00 | $307.00 | — |
| New patient office visit, about 60 minutes CPT 99205 PR Visit Office Outpatient New High Level | $402.00 | $402.00 | — |
| New patient office visit, about 60 minutes CPT 99205 PR Visit Office Outpatient New High Level | $402.00 | $402.00 | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 PR Visit Office Outpatient New High Level | $402.00 | $402.00 | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 PR Visit Office Outpatient New High Level | $402.00 | $402.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC Ot Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes | $78.65 | $121.00 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC Pt Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes | $78.65 | $121.00 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC Pt Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes | $979.00 | — | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC Ot Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes | $78.65 | $121.00 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC Pt Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes | $78.65 | $121.00 | 35% |
| Preventive checkup, new patient aged 18–39 CPT 99385 HC E&M Preventive Medicine Initial Comprehensive New Patient 18-39 Years | $110.50 | $170.00 | 35% |
| Preventive checkup, new patient aged 18–39 CPT 99385 PR E&M Preventive Medicine Initial Comprehensive New Patient 18-39 Years | $237.00 | $237.00 | — |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 HC E&M Preventive Medicine Initial Comprehensive New Patient 18-39 Years | $110.50 | $170.00 | 35% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 PR E&M Preventive Medicine Initial Comprehensive New Patient 18-39 Years | $237.00 | $237.00 | — |
| Preventive checkup, new patient aged 40–64 CPT 99386 HC E&M Preventive Medicine Initial Comprehensive New Patient 40-64 Years | $175.50 | $270.00 | 35% |
| Preventive checkup, new patient aged 40–64 CPT 99386 PR E&M Preventive Medicine Initial Comprehensive New Patient 40-64 Years | $288.00 | $288.00 | — |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 HC E&M Preventive Medicine Initial Comprehensive New Patient 40-64 Years | $175.50 | $270.00 | 35% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 PR E&M Preventive Medicine Initial Comprehensive New Patient 40-64 Years | $288.00 | $288.00 | — |
| Psychotherapy session, 30 minutes CPT 90832 PR Psychotherapy Patient 30 Minutes | $189.00 | $189.00 | — |
| Psychotherapy session, 30 minutes CPT 90832 HC Psychotherapy Patient Individual Therapy 30 Minutes | $300.30 | $462.00 | 35% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PR Psychotherapy Patient 30 Minutes | $189.00 | $189.00 | — |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC Psychotherapy Patient Individual Therapy 30 Minutes | $300.30 | $462.00 | 35% |
| Psychotherapy session, 45 minutes CPT 90834 PR Psychotherapy Patient 45 Minutes | $251.00 | $251.00 | — |
| Psychotherapy session, 45 minutes CPT 90834 HC Psychotherapy Patient Individual Therapy 45 Minutes | $300.30 | $462.00 | 35% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PR Psychotherapy Patient 45 Minutes | $251.00 | $251.00 | — |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HC Psychotherapy Patient Individual Therapy 45 Minutes | $300.30 | $462.00 | 35% |
| Psychotherapy session, 60 minutes CPT 90837 HC Psychotherapy Patient Individual Therapy 60 Minutes | $192.40 | $296.00 | 35% |
| Psychotherapy session, 60 minutes CPT 90837 PR Psychotherapy Patient 60 Minutes | $376.00 | $376.00 | — |
| Psychotherapy session, 60 minutes CPT 90837 PR Psychotherapy Patient 60 Minutes | $376.00 | $376.00 | — |
| Psychotherapy session, 60 minutes inpatient CPT 90837 HC Psychotherapy Patient Individual Therapy 60 Minutes | $192.40 | $296.00 | 35% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PR Psychotherapy Patient 60 Minutes | $376.00 | $376.00 | — |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PR Psychotherapy Patient 60 Minutes | $376.00 | $376.00 | — |
Source file: https://hpt.trinity-health.org/311373080_mercy-health-services-iowa-corp_standardcharges.zip