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 |
|---|---|---|---|---|
| Forearm X-ray (both sides) CPT 73090 | $560.00 | $840.00 | $4.90 – $560.00 | 780 |
| Forehead flap w/vasc pedicle 15731 CPT 15731 | $3,285.00 | $3,285.00 | $35.77 – $453.84 | 768 |
| Fosaprepitant 150 mg intravenous powder for solution HCPCS J1453 | $184.00 | $184.00 | $36.98 – $184.00 | 28 |
| Foscarnet sodium injection HCPCS J1455 | $1,168.75 | $1,168.75 | $93.48 – $1,168.75 | 94 |
| Fosphenytoin 50 mg pe/ml injection (wrapper) HCPCS Q2009 | $25.20 | $25.20 | $1.31 – $25.20 | 106 |
| _fragile x methylation-sendout CPT 81244 | $766.35 | $1,179.00 | $43.50 – $1,179.00 | 43 |
| Freeing of bowel adhesion 44005 CPT 44005 | $3,897.00 | $3,897.00 | $325.36 – $2,368.00 | 768 |
| Free/remove chest lining 32320 CPT 32320 | $4,941.00 | $4,941.00 | $37.48 – $549.44 | 768 |
| Frenectomy 41115 CPT 41115 | $12,938.25 | $540.00 | $0.36 – $3,012.26 | 769 |
| Fresh frozen plasma 8-24 hours collection each unit HCPCS P9059 | $187.20 | $288.00 | $57.89 – $546.00 | 109 |
| Fresh frozen plasma frozen within 8 hours of collection each unit HCPCS P9017 | $161.85 | $249.00 | $50.05 – $546.00 | 109 |
| Fresh frozen plasma thawing ea un CPT 86927 | $102.70 | $158.00 | $31.76 – $158.00 | 28 |
| Fructosamine glycated protein CPT 82985 | $49.40 | $76.00 | $15.28 – $76.00 | 43 |
| Fth/gft fr trnk each addl CPT 15201 | $59,728.88 | $248.00 | $41.32 – $12,891.30 | 769 |
| Full Spine X-ray (Scoliosis Survey) CPT 72082 | $624.65 | $961.00 | $98.68 – $961.00 | 109 |
| Full thick gft/scalp/arm/leg/20sqcm or< 15220 CPT 15220 | $35,372.87 | not published | $0.96 – $4,005.68 | 82 |
| Full thick gft w/close donor fccmnaghf <=20sqcm 15240 CPT 15240 | $35,119.33 | $2,617.00 | $0.96 – $4,005.68 | 769 |
| Furosemide 10 mg/ml injection solution HCPCS J1938 | $3.00 | $3.00 | $0.40 – $3.00 | 94 |
| Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr HCPCS J1940 | $6.75 | $6.75 | $0.57 – $6.75 | 36 |
| Fusion of big toe joint CPT 28750 | $36,080.51 | not published | $0.96 – $24,925.18 | 82 |
| Fusion of big toe joint CPT 28755 | $22,161.35 | not published | $0.36 – $14,087.30 | 82 |
| G0180 home health certification HCPCS G0180 | $118.00 | $118.00 | $38.37 – $118.00 | 767 |
| Ga-67 gallium 0.1 mci HCPCS A9556 | $253.10 | $253.10 | $50.87 – $319.00 | 28 |
| Ga-68 gallium 68 dotatate HCPCS A9587 | $15,600.00 | $15,600.00 | $48.64 – $15,600.00 | 106 |
| Gadobutrol 1 mmol/ml intravenous solution (wrapper) HCPCS A9585 | $591.40 | $591.40 | $19.76 – $591.40 | 28 |
| Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper) HCPCS A9579 | $231.00 | $231.00 | $7.35 – $231.00 | 28 |
| Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution HCPCS A9575 | $106.25 | $106.25 | $12.00 – $106.25 | 28 |
| Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution HCPCS A9581 | $674.30 | $674.30 | $135.53 – $674.30 | 28 |
| Gallbladder and Bile Duct Scan (HIDA Scan) CPT 78226 | $1,668.55 | $2,567.00 | $377.34 – $2,567.00 | 109 |
| Gallbladder Function Scan (HIDA with Medication) CPT 78227 | $1,369.55 | $2,107.00 | $423.51 – $2,107.00 | 109 |
| Gallbladder Removal (Laparoscopic) CPT 47562 | $27,991.10 | $2,363.00 | $1.92 – $11,736.86 | 769 |
| Gammaglobulin iga CPT 82784 | $17,579.35 | $223.00 | $9.02 – $1,222.56 | 109 |
| Gammaglobulin ige CPT 82785 | $160.55 | $247.00 | $15.95 – $247.00 | 43 |
| Gamma glutamyltransferase CPT 82977 | $105.30 | $162.00 | $6.98 – $162.00 | 43 |
| Gamunex-c/gammaked HCPCS J1561 | $28,520.25 | $14,238.00 | $48.09 – $1,779.75 | 109 |
| Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr HCPCS J1570 | $447.35 | $447.35 | $16.64 – $82.80 | 94 |
| Gastroesophageal reflux study CPT 78262 | $631.15 | $971.00 | $195.17 – $971.00 | 28 |
| Gemcitabine 1 gram intravenous solution HCPCS J9201 | $540.20 | $540.20 | $10.08 – $50.15 | 94 |
| Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln HCPCS J9203 | $31,504.65 | $31,504.65 | $6,332.43 – $31,504.65 | 94 |
| General health panel CPT 80050 | $285.35 | $439.00 | $40.66 – $439.00 | 36 |
| Generator barostim neo2 2014 HCPCS C1767 | $44,831.44 | $68,971.44 | $0.68 – $3.36 | 28 |
| Generator emblem MRI sicd subq HCPCS C1722 | $22,347.00 | $34,380.00 | $151.37 – $753.08 | 28 |
| Generator stim baroreceptor neo legacy implant pulse HCPCS C1825 | $35,196.52 | $54,148.50 | $8,983.49 – $44,694.00 | 28 |
| Gentamicin 10 mg/ml liquid compound - enteral use only HCPCS J1580 | $17.40 | $17.40 | $0.87 – $4.35 | 28 |
| Gentamicin peak therapeutic drug level CPT 80170 | $284.70 | $438.00 | $15.87 – $438.00 | 43 |
| G-esoph reflx tst w/electrod CPT 91035 | $16,452.35 | $7,470.00 | $0.96 – $7,470.00 | 780 |
| Ghs abscess perianal iandd CPT 46050 | $5,155.00 | $4,937.00 | $16.12 – $4,937.00 | 781 |
| Ghs abscess postoperative iandd complex CPT 10180 | $23,390.75 | $580.00 | $9.09 – $5,639.25 | 769 |
| Ghs analysis neurostim without reprogramming CPT 95970 | $313.95 | $483.00 | $7.52 – $483.00 | 781 |
| Ghs bladder cath - complex-foley CPT 51703 | $162.00 | $162.00 | $11.23 – $162.00 | 768 |
| Ghs block ilioinguinal/gentitofemoral CPT 64425 | $1,454.05 | $2,237.00 | $299.69 – $1,491.00 | 108 |
| Ghs central line insert < age 5, failed CPT 36555 | $3,591.25 | $5,525.00 | $1,110.53 – $5,525.00 | 27 |
| Ghs change cysto/gastrost CPT 43762 | $843.00 | $682.00 | $3.53 – $682.00 | 780 |
| Ghs chemo >8 hrs CPT 96416 | $531.70 | $818.00 | $164.42 – $818.00 | 109 |
| Ghs chemo IV push, ea addtl CPT 96411 | $356.20 | $548.00 | $67.96 – $548.00 | 109 |
| Ghs closd tx interphalang jt disloc w/ma CPT 26770 | $925.00 | $925.00 | $34.12 – $728.38 | 768 |
| Ghs closed reduction ankle dislocation CPT 27840 | $1,352.00 | $1,352.00 | $135.45 – $1,121.38 | 768 |
| Ghs closed tx tibial fracture w/manip CPT 27752 | $1,136.00 | $1,136.00 | $147.97 – $1,136.00 | 768 |
| Ghs closure surg wound/dehiscence-13160 CPT 13160 | $16,736.60 | $2,608.00 | $0.36 – $3,206.43 | 769 |
| Ghs community re-entry 15 minutes CPT 97537 | $65.00 | $100.00 | $20.10 – $189.00 | 43 |
| Ghs ed therapeutic lp, drain csf w fluoro CPT 62329 | $332.00 | $332.00 | $29.61 – $1,370.41 | 780 |
| Ghs eeg cont rec w/video by tec min 8 chnls CPT 95700 | $870.00 | $849.00 | $95.23 – $849.00 | 558 |
| Ghs fb removal - incisional CPT 10121 | $606.00 | $606.00 | $54.19 – $503.32 | 768 |
| Ghs fish cytogen CPT 88271 | $111.80 | $172.00 | $20.76 – $172.00 | 43 |
| Ghs fish hybrid in situ 100-300 CPT 88275 | $439.40 | $676.00 | $49.60 – $676.00 | 43 |
| Ghs flow volume loop CPT 94375 | $801.45 | $1,233.00 | $189.00 – $1,233.00 | 109 |
| Ghs gastric intub aspiration lavage CPT 43753 | $534.95 | $823.00 | $165.42 – $823.00 | 27 |
| Ghs hgb stability-thal CPT 83068 | $106.60 | $164.00 | $9.18 – $164.00 | 43 |
| Ghs histoplasma antigen CPT 87385 | $235.95 | $363.00 | $12.84 – $363.00 | 43 |
| Ghs i and d perirectal abscess 46040 CPT 46040 | $20,188.97 | $1,544.00 | $9.09 – $2,323.17 | 769 |
| Ghs i and d pilonidal cyst complex CPT 10081 | $22,939.70 | $2,052.00 | $9.09 – $2,052.00 | 780 |
| Ghs i and d pilonidal cyst simple CPT 10080 | $17,980.90 | $344.00 | $0.96 – $1,374.78 | 769 |
| Ghs incision thrombosed ext hemorrhoid CPT 46083 | $656.50 | $1,010.00 | $203.01 – $1,010.00 | 108 |
| Ghs inf midline insertion CPT 36140 | $38,117.57 | $3,439.00 | $9.09 – $6,293.93 | 780 |
| Ghs inhibitor screen CPT 85335 | $344.50 | $530.00 | $12.47 – $530.00 | 43 |
| Ghs inj neurolytic intercostal nerve CPT 64620 | $599.50 | $554.00 | $28.85 – $554.00 | 768 |
| Ghs inj tendon origin/insertion CPT 20551 | $573.95 | $883.00 | $177.48 – $883.00 | 108 |
| Ghs inj transforaminal cerv single bil CPT 64479 | $2,553.20 | $3,928.00 | $526.42 – $2,619.00 | 108 |
| Ghs insertion of needle - bone CPT 36680 | $198.00 | $198.00 | $18.43 – $198.00 | 768 |
| Ghs intermed repair over 30 cm - 12037 CPT 12037 | $1,061.00 | $1,061.00 | $85.25 – $740.00 | 768 |
| Ghs intro needle/intracath vein - 36000 CPT 36000 | $390.65 | $601.00 | $5.80 – $601.00 | 778 |
| Ghs IV inf sq injection, on-body injector CPT 96377 | $98.80 | $152.00 | $30.55 – $427.00 | 109 |
| Ghs layer closure 2.5 cm or less - 12031 CPT 12031 | $17,109.60 | $500.00 | $0.96 – $789.21 | 769 |
| Ghs layer closure 2.5 cm or less - 12041 CPT 12041 | $479.00 | $479.00 | $6.59 – $51.36 | 768 |
| Ghs layer closure 2.5cm or less - 12051 CPT 12051 | $16,380.55 | $559.00 | $0.96 – $789.21 | 769 |
| Ghs layer closure 2.6 - 5.0 cm - 12052 CPT 12052 | $17,368.75 | $659.00 | $0.96 – $3,206.43 | 769 |
| Ghs layer closure 2.6 - 7.5 cm - 12042 CPT 12042 | $16,315.75 | $646.00 | $31.45 – $3,206.43 | 769 |
| Ghs layer closure 7.6 - 12.5 cm - 12054 CPT 12054 | $722.00 | $722.00 | $62.84 – $670.18 | 768 |
| Ghs mbp CPT 83873 | $81.90 | $126.00 | $16.67 – $126.00 | 43 |
| Ghs moderate sedation < 5 yr, 30 min, other CPT 99155 | $250.00 | $250.00 | $51.97 – $250.00 | 768 |
| Ghs moderate sedation, > 5 yr, 30 min, other CPT 99156 | $230.00 | $230.00 | $45.37 – $230.00 | 768 |
| Ghs moderate sedation ea addtl 15 min CPT 99153 | $32.00 | $32.00 | $8.88 – $32.00 | 767 |
| Ghs moderate sedation ea addtl 15 min, other CPT 99157 | $188.00 | $188.00 | $34.51 – $188.00 | 768 |
| Ghs musc test done w/n test comp CPT 95886 | $2,391.00 | $712.00 | $28.97 – $724.45 | 781 |
| Ghs musc tst done w/nerv tst lim CPT 95885 | $388.05 | $597.00 | $11.72 – $398.00 | 780 |
| Ghs musc tst done w/n tst non ext CPT 95887 | $434.20 | $668.00 | $89.45 – $445.00 | 28 |
| Ghs myocardial strain img spckl track CPT 93356 | $239.20 | $368.00 | $6.39 – $368.00 | 779 |
| Ghs nerve blk intercostal, ea addtl level CPT 64421 | $5,521.45 | $1,959.00 | $53.57 – $1,717.13 | 108 |
| Ghs nerve blk intercostal, single level CPT 64420 | $5,521.45 | $2,358.00 | $53.57 – $1,572.00 | 108 |
| Ghs nerve block celiac plexus CPT 64530 | $1,901.25 | $2,925.00 | $587.93 – $2,925.00 | 108 |
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.