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 |
|---|---|---|---|---|
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | $1,248.00 | $2,080.00 | not published | 0 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $121.97 | $203.29 | not published | 0 |
| Loncastuximab tesirine-lpyl 10 mg intravenous solution HCPCS J9359 | $50,204.85 | $83,674.75 | $207.47 – $303.44 | 2 |
| Loop ostmy bridg ster HCPCS A4421 | $3.60 | $6.00 | not published | 0 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $40.60 | $67.67 | not published | 0 |
| Loudness balance test CPT 92562 | $26.40 | $44.00 | $28.60 – $298.08 | 2 |
| Low back disk surgery CPT 63030 | $2,107.80 | $3,513.00 | not published | 0 |
| Low cost skin substitute app HCPCS C5271 | not published | not published | $585.94 – $820.32 | 2 |
| Low cost skin substitute app HCPCS C5273 | not published | not published | $1,750.98 – $2,451.37 | 2 |
| Low cost skin substitute app HCPCS C5275 | not published | not published | $585.94 – $820.32 | 2 |
| Low cost skin substitute app HCPCS C5277 | not published | not published | $585.94 – $820.32 | 2 |
| Low-Dose Lung Cancer Screening CT Scan CPT 71271 | $420.60 | $701.00 | $101.79 – $142.51 | 2 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $1,909.80 | $3,183.00 | $170.40 – $238.57 | 2 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $1,486.20 | $2,477.00 | $341.85 – $478.59 | 2 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $1,414.80 | $2,358.00 | $101.79 – $142.51 | 2 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $2,361.60 | $3,936.00 | $341.85 – $478.59 | 2 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $1,275.60 | $2,126.00 | $341.85 – $478.59 | 2 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $1,750.80 | $2,918.00 | $231.38 – $323.93 | 2 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $257.40 | $429.00 | not published | 0 |
| Lower Back (Lumbar Spine) X-ray (4 or more views) CPT 72110 | $355.20 | $592.00 | $101.79 – $142.51 | 2 |
| Lower Back (Lumbar Spine) X-ray (with bending views) CPT 72114 | $438.60 | $731.00 | $101.79 – $142.51 | 2 |
| Lower jaw bone graft CPT 21215 | not published | not published | $5,662.59 – $7,927.62 | 2 |
| Lower Leg (Shin) X-ray (both sides) CPT 73590 | $249.00 | $415.00 | not published | 0 |
| Low frequency non-thermal Ultrasound CPT 97610 | $242.40 | $404.00 | $190.20 – $262.60 | 2 |
| Lsh uterus 250 g or less CPT 58541 | $1,679.40 | $2,799.00 | not published | 0 |
| Lsh uterus above 250 g CPT 58543 | $1,907.40 | $3,179.00 | not published | 0 |
| Lsh w/t/o ut 250 g or less CPT 58542 | $1,875.60 | $3,126.00 | not published | 0 |
| Lsh w/t/o uterus above 250 g CPT 58544 | $2,064.60 | $3,441.00 | not published | 0 |
| L/s ratio fetal lung CPT 83661 | $97.20 | $162.00 | not published | 0 |
| Lumbar diskogram s&i CPT 72295 | $2,169.60 | $3,616.00 | $1,869.23 – $2,350.40 | 2 |
| Lumbar Spinal Fusion (single level) CPT 22612 | $2,995.20 | $4,992.00 | not published | 0 |
| Lumizyme injection HCPCS J0221 | $1,789.05 | $2,981.75 | $197.78 – $289.27 | 2 |
| Lung Function Test Before and After an Inhaler CPT 94060 | $444.00 | $740.00 | $184.60 – $298.08 | 2 |
| Lung function test (mbc/mvv) CPT 94200 | $107.40 | $179.00 | $56.86 – $79.60 | 2 |
| Lung Function Test (Spirometry) CPT 94010 | $116.40 | $194.00 | $100.75 – $149.77 | 2 |
| Lung perfusion imaging CPT 78580 | not published | not published | $384.64 – $538.50 | 2 |
| Lung volume reduction 32491 CPT 32491 | $2,248.20 | $3,747.00 | not published | 0 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | $14,405.83 | $24,009.72 | $197.31 – $288.58 | 2 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | $21,867.91 | $36,446.52 | $40.17 – $58.74 | 2 |
| Lutetium lu 177 dotatat ther HCPCS A9513 | not published | not published | $299.31 – $437.77 | 2 |
| Lutetium lu 177 vipivotide HCPCS A9607 | not published | not published | $242.35 – $354.45 | 2 |
| Lw ntsty Ultrasound stimj bone healg CPT 20979 | not published | not published | $23.44 – $32.82 | 2 |
| Lymphadenect/stage/pelv/paraaortic 38562 CPT 38562 | $1,335.60 | $2,226.00 | not published | 0 |
| Lymphatics/lymph node imaging CPT 78195 | $1,086.60 | $1,811.00 | $515.24 – $721.34 | 2 |
| Lymphocyte transformation mitogen CPT 86353 | $516.00 | $860.00 | not published | 0 |
| Lymph vessel x-ray arm/leg CPT 75801 | not published | not published | $591.81 – $828.54 | 2 |
| Lymph vessel x-ray arms/legs CPT 75803 | not published | not published | $1,486.98 – $2,081.78 | 2 |
| Lymph vessel x-ray trunk CPT 75805 | $1,293.60 | $2,156.00 | $1,401.40 – $3,012.85 | 2 |
| Lymph vessel x-ray trunk CPT 75807 | $1,570.20 | $2,617.00 | $1,701.05 – $3,012.85 | 2 |
| Lysis intranasal synechia 30560 CPT 30560 | $526.80 | $878.00 | not published | 0 |
| Lysis of labial adhesions CPT 56441 | $281.40 | $469.00 | not published | 0 |
| Lysis penil circumic lesion CPT 54162 | $511.20 | $852.00 | not published | 0 |
| Macroscopic exam arthropod CPT 87168 | $55.20 | $92.00 | not published | 0 |
| Macroscopic exam parasite CPT 87169 | $30.00 | $50.00 | not published | 0 |
| Magnesium CPT 83735 | $94.80 | $158.00 | not published | 0 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $221.80 | $369.67 | not published | 0 |
| Magnetic image bone marrow CPT 77084 | not published | not published | $231.38 – $323.93 | 2 |
| Makena, 10 mg HCPCS J1726 | $6,123.06 | $10,205.10 | not published | 0 |
| Malaria antibody CPT 86750 | $59.40 | $99.00 | not published | 0 |
| Male sling procedure CPT 53440 | not published | not published | $12,436.60 – $17,411.25 | 2 |
| Management of liver hemorrhage 47361 CPT 47361 | $4,383.00 | $7,305.00 | not published | 0 |
| Manipulate finger w/anesth CPT 26340 | not published | not published | $1,531.94 – $2,144.72 | 2 |
| Manipulate wrist w/anesthes CPT 25259 | not published | not published | $1,531.94 – $2,144.72 | 2 |
| Manipulation of hip joint CPT 27275 | not published | not published | $1,531.94 – $2,144.72 | 2 |
| Manipulation of spine CPT 22505 | not published | not published | $1,531.94 – $2,144.72 | 2 |
| Manipulat palm cord post inj CPT 26341 | not published | not published | $229.62 – $321.47 | 2 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | $17.29 | $28.82 | not published | 0 |
| Manual diff wbc count b-coat CPT 85009 | $19.80 | $33.00 | not published | 0 |
| Mapping io sentinel lymph node CPT 38900 | $256.80 | $428.00 | not published | 0 |
| Map tachycard site(s) CPT 93609 | $1,425.00 | $2,375.00 | not published | 0 |
| Margetuximab-cmkb 25 mg/ml intravenous solution HCPCS J9353 | not published | not published | $48.29 – $70.63 | 2 |
| Marker biop eviva buckle ss HCPCS A4648 | $616.80 | $1,028.00 | not published | 0 |
| Marker lymphatic sentimag magtrace 10 vial HCPCS A9697 | not published | not published | $10,893.08 – $15,931.87 | 2 |
| Marsupialization liver lesion 47300 CPT 47300 | $2,128.20 | $3,547.00 | not published | 0 |
| Mastectomy partial CPT 19301 | $1,211.40 | $2,019.00 | not published | 0 |
| Mast mod rad CPT 19307 | $2,229.60 | $3,716.00 | not published | 0 |
| Mastoidectomy CPT 69501 | not published | not published | $5,662.59 – $7,927.62 | 2 |
| Mastoidectomy complete 69502 CPT 69502 | $1,909.80 | $3,183.00 | not published | 0 |
| Mastoids complete CPT 70130 | $235.20 | $392.00 | $101.79 – $142.51 | 2 |
| Mastoid surgery revision CPT 69603 | not published | not published | $5,662.59 – $7,927.62 | 2 |
| Mastopexy CPT 19316 | $1,756.80 | $2,928.00 | not published | 0 |
| Mast simple complete CPT 19303 | $1,876.80 | $3,128.00 | not published | 0 |
| Maxillofacial fixation CPT 21100 | not published | not published | $5,662.59 – $7,927.62 | 2 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $108.60 | $181.00 | not published | 0 |
| Mayo aathr protein s free CPT 85306 | $255.60 | $426.00 | not published | 0 |
| Mayo activated protein c resistance assay CPT 85307 | $263.40 | $439.00 | not published | 0 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $109.80 | $183.00 | not published | 0 |
| Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation CPT 80321 | $230.40 | $384.00 | not published | 0 |
| Mayo alcohol definitive assay volatile screen CPT 80320 | $230.40 | $384.00 | not published | 0 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $304.80 | $508.00 | not published | 0 |
| Mayo alkaloids definitive assay nicotine/cotinine CPT 80323 | $208.20 | $347.00 | not published | 0 |
| Mayo alpha 1 antitrypsin CPT 82103 | $145.80 | $243.00 | not published | 0 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $122.40 | $204.00 | not published | 0 |
| Mayo analysis gene calr common variants exon 9 CPT 81219 | $374.40 | $624.00 | not published | 0 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $312.00 | $520.00 | not published | 0 |
| Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 | $1,628.40 | $2,714.00 | not published | 0 |
| Mayo androstenedione CPT 82157 | $252.00 | $420.00 | not published | 0 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | $157.20 | $262.00 | not published | 0 |
| Mayo antithrombin iii antigen CPT 85301 | $297.60 | $496.00 | not published | 0 |
| Mayo aspergillus fumigatus antibody CPT 86606 | $78.60 | $131.00 | not published | 0 |
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.