MercyOne Des Moines Medical Center
1111 6th Ave, Des Moines, IA · MercyOne · Nonprofit · NPI 1234567893
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 |
|---|---|---|---|---|
| Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device CPT 94664 | $2,256.00 | $320.00 | $13.45 – $425.12 | 779 |
| Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution HCPCS J0897 | $15,865.45 | $15,865.45 | $13.96 – $11,252.60 | 779 |
| Deodorant ostmy adapt lube 8ml HCPCS A4394 | $0.06 | $0.10 | $0.02 – $0.10 | 28 |
| Descend thora aorta rpr/lt sub art 33880 CPT 33880 | $5,758.00 | $5,758.00 | $37.48 – $644.64 | 768 |
| Design mlc device for imrt CPT 77338 | $46,768.00 | $2,239.00 | $88.83 – $2,239.00 | 780 |
| Desmopressin 4 mcg/ml injection solution HCPCS J2597 | $42.90 | $42.90 | $8.62 – $42.90 | 28 |
| Des thora aorta/ea add prox prosth 33884 CPT 33884 | $1,261.00 | $1,261.00 | $258.47 – $1,261.00 | 767 |
| Des thora aorta rpr without left sub art 33881 CPT 33881 | $4,936.00 | $4,936.00 | $344.64 – $3,305.81 | 768 |
| Des thor aorta/prox ext prosth/ini 33883 CPT 33883 | $3,584.00 | $3,584.00 | $306.62 – $3,584.00 | 768 |
| Destroy cervthor facet jnt 64633 CPT 64633 | $5,544.50 | $8,530.00 | $1,143.09 – $5,687.00 | 108 |
| Destroy cth facet jnt addl 64634 CPT 64634 | $6,056.70 | $9,318.00 | $1,248.61 – $6,212.00 | 27 |
| Destruct cut vasl lesions >50cm 17108 CPT 17108 | $20,778.75 | $2,384.00 | $31.45 – $3,206.43 | 769 |
| Destruction anal lesion(s) CPT 46910 | $4,427.80 | $6,812.00 | $1,369.21 – $6,812.00 | 108 |
| Destruction anal lesion(s) CPT 46924 | $661.00 | $661.00 | $38.87 – $594.90 | 768 |
| Destruction benign lesions < 14 lesions CPT 17110 | $13,781.80 | not published | $0.96 – $389.51 | 82 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides) CPT 64636 | $27,136.69 | $12,795.00 | $1,714.53 – $8,530.00 | 108 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides) CPT 64635 | $26,986.06 | $11,289.00 | $1,512.53 – $7,525.00 | 108 |
| Destruction rectal tumor 45190 CPT 45190 | $2,556.00 | $2,556.00 | $214.39 – $2,091.00 | 768 |
| Device ablt adv novasure HCPCS C1886 | $6,237.48 | $9,596.13 | $87.55 – $435.55 | 28 |
| Device hemospray 7frx220cm endo hemostat min access HCPCS C1052 | $2,599.67 | $3,999.50 | $655.81 – $3,262.75 | 28 |
| Device intraute mirena HCPCS J7298 | $6,362.20 | $6,362.20 | $530.49 – $6,362.20 | 552 |
| Device sut capio slim opn HCPCS C2631 | $1,534.26 | $2,360.40 | $212.93 – $1,059.37 | 28 |
| Device tiss remov myosure reach HCPCS C1782 | $3,961.70 | $6,094.92 | $214.06 – $1,064.99 | 28 |
| Dev interrog remote 1/2/mlt CPT 93295 | $157.00 | $157.00 | $23.00 – $157.00 | 771 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | $654.00 | $278.00 | $5.96 – $278.00 | 781 |
| Dexamethasone 0.4 mg/0.1 ml intraocular injection - cnr HCPCS J1095 | $21.00 | $21.00 | $4.22 – $21.00 | 28 |
| Dexamethasone 4 mg tablet HCPCS J8540 | $130,837.85 | $13.00 | $0.04 – $94.56 | 779 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $23,929.11 | $20.20 | $0.48 – $6,129.97 | 779 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | $884.80 | $884.80 | $32.09 – $344.95 | 109 |
| Dextran 40 infusion HCPCS J7100 | $1,820.00 | $1,820.00 | $66.56 – $1,820.00 | 94 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | $20.00 | $20.00 | $4.02 – $20.00 | 28 |
| Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 | $20.00 | $20.00 | $4.02 – $20.00 | 28 |
| Dextrose 5 % IV bolus HCPCS J7070 | $30.00 | $30.00 | $1.76 – $8.75 | 28 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $175.50 | $270.00 | $21.54 – $270.00 | 43 |
| Diabetes (HbA1c) Test CPT 83036 | $317.00 | $245.00 | $6.80 – $130.00 | 780 |
| Diabetes training group per 30 min g0109 HCPCS G0136 | $49.00 | $49.00 | $5.11 – $42.13 | 767 |
| Diag laparo separate proc 49320 CPT 49320 | $35,313.39 | $1,182.00 | $100.86 – $11,736.86 | 769 |
| Diagnostic anoscopy spx 46600 CPT 46600 | $580.00 | $362.00 | $10.42 – $362.00 | 781 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | $2,302.00 | not published | $81.59 – $224.70 | 84 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $628.55 | $967.00 | $19.49 – $967.00 | 780 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $437.45 | $673.00 | $98.64 – $673.00 | 109 |
| Diagnostic Mammogram (one breast) CPT 77065 | $354.90 | $546.00 | $77.11 – $546.00 | 109 |
| Dialysis one evaluation CPT 90945 | $1,124.50 | $1,730.00 | $347.73 – $1,730.00 | 109 |
| Dialysis repeated eval CPT 90947 | $3,749.20 | $5,768.00 | $1,104.09 – $5,493.00 | 28 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | $103.50 | $103.50 | $20.80 – $103.50 | 28 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $111.85 | $111.85 | $22.48 – $111.85 | 28 |
| Diffusing capacity CPT 94729 | $276.25 | $425.00 | $5.93 – $425.00 | 780 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $503.10 | $503.10 | $1.99 – $12.79 | 94 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | $13,725.30 | $13,725.30 | $2,758.79 – $13,725.30 | 94 |
| Digoxin total therapeutic drug level CPT 80162 | $195.65 | $301.00 | $12.87 – $301.00 | 43 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | $358.75 | $358.75 | $18.49 – $92.00 | 28 |
| Dilate biliary duct/ampulla CPT 47542 | $3,833.70 | $5,898.00 | $1,185.50 – $5,898.00 | 27 |
| Dilation of anal sphincter CPT 45905 | $621.00 | $621.00 | $53.89 – $540.25 | 768 |
| Dilator fascial 10fx20cm HCPCS C2627 | $274.98 | $423.05 | $9.30 – $46.25 | 28 |
| Diltiazem 5 mg/ml intravenous solution HCPCS J1163 | $26.00 | $26.00 | $0.20 – $3.00 | 94 |
| Dimenhydrinate injection HCPCS J1240 | $11.65 | $11.65 | $2.34 – $12.57 | 94 |
| Diphenhydramine 12.5 mg/5 ml oral elixir HCPCS Q0163 | $3.40 | $3.40 | $0.02 – $3.40 | 94 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $5.40 | $5.40 | $0.50 – $5.40 | 778 |
| Disability dlco CPT 94727 | $352.30 | $542.00 | $7.67 – $542.00 | 781 |
| Disaccharidases CPT 82657 | $526.50 | $810.00 | $21.48 – $810.00 | 43 |
| Dna antibody native/double stranded CPT 86225 | $100.10 | $154.00 | $13.31 – $154.00 | 43 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $183.75 | $183.75 | $7.70 – $38.30 | 94 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | $321.95 | $321.95 | $8.20 – $115.00 | 94 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $91.25 | $91.25 | $2.43 – $12.10 | 94 |
| Doppler echo complete CPT 93320 | $679.25 | $1,045.00 | $11.08 – $1,045.00 | 779 |
| Doppler intravascular pressure flow initial vessel CPT 93571 | $46,828.53 | $2,764.00 | $2.28 – $11,049.67 | 780 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $2,453.00 | $867.00 | $13.63 – $867.00 | 780 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $2,013.00 | $804.00 | $7.46 – $804.00 | 780 |
| Dornhoffer fixed part w/window HCPCS L8614 | $20,628.52 | $31,736.18 | $275.75 – $1,371.90 | 28 |
| Dostarlimab-gxly 50 mg/ml intravenous solution HCPCS J9272 | $36,812.65 | $36,812.65 | $229.63 – $36,812.65 | 109 |
| Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 | $1,578.20 | $1,578.20 | $14.90 – $112.75 | 94 |
| Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension HCPCS Q2050 | $7,093.75 | $7,093.75 | $342.45 – $1,920.95 | 31 |
| Doxycycline hyclate 100 mg intravenous powder for solution HCPCS J1271 | $121.10 | $121.10 | $5.13 – $121.10 | 514 |
| Dpyd gene common variants CPT 81232 | $373.75 | $575.00 | $105.32 – $524.00 | 40 |
| Drainage external ear complex 69005 CPT 69005 | $711.67 | $571.00 | $46.65 – $571.00 | 768 |
| Drainage of kidney lesion CPT 50390 | $4,093.05 | $6,297.00 | $668.39 – $4,198.00 | 108 |
| Drainage of mouth lesion CPT 41008 | $947.00 | $947.00 | $22.82 – $947.00 | 768 |
| Drainage of pelvis lesion 26990 CPT 26990 | $2,348.00 | $2,348.00 | $210.66 – $1,525.00 | 768 |
| Drain cath image guided visceral pq CPT 49405 | $371.80 | $572.00 | $114.97 – $3,206.43 | 108 |
| Drain cerebro spinal fluid 62272 CPT 62272 | $272.00 | $272.00 | $25.03 – $202.00 | 768 |
| Drain chst dry seal exp thorastat HCPCS A7041 | $138.44 | $212.98 | $42.81 – $212.98 | 28 |
| Drain finger abscess;simple 26010 CPT 26010 | $318.00 | $318.00 | $3.65 – $50.88 | 768 |
| Drain lower leg lesion 27603 CPT 27603 | $1,744.00 | $1,744.00 | $118.43 – $891.00 | 768 |
| Drain neck/chest lesion 21501 CPT 21501 | $16,649.99 | $1,155.00 | $0.96 – $5,639.25 | 769 |
| Drain thigh/knee lesion 27301 CPT 27301 | $12,094.00 | $18,141.00 | $19.40 – $12,094.00 | 780 |
| Drain to peritoneal cavity CPT 49062 | $2,748.00 | $2,748.00 | $233.88 – $2,748.00 | 768 |
| Dress/debride pt-thick burn/<5% bs 16020 CPT 16020 | $330.85 | $509.00 | $13.13 – $509.00 | 780 |
| Dressing change not for burn w/anes 15852 CPT 15852 | $150.00 | $150.00 | $12.36 – $92.86 | 768 |
| Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm HCPCS Q4108 | $978.05 | $1,504.70 | $15.11 – $92.61 | 36 |
| Drill hole implt ventricular cath/device 61107 CPT 61107 | $934.00 | $934.00 | $183.39 – $681.00 | 768 |
| Drng of hydrocele 55000 CPT 55000 | $27,411.79 | $303.00 | $0.96 – $11,736.86 | 769 |
| Drng of scrotum abscess 55100 CPT 55100 | $602.00 | $602.00 | $18.75 – $553.79 | 768 |
| Drng peritoneal abscess open 49020 CPT 49020 | $5,698.00 | $5,698.00 | $37.48 – $553.60 | 768 |
| Dronabinol 2.5mg oral HCPCS Q0167 | $2.10 | $2.10 | $0.42 – $2.68 | 94 |
| Droperidol 2.5 mg/ml injection solution HCPCS J1790 | $32.80 | $32.80 | $5.36 – $32.80 | 94 |
| Drsg interceed 3x4in adh wnd barr absorb HCPCS C1765 | $3,826.54 | $5,886.99 | $138.77 – $690.42 | 28 |
| Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm HCPCS Q4103 | $156.82 | $241.26 | $39.37 – $241.26 | 36 |
| Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm HCPCS Q4102 | $34.84 | $53.60 | $7.12 – $43.65 | 36 |
| Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm HCPCS Q4124 | $41.79 | $64.30 | $9.88 – $60.55 | 36 |
| Drsg sht 5.625x4.625in std HCPCS A6025 | $80.11 | $123.24 | $21.41 – $106.53 | 28 |
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.