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 |
|---|---|---|---|---|
| Sinus CT scan (with contrast) CPT 70487 | $1,195.20 | $1,992.00 | $170.40 – $238.57 | 2 |
| Sinus CT scan (without contrast) CPT 70486 | $909.00 | $1,515.00 | $101.79 – $142.51 | 2 |
| Sinus/juglr venogram s&i CPT 75860 | $876.00 | $1,460.00 | $550.55 – $3,012.85 | 2 |
| Sinusotomy maxillary sinus 31020 CPT 31020 | $892.80 | $1,488.00 | not published | 0 |
| Sinusotomy sinus remove polyps 31032 CPT 31032 | $1,057.80 | $1,763.00 | not published | 0 |
| Sinusotomy sphenoid w/wo bx 31050 CPT 31050 | $902.40 | $1,504.00 | not published | 0 |
| Sinus X-ray (complete) CPT 70220 | $229.20 | $382.00 | $84.28 – $118.00 | 2 |
| Sinus X-ray (limited) CPT 70210 | $189.60 | $316.00 | $84.28 – $118.00 | 2 |
| Sipuleucel-t - su HCPCS Q2043 | $98,900.28 | $164,833.80 | $55,945.97 – $78,324.36 | 2 |
| Sirolimus, oral HCPCS J7520 | $60.62 | $101.04 | not published | 0 |
| Sirolimus-protein bound 100 mg intravenous suspension HCPCS J9331 | not published | not published | $84.53 – $118.34 | 2 |
| Skin and muscle repair face CPT 15845 | not published | not published | $3,504.35 – $4,906.10 | 2 |
| Skin Biopsy CPT 11102 | $153.00 | $255.00 | $118.30 – $190.20 | 2 |
| Skin full graft 20sq cm less 15200 CPT 15200 | $1,498.20 | $2,497.00 | not published | 0 |
| Skin full graft add-on 15241 CPT 15241 | $255.60 | $426.00 | not published | 0 |
| Skin pedicle flap arms/legs CPT 15572 | not published | not published | $3,504.35 – $4,906.10 | 2 |
| Skin pedicle flap trunk CPT 15570 | not published | not published | $1,750.98 – $2,451.37 | 2 |
| Skin split graft addl 100sq cm 15101 CPT 15101 | $337.20 | $562.00 | not published | 0 |
| Skin test unlisted antigen ea CPT 86486 | $64.20 | $107.00 | $23.44 – $32.82 | 2 |
| Skull X-ray (1 to 3 views) CPT 70250 | $150.60 | $251.00 | $101.79 – $142.51 | 2 |
| Skull X-ray (complete) CPT 70260 | $249.60 | $416.00 | $101.79 – $142.51 | 2 |
| Skyla, 13.5 mg HCPCS J7301 | $1,634.65 | $2,724.42 | not published | 0 |
| Slco1b1 gene com variants CPT 81328 | not published | not published | $174.81 – $174.81 | 1 |
| Sleep study attended CPT 95807 | $1,049.40 | $1,749.00 | $507.90 – $711.06 | 2 |
| Sleep Study (Polysomnography) CPT 95810 | $2,722.80 | $4,538.00 | $973.87 – $1,363.41 | 2 |
| Sleep study unattended CPT 95806 | $1,063.20 | $1,772.00 | $149.77 – $209.67 | 2 |
| Sling arm deluxe w/pad xs HCPCS A4565 | $16.20 | $27.00 | not published | 0 |
| Sling pelv split sam med HCPCS L0621 | $22.20 | $37.00 | not published | 0 |
| Sling suprapubic suburetheral HCPCS C1771 | $3,130.80 | $5,218.00 | not published | 0 |
| Slitting of prepuce CPT 54000 | not published | not published | $3,301.42 – $4,621.99 | 2 |
| Slitting of prepuce CPT 54001 | not published | not published | $1,960.87 – $2,745.22 | 2 |
| Slp pure tone screening CPT 92551 | $22.80 | $38.00 | not published | 0 |
| Slp stdy unatnd w/anal CPT 95801 | not published | not published | $56.86 – $79.60 | 2 |
| Sm-153 lexidron ther HCPCS A9604 | $4,258.80 | $7,098.00 | $4,314.91 – $4,613.70 | 2 |
| Small animal inoculation CPT 87003 | not published | not published | $16.84 – $16.84 | 1 |
| Small Bowel Barium X-ray (Follow-Through) CPT 74250 | $322.80 | $538.00 | $170.40 – $238.57 | 2 |
| Small bowel endoscopy CPT 44360 | $310.20 | $517.00 | not published | 0 |
| Small bowel endoscopy CPT 44364 | $295.20 | $492.00 | not published | 0 |
| Small bowel endoscopy CPT 44366 | $351.60 | $586.00 | not published | 0 |
| Small bowel endoscopy CPT 44369 | $354.00 | $590.00 | not published | 0 |
| Small bowel endoscopy CPT 44376 | $561.00 | $935.00 | not published | 0 |
| Small bowel endoscopy CPT 44378 | not published | not published | $1,815.84 – $2,542.17 | 2 |
| Small bowel endoscopy CPT 44382 | $292.80 | $488.00 | not published | 0 |
| Small bowel endoscopy CPT 44384 | not published | not published | $1,815.84 – $2,542.17 | 2 |
| Small bowel endoscopy >2nd w/remove 44363 CPT 44363 | $391.80 | $653.00 | not published | 0 |
| Small bowel endoscopy 44365 CPT 44365 | $360.00 | $600.00 | not published | 0 |
| Small bowel endoscopy/biopsy CPT 44361 | $297.00 | $495.00 | not published | 0 |
| Small bowel endoscopy/biopsy CPT 44377 | not published | not published | $1,815.84 – $2,542.17 | 2 |
| Small bowel endoscopy br/wa CPT 44380 | $241.80 | $403.00 | not published | 0 |
| Small bowel endoscopy br/wa CPT 44381 | not published | not published | $1,815.84 – $2,542.17 | 2 |
| Small bowel endoscopy/stent 44370 CPT 44370 | $385.80 | $643.00 | not published | 0 |
| Smallpox&monkeypox vac 0.5ml CPT 90611 | not published | not published | $0.01 – $0.01 | 2 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $142.80 | $238.00 | $5.39 – $5.39 | 1 |
| Smear gram stain CPT 87205 | $72.00 | $120.00 | $4.27 – $4.27 | 1 |
| Smear nasal eosinophil CPT 89190 | $39.00 | $65.00 | $5.79 – $5.79 | 1 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $94.20 | $157.00 | $5.99 – $5.99 | 1 |
| Smear wet mount CPT 87210 | $69.00 | $115.00 | $5.82 – $5.82 | 1 |
| Smn1 gene full gene sequence CPT 81336 | not published | not published | $301.35 – $301.35 | 1 |
| Smn1 gen nown famil seq vrnt CPT 81337 | not published | not published | $185.20 – $185.20 | 1 |
| Smpd1 gene common variants CPT 81330 | not published | not published | $47.00 – $47.00 | 1 |
| Snrpn/ube3a gene CPT 81331 | not published | not published | $51.07 – $51.07 | 1 |
| Sodium 24 hour urine CPT 84300 | $43.20 | $72.00 | $5.06 – $5.06 | 1 |
| Sodium chloride 0.9 % intravenous solution HCPCS J7030 | $37.05 | $61.75 | not published | 0 |
| Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous HCPCS J2916 | $68.74 | $114.57 | not published | 0 |
| Sodium hyaluronate 20 mg/2 ml syringe HCPCS J7321 | $432.56 | $720.94 | not published | 0 |
| Sodium serum/plasma/whole blood CPT 84295 | $44.40 | $74.00 | $4.81 – $4.81 | 1 |
| Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution HCPCS J0209 | $170.35 | $283.92 | not published | 0 |
| Software meas of cardiac vol HCPCS G0183 | not published | not published | $84.28 – $118.00 | 2 |
| So gsap cl fr cpy nmbr&mcrst CPT 81463 | not published | not published | $1,345.31 – $1,345.31 | 1 |
| So gsap cll fr dna/dna&rna CPT 81462 | not published | not published | $1,195.83 – $1,195.83 | 1 |
| So gsap cll fr mcrstl ins CPT 81464 | not published | not published | $3,288.51 – $3,288.51 | 1 |
| So gsap dna cpy nmbr&mcrstl CPT 81458 | not published | not published | $1,046.35 – $1,046.35 | 1 |
| Somatosensory testing CPT 95927 | not published | not published | $298.08 – $417.31 | 2 |
| Somatropin injection HCPCS J2941 | not published | not published | $48.92 – $68.49 | 2 |
| So neo gsap dna/dna&rna CPT 81459 | not published | not published | $2,989.55 – $2,989.55 | 1 |
| So neo gsap dna mcrstl ins CPT 81457 | not published | not published | $896.87 – $896.87 | 1 |
| Sotalol hydrochloride IV HCPCS C9482 | not published | not published | $25.05 – $35.07 | 2 |
| Spacer bag/reservoir HCPCS A4627 | $6.00 | $10.00 | not published | 0 |
| Special casting material HCPCS A4590 | $34.80 | $58.00 | not published | 0 |
| Special physics consult CPT 77370 | $436.80 | $728.00 | $127.09 – $177.93 | 2 |
| Special radiation dosimetry CPT 77331 | $249.00 | $415.00 | $127.09 – $177.93 | 2 |
| Special radiation treatment CPT 77470 | $1,415.40 | $2,359.00 | $553.72 – $775.21 | 2 |
| Special supplies phys/qhp CPT 99070 | $98.40 | $164.00 | not published | 0 |
| Special teletx port plan CPT 77321 | $490.80 | $818.00 | $350.41 – $490.57 | 2 |
| Specific gravity body fluid CPT 84315 | $30.60 | $51.00 | $3.28 – $3.28 | 1 |
| Specimen fat stain CPT 89125 | not published | not published | $5.88 – $5.88 | 1 |
| Speech and Language Evaluation (comprehensive) CPT 92523 | $342.60 | $571.00 | $292.08 – $292.08 | 1 |
| Speech audiometry complete CPT 92556 | $20.40 | $34.00 | $22.10 – $56.86 | 2 |
| Speech evaluation complex CPT 70371 | not published | not published | $231.38 – $323.93 | 2 |
| Speech recep thresh CPT 92555 | $39.60 | $66.00 | $20.15 – $56.86 | 2 |
| Speech Therapy Session (one-on-one) CPT 92507 | $265.20 | $442.00 | $98.27 – $98.27 | 1 |
| Sperm antibody test CPT 89325 | $142.20 | $237.00 | $10.67 – $10.67 | 1 |
| Sperm evaluation test CPT 89329 | not published | not published | $19.59 – $19.59 | 1 |
| Sperm identification CPT 89257 | not published | not published | $51.14 – $71.60 | 2 |
| Sperm isolation complex CPT 89261 | not published | not published | $51.14 – $71.60 | 2 |
| Sperm isolation simple CPT 89260 | not published | not published | $51.14 – $71.60 | 2 |
| Sperm washing 58323 CPT 58323 | $37.80 | $63.00 | not published | 0 |
| Sphenoid sinus surgery CPT 31051 | not published | not published | $5,662.59 – $7,927.62 | 2 |
| Sphincteroplasty inc/prolapse adult 46750 CPT 46750 | $1,386.60 | $2,311.00 | not published | 0 |
| Spinal bone allograftstructural 20931 CPT 20931 | $231.60 | $386.00 | 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.