MercyOne Genesis Davenport West Medical Center
1404 West Central Park Avenue, Davenport, IA · MercyOne · · NPI 1427097716
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 |
|---|---|---|---|---|
| 11-desoxycortisol - sendout CPT 82634 | $136.20 | $227.00 | $29.28 – $29.28 | 1 |
| 17-hydroxypregnenolone CPT 84143 | $98.40 | $164.00 | $22.81 – $22.81 | 1 |
| 17-ketosteroids CPT 83586 | $98.40 | $164.00 | $12.80 – $12.80 | 1 |
| 1st hosp/birthing center care per day nml nb 99460 CPT 99460 | $185.40 | $309.00 | not published | 0 |
| 1st inpatient critical care pr day age 28 days/less than 99468 CPT 99468 | $1,766.40 | $2,944.00 | not published | 0 |
| 1st psyc collab care mgmt CPT 99492 | not published | not published | $88.54 – $123.96 | 2 |
| 2019-ncov diagnostic p HCPCS U0001 | not published | not published | $35.92 – $35.92 | 1 |
| 24 hr ambulatory b/p monitor CPT 93786 | $306.00 | $510.00 | $123.39 – $172.74 | 2 |
| 2d tee w or without fol w/con,in HCPCS C8925 | not published | not published | $756.26 – $1,058.77 | 2 |
| 2d tte w or without fol w/con,co HCPCS C8923 | not published | not published | $756.26 – $1,058.77 | 2 |
| 2nd order venous cath CPT 36012 | $1,638.60 | $2,731.00 | not published | 0 |
| 3d anat seg imaging preop HCPCS C8001 | not published | not published | $149.77 – $209.67 | 2 |
| 3d bn img algor drvd fr MRI HCPCS G0566 | not published | not published | $149.77 – $209.67 | 2 |
| 3d ech img cgen car anomal CPT 93319 | $180.00 | $300.00 | not published | 0 |
| 3-d radiotherapy plan CPT 77295 | $3,328.80 | $5,548.00 | $1,309.73 – $1,833.62 | 2 |
| 3d recon without postprocess indpndt CPT 76376 | $241.80 | $403.00 | not published | 0 |
| 5' nucleotidase - sendout CPT 83915 | $105.60 | $176.00 | $11.15 – $11.15 | 1 |
| 88334 ap bill cytologic exam each additional site CPT 88334 | $69.60 | $116.00 | not published | 0 |
| 99381 initial comp preventive med less than 1 year new CPT 99381 | $132.00 | $220.00 | not published | 0 |
| 99382 initial comp preventive med 1 to 4 years new CPT 99382 | $143.40 | $239.00 | not published | 0 |
| 99383 initial comp preventive med 5 to 11 years new CPT 99383 | $141.60 | $236.00 | not published | 0 |
| 99391 periodic comp preventive med less than 1 year est CPT 99391 | $99.00 | $165.00 | not published | 0 |
| 99392 periodic comp preventive med 1 to 4 years est CPT 99392 | $114.00 | $190.00 | not published | 0 |
| 99393 periodic comp preventive med 5 to 11 years est CPT 99393 | $112.80 | $188.00 | not published | 0 |
| 99394 periodic comp preventive med 12 to 17 years est CPT 99394 | $127.20 | $212.00 | not published | 0 |
| 99397 periodic comp preventive med 65+ years est CPT 99397 | $232.20 | $387.00 | not published | 0 |
| Aa graft w/bp/aortic root replace 33863 CPT 33863 | $5,848.80 | $9,748.00 | not published | 0 |
| Abatacept (with maltose) 250 mg intravenous solution HCPCS J0129 | $2,473.69 | $4,122.81 | $44.49 – $62.29 | 2 |
| #a/b/c/c/h pnl-candida albicans ab CPT 86628 | $175.20 | $292.00 | $12.01 – $12.01 | 1 |
| Abciximab injection HCPCS J0130 | $2,400.32 | $4,000.54 | not published | 0 |
| Abd aorta w/runoff s&i CPT 75630 | $3,291.60 | $5,486.00 | $3,012.85 – $3,565.90 | 2 |
| Abd exp/postop hem/throm/infec 35840 CPT 35840 | $2,121.00 | $3,535.00 | not published | 0 |
| Abd/low ext cath 1st CPT 36245 | $2,209.80 | $3,683.00 | not published | 0 |
| Abd/low ext cath 2nd CPT 36246 | $2,357.40 | $3,929.00 | not published | 0 |
| Abd/low ext cath 3rd CPT 36247 | $2,798.40 | $4,664.00 | not published | 0 |
| Abd/low ext cath addl CPT 36248 | $2,229.60 | $3,716.00 | not published | 0 |
| Abdominal and Pelvic Blood Vessel Ultrasound (complete) CPT 93975 | $667.80 | $1,113.00 | $231.38 – $323.93 | 2 |
| Abdominal and Pelvic Blood Vessel Ultrasound (limited) CPT 93976 | $369.60 | $616.00 | $101.79 – $142.51 | 2 |
| Abdominal CT scan (with and without contrast) CPT 74170 | $1,477.20 | $2,462.00 | $170.40 – $238.57 | 2 |
| Abdominal CT scan (with contrast) CPT 74160 | $1,311.60 | $2,186.00 | $170.40 – $238.57 | 2 |
| Abdominal CT scan (without contrast) CPT 74150 | $958.80 | $1,598.00 | $101.79 – $142.51 | 2 |
| Abdominal MRI (with and without contrast) CPT 74183 | $2,814.60 | $4,691.00 | $341.85 – $478.59 | 2 |
| Abdominal MRI (with contrast) CPT 74182 | $971.40 | $1,619.00 | $341.85 – $478.59 | 2 |
| Abdominal MRI (without contrast) CPT 74181 | $1,414.20 | $2,357.00 | $231.38 – $323.93 | 2 |
| Abdominal paracentesis w/image guidance CPT 49083 | $912.60 | $1,521.00 | $897.45 – $988.65 | 2 |
| Abdominal Ultrasound (complete) CPT 76700 | $648.60 | $1,081.00 | $101.79 – $142.51 | 2 |
| Abdominal Ultrasound (limited) CPT 76705 | $400.80 | $668.00 | $101.79 – $142.51 | 2 |
| Abdominal X-ray (2 views) CPT 74019 | $168.00 | $280.00 | $101.79 – $142.51 | 2 |
| Abdominal X-ray Series (acute, with chest view) CPT 74022 | $231.00 | $385.00 | $101.79 – $142.51 | 2 |
| Abdominal X-ray (single view) CPT 74018 | $141.60 | $236.00 | $84.28 – $93.60 | 2 |
| Abdominoplasty 15830 CPT 15830 | $2,129.40 | $3,549.00 | not published | 0 |
| Abd paracentesis/w/o image guide 49082 CPT 49082 | $771.00 | $1,285.00 | $835.25 – $897.45 | 2 |
| Abl1 gene CPT 81170 | not published | not published | $300.00 – $300.00 | 1 |
| Ablate arrhythmia add on CPT 93655 | $13,027.80 | $21,713.00 | not published | 0 |
| Ablate atria lmtd endo 33265 CPT 33265 | $2,509.20 | $4,182.00 | not published | 0 |
| Ablate atria w/bypass exten 33256 CPT 33256 | $3,631.20 | $6,052.00 | not published | 0 |
| Ablate atria x10sv add-on 33258 CPT 33258 | $1,215.00 | $2,025.00 | not published | 0 |
| Ablate atria x10sv endo 33266 CPT 33266 | $3,423.00 | $5,705.00 | not published | 0 |
| Ablate bone tumor(s) cryo perq 20983 CPT 20983 | $794.40 | $1,324.00 | not published | 0 |
| Ablate bone tumor(s) perq CPT 20982 | not published | not published | $12,316.38 – $17,242.93 | 2 |
| Ablate heart dysrhythm focus CPT 93650 | $7,438.80 | $12,398.00 | $7,263.48 – $8,058.70 | 2 |
| Ablate inf turbinate submuc 30802 CPT 30802 | $538.20 | $897.00 | not published | 0 |
| Ablate inf turbinate superf 30801 CPT 30801 | $421.80 | $703.00 | not published | 0 |
| Ablate pulm tumor perq crybl CPT 32994 | not published | not published | $9,965.83 – $13,952.16 | 2 |
| Ablate pulm tumor perq rf CPT 32998 | not published | not published | $5,584.77 – $7,818.67 | 2 |
| Ablation cardiac vagal inputs atrium CPT 93799 | $274.20 | $457.00 | $149.77 – $209.67 | 2 |
| Ablation cryo abd perit om CPT 49999 | $1,770.00 | $2,950.00 | not published | 0 |
| Ablation cryo adrenal tumor CPT 60699 | $3,635.40 | $6,059.00 | $3,938.35 – $5,584.77 | 2 |
| Ablation cryo pq chest wall tumor(s) w/guid CPT 23929 | $1,230.00 | $2,050.00 | not published | 0 |
| Ablation cryo pq liver tumor(s) CPT 47383 | $967.80 | $1,613.00 | not published | 0 |
| Ablation cryo retro lymph node CPT 38999 | $511.20 | $852.00 | $418.48 – $522.60 | 2 |
| Ablation cryo thigh/knee CPT 27599 | not published | not published | $229.62 – $321.47 | 2 |
| Ablation of upper extremity nerves rf CPT 64999 | $196.80 | $328.00 | not published | 0 |
| Abltj 1/+thyr ndul 1lobe prq CPT 60660 | not published | not published | $1,550.93 – $2,171.30 | 2 |
| Abltj mal prst8 tiss hifu CPT 55880 | not published | not published | $8,851.56 – $12,392.18 | 2 |
| Ablt trurl prst8 tis trnsdcr CPT 55882 | not published | not published | $12,436.60 – $17,411.25 | 2 |
| Abobotulinumtoxina HCPCS J0586 | $842.47 | $1,404.11 | $9.17 – $12.84 | 2 |
| Abortion (mpr) CPT 59866 | not published | not published | $291.18 – $407.65 | 2 |
| Abrasion lesion single CPT 15786 | not published | not published | $190.20 – $266.28 | 2 |
| Abscess drain retroperitoneal surg code CPT 49406 | $2,085.60 | $3,476.00 | $1,550.93 – $1,795.30 | 2 |
| Absorpt drg >16 <=48 without bdr HCPCS A6252 | $6.00 | $10.00 | not published | 0 |
| Absorpt drg <=16 sq in without b HCPCS A6251 | $7.80 | $13.00 | not published | 0 |
| Access & clsr pq fem art endogft dlvry w/img uni CPT 34713 | $169.20 | $282.00 | not published | 0 |
| Acetaminophen 120 mg rectal suppository HCPCS A9270 | $6.60 | $11.00 | not published | 0 |
| Acetaminophen level CPT 80143 | $99.60 | $166.00 | $18.64 – $18.64 | 1 |
| Acetazolamide 500 mg solution for injection HCPCS J1120 | $77.07 | $128.45 | not published | 0 |
| Acetone qualitative CPT 82009 | $39.00 | $65.00 | $4.52 – $4.52 | 1 |
| Acetylcholine receptor modulating antibody CPT 86043 | $94.20 | $157.00 | $12.05 – $12.05 | 1 |
| Acetylcholinesterase assay CPT 82013 | $173.40 | $289.00 | $12.29 – $12.29 | 1 |
| Acetylcysteine 200 mg/ml (20 %) intravenous solution HCPCS J0132 | $306.72 | $511.20 | not published | 0 |
| Acetylcysteine non-comp unit HCPCS J7608 | $10.48 | $17.46 | not published | 0 |
| Acid perfusion of esophagus CPT 91030 | not published | not published | $507.90 – $711.06 | 2 |
| Acne surgery 10040 CPT 10040 | $185.40 | $309.00 | not published | 0 |
| Aco annual medicare visit (awv), initial g0438aco HCPCS G0438 | $270.60 | $451.00 | not published | 0 |
| Aco annual medicare visit (awv), subsq g0439aco HCPCS G0439 | $181.20 | $302.00 | not published | 0 |
| Aco ccm; at least 20 min 99490aco CPT 99490 | $76.80 | $128.00 | not published | 0 |
| Aco ccm; ea addl 20 min 99439aco CPT 99439 | $49.20 | $82.00 | not published | 0 |
| Aco cmplx chron care addl 20 min 99489aco CPT 99489 | $82.80 | $138.00 | not published | 0 |
| Aco cmplx chron care without pt visit, 60 min 99487aco CPT 99487 | $162.60 | $271.00 | not published | 0 |
| Aco cont gluc mnt phys/qhp eqp 95250aco CPT 95250 | $265.80 | $443.00 | 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.