UnityPoint Health - Trinity Moline
2701 17th St, Rock Island, IL · UnityPoint Health · · NPI 1316047632
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 |
|---|---|---|---|---|
| Somatropin injection HCPCS J2941 | not published | not published | $45.98 – $442.32 | 14 |
| So neo gsap dna/dna&rna CPT 81459 | $2,869.97 | $3,587.46 | $2.94 – $6,787.48 | 16 |
| So neo gsap dna mcrstl ins CPT 81457 | $861.00 | $1,076.24 | $2.94 – $2,036.25 | 16 |
| Sotalol hydrochloride IV HCPCS C9482 | not published | not published | $22.78 – $40.08 | 11 |
| So vest canvas/web pre ots HCPCS L3675 | not published | not published | $95.52 – $307.94 | 14 |
| Spacer bag/reservoir HCPCS A4627 | not published | not published | $6.68 – $50.00 | 8 |
| Sp bone agrft morsel add-on CPT 20937 | $406.40 | $508.00 | $144.30 – $383.93 | 14 |
| Sp bone agrft struct add-on CPT 20938 | $442.40 | $553.00 | $156.77 – $418.97 | 14 |
| Sp bone algrft morsel add-on CPT 20930 | $291.20 | $364.00 | $207.30 – $363.06 | 8 |
| Special casting material HCPCS A4590 | $47.20 | $59.00 | $1.80 – $126.40 | 8 |
| Special physics consult CPT 77370 | $999.56 | $1,249.44 | $103.29 – $551.00 | 17 |
| Special pump services CPT 99190 | $928.00 | $1,160.00 | $482.15 – $1,070.13 | 8 |
| Special pump services CPT 99191 | $649.60 | $812.00 | $337.52 – $749.04 | 8 |
| Special pump services CPT 99192 | $464.80 | $581.00 | $241.57 – $535.75 | 8 |
| Special radiation dosimetry CPT 77331 | $999.56 | $1,249.44 | $16.98 – $551.00 | 17 |
| Special radiation treatment CPT 77470 | $2,357.19 | $2,946.48 | $30.46 – $1,299.40 | 17 |
| Special supplies phys/qhp CPT 99070 | $90.40 | $113.00 | $50.00 – $115.24 | 6 |
| Special teletx port plan CPT 77321 | $2,498.88 | $3,123.59 | $39.72 – $1,377.50 | 17 |
| Specific gravity body fluid CPT 84315 | $33.57 | $41.96 | $1.97 – $18.50 | 16 |
| Specimen fat stain CPT 89125 | $56.44 | $70.54 | $3.50 – $31.11 | 16 |
| Speech and Language Evaluation (comprehensive) CPT 92523 | $450.28 | $562.85 | $203.32 – $326.84 | 16 |
| Speech audiometry complete CPT 92556 | $83.20 | $104.00 | $41.49 – $104.55 | 15 |
| Speech evaluation complex CPT 70371 | $228.00 | $285.00 | $38.84 – $205.56 | 15 |
| Speech recep thresh CPT 92555 | $53.60 | $67.00 | $26.73 – $67.24 | 15 |
| Speech Therapy Session (one-on-one) CPT 92507 | $209.61 | $262.01 | $68.24 – $138.08 | 16 |
| Sperm antibody test CPT 89325 | $56.44 | $70.54 | $3.50 – $31.11 | 16 |
| Sperm evaluation test CPT 89329 | $49.60 | $62.00 | $3.50 – $31.34 | 14 |
| Sperm identification CPT 89257 | $109.60 | $137.00 | $52.35 – $89.11 | 12 |
| Sperm isolation complex CPT 89261 | $140.80 | $176.00 | $52.35 – $500.00 | 13 |
| Sperm isolation simple CPT 89260 | $104.80 | $131.00 | $52.35 – $500.00 | 13 |
| Sperm washing 58323 CPT 58323 | $38.40 | $48.00 | $10.69 – $28.67 | 14 |
| Sphenoid sinus surgery CPT 31051 | $3,276.80 | $4,096.00 | $618.74 – $4,602.15 | 15 |
| Sphincteroplasty inc/prolapse adult 46750 CPT 46750 | $1,876.80 | $2,346.00 | $670.79 – $2,133.47 | 15 |
| Spinal bone allograftstructural 20931 CPT 20931 | $266.40 | $333.00 | $94.59 – $255.66 | 14 |
| Spinal bone autograftlocal 20936 CPT 20936 | $309.60 | $387.00 | $220.80 – $386.44 | 8 |
| Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance CPT 62328 | $1,387.82 | $1,734.77 | $77.23 – $765.03 | 17 |
| Spine device implant surgery HCPCS C9757 | not published | not published | $10,009.88 – $21,460.21 | 13 |
| Spine X-ray (single view, one level) CPT 72020 | $159.16 | $198.94 | $7.10 – $87.73 | 17 |
| Spirmtry w/brnchdil inf-2 yr CPT 94012 | $316.00 | $395.00 | $125.56 – $332.02 | 15 |
| Spirometry up to 2 yrs old CPT 94011 | $194.40 | $243.00 | $77.13 – $203.40 | 15 |
| Spleen imaging CPT 78185 | $1,204.32 | $1,505.40 | $15.15 – $663.88 | 17 |
| Splenectomy total open 38100 CPT 38100 | $2,828.80 | $3,536.00 | $1,009.28 – $2,690.84 | 14 |
| Splice spleen/kidney veins CPT 37181 | not published | not published | $2,018.01 – $6,269.93 | 14 |
| Splicing of ureters CPT 50770 | not published | not published | $1,040.53 – $2,773.46 | 14 |
| Splint arm vnyl coated padded lft med HCPCS Q4051 | $48.00 | $60.00 | not published | 0 |
| Splint dorsal bloc wh med perf 3.2mm lf polyflex ii HCPCS L3906 | $881.60 | $1,102.00 | $219.83 – $889.09 | 14 |
| Splint extn xsm w sof-stretch rolyan HCPCS L3925 | not published | not published | $34.95 – $115.25 | 14 |
| Splint finger 4 prong foam sm HCPCS A4570 | $20.80 | $26.00 | $2.90 – $48.00 | 8 |
| Splint finger fold over sm HCPCS L3924 | not published | not published | $48.85 – $169.47 | 14 |
| Splint finger frog med HCPCS L3927 | not published | not published | $19.05 – $61.41 | 14 |
| Splint fing stax assort 1-7in HCPCS Q4049 | $5.60 | $7.00 | $1.31 – $4.21 | 14 |
| Splint rstrc wrst/cmc right med HCPCS L3923 | $196.00 | $245.00 | $48.85 – $169.47 | 14 |
| Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 % CPT 15120 | $6,005.04 | $7,506.30 | $621.01 – $3,310.28 | 17 |
| Split blood or products CPT 86985 | $164.99 | $206.23 | $14.53 – $285.81 | 17 |
| Split flat caliper stirr & p HCPCS L2230 | not published | not published | $44.40 – $184.42 | 14 |
| Splt agrft f/s/n/h/f/g/m ea CPT 15121 | $516.00 | $645.00 | $115.50 – $309.84 | 14 |
| Spontaneous nystagmus study CPT 92531 | $52.80 | $66.00 | $22.65 – $41.55 | 8 |
| Sprchoroidal spc njx rx agt CPT 67516 | $313.60 | $392.00 | $87.74 – $481.79 | 14 |
| Spring-ass rot wrst with latch HCPCS L6623 | not published | not published | $434.90 – $1,378.08 | 14 |
| Sputum specimen collection CPT 89220 | $180.00 | $224.99 | $8.93 – $99.22 | 16 |
| Sr-89 stront chlor ther / mci HCPCS A9600 | not published | not published | $918.74 – $6,634.14 | 14 |
| Srs cranial lesion complex CPT 61798 | $3,244.00 | $4,055.00 | $1,187.67 – $3,166.22 | 14 |
| Srs cranial lesion simple CPT 61796 | $2,384.00 | $2,980.00 | $881.41 – $2,345.83 | 14 |
| Srs cran les complex addl CPT 61799 | $711.20 | $889.00 | $253.96 – $679.70 | 14 |
| Srs cran les simple addl CPT 61797 | $719.20 | $899.00 | $183.91 – $491.76 | 14 |
| Srsf2 gene common variants CPT 81348 | not published | not published | $3.50 – $280.64 | 14 |
| Srs linear based CPT 77372 | $16,473.10 | $20,591.37 | $822.33 – $9,080.79 | 17 |
| Srs multisource CPT 77371 | $2,114.40 | $2,643.00 | $1,722.40 – $12,750.03 | 15 |
| Srs spinal lesion CPT 63620 | $2,631.20 | $3,289.00 | $971.62 – $2,587.83 | 14 |
| Srs spinal lesion addl CPT 63621 | $591.20 | $739.00 | $211.51 – $565.03 | 14 |
| Staggered spondaic word test CPT 92572 | $100.80 | $126.00 | $50.35 – $123.97 | 15 |
| Staging lapro hodgkins disease/lymphoma 49220 CPT 49220 | not published | not published | $1,768.00 – $1,768.00 | 1 |
| Stainless steel any wrist HCPCS L6630 | not published | not published | $129.05 – $551.84 | 14 |
| St analysis behavior qualitative voice/resonance CPT 92524 | $238.73 | $298.41 | $97.36 – $158.03 | 16 |
| Stance phase only HCPCS L5858 | not published | not published | $11,138.25 – $35,898.11 | 14 |
| Standard control cable extra HCPCS L6655 | not published | not published | $53.84 – $147.98 | 14 |
| Staph a dna amp probe CPT 87640 | $87.20 | $109.00 | $3.50 – $56.14 | 16 |
| Static or dynami afo pre ots HCPCS L4397 | not published | not published | $96.80 – $323.50 | 14 |
| Stationary o2 contents, gas HCPCS E0441 | not published | not published | $34.58 – $105.26 | 13 |
| Stationary o2 contents, liq HCPCS E0442 | not published | not published | $34.58 – $105.26 | 13 |
| St cognitve performance testing healthcare professional each hour CPT 96125 | $243.20 | $304.00 | $90.67 – $248.90 | 14 |
| Stem cells total count CPT 86367 | $156.00 | $195.00 | $3.50 – $124.45 | 16 |
| Stenger test pure tone CPT 92565 | $39.20 | $49.00 | $19.34 – $48.57 | 15 |
| Stenger test speech CPT 92577 | $40.80 | $51.00 | $20.23 – $412.79 | 15 |
| Stent/athrectomy/fem/pop/unilat 37227 CPT 37227 | $70,321.60 | $87,902.00 | $611.31 – $20,756.63 | 17 |
| Stent axios caut enh 15x10mm electrocaut HCPCS C1874 | $1,628.38 | $2,035.47 | $551.61 – $1,072.69 | 7 |
| Stent bili rx wallflx 10x80 uncvr HCPCS C1876 | $4,850.09 | $6,062.61 | $1,642.97 – $3,195.00 | 7 |
| Stent iliac/open or perc/uni/init 37221 CPT 37221 | $23,822.18 | $29,777.72 | $419.22 – $13,131.97 | 17 |
| Stent iliac/open/perc/ea ad/ipsila 37223 CPT 37223 | $14,743.78 | $18,429.72 | $180.02 – $8,127.51 | 16 |
| Stent placemt retro carotid CPT 37217 | $5,328.00 | $6,660.00 | $923.62 – $2,885.00 | 14 |
| Stent/tib/peroneal/unilat/initial 37230 CPT 37230 | $49,374.40 | $61,718.00 | $592.65 – $17,595.34 | 17 |
| Stereoscopic x-ray guidance HCPCS G6002 | $136.00 | $170.00 | $19.11 – $140.40 | 14 |
| Stereotactic bx aspir/exc burr intracranial les 61750 CPT 61750 | $3,308.00 | $4,135.00 | $1,212.87 – $3,229.05 | 14 |
| Stereotactic radiation trmt CPT 77432 | $845.60 | $1,057.00 | $393.37 – $994.14 | 14 |
| Sterile gauze <= 16 sq in HCPCS A6402 | not published | not published | $0.08 – $0.50 | 14 |
| Sterile needle HCPCS A4215 | not published | not published | $0.22 – $0.52 | 6 |
| Sterile water/saline, 10 ml HCPCS A4216 | $1.20 | $1.50 | $0.31 – $3.36 | 14 |
| Sterile water/saline, 500 ml HCPCS A4217 | not published | not published | $2.18 – $8.14 | 14 |
| Sternal debridement CPT 21627 | $1,318.40 | $1,648.00 | $488.07 – $1,298.58 | 14 |
| Sternal pad HCPCS L1050 | not published | not published | $46.79 – $193.42 | 14 |
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.