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 |
|---|---|---|---|---|
| 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 | $4,289.09 | $7,148.48 | $734.15 – $1,027.81 | 2 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $2,391.60 | $3,986.00 | 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 | $10,371.60 | $17,286.00 | not published | 0 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | $3,762.00 | $6,270.00 | 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 | $1,956.60 | $3,261.00 | not published | 0 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $2,767.80 | $4,613.00 | not published | 0 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | $4,983.00 | $8,305.00 | not published | 0 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $27,657.00 | $46,095.00 | 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 | $322.20 | $537.00 | not published | 0 |
| Grfg autol fat lipo 25 cc/< CPT 15773 | not published | not published | $1,750.98 – $2,451.37 | 2 |
| Grfg autol fat lipo 50 cc/< CPT 15771 | not published | not published | $3,504.35 – $4,906.10 | 2 |
| 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 | $37.80 | $63.00 | not published | 0 |
| Group train without patient HCPCS G0543 | not published | not published | $14.15 – $14.15 | 1 |
| Growth hormone antibody CPT 86277 | $73.20 | $122.00 | $15.74 – $15.74 | 1 |
| Growth hormone panel CPT 80428 | not published | not published | $66.70 – $66.70 | 1 |
| Growth hormone panel CPT 80430 | not published | not published | $129.33 – $129.33 | 1 |
| Growth stimulation gene 2 CPT 83006 | not published | not published | $75.60 – $75.60 | 1 |
| 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 | $3,432.60 | $5,721.00 | not published | 0 |
| Gstrst open wo constj tube CPT 43830 | $1,252.80 | $2,088.00 | not published | 0 |
| G-tube reposition CPT 43761 | $313.20 | $522.00 | $232.81 – $325.93 | 2 |
| Gu dilat ureter/urethra s&i CPT 74485 | $4,414.20 | $7,357.00 | $1,960.87 – $2,745.22 | 2 |
| Guided cath fluid drainage 10030 CPT 10030 | $704.40 | $1,174.00 | 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 | $264.60 | $441.00 | 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 | $370.80 | $618.00 | not published | 0 |
| Gynecomastia (males) 19300 CPT 19300 | $926.40 | $1,544.00 | not published | 0 |
| Hair removal by electrolysis 17380 CPT 17380 | $107.40 | $179.00 | 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 | $187.24 | $312.06 | 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 | $66.60 | $111.00 | not published | 0 |
| Hand orthosis metacarpal fracture orthosis prefa l3918 HCPCS L3918 | $72.00 | $120.00 | not published | 0 |
| Hands-On Manual Therapy (each 15 minutes) CPT 97140 | $79.80 | $133.00 | $35.04 – $35.04 | 1 |
| 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 | $242.40 | $404.00 | $84.28 – $118.00 | 2 |
| Hand X-ray (2 views, both hands) CPT 73120 | $192.60 | $321.00 | $101.79 – $142.51 | 2 |
| Haptoglobin quantitative CPT 83010 | $116.40 | $194.00 | $12.58 – $12.58 | 1 |
| Harvest auto stem cells CPT 38206 | not published | not published | $1,569.15 – $2,196.81 | 2 |
| Harvest cultured skin graft 15040 CPT 15040 | $461.40 | $769.00 | not published | 0 |
| Harvest eye tissue alograft CPT 68371 | not published | not published | $2,233.16 – $3,126.42 | 2 |
| Harvest femoropopliteal vein 35572 CPT 35572 | $655.20 | $1,092.00 | not published | 0 |
| Harvest stem cell concentrte CPT 38215 | not published | not published | $418.48 – $585.87 | 2 |
| Harvest vein for bypass 35500 CPT 35500 | $470.40 | $784.00 | not published | 0 |
| Hast w/i&r phys/qhp CPT 94452 | not published | not published | $123.39 – $172.74 | 2 |
| Hast w/oxygen titrate CPT 94453 | not published | not published | $123.39 – $172.74 | 2 |
| Hba1/hba2 full gene sequence CPT 81259 | not published | not published | $600.00 – $600.00 | 1 |
| Hba1/hba2 gene dup/del vrnts CPT 81269 | not published | not published | $202.40 – $202.40 | 1 |
| Hba1/hba2 gene fam vrnt CPT 81258 | not published | not published | $375.25 – $375.25 | 1 |
| Hbb full gene sequence CPT 81364 | not published | not published | $324.58 – $324.58 | 1 |
| Hbb gene com variants CPT 81361 | not published | not published | $174.81 – $174.81 | 1 |
| Hbb gene dup/del variants CPT 81363 | not published | not published | $202.40 – $202.40 | 1 |
| Hbb gene known fam variant CPT 81362 | not published | not published | $375.25 – $375.25 | 1 |
| Hb glycosylated a1c home dev CPT 83037 | not published | not published | $9.71 – $9.71 | 1 |
| Hbot, full body chamber, 30m HCPCS G0277 | $262.20 | $437.00 | $132.00 – $184.80 | 2 |
| Hc fl sm bowel enteroclss tube w kub double contrast CPT 74251 | $574.80 | $958.00 | $170.40 – $238.57 | 2 |
| Hcg free betachain test CPT 84704 | not published | not published | $15.29 – $15.29 | 1 |
| Hcg qualitative CPT 84703 | $62.40 | $104.00 | $7.52 – $7.52 | 1 |
| Hcg quantitative CPT 84702 | $157.20 | $262.00 | $15.05 – $15.05 | 1 |
| Hc hearing aid chck binaurl CPT 92593 | $59.40 | $99.00 | not published | 0 |
| Hc hearing aid chck monarl CPT 92592 | $39.60 | $66.00 | not published | 0 |
| Hc hearing aid exam both ears CPT 92591 | $118.80 | $198.00 | not published | 0 |
| Hc hearing aid exam one ear CPT 92590 | $79.20 | $132.00 | not published | 0 |
| Hc i-131 sodium iodide cap dx per mci HCPCS A9528 | $306.00 | $510.00 | not published | 0 |
| Hc metata joint dislocation anes CPT 28635 | not published | not published | $1,531.94 – $2,144.72 | 2 |
| Hc mohs micrographic h/n/h/f/g 1st stage 5 blocks CPT 17311 | not published | not published | $585.94 – $820.32 | 2 |
| Hc mohs trunk/arm/leg 1st stage 5 blocks CPT 17313 | not published | not published | $585.94 – $820.32 | 2 |
| Hc nm cardiac blood pool planar 1 stdy wal motn eject fract CPT 78481 | $842.40 | $1,404.00 | $515.24 – $721.34 | 2 |
| Hc nm fusion spect CT unlisted CPT 78999 | $167.40 | $279.00 | $181.35 – $384.64 | 2 |
| Hc nm kidney imaging with flow CPT 78701 | $636.60 | $1,061.00 | $384.64 – $538.50 | 2 |
| Hc nm myocard infarct avid plnr tomo spect w/wo quant CPT 78469 | $1,086.60 | $1,811.00 | $515.24 – $721.34 | 2 |
| Hc pet myocardial imaging metabolic eval single study CPT 78459 | $2,018.40 | $3,364.00 | $1,249.63 – $1,749.48 | 2 |
| Hdr rdncl ntrstl/icav brchtx CPT 77770 | not published | not published | $664.13 – $929.78 | 2 |
| Hdr rdncl ntrstl/icav brchtx CPT 77771 | not published | not published | $664.13 – $929.78 | 2 |
| Hdr rdncl ntrstl/icav brchtx CPT 77772 | not published | not published | $664.13 – $929.78 | 2 |
| Hdr rdncl skn surf brachytx CPT 77767 | not published | not published | $251.73 – $352.42 | 2 |
| Hdr rdncl skn surf brachytx CPT 77768 | not published | not published | $251.73 – $352.42 | 2 |
| Head CT scan (with and without contrast) CPT 70470 | $1,342.80 | $2,238.00 | $170.40 – $238.57 | 2 |
| Head CT scan (with contrast) CPT 70460 | $1,124.40 | $1,874.00 | $170.40 – $238.57 | 2 |
| Head CT scan (without contrast) CPT 70450 | $1,066.80 | $1,778.00 | $101.79 – $142.51 | 2 |
| Hearing loss dup/del analys CPT 81431 | not published | not published | $679.57 – $679.57 | 1 |
| Hearing loss sequence analys CPT 81430 | not published | not published | $1,625.00 – $1,625.00 | 1 |
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.