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 |
|---|---|---|---|---|
| Destruct penis les/smp/electrodesi 54055 CPT 54055 | $311.20 | $389.00 | $88.43 – $1,423.07 | 15 |
| Detect agent nos dna dir CPT 87797 | $67.15 | $83.93 | $3.50 – $48.05 | 16 |
| Detect agnt mult dna direc CPT 87800 | $109.60 | $137.00 | $3.50 – $69.87 | 16 |
| Determination venous press CPT 93770 | $18.40 | $23.00 | $1.12 – $20.88 | 8 |
| Determine refractive state CPT 92015 | not published | not published | $24.99 – $51.76 | 8 |
| Developmental screen/score/document 96110 CPT 96110 | $56.80 | $71.00 | $17.81 – $26.81 | 8 |
| Devel tst phys/qhp 1st hr CPT 96112 | $307.20 | $384.00 | $111.75 – $299.96 | 15 |
| Device ablt adv novasure HCPCS C1886 | $231.43 | $289.28 | $78.39 – $152.45 | 7 |
| Device hemospray 7frx220cm endo hemostat min access HCPCS C1052 | $7,447.78 | $9,309.72 | $2,124.64 – $4,131.68 | 7 |
| Device intraute mirena HCPCS J7298 | $1,544.80 | $1,931.00 | $489.87 – $3,298.21 | 9 |
| Dev interrog remote 1/2/mlt CPT 93295 | $115.20 | $144.00 | $33.09 – $126.64 | 14 |
| Devise bowel pouch CPT 44316 | $3,464.00 | $4,330.00 | $1,238.33 – $3,301.32 | 14 |
| Devlopment test interpt&rep HCPCS G0451 | $49.60 | $62.00 | $10.19 – $71.96 | 15 |
| Dev tst admin phys/qhp ea addl 30 min CPT 96113 | $137.60 | $172.00 | $46.68 – $137.23 | 14 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | $108.69 | $135.86 | $8.68 – $68.50 | 17 |
| Dexametha opth insert 0.1 mg HCPCS J1096 | not published | not published | $99.44 – $415.38 | 13 |
| Dexamethasone 0.4 mg/0.1 ml intraocular injection - cnr HCPCS J1095 | not published | not published | $1.15 – $3.45 | 4 |
| Dexamethasone 4 mg tablet HCPCS J8540 | $0.40 | $0.50 | $0.01 – $1.48 | 9 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $18.21 | $22.76 | $0.02 – $1.48 | 9 |
| Dexamethasone intra implant HCPCS J7312 | not published | not published | $192.96 – $671.90 | 14 |
| Dexamethasone panel CPT 80420 | $324.00 | $405.00 | $3.50 – $259.01 | 16 |
| Dexmedetomidine film, 1 mcg HCPCS J1105 | not published | not published | $0.58 – $1.02 | 11 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | $259.20 | $324.00 | $30.16 – $561.21 | 14 |
| Dextran 40 infusion HCPCS J7100 | not published | not published | $37.73 – $96.58 | 7 |
| Dextran 75 infusion HCPCS J7110 | not published | not published | $14.52 – $50.49 | 5 |
| Dextroamphetamine HCPCS S0160 | not published | not published | $0.78 – $7.25 | 7 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | $2.80 | $3.50 | $0.85 – $4.19 | 7 |
| Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 | $48.00 | $60.00 | $5.68 – $31.62 | 9 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | $5.60 | $7.00 | $1.68 – $5.67 | 7 |
| Dextrose 5 % IV bolus HCPCS J7070 | $48.00 | $60.00 | $3.36 – $26.46 | 9 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $56.00 | $70.00 | $3.50 – $35.57 | 16 |
| Diabetes (HbA1c) Test CPT 83036 | $33.57 | $41.96 | $3.50 – $18.50 | 16 |
| Diabetes training group per 30 min g0109 HCPCS G0136 | $36.00 | $45.00 | $8.33 – $43.27 | 15 |
| Diabetic custom molded shoe HCPCS A5501 | not published | not published | $132.94 – $426.35 | 14 |
| Diabetic shoe with wedge HCPCS A5504 | not published | not published | $21.32 – $72.42 | 14 |
| Diabetic shoe w/off set heel HCPCS A5506 | not published | not published | $21.32 – $72.42 | 14 |
| Diabetic shoe w/roller/rockr HCPCS A5503 | not published | not published | $21.32 – $72.42 | 14 |
| Diab manage trn ind/group HCPCS G0109 | $60.18 | $75.22 | $13.84 – $37.99 | 16 |
| Diab shoe for density insert HCPCS A5500 | $178.40 | $223.00 | $44.32 – $142.16 | 14 |
| Diab shoe w/metatarsal bar HCPCS A5505 | not published | not published | $21.32 – $72.42 | 14 |
| Diag bronchoscope/catheter CPT 31643 | $448.00 | $560.00 | $152.76 – $1,341.57 | 15 |
| Diag laparo separate proc 49320 CPT 49320 | $807.20 | $1,009.00 | $292.53 – $4,538.91 | 15 |
| Diagnostic anoscopy CPT 46601 | $355.20 | $444.00 | $75.71 – $310.44 | 15 |
| Diagnostic anoscopy & biopsy CPT 46607 | $496.80 | $621.00 | $111.48 – $917.28 | 15 |
| Diagnostic anoscopy spx 46600 CPT 46600 | $252.00 | $315.00 | $37.28 – $126.31 | 17 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | $382.40 | $478.00 | $63.77 – $296.96 | 8 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | $382.40 | $478.00 | $51.86 – $234.52 | 8 |
| Diagnostic laryngoscopy 31505 CPT 31505 | $212.80 | $266.00 | $44.98 – $151.03 | 17 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $482.31 | $602.88 | $62.16 – $265.87 | 17 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $484.25 | $605.31 | $43.57 – $266.94 | 16 |
| Diagnostic Mammogram (one breast) CPT 77065 | $401.76 | $502.20 | $35.36 – $221.47 | 16 |
| Diagnostic radio unlisted proc CPT 76499 | not published | not published | $68.50 – $146.86 | 13 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | $14,977.66 | $18,722.07 | $174.92 – $8,256.43 | 16 |
| Dialysis one evaluation CPT 90945 | $2,120.40 | $2,650.50 | $78.81 – $663.88 | 17 |
| Dialysis repeated eval CPT 90947 | $280.00 | $350.00 | $111.79 – $293.05 | 14 |
| Dialysis training complete CPT 90989 | $789.60 | $987.00 | $424.38 – $985.35 | 8 |
| Dialysis training incompl CPT 90993 | $172.00 | $215.00 | $92.46 – $214.60 | 8 |
| Diathermy eg microwave CPT 97024 | $13.60 | $17.00 | $6.40 – $10.89 | 14 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | $0.11 | $0.13 | $0.04 – $0.50 | 10 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $96.96 | $121.20 | $0.64 – $23.94 | 9 |
| Dicyclomine injection HCPCS J0500 | $132.40 | $165.50 | $11.22 – $76.57 | 9 |
| Difelikefalin, esrd on dialy HCPCS J0879 | not published | not published | $0.07 – $1.48 | 12 |
| Diffusing capacity CPT 94729 | $280.46 | $350.57 | $8.07 – $154.60 | 16 |
| Digital analysis of eeg CPT 95957 | $605.60 | $757.00 | $64.11 – $392.39 | 16 |
| Digit nerve surgery add-on CPT 64778 | $450.40 | $563.00 | $158.34 – $421.99 | 14 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $137.60 | $172.00 | $0.54 – $24.74 | 9 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | not published | not published | $3,284.24 – $15,444.80 | 14 |
| Digoxin total therapeutic drug level CPT 80162 | $66.43 | $83.03 | $3.50 – $36.62 | 16 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | $309.20 | $386.50 | $47.11 – $194.36 | 9 |
| Dilate biliary duct/ampulla CPT 47542 | $1,273.60 | $1,592.00 | $120.69 – $687.80 | 14 |
| Dilate esophagus CPT 43453 | $2,142.40 | $2,678.00 | $77.80 – $1,475.78 | 15 |
| Dilate esophagus 1/mult pass CPT 43450 | $420.80 | $526.00 | $71.53 – $729.38 | 15 |
| Dilate ic vasospasm ea add vsl diff territory CPT 61642 | not published | not published | $562.33 – $1,076.17 | 8 |
| Dilate ic vasospasm ea add vsl same territory CPT 61641 | not published | not published | $281.16 – $538.10 | 8 |
| Dilate ic vasospasm init CPT 61640 | not published | not published | $800.84 – $1,531.55 | 8 |
| Dilate tear duct opening CPT 68801 | $454.40 | $568.00 | $71.71 – $310.44 | 15 |
| Dilate urethra stricture CPT 53600 | $719.10 | $898.87 | $57.45 – $396.40 | 17 |
| Dilate urethra stricture CPT 53601 | $200.80 | $251.00 | $48.09 – $127.81 | 15 |
| Dilate urethra stricture CPT 53605 | $164.00 | $205.00 | $57.35 – $2,683.16 | 15 |
| Dilate urethra stricture CPT 53621 | $565.77 | $707.21 | $64.64 – $311.88 | 17 |
| Dilation/female urethra/initial 53660 CPT 53660 | $174.40 | $218.00 | $37.44 – $144.52 | 15 |
| Dilation of anal sphincter CPT 45905 | $416.80 | $521.00 | $153.25 – $917.28 | 15 |
| Dilation of cervical canal 57800 CPT 57800 | $172.80 | $216.00 | $43.07 – $2,473.55 | 15 |
| Dilation of rectal stricture 45910 CPT 45910 | $476.80 | $596.00 | $174.00 – $917.28 | 15 |
| Dilation of salivary duct CPT 42660 | $296.80 | $371.00 | $71.40 – $396.18 | 15 |
| Dilation of urethra CPT 53661 | $172.00 | $215.00 | $36.29 – $126.31 | 15 |
| Dilation of urethra CPT 53665 | $97.60 | $122.00 | $33.74 – $1,593.66 | 15 |
| Dilation of vagina CPT 57400 | $328.80 | $411.00 | $116.40 – $2,473.55 | 15 |
| Dilation salivary duct 42650 CPT 42650 | $193.60 | $242.00 | $53.85 – $1,152.38 | 15 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | $4,795.88 | $5,994.85 | $78.39 – $2,643.73 | 17 |
| Dilator fascial 10fx20cm HCPCS C2627 | $353.91 | $442.38 | $119.88 – $233.13 | 7 |
| Dilat xst trc ndurlgc px CPT 50436 | $3,883.16 | $4,853.94 | $136.15 – $2,683.16 | 17 |
| Dilat xst trc new access rcs CPT 50437 | $6,532.83 | $8,166.03 | $226.29 – $3,601.22 | 17 |
| Diltiazem 5 mg/ml intravenous solution HCPCS J1163 | $3.56 | $4.45 | $0.01 – $0.01 | 7 |
| Dimecaprol injection HCPCS J0470 | not published | not published | $40.93 – $160.11 | 6 |
| Dimenhydrinate injection HCPCS J1240 | not published | not published | $7.19 – $24.35 | 7 |
| Dimethyl sulfoxide 50% 50 ml HCPCS J1212 | $746.40 | $933.00 | $125.35 – $2,147.46 | 14 |
| Diphenhydramine 12.5 mg/5 ml oral elixir HCPCS Q0163 | $0.60 | $0.75 | $0.02 – $1.48 | 7 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $74.16 | $92.70 | $0.09 – $3.80 | 9 |
| Diphtheria-tetanus toxoids 0.5 ml (peds) CPT 90702 | $62.40 | $78.00 | $40.43 – $79.80 | 8 |
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.