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 |
|---|---|---|---|---|
| Surgery to stop leg growth CPT 27485 | not published | not published | $6,838.12 – $9,573.37 | 2 |
| Surgical exposure prostate 55860 CPT 55860 | $1,561.80 | $2,603.00 | not published | 0 |
| Surgical opening of stomach CPT 43510 | not published | not published | $897.45 – $1,256.43 | 2 |
| Surgical opening of stomach 43500 CPT 43500 | $1,407.60 | $2,346.00 | not published | 0 |
| Surgical opening of throat CPT 42955 | not published | not published | $1,417.91 – $1,985.08 | 2 |
| Surgical pathology level 1 gross examination only CPT 88300 | $33.60 | $56.00 | $23.44 – $29.25 | 2 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $66.60 | $111.00 | $37.57 – $52.60 | 2 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $70.80 | $118.00 | $51.14 – $71.60 | 2 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $79.20 | $132.00 | $51.14 – $61.75 | 2 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $98.40 | $164.00 | $96.20 – $344.33 | 2 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $138.00 | $230.00 | $104.00 – $781.95 | 2 |
| Surgical repair stomach bleedin ulcer 43501 CPT 43501 | $2,415.60 | $4,026.00 | not published | 0 |
| Surgical repair stomach gastric lac 43502 CPT 43502 | $2,728.20 | $4,547.00 | not published | 0 |
| Surg tx anal fistula 2nd stage 46285 CPT 46285 | $969.00 | $1,615.00 | not published | 0 |
| Susceptibility agar dilution per agent CPT 87181 | $35.40 | $59.00 | $4.75 – $4.75 | 1 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $57.60 | $96.00 | $4.75 – $4.75 | 1 |
| Susceptibility mic per plate CPT 87186 | $184.80 | $308.00 | $8.65 – $8.65 | 1 |
| Suscept studies macrobroth dilution ea CPT 87188 | $370.80 | $618.00 | $6.64 – $6.64 | 1 |
| Suspension of testis CPT 54620 | not published | not published | $3,301.42 – $4,621.99 | 2 |
| Suspension of uterus 58400 CPT 58400 | $816.00 | $1,360.00 | not published | 0 |
| Sutr lg intestine 1/mult perf without colostomy 44604 CPT 44604 | $1,900.20 | $3,167.00 | not published | 0 |
| Suture bile duct injury 47900 CPT 47900 | $2,437.80 | $4,063.00 | not published | 0 |
| Svc venogram s&i CPT 75827 | $1,563.60 | $2,606.00 | $1,018.55 – $1,486.98 | 2 |
| Swallowing Evaluation (Bedside) CPT 92610 | $216.00 | $360.00 | $91.47 – $91.47 | 1 |
| Swallowing Therapy Session CPT 92526 | $186.00 | $310.00 | $107.20 – $107.20 | 1 |
| Sweat collection by iontophoresis CPT 89230 | $90.00 | $150.00 | $51.14 – $71.60 | 2 |
| Sympathectomy cervical CPT 64802 | not published | not published | $1,869.23 – $2,616.92 | 2 |
| Sympathectomy digital artery CPT 64820 | not published | not published | $1,869.23 – $2,616.92 | 2 |
| Sympathectomy supfc palmar CPT 64823 | not published | not published | $3,105.81 – $4,348.13 | 2 |
| Synthetic sentence id test CPT 92576 | not published | not published | $37.57 – $52.60 | 2 |
| Synvisc or synvisc-one HCPCS J7325 | $2,438.29 | $4,063.81 | $9.09 – $12.73 | 2 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $55.20 | $92.00 | $4.40 – $4.40 | 1 |
| System cardiomems hosp electronics HCPCS C2624 | $52,875.00 | $88,125.00 | not published | 0 |
| System pacing micra av HCPCS C1786 | $25,312.80 | $42,188.00 | not published | 0 |
| System pcmkr dual chamber leadless micra av2 intrdcr cath HCPCS C1785 | $9,433.20 | $15,722.00 | not published | 0 |
| T3 (triiodothyronine) free CPT 84481 | $231.60 | $386.00 | $16.94 – $16.94 | 1 |
| T3 (triiodothyronine) total CPT 84480 | $159.00 | $265.00 | $14.18 – $14.18 | 1 |
| T4 (thyroxine) free CPT 84439 | $151.20 | $252.00 | $9.02 – $9.02 | 1 |
| T4 (thyroxine) total CPT 84436 | $124.20 | $207.00 | $6.87 – $6.87 | 1 |
| Tacrol envarsus ex rel oral HCPCS J7503 | $8.57 | $14.28 | not published | 0 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | $50.21 | $83.68 | not published | 0 |
| Tacrolimus 5 mg/ml intravenous solution HCPCS J7525 | $438.20 | $730.33 | $262.23 – $367.12 | 2 |
| Tacrolimus therapeutic drug level CPT 80197 | $262.80 | $438.00 | $13.73 – $13.73 | 1 |
| Tafasitamab-cxix 200 mg intravenous solution HCPCS J9349 | $2,359.28 | $3,932.13 | $14.08 – $19.71 | 2 |
| Tah rad debulk/lymph remove 58954 CPT 58954 | $3,901.20 | $6,502.00 | not published | 0 |
| Tah rad dissect for debulk 58953 CPT 58953 | $3,598.80 | $5,998.00 | not published | 0 |
| Tah w/mmk 58152 CPT 58152 | $2,313.00 | $3,855.00 | not published | 0 |
| Tailbone (Sacrum and Coccyx) X-ray CPT 72220 | $171.00 | $285.00 | $84.28 – $118.00 | 2 |
| Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection HCPCS J9325 | not published | not published | $73.55 – $102.97 | 2 |
| Talquetamab-tgvs 2 mg/ml subcutaneous solution HCPCS J3055 | not published | not published | $72.40 – $101.36 | 2 |
| Tap block bilat cont infusion 64489 CPT 64489 | $178.20 | $297.00 | not published | 0 |
| Tap block uni by cont infusion 64487 CPT 64487 | $145.80 | $243.00 | not published | 0 |
| Tape plstc 1inx5yd hosp tb pk HCPCS A4452 | $16.20 | $27.00 | not published | 0 |
| Target gsa panel hmtlmph neop CPT 81450 | not published | not published | $759.53 – $759.53 | 1 |
| Target gsa panel organ/hmtlmph neop CPT 81455 | not published | not published | $2,919.60 – $2,919.60 | 1 |
| Target gsa panel organ neop CPT 81445 | not published | not published | $597.91 – $597.91 | 1 |
| Tarlatamab-dlle 10 mg intravenous solution HCPCS J9026 | not published | not published | $1,567.49 – $2,194.49 | 2 |
| Tattooing/intraderm 6.1-20.0 sq cm 11921 CPT 11921 | $365.40 | $609.00 | not published | 0 |
| Tavr perq femoral CPT 33361 | $1,800.00 | $3,000.00 | not published | 0 |
| Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe HCPCS J1447 | $780.64 | $1,301.06 | $0.30 – $0.42 | 2 |
| Tbp gene detc abnor alleles CPT 81344 | not published | not published | $137.00 – $137.00 | 1 |
| Tbs techl calculation only CPT 77091 | not published | not published | $84.28 – $118.00 | 2 |
| Tbs techl prep&transmis data CPT 77090 | not published | not published | $84.28 – $118.00 | 2 |
| Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells CPT 86481 | not published | not published | $100.00 – $100.00 | 1 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $239.40 | $399.00 | $61.98 – $61.98 | 1 |
| Tc-99m arcitumomab HCPCS A9568 | not published | not published | $809.51 – $1,133.31 | 2 |
| Tc-99m bicisate HCPCS A9557 | not published | not published | $683.80 – $957.32 | 2 |
| Tc-99m exame autol wbc diag per dose HCPCS A9569 | not published | not published | $1,040.32 – $1,456.45 | 2 |
| Tc-99m exametazime diag HCPCS A9521 | $1,605.60 | $2,676.00 | $802.34 – $1,123.28 | 2 |
| Tc-99m gluceptate HCPCS A9550 | $729.00 | $1,215.00 | not published | 0 |
| Tc-99m graphite crucible HCPCS A9506 | not published | not published | $328.60 – $460.04 | 2 |
| Tc-99m labeled rbc HCPCS A9560 | $294.00 | $490.00 | not published | 0 |
| Tc-99m maa HCPCS A9540 | $187.20 | $312.00 | not published | 0 |
| Tc-99m mebrofenin HCPCS A9537 | $169.80 | $283.00 | not published | 0 |
| Tc-99m medronate HCPCS A9503 | $63.60 | $106.00 | not published | 0 |
| Tc-99m mertiatide HCPCS A9562 | $530.40 | $884.00 | not published | 0 |
| Tc-99m non-heu per study dose HCPCS Q9969 | not published | not published | $10.00 – $14.00 | 2 |
| Tc-99m oxidronate HCPCS A9561 | $120.60 | $201.00 | not published | 0 |
| Tc-99m pentetate dtpa HCPCS A9539 | $121.20 | $202.00 | not published | 0 |
| Tc-99m pertechnetate per mci HCPCS A9512 | $114.00 | $190.00 | not published | 0 |
| Tc-99m pyroph diag per dose up to 25 mci HCPCS A9538 | $133.80 | $223.00 | not published | 0 |
| Tc-99m sestamibi p study dose HCPCS A9500 | $302.40 | $504.00 | not published | 0 |
| Tc-99m succimer (dmsa) HCPCS A9551 | $338.40 | $564.00 | not published | 0 |
| Tc-99m sulfur colloid HCPCS A9541 | $201.60 | $336.00 | not published | 0 |
| Tc-99m tetrofosmin p study dose HCPCS A9502 | $243.00 | $405.00 | not published | 0 |
| Tca peel dermal 15789 CPT 15789 | $1,011.60 | $1,686.00 | not published | 0 |
| Tcd emboli detect w/inj CPT 93893 | not published | not published | $101.79 – $142.51 | 2 |
| Tcd emboli detect without inj CPT 93892 | not published | not published | $101.79 – $142.51 | 2 |
| T-cell depletion of harvest CPT 38210 | not published | not published | $418.48 – $585.87 | 2 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $155.40 | $259.00 | $46.98 – $46.98 | 1 |
| T cells absolute cd 4 count CPT 86361 | $88.20 | $147.00 | $26.78 – $26.78 | 1 |
| T cells total count CPT 86359 | $127.80 | $213.00 | $37.73 – $37.73 | 1 |
| Tcranial magn stim tx deli CPT 90868 | not published | not published | $298.08 – $417.31 | 2 |
| Tcranial magn stim tx plan CPT 90867 | not published | not published | $298.08 – $417.31 | 2 |
| Tcran magn stim redetemine CPT 90869 | not published | not published | $298.08 – $417.31 | 2 |
| Teaec w/wo patch graft iliofemoral CPT 35355 | $2,212.20 | $3,687.00 | not published | 0 |
| Team conf w/pat by hc prof CPT 99366 | $70.80 | $118.00 | not published | 0 |
| Tebentafusp-tebn 100 mcg/0.5 ml intravenous solution HCPCS J9274 | not published | not published | $217.09 – $303.93 | 2 |
| Tee w or without fol w/cont,cong HCPCS C8926 | not published | not published | $756.26 – $1,058.77 | 2 |
| Tee w or without fol w/cont, mon HCPCS C8927 | not published | not published | $756.26 – $1,058.77 | 2 |
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.