MercyOne Genesis Davenport Medical Center
1227 East Rusholme Street, Davenport, IA · MercyOne · · NPI 1972542264
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 sphenopalatine ganglion block CPT 64505 | $511.80 | $853.00 | $282.56 – $395.59 | 2 |
| Ghs spont nystagmus CPT 92541 | $144.00 | $240.00 | $123.39 – $156.00 | 2 |
| Ghs sp train/fitting sp device - kx CPT 92609 | $183.00 | $305.00 | not published | 0 |
| Ghs st - eval for alt comm CPT 92567 | $133.20 | $222.00 | $37.57 – $52.60 | 2 |
| Ghs strapping shoulder - 29240 CPT 29240 | $156.00 | $260.00 | $123.39 – $169.00 | 2 |
| Ghs st - re-eval for alt comm CPT 92597 | $140.40 | $234.00 | not published | 0 |
| Ghs subcutaneous infus, for therapy ea. add. hr CPT 96370 | $69.00 | $115.00 | $44.17 – $46.15 | 2 |
| Ghs subcutaneous infus. for therapy init 1 hr CPT 96369 | $351.60 | $586.00 | $201.68 – $282.35 | 2 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $520.20 | $867.00 | $306.15 – $585.94 | 2 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | $315.00 | $525.00 | $321.10 – $382.44 | 2 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | $1,206.00 | $2,010.00 | $1,306.50 – $1,417.91 | 2 |
| Ghs trypsin (fecal) CPT 84488 | $108.60 | $181.00 | not published | 0 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $591.00 | $985.00 | $229.62 – $321.47 | 2 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | $475.80 | $793.00 | $229.62 – $321.47 | 2 |
| Ghs urine, hydroxproline total CPT 83505 | $224.40 | $374.00 | not published | 0 |
| Ghs urine, porphyrins quant CPT 84120 | $160.20 | $267.00 | not published | 0 |
| Ghs vaginal delivery only CPT 59409 | $2,466.60 | $4,111.00 | $2,672.15 – $3,043.51 | 2 |
| Ghs veeg 12-26 hr intmt mont CPT 95715 | $1,576.80 | $2,628.00 | $507.90 – $711.06 | 2 |
| Ghs windowing of cast CPT 29730 | $151.20 | $252.00 | $151.04 – $163.80 | 2 |
| Gi endoscopic ultrasound CPT 76975 | not published | not published | $231.38 – $323.93 | 2 |
| Gi inhouse confirmation CPT 87045 | $87.00 | $145.00 | not published | 0 |
| Gingivoplasty each quadrant CPT 41872 | not published | not published | $3,104.33 – $4,346.06 | 2 |
| Gi protein loss CPT 78282 | not published | not published | $384.64 – $538.50 | 2 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | $1,345.80 | $2,243.00 | not published | 0 |
| Gi trc img intral colon i&r CPT 91113 | not published | not published | $872.71 – $1,221.79 | 2 |
| Gi trc img intral esophagus CPT 91111 | $76.20 | $127.00 | $897.45 – $1,256.43 | 2 |
| Gi wireless capsule measure CPT 91112 | not published | not published | $897.45 – $1,256.43 | 2 |
| Glassia injection HCPCS J0257 | $40.24 | $67.06 | $5.47 – $7.99 | 2 |
| Glaucoma scrn hgh risk direc HCPCS G0117 | not published | not published | $23.44 – $32.82 | 2 |
| Glaucoma scrn hgh risk direc HCPCS G0118 | not published | not published | $37.57 – $52.60 | 2 |
| Glaucoma surgery CPT 66150 | not published | not published | $3,850.76 – $5,391.07 | 2 |
| Glaucoma surgery CPT 66155 | not published | not published | $3,850.76 – $5,391.07 | 2 |
| Glaucoma surgery CPT 66160 | not published | not published | $2,183.16 – $3,056.42 | 2 |
| Glaucoma surgery CPT 66170 | not published | not published | $2,183.16 – $3,056.42 | 2 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $509.77 | $849.62 | $187.41 – $274.11 | 2 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | not published | not published | $138.68 – $202.83 | 2 |
| Glucagon plasma - sendout CPT 82943 | $228.60 | $381.00 | not published | 0 |
| Glucose 1 hr post dose CPT 82950 | $40.20 | $67.00 | not published | 0 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $29.40 | $49.00 | not published | 0 |
| Glucose blood quantitative CPT 82947 | $80.40 | $134.00 | not published | 0 |
| Glucose body fluid CPT 82945 | $49.20 | $82.00 | not published | 0 |
| Glucose monitoring continual min 72hr pt CPT 95249 | $179.40 | $299.00 | not published | 0 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $75.00 | $125.00 | not published | 0 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $67.80 | $113.00 | not published | 0 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | not published | not published | $0.41 – $0.60 | 2 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $3,570.58 | $5,950.96 | $10.56 – $15.44 | 2 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $106.80 | $178.00 | not published | 0 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $114.60 | $191.00 | not published | 0 |
| Gonioscopy CPT 92020 | not published | not published | $123.39 – $172.74 | 2 |
| Goniotomy CPT 65820 | not published | not published | $3,850.76 – $5,391.07 | 2 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | $5,489.50 | $9,149.17 | $702.74 – $1,027.81 | 2 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $2,868.60 | $4,781.00 | not published | 0 |
| Graft hand or finger tendon CPT 26416 | not published | not published | $3,105.81 – $4,348.13 | 2 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $31,054.80 | $51,758.00 | not published | 0 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $26,257.80 | $43,763.00 | not published | 0 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $10,269.00 | $17,115.00 | not published | 0 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | $3,950.40 | $6,584.00 | not published | 0 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $11,542.80 | $19,238.00 | not published | 0 |
| Graft repair of spine defect 63710 CPT 63710 | $2,054.40 | $3,424.00 | not published | 0 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $6,142.80 | $10,238.00 | not published | 0 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | $5,232.60 | $8,721.00 | not published | 0 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $53,325.60 | $88,876.00 | not published | 0 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $5,876.40 | $9,794.00 | not published | 0 |
| Granisetron 1 mg tab HCPCS Q0166 | $94.60 | $157.66 | not published | 0 |
| Granisetron hcl injection HCPCS J1626 | $300.53 | $500.89 | not published | 0 |
| Great toe with reduction 28495 CPT 28495 | $338.40 | $564.00 | not published | 0 |
| Grfg autol fat lipo 25 cc/< CPT 15773 | $930.00 | $1,550.00 | not published | 0 |
| Grfg autol fat lipo 50 cc/< CPT 15771 | $907.20 | $1,512.00 | not published | 0 |
| Grfg autol fat lipo ea addl CPT 15772 | $291.00 | $485.00 | not published | 0 |
| Grfg autol soft tiss dir exc CPT 15769 | not published | not published | $3,504.35 – $4,906.10 | 2 |
| Group behave couns 2-10 HCPCS G0473 | not published | not published | $28.52 – $39.92 | 2 |
| Group mnt 2 or more 30 mins HCPCS G0271 | $39.60 | $66.00 | not published | 0 |
| Growth hormone antibody CPT 86277 | $81.60 | $136.00 | not published | 0 |
| Grp adapt bhv tx by phy/qhp CPT 97158 | not published | not published | $28.52 – $39.92 | 2 |
| Grp adapt bhv tx by tech CPT 97154 | not published | not published | $28.52 – $39.92 | 2 |
| Gstrct prtl dstl w/roux-en-y rcnstj 43633 CPT 43633 | $3,604.20 | $6,007.00 | not published | 0 |
| Gstrst open wo constj tube CPT 43830 | $1,315.20 | $2,192.00 | not published | 0 |
| G-tube reposition CPT 43761 | $361.80 | $603.00 | $232.81 – $325.93 | 2 |
| Gu dilat ureter/urethra s&i CPT 74485 | $4,820.40 | $8,034.00 | $1,960.87 – $2,745.22 | 2 |
| Guided cath fluid drainage 10030 CPT 10030 | $739.80 | $1,233.00 | not published | 0 |
| Guide endoanchr sg-64 aaa 62cm HCPCS L8670 | $4,200.60 | $7,001.00 | not published | 0 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $4,939.20 | $8,232.00 | not published | 0 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $695.40 | $1,159.00 | not published | 0 |
| Guid loc target vol rad tx CPT 77387 | $289.20 | $482.00 | not published | 0 |
| Gum graft CPT 41870 | not published | not published | $1,417.91 – $1,985.08 | 2 |
| Gw stiffened micro access kit HCPCS C1894 | $1,428.60 | $2,381.00 | not published | 0 |
| Gynecomastia (males) 19300 CPT 19300 | $972.60 | $1,621.00 | not published | 0 |
| Hair removal by electrolysis 17380 CPT 17380 | $112.80 | $188.00 | not published | 0 |
| Hair trnspl 1-15 punch grfts CPT 15775 | not published | not published | $382.44 – $535.41 | 2 |
| Hair trnspl >15 punch grafts CPT 15776 | not published | not published | $382.44 – $535.41 | 2 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | $103.60 | $172.67 | not published | 0 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $32.08 | $53.47 | not published | 0 |
| Hand-held pefr meter a4614 HCPCS A4614 | $2.40 | $4.00 | not published | 0 |
| Handle/convey/speciman/office-lab 99000 CPT 99000 | $70.20 | $117.00 | not published | 0 |
| Hand orthosis metacarpal fracture orthosis prefa l3918 HCPCS L3918 | $75.60 | $126.00 | not published | 0 |
| Hands-On Manual Therapy (each 15 minutes) CPT 97140 | $92.40 | $154.00 | not published | 0 |
| Hand tendon/muscle transfer CPT 26494 | not published | not published | $3,105.81 – $4,348.13 | 2 |
| Hand tendon reconstruction CPT 26500 | not published | not published | $6,838.12 – $9,573.37 | 2 |
| Hand tendon reconstruction CPT 26502 | not published | not published | $3,105.81 – $4,348.13 | 2 |
| Hand X-ray CPT 73130 | $264.60 | $441.00 | $84.28 – $118.00 | 2 |
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.