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 |
|---|---|---|---|---|
| Upper Endoscopy (EGD, with biopsy) CPT 43239 | $195.00 | $325.00 | not published | 0 |
| Upper ext harvest for cabg1 seg 35600 CPT 35600 | $480.00 | $800.00 | not published | 0 |
| Upper GI Barium X-ray (barium and gas) CPT 74246 | $333.00 | $555.00 | $170.40 – $238.57 | 2 |
| Upper GI Barium X-ray (barium only) CPT 74240 | $317.40 | $529.00 | $170.40 – $238.57 | 2 |
| Uppr gi scope w/submuc inj CPT 43236 | $630.00 | $1,050.00 | not published | 0 |
| Urachal cyst/sinus excision 51500 CPT 51500 | $1,254.60 | $2,091.00 | not published | 0 |
| Urea nitrogen CPT 84520 | $34.20 | $57.00 | $3.95 – $3.95 | 1 |
| Urea nitrogen 24 hour urine CPT 84540 | $50.40 | $84.00 | $5.56 – $5.56 | 1 |
| Urea nitrogen clearance CPT 84545 | not published | not published | $7.20 – $7.20 | 1 |
| Urea nitrogen semi-quant CPT 84525 | not published | not published | $5.13 – $5.13 | 1 |
| Ureteral reflux study CPT 78740 | $735.00 | $1,225.00 | $384.64 – $538.50 | 2 |
| Ureter endoscopy CPT 50970 | not published | not published | $3,301.42 – $4,621.99 | 2 |
| Ureter endoscopy & biopsy CPT 50955 | not published | not published | $4,866.14 – $6,812.60 | 2 |
| Ureter endoscopy & biopsy CPT 50974 | not published | not published | $4,866.14 – $6,812.60 | 2 |
| Ureter endoscopy & catheter CPT 50972 | not published | not published | $3,301.42 – $4,621.99 | 2 |
| Ureter endoscopy & treatment CPT 50957 | not published | not published | $4,866.14 – $6,812.60 | 2 |
| Ureter endoscopy & treatment CPT 50961 | not published | not published | $4,866.14 – $6,812.60 | 2 |
| Ureter endoscopy & treatment CPT 50976 | not published | not published | $4,866.14 – $6,812.60 | 2 |
| Ureter endoscopy & treatment CPT 50980 | not published | not published | $4,866.14 – $6,812.60 | 2 |
| Ureteroneocystostomy 50780 CPT 50780 | $2,203.20 | $3,672.00 | not published | 0 |
| Ureteroureterostomy 50760 CPT 50760 | $2,095.20 | $3,492.00 | not published | 0 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | $313.80 | $523.00 | $231.38 – $271.70 | 2 |
| Urethrlys transvag with scope CPT 53500 | not published | not published | $3,301.42 – $4,621.99 | 2 |
| Urethrocystography void s&i CPT 74455 | $439.80 | $733.00 | $231.38 – $323.93 | 2 |
| Uric acid blood CPT 84550 | $35.40 | $59.00 | $4.52 – $4.52 | 1 |
| Uric acid urine CPT 84560 | $38.40 | $64.00 | $5.08 – $5.08 | 1 |
| Urinalysis glass test CPT 81020 | not published | not published | $4.70 – $4.70 | 1 |
| Urinalysis microscopic only CPT 81015 | $16.20 | $27.00 | $3.05 – $3.05 | 1 |
| Urinalysis qual/semiquant excpt ia CPT 81005 | $102.00 | $170.00 | $2.17 – $2.17 | 1 |
| Urinalysis (with microscopy) CPT 81001 | $26.40 | $44.00 | $3.17 – $3.17 | 1 |
| Urinalysis (without microscopy) CPT 81003 | $200.40 | $334.00 | $2.25 – $2.25 | 1 |
| Urinary bldr retent nuc study CPT 78730 | $267.00 | $445.00 | not published | 0 |
| Urinary reflex study CPT 51792 | not published | not published | $56.86 – $79.60 | 2 |
| Urine Culture Test CPT 87086 | $45.00 | $75.00 | $8.07 – $8.07 | 1 |
| Urine flow measurement 51736 CPT 51736 | $85.80 | $143.00 | not published | 0 |
| Urine pregnancy test CPT 81025 | $60.60 | $101.00 | $8.61 – $8.61 | 1 |
| Urine screen for bacteria CPT 81007 | not published | not published | $29.98 – $29.98 | 1 |
| Urography, antegrade CPT 74425 | $550.80 | $918.00 | $341.85 – $477.10 | 2 |
| Urography inf drip &/or bolus CPT 74410 | $393.00 | $655.00 | $170.40 – $238.57 | 2 |
| Use 1st target lesion CPT 76982 | not published | not published | $101.79 – $142.51 | 2 |
| Ustekinumab 130 mg/26 ml intravenous solution HCPCS J3358 | $23,483.45 | $39,139.09 | $13.29 – $18.61 | 2 |
| Ustekinumab 45 mg/0.5 ml subcutaneous solution HCPCS J3357 | $46,966.91 | $78,278.18 | $157.68 – $220.75 | 2 |
| U/s trtmt, not leiomyomata HCPCS C9734 | not published | not published | $12,316.38 – $17,242.93 | 2 |
| Vaccine Administration (one shot) CPT 90471 | $43.20 | $72.00 | $46.80 – $68.13 | 2 |
| Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im CPT 91320 | $240.91 | $401.51 | not published | 0 |
| Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im CPT 91319 | $148.80 | $248.00 | not published | 0 |
| Vaccine covid-19 pfizer tris-sucrose 6mos-4yrs 3mcg/0.3ml im CPT 91318 | $114.26 | $190.44 | not published | 0 |
| Vaccine dtap < 7 years im CPT 90700 | $61.39 | $102.31 | not published | 0 |
| Vaccine dtap-hep b-ipv im CPT 90723 | $169.85 | $283.09 | not published | 0 |
| Vaccine dtap-ipv 4-6 years im CPT 90696 | $119.81 | $199.68 | not published | 0 |
| Vaccine dtap-ipv-hib-hepb im CPT 90697 | $270.73 | $451.22 | not published | 0 |
| Vaccine dtap-ipv/hib im CPT 90698 | $199.37 | $332.29 | not published | 0 |
| Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im CPT 90647 | $65.04 | $108.40 | not published | 0 |
| Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im CPT 90648 | $63.25 | $105.41 | not published | 0 |
| Vaccine hepatitis a (hepa) adult im CPT 90632 | $152.29 | $253.82 | not published | 0 |
| Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im CPT 90636 | $112.22 | $187.04 | not published | 0 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im CPT 90633 | $140.56 | $234.27 | not published | 0 |
| Vaccine hepatitis b (hepb) adult 3 dose im CPT 90746 | $130.79 | $217.98 | not published | 0 |
| Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im CPT 90739 | $261.45 | $435.75 | not published | 0 |
| Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 | $60.45 | $100.75 | not published | 0 |
| Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im CPT 90651 | $521.70 | $869.50 | not published | 0 |
| Vaccine influenza (iiv) preservative free antigen content im CPT 90662 | $126.46 | $210.77 | not published | 0 |
| Vaccine influenza quadrivalent (iiv4) 0.5ml dose im CPT 90688 | $16.34 | $27.24 | not published | 0 |
| Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im CPT 90694 | $132.61 | $221.02 | not published | 0 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im CPT 90686 | $50.08 | $83.47 | not published | 0 |
| Vaccine influenza quadrivalent live (laiv4) intranasal CPT 90672 | $43.75 | $72.91 | not published | 0 |
| Vaccine influenza quadrivalent (riv4) rdna antibiotic/preservative free im CPT 90682 | $57.43 | $95.71 | not published | 0 |
| Vaccine mengingoccocal serogroup b 2 dose im CPT 90620 | $385.39 | $642.31 | not published | 0 |
| Vaccine mengingoccocal serogroup b 2 or 3 dose im CPT 90621 | $335.00 | $558.34 | not published | 0 |
| Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im CPT 90619 | $288.70 | $481.16 | not published | 0 |
| Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im CPT 90734 | $513.94 | $856.56 | not published | 0 |
| Vaccine mmr live subcutaneous CPT 90707 | $176.24 | $293.74 | not published | 0 |
| Vaccine mmrv live subcutaneous CPT 90710 | $490.91 | $818.18 | not published | 0 |
| Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im CPT 90732 | $219.79 | $366.32 | not published | 0 |
| Vaccine pneumococcal conjugate 13 valent (pcv13) im CPT 90670 | $424.69 | $707.81 | not published | 0 |
| Vaccine pneumonococcal conjugate 20 valent (pcv20) im CPT 90677 | $475.00 | $791.67 | not published | 0 |
| Vaccine polio (ipv) subcutaneous/im CPT 90713 | $84.19 | $140.31 | not published | 0 |
| Vaccine rabies im CPT 90675 | $683.78 | $1,139.63 | $312.03 – $343.25 | 2 |
| Vaccine respiratory syncytial virus bivalent subunit/preservative free im CPT 90678 | $534.92 | $891.54 | not published | 0 |
| Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im CPT 90380 | $889.16 | $1,481.94 | not published | 0 |
| Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im CPT 90381 | $889.16 | $1,481.94 | not published | 0 |
| Vaccine respiratory syncytial virus recombinant subunit adjuvanted/preservative free im CPT 90679 | $508.36 | $847.26 | not published | 0 |
| Vaccine rotavirus attenuated (rv1) live 2 dose oral CPT 90681 | $241.04 | $401.73 | not published | 0 |
| Vaccine rotavirus pentavalent (rv5) live 3 dose oral CPT 90680 | $87.62 | $146.04 | not published | 0 |
| Vaccine tdap >=7 years im CPT 90715 | $96.27 | $160.45 | not published | 0 |
| Vaccine td preservative free >= 7 years im CPT 90714 | $74.69 | $124.48 | not published | 0 |
| Vaccine varicella live subcutaneous CPT 90716 | $321.18 | $535.30 | not published | 0 |
| Vaccinia vrs vac 0.3 ml perq CPT 90622 | not published | not published | $0.01 – $0.01 | 2 |
| Vag hys/<250g/rmv tube/rpr entero 58263 CPT 58263 | $1,898.40 | $3,164.00 | not published | 0 |
| Vag hyst incl t/o complex CPT 58291 | $2,314.80 | $3,858.00 | not published | 0 |
| Vag hyst including t/o CPT 58262 | $1,711.80 | $2,853.00 | not published | 0 |
| Vag hyst t/o & repair compl CPT 58292 | $2,444.40 | $4,074.00 | not published | 0 |
| Vag hyst w/enterocele compl 58294 CPT 58294 | $2,265.00 | $3,775.00 | not published | 0 |
| Vag hyst w/enterocele repair CPT 58270 | $1,636.20 | $2,727.00 | not published | 0 |
| Vag hyst w/uro repair compl 58293 CPT 58293 | $2,540.40 | $4,234.00 | not published | 0 |
| Vaginal bx CPT 58999 | $123.60 | $206.00 | not published | 0 |
| Vaginal delivery after cesarean delivery 59612 CPT 59612 | $1,791.60 | $2,986.00 | not published | 0 |
| Vaginal Delivery (full care) CPT 59400 | $4,060.80 | $6,768.00 | not published | 0 |
| Vaginal hysterectomy CPT 58260 | $1,533.60 | $2,556.00 | not published | 0 |
| Vaginectomy partial w/nodes CPT 57109 | not published | not published | $3,043.51 – $4,260.91 | 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.