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 |
|---|---|---|---|---|
| Rpl tun cvc wo subq port CPT 36581 | $3,291.60 | $5,486.00 | $3,012.85 – $3,565.90 | 2 |
| Rpm tx mgmt 1st 20 min CPT 99457 | $69.00 | $115.00 | not published | 0 |
| Rpm tx mgmt ea addl 20 min CPT 99458 | $56.40 | $94.00 | not published | 0 |
| Rpr aa hrn 1st > 10 ncr/strn CPT 49596 | $1,357.20 | $2,262.00 | not published | 0 |
| Rpr aa hrn 1st > 10 rdc CPT 49595 | $1,021.80 | $1,703.00 | not published | 0 |
| Rpr aa hrn 1st 3-10 ncr/strn CPT 49594 | $988.20 | $1,647.00 | not published | 0 |
| Rpr aa hrn 1st 3-10 rdc CPT 49593 | $759.60 | $1,266.00 | not published | 0 |
| Rpr aa hrn 1st < 3 cm rdc CPT 49591 | $453.60 | $756.00 | not published | 0 |
| Rpr aa hrn 1st < 3 ncr/strn CPT 49592 | $630.00 | $1,050.00 | not published | 0 |
| Rpr aa hrn rcr > 10 ncr/strn CPT 49618 | $1,644.00 | $2,740.00 | not published | 0 |
| Rpr aa hrn rcr > 10 rdc CPT 49617 | $1,174.20 | $1,957.00 | not published | 0 |
| Rpr aa hrn rcr 3-10 ncr/strn CPT 49616 | $1,137.60 | $1,896.00 | not published | 0 |
| Rpr aa hrn rcr 3-10 rdc CPT 49615 | $847.80 | $1,413.00 | not published | 0 |
| Rpr aa hrn rcr < 3 ncr/strn CPT 49614 | $757.80 | $1,263.00 | not published | 0 |
| Rpr aa hrn rcr < 3 rdc CPT 49613 | $559.20 | $932.00 | not published | 0 |
| Rpr blood ves w/vein graft/up ext 35236 CPT 35236 | $1,858.80 | $3,098.00 | not published | 0 |
| Rpr blood vsl grf oth vein lo ex CPT 35286 | $1,777.20 | $2,962.00 | not published | 0 |
| Rpr choanal atresia ntranasl CPT 30540 | not published | not published | $5,662.59 – $7,927.62 | 2 |
| Rpr choanal atresia trsnpltn CPT 30545 | not published | not published | $5,662.59 – $7,927.62 | 2 |
| Rpr csf leak/pseudomeng/laminectomy63709 CPT 63709 | $1,841.40 | $3,069.00 | not published | 0 |
| Rpr diaphragm hernia/chronic/not neonate 39541 CPT 39541 | $1,705.80 | $2,843.00 | not published | 0 |
| Rpr diaphragm lac/any approach 39501 CPT 39501 | $1,539.60 | $2,566.00 | not published | 0 |
| Rpr fem hernia init blocked CPT 49553 | $1,129.80 | $1,883.00 | not published | 0 |
| Rpr hern preemie reduc CPT 49491 | $1,378.80 | $2,298.00 | not published | 0 |
| Rpr hypspad comp dsj & urtp CPT 54348 | not published | not published | $4,866.14 – $6,812.60 | 2 |
| Rpr hypspad comp simple CPT 54340 | not published | not published | $3,301.42 – $4,621.99 | 2 |
| Rpr ing hernia baby blocked CPT 49496 | $1,067.40 | $1,779.00 | not published | 0 |
| Rpr ing hernia baby reduc CPT 49495 | not published | not published | $3,378.09 – $4,729.32 | 2 |
| Rpr ing hernia init blocked CPT 49501 | not published | not published | $3,378.09 – $4,729.32 | 2 |
| Rpr ing hernia init reduce CPT 49500 | $730.80 | $1,218.00 | not published | 0 |
| Rpr ing hern premie blocked CPT 49492 | not published | not published | $3,378.09 – $4,729.32 | 2 |
| Rpr intst excl anrect fist HCPCS C9796 | not published | not published | $2,625.07 – $3,675.10 | 2 |
| Rpr nsl vlv collapse w/implt CPT 30468 | not published | not published | $5,662.59 – $7,927.62 | 2 |
| Rpr nsl vlv collapse w/rmdlg CPT 30469 | not published | not published | $5,662.59 – $7,927.62 | 2 |
| Rpr parastomal hernia rdc 49621 CPT 49621 | $1,015.80 | $1,693.00 | not published | 0 |
| Rpr parastomal hrna ncr/strn 49622 CPT 49622 | $1,254.00 | $2,090.00 | not published | 0 |
| Rpr&refit spct prsth aphakia CPT 92371 | not published | not published | $56.86 – $79.60 | 2 |
| Rpr rem hernia init reduce CPT 49550 | $1,030.20 | $1,717.00 | not published | 0 |
| Rpr xtnsr tndn leg prim without grft ea tndn CPT 27664 | not published | not published | $6,838.12 – $9,573.37 | 2 |
| Rp therapy unlisted px CPT 79999 | not published | not published | $214.54 – $300.36 | 2 |
| Rrp hypspad comp moblj&urtp CPT 54344 | not published | not published | $8,851.56 – $12,392.18 | 2 |
| Rsv assay w/optic CPT 87807 | not published | not published | $13.10 – $13.10 | 1 |
| Rtm 1st set-up&pt educaj eqp CPT 98975 | $134.40 | $224.00 | $123.36 – $172.70 | 2 |
| Rtm dev sply cbt 16-30 d CPT 98978 | not published | not published | $35.69 – $49.97 | 2 |
| Rtm dev sply mscskl 16-30 d CPT 98977 | $52.80 | $88.00 | $35.69 – $49.97 | 2 |
| Rtm dev sply resp sys 16-30d CPT 98976 | $52.80 | $88.00 | $35.69 – $49.97 | 2 |
| Rtm tx mgmt 1st 20 min CPT 98980 | not published | not published | $39.59 – $39.59 | 1 |
| Rtm tx mgmt ea addl 20 min CPT 98981 | not published | not published | $38.75 – $38.75 | 1 |
| Rubella antibody igg CPT 86762 | $189.00 | $315.00 | $14.39 – $14.39 | 1 |
| Rubeola ag if CPT 87283 | not published | not published | $60.80 – $60.80 | 1 |
| Rubeola antibody igg CPT 86765 | $148.80 | $248.00 | $12.88 – $12.88 | 1 |
| Runx1 gene targeted seq alys CPT 81334 | not published | not published | $329.51 – $329.51 | 1 |
| Russell viper venom diluted CPT 85613 | $117.60 | $196.00 | $9.58 – $9.58 | 1 |
| Rx metab gen seq alys pnl 6 CPT 81418 | not published | not published | $917.08 – $917.08 | 1 |
| Sacituzumab govitecan-hziy 180 mg intravenous solution HCPCS J9317 | not published | not published | $36.26 – $50.76 | 2 |
| Sacroiliac Joint X-ray (3 or more views) CPT 72202 | $169.20 | $282.00 | $101.79 – $142.51 | 2 |
| Safety plan interven HCPCS G0560 | not published | not published | $58.71 – $58.71 | 1 |
| Salivary gland function exam CPT 78232 | not published | not published | $384.64 – $538.50 | 2 |
| Salivary gland imaging CPT 78230 | not published | not published | $384.64 – $538.50 | 2 |
| Salivary glnd img serial img CPT 78231 | not published | not published | $384.64 – $538.50 | 2 |
| Salmonella antibody CPT 86768 | not published | not published | $13.19 – $13.19 | 1 |
| Salpingostomy 58770 CPT 58770 | $1,576.80 | $2,628.00 | not published | 0 |
| Same day nb discharge 99463 CPT 99463 | $218.40 | $364.00 | not published | 0 |
| Sargramostim injection HCPCS J2820 | $463.93 | $773.21 | $56.09 – $78.53 | 2 |
| Sars-cov-2 antb quantitative CPT 86413 | not published | not published | $51.43 – $51.43 | 1 |
| Sarscov coronavirus ag ia CPT 87426 | not published | not published | $35.33 – $35.33 | 1 |
| Sarscov & inf vir a&b ag ia CPT 87428 | not published | not published | $70.29 – $70.29 | 1 |
| S bowel endoscope w/stent CPT 44379 | not published | not published | $5,698.15 – $7,977.41 | 2 |
| Sbrt w/positron emission del HCPCS G0563 | not published | not published | $3,590.05 – $5,026.08 | 2 |
| Sbsq ic vlbw inf<1,500 gm CPT 99478 | $266.40 | $444.00 | not published | 0 |
| Sbsq nurs facil care/day unstabl/new prob 35 min 99310 CPT 99310 | $246.60 | $411.00 | not published | 0 |
| Sbsq nursing facil care/day minor complj 15 min CPT 99308 | $126.60 | $211.00 | not published | 0 |
| Sbsq nursing facil care/day new problem 25 min CPT 99309 | $166.20 | $277.00 | not published | 0 |
| Sbsq nursing facility care/day e/m stable 10 min CPT 99307 | $82.20 | $137.00 | not published | 0 |
| Sbsq psyc collab care mgmt CPT 99493 | not published | not published | $88.54 – $123.96 | 2 |
| Scan duplex aorta/ivc/iliac or bypass grafts complete CPT 93978 | $460.20 | $767.00 | $231.38 – $249.93 | 2 |
| Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 | $108.00 | $180.00 | $101.79 – $117.00 | 2 |
| Scan duplex extracranial arteries unilateral/limited study CPT 93882 | $311.40 | $519.00 | $101.79 – $142.51 | 2 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $424.80 | $708.00 | $101.79 – $142.51 | 2 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $349.80 | $583.00 | $101.79 – $142.51 | 2 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $329.40 | $549.00 | $101.79 – $142.51 | 2 |
| Scan proc cranial intra 61781 CPT 61781 | $415.80 | $693.00 | not published | 0 |
| Sclerotherapy fluid collection pq w/img CPT 49185 | $1,731.00 | $2,885.00 | not published | 0 |
| Scope plantar fasciotomy CPT 29893 | $1,110.00 | $1,850.00 | not published | 0 |
| Scope uretscp lithovue dig disp HCPCS C1747 | $3,375.00 | $5,625.00 | not published | 0 |
| Scr c/v cyto, automated sys HCPCS G0147 | not published | not published | $18.19 – $18.19 | 1 |
| Scr c/v cyto, autosys, rescr HCPCS G0148 | not published | not published | $31.94 – $31.94 | 1 |
| Scr c/v cyto,thinlayer,rescr HCPCS G0144 | not published | not published | $43.97 – $43.97 | 1 |
| Scr c/v cyto,thinlayer,rescr HCPCS G0145 | not published | not published | $26.49 – $26.49 | 1 |
| Scr c/v cyto,thinlayer,rescr HCPCS G0143 | not published | not published | $27.05 – $27.05 | 1 |
| Screen cerv/vag thin layer HCPCS G0123 | not published | not published | $20.26 – $20.26 | 1 |
| Screening Colonoscopy (average risk) HCPCS G0121 | $612.60 | $1,021.00 | not published | 0 |
| Screening Colonoscopy (high risk) HCPCS G0105 | $612.60 | $1,021.00 | not published | 0 |
| Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations HCPCS G0328 | $45.60 | $76.00 | $18.05 – $18.05 | 1 |
| Screening hepatitis b non-obstetric high risk HCPCS G0499 | not published | not published | $28.27 – $28.27 | 1 |
| Screening hepatitis c antibody high risk HCPCS G0472 | not published | not published | $46.35 – $46.35 | 1 |
| Screening HIV antigen/antibody combination assay HCPCS G0475 | not published | not published | $24.08 – $24.08 | 1 |
| Screening Mammogram CPT 77067 | $253.20 | $422.00 | $169.06 – $169.06 | 1 |
| Screening prostate cancer PSA HCPCS G0103 | $74.40 | $124.00 | $19.31 – $19.31 | 1 |
| Screen pap by tech w md supv HCPCS P3000 | not published | not published | $18.19 – $18.19 | 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.