Mercy Medical Center-Clinton Inc
Mercy Medical Center-Clinton Inc in Clinton, IA publishes cash prices for 53 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.
1410 N. Fourth St, Clinton, IA 52732 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 | $3,352.05 | $5,157.00 | 35% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT Abdomen & Pelvis W/Contrast | $3,723.85 | — | — |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT Abdomen & Pelvis W/Contrast | $3,352.05 | $5,157.00 | 35% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT Head/Brain W/O Contrast | $1,633.45 | — | — |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT Head/Brain W/O Contrast | $1,633.45 | $2,513.00 | 35% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT Head/Brain W/O Contrast | $1,633.45 | $2,513.00 | 35% |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT Pelvis W/Contrast | $1,805.05 | $2,777.00 | 35% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT Pelvis W/Contrast | $1,805.05 | $2,777.00 | 35% |
| Diagnostic mammogram, both breasts both sides CPT 77066 HC Mammography Diagnostic Bilateral | $432.90 | $666.00 | 35% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC Mammography Diagnostic Bilateral | $432.90 | $666.00 | 35% |
| Diagnostic mammogram, one breast one side CPT 77065 HC Mammography Diagnostic Unilateral Rt | $364.00 | $560.00 | 35% |
| Diagnostic mammogram, one breast one side CPT 77065 HC Mammography Diagnostic Unilateral Lt | $364.00 | $560.00 | 35% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 HC Mammography Diagnostic Unilateral Rt | $364.00 | $560.00 | 35% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 HC Mammography Diagnostic Unilateral Lt | $364.00 | $560.00 | 35% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI Lower Extremity Joint W/O Contrast Bl | $2,237.30 | $3,442.00 | 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 | $1,491.10 | $2,294.00 | 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 | $1,491.10 | $2,294.00 | 35% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI Lower Extremity Joint W/O Contrast Bl | $2,237.30 | $3,442.00 | 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 | $1,491.10 | $2,294.00 | 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 | $1,491.10 | $2,294.00 | 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 | $2,603.90 | $4,006.00 | 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 | $1,735.50 | $2,670.00 | 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 | $1,735.50 | $2,670.00 | 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 | $2,603.90 | $4,006.00 | 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 | $1,735.50 | $2,670.00 | 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 | $1,735.50 | $2,670.00 | 35% |
| MRI of the brain, no contrast dye CPT 70551 HC MRI Brain W/O Contrast | $1,944.15 | $2,991.00 | 35% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI Brain W/O Contrast | $1,944.15 | $2,991.00 | 35% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI Brain W/O & W/Contrast | $4,357.60 | $6,704.00 | 35% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI Brain W/O & W/Contrast | $4,357.60 | $6,704.00 | 35% |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI Lumbar Spine W/O Contrast | $2,598.70 | $3,998.00 | 35% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI Lumbar Spine W/O Contrast | $2,598.70 | $3,998.00 | 35% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US Pregnant Uterus >= 14 Weeks Single/1st Gestation | $819.00 | $1,260.00 | 35% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US Pregnant Uterus >= 14 Weeks Single/1st Gestation | $819.00 | $1,260.00 | 35% |
| Screening mammogram, both breasts both sides CPT 77067 HC Mammography Screen Bilateral | $352.95 | $543.00 | 35% |
| Screening mammogram, both breasts one side CPT 77067 HC Mammography Screen Bl Reduced Service Unilateral Only Completed | $334.75 | $515.00 | 35% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 HC Mammography Screen Bilateral | $352.95 | $543.00 | 35% |
| Screening mammogram, both breasts inpatient one side CPT 77067 HC Mammography Screen Bl Reduced Service Unilateral Only Completed | $334.75 | $515.00 | 35% |
| Sleep study in a lab (polysomnography) CPT 95810 PR Polysomnography Sleep Staging >=4 Parameters Age >=6 Years | $2,543.00 | — | — |
| Sleep study in a lab (polysomnography) CPT 95810 HC Polysomnography Sleep Staging >=4 Parameters Age >=6 Years | $4,249.70 | $6,538.00 | 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 | $4,249.70 | $6,538.00 | 35% |
| Transvaginal pelvic ultrasound CPT 76830 HC US Transvaginal Non Obstetric | $640.25 | $985.00 | 35% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC US Transvaginal Non Obstetric | $640.25 | $985.00 | 35% |
| Ultrasound of the abdomen, complete CPT 76700 HC US Abdomen Complete | $1,084.20 | $1,668.00 | 35% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HC US Abdomen Complete | $1,084.20 | $1,668.00 | 35% |
| X-ray of the lower back, 4 or more views CPT 72110 HC Xr Lumbosacral Spine >= 4 Views | $585.00 | $900.00 | 35% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC Xr Lumbosacral Spine >= 4 Views | $585.00 | $900.00 | 35% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 HC Basic Metabolic Panel (Calcium Total) | $73.45 | $113.00 | 35% |
| Basic metabolic panel (blood test) CPT 80048 HC Basic Metabolic Panel (Calcium Total) | $273.65 | — | — |
| Basic metabolic panel (blood test) inpatient CPT 80048 HC Basic Metabolic Panel (Calcium Total) | $73.45 | $113.00 | 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 CPT 80061 HC Lipid Panel | $461.50 | — | — |
| 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 | $61.75 | $95.00 | 35% |
| Complete blood count (CBC) with differential CPT 85025 HC Cbc Automated/Differential Wbc Automated | $472.55 | — | — |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC Cbc Automated/Differential Wbc Automated | $61.75 | $95.00 | 35% |
| Complete blood count (CBC), no differential CPT 85027 HC Cbc Automated | $70.85 | $109.00 | 35% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HC Cbc Automated | $70.85 | $109.00 | 35% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC Comprehensive Metabolic Panel | $85.15 | $131.00 | 35% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC Comprehensive Metabolic Panel | $477.10 | — | — |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC Comprehensive Metabolic Panel | $85.15 | $131.00 | 35% |
| Kidney function blood test panel CPT 80069 HC Renal Function Panel | $103.35 | $159.00 | 35% |
| Kidney function blood test panel inpatient CPT 80069 HC Renal Function Panel | $103.35 | $159.00 | 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 | $97.50 | $150.00 | 35% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC Prostate Specific Antigen Free | $97.50 | $150.00 | 35% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC Mayo Psaft Prostate Specific Antigen Free | $97.50 | $150.00 | 35% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC Prostate Specific Antigen Free | $97.50 | $150.00 | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC Mayo Psaft Prostate Specific Antigen Total | $118.30 | $182.00 | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC Prostate Specific Antigen Total | $118.30 | $182.00 | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC Mayo Prostate Specific Antigen Total Ultrasensitive | $174.85 | $269.00 | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC Prostate Specific Antigen Total | $380.90 | — | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC Prostate Specific Antigen Total | $118.30 | $182.00 | 35% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC Mayo Psaft Prostate Specific Antigen Total | $118.30 | $182.00 | 35% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC Mayo Prostate Specific Antigen Total Ultrasensitive | $174.85 | $269.00 | 35% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC Mayo Aathr Thromboplastin Time Partial (Ptt) | $57.85 | $89.00 | 35% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC Thromboplastin Time Partial (Ptt) | $57.85 | $89.00 | 35% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC Warde 3514930 Thromboplastin Time Partial (Ptt) | $57.85 | $89.00 | 35% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC Thromboplastin Time Partial (Ptt) | $698.75 | — | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC Warde 3514930 Thromboplastin Time Partial (Ptt) | $57.85 | $89.00 | 35% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC Thromboplastin Time Partial (Ptt) | $57.85 | $89.00 | 35% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC Mayo Aathr Thromboplastin Time Partial (Ptt) | $57.85 | $89.00 | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PR Prothrombin Time | $9.00 | $9.00 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 PR Prothrombin Time | $9.00 | $9.00 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC Warde 3514930 Prothrombin Time | $42.25 | $65.00 | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC Prothrombin Time | $42.25 | $65.00 | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC Mayo Aathr Prothrombin Time | $42.25 | $65.00 | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC Prothrombin Time | $65.65 | — | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PR Prothrombin Time | $9.00 | $9.00 | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PR Prothrombin Time | $9.00 | $9.00 | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC Prothrombin Time | $42.25 | $65.00 | 35% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC Mayo Aathr Prothrombin Time | $42.25 | $65.00 | 35% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC Warde 3514930 Prothrombin Time | $42.25 | $65.00 | 35% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC Thyroid Stimulating Hormone | $92.95 | $143.00 | 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 Mayo Fcuip Thyroid Stimulating Hormone | $92.95 | $143.00 | 35% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC Thyroid Stimulating Hormone | $525.20 | — | — |
| 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 | $92.95 | $143.00 | 35% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC Mayo Fcuip Thyroid Stimulating Hormone | $92.95 | $143.00 | 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 | $406.90 | — | — |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HC Urinalysis With Microscopy Automated | $51.35 | $79.00 | 35% |
| Urinalysis without microscope exam, automated CPT 81003 HC Urinalysis Without Microscopy Automated | $46.15 | $71.00 | 35% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC Urinalysis Without Microscopy Automated | $46.15 | $71.00 | 35% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Cataract surgery with lens implant CPT 66984 PR Rem Cataract Extracapsular Insert Intraocular Lens Prosth Man/Mech Tech | $11,667.47 | — | — |
| 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 PR Colonoscopy Flexible With Removal Tumor/Polyp/Other Lesion by Snare Tech | $551.00 | $551.00 | — |
| 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) | $10,754.67 | — | — |
| Colonoscopy with polyp removal inpatient CPT 45385 PR Colonoscopy Flexible With Removal Tumor/Polyp/Other Lesion by Snare Tech | $924.00 | $924.00 | — |
| Colonoscopy with tissue sample CPT 45380 PR Colonoscopy Flexible With Biopsy Single/Multiple | $730.00 | — | — |
| Colonoscopy with tissue sample CPT 45380 HC Colonoscopy Flexible With Biopsy Single/Multiple (Restricted Method II CAH) | $12,645.88 | — | — |
| Colonoscopy with tissue sample inpatient CPT 45380 PR Colonoscopy Flexible With Biopsy Single/Multiple | $730.00 | $730.00 | — |
| Colonoscopy, diagnostic CPT 45378 PR Colonoscopy Flexible Diagnostic W Collection Specimen Brushing/Washing | $671.00 | — | — |
| Colonoscopy, diagnostic CPT 45378 HC Colon Flexible Dx W/Collection of Specimen(S) by Brushing/Washing (Restricted Method II CAH) | $8,793.52 | — | — |
| Colonoscopy, diagnostic inpatient CPT 45378 PR Colonoscopy Flexible Diagnostic W Collection Specimen Brushing/Washing | $671.00 | $671.00 | — |
| Gallbladder removal, laparoscopic CPT 47562 PR Laparoscopy Surgical Cholecystectomy | $1,451.00 | $1,451.00 | — |
| Gallbladder removal, laparoscopic CPT 47562 HC Cholecystectomy W/Laparoscopy (Restricted Method II CAH) | $26,382.62 | — | — |
| Gallbladder removal, laparoscopic inpatient CPT 47562 PR Laparoscopy Surgical Cholecystectomy | $2,363.00 | $2,363.00 | — |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 PR Repr Init Ing Hernia 5y or Older Reducible | $1,157.00 | $1,157.00 | — |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 HC Repr Hernia Ing Init >=5yr Bl (Restricted Method II CAH) | $18,665.79 | — | — |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 PR Repr Init Ing Hernia 5y or Older Reducible | $1,878.00 | $1,878.00 | — |
| Knee arthroscopy with meniscus trim CPT 29881 PR Arthroscopy Knee Surg W/ Meniscectomy Incl Debr/Shvi Artc Cartilage | $1,220.00 | $1,220.00 | — |
| Knee arthroscopy with meniscus trim inpatient CPT 29881 PR Arthroscopy Knee Surg W/ Meniscectomy Incl Debr/Shvi Artc Cartilage | $1,870.00 | $1,870.00 | — |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC Injection(S) Epidural/Subarachnoid Lumbar/Sacral Needle Placement W/Guidance | $1,292.85 | $1,989.00 | 35% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC Injection(S) Epidural/Subarachnoid Lumbar/Sacral Needle Placement W/Guidance | $2,582.71 | — | — |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC Injection(S) Epidural/Subarachnoid Lumbar/Sacral Needle Placement W/Guidance | $1,292.85 | $1,989.00 | 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 | $3,047.85 | $4,689.00 | 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 | $2,031.90 | $3,126.00 | 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 | $2,031.90 | $3,126.00 | 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 | $3,047.85 | $4,689.00 | 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 | $2,031.90 | $3,126.00 | 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 | $2,031.90 | $3,126.00 | 35% |
| Prostate biopsy CPT 55700 PR Biopsy Prostate Needle/Punch Single/Multiple Any Approach | $466.00 | $466.00 | — |
| Prostate biopsy CPT 55700 PR Biopsy Prostate Needle/Punch Single/Multiple Any Approach | $466.00 | $466.00 | — |
| Prostate biopsy CPT 55700 HC Biopsy Prostate Needle/Punch Single/Multiple Any Approach | $1,118.65 | $1,721.00 | 35% |
| Prostate biopsy CPT 55700 HC Biopsy Prostate Needle/Punch Single/Multiple Any Approach | $14,818.54 | — | — |
| Prostate biopsy inpatient CPT 55700 PR Biopsy Prostate Needle/Punch Single/Multiple Any Approach | $466.00 | $466.00 | — |
| Prostate biopsy inpatient CPT 55700 PR Biopsy Prostate Needle/Punch Single/Multiple Any Approach | $466.00 | $466.00 | — |
| Prostate biopsy inpatient CPT 55700 HC Biopsy Prostate Needle/Punch Single/Multiple Any Approach | $1,118.65 | $1,721.00 | 35% |
| Tonsil and adenoid removal, child under 12 CPT 42820 PR Tonsillectomy & Adenoidectomy Younger Than Age 12 | $17,294.97 | — | — |
| Tonsil and adenoid removal, child under 12 inpatient CPT 42820 PR Tonsillectomy & Adenoidectomy Younger Than Age 12 | $1,077.00 | $1,077.00 | — |
| Total hip replacement one side CPT 27130 HC Arthoplasty Acetabular & Proximal Femoral Prosthetic Repl Rt (Restricted Method II CAH) | $42,087.80 | — | — |
| Total knee replacement CPT 27447 PR Arthroplasty Knee Condyle&Plateau Med/Lat Cpts W/WO Patella Resurfacing | $2,821.00 | $2,821.00 | — |
| 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) | $34,613.25 | — | — |
| Total knee replacement inpatient CPT 27447 PR Arthroplasty Knee Condyle&Plateau Med/Lat Cpts W/WO Patella Resurfacing | $4,383.00 | $4,383.00 | — |
| Upper endoscopy (EGD) with biopsy CPT 43239 PR Egd Flexible Transoral W/ Biopsy Single/Multiple | $301.00 | $301.00 | — |
| Upper endoscopy (EGD) with biopsy CPT 43239 HC Egd Flexible Transoral W/Bx Single/Mult (Restricted Method II CAH) | $11,677.09 | — | — |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 PR Egd Flexible Transoral W/ Biopsy Single/Multiple | $503.00 | $503.00 | — |
| Upper endoscopy (EGD), diagnostic CPT 43235 PR Egd Flexible Transoral Dx Incl Coll Spec by Brushing/Washing | $10,152.54 | $267.00 | -3702% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 PR Egd Flexible Transoral Dx Incl Coll Spec by Brushing/Washing | $446.00 | $446.00 | — |
| 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 |
|---|---|---|---|
| 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 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 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 | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC Pt Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes | $89.05 | $137.00 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC Ot Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes | $89.05 | $137.00 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC Pt Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes | $1,063.40 | — | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC Ot Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes | $89.05 | $137.00 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC Pt Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes | $89.05 | $137.00 | 35% |
| Preventive checkup, new patient aged 18–39 CPT 99385 PR E&M Preventive Medicine Initial Comprehensive New Patient 18-39 Years | $199.00 | $199.00 | — |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 PR E&M Preventive Medicine Initial Comprehensive New Patient 18-39 Years | $199.00 | $199.00 | — |
| Preventive checkup, new patient aged 40–64 CPT 99386 PR E&M Preventive Medicine Initial Comprehensive New Patient 40-64 Years | $241.00 | $241.00 | — |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 PR E&M Preventive Medicine Initial Comprehensive New Patient 40-64 Years | $241.00 | $241.00 | — |
Source file: https://hpt.trinity-health.org/421336618_mercy-medical-center-clinton-inc_standardcharges.zip