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 |
|---|---|---|---|---|
| Ghs nerve block interscaline CPT 64510 | $1,607.45 | $2,473.00 | $331.45 – $1,717.13 | 108 |
| Ghs nerve block lumbar or thoracic symp CPT 64520 | $1,584.70 | $2,438.00 | $326.63 – $1,717.13 | 108 |
| Ghs nerve block suprascapular CPT 64418 | $1,680.90 | $2,586.00 | $346.52 – $1,724.00 | 108 |
| Ghs ng placement w fluoro guidance CPT 43752 | $1,149.20 | $1,768.00 | $355.37 – $1,768.00 | 108 |
| Ghs o2 saturation CPT 82810 | $55.90 | $86.00 | $9.47 – $86.00 | 43 |
| Ghs opcc repair cvp w subq port CPT 36576 | $608.00 | $608.00 | $31.50 – $393.00 | 768 |
| Ghs ot prosthetic training/15 min CPT 97761 | $66.30 | $102.00 | $20.50 – $189.00 | 43 |
| Ghs ot sensory integrative tech/15min CPT 97533 | $126.00 | $186.00 | $22.01 – $186.00 | 780 |
| Ghs pacing - transcutaneous CPT 92953 | $981.50 | $1,510.00 | $303.51 – $1,510.00 | 108 |
| Ghs paravert facet/nerve cerv ea add bil CPT 64492 | $3,859.70 | $5,938.00 | $795.76 – $3,959.00 | 27 |
| Ghs paravert facet/nerve lumb ea add bil CPT 64495 | $4,395.95 | $6,763.00 | $906.31 – $4,509.00 | 27 |
| Ghs peritonsillar abscess i andd CPT 42700 | $544.14 | $501.00 | $38.84 – $501.00 | 768 |
| Ghs picc line insert < 5 CPT 36568 | $3,671.20 | $5,648.00 | $1,135.25 – $5,648.00 | 108 |
| Ghs polysom <6 yrs 4/> parameters CPT 95782 | $5,254.60 | $8,084.00 | $77.11 – $8,084.00 | 780 |
| Ghs prostatic acid phosphatase (mayo) CPT 84066 | $33.15 | $51.00 | $9.36 – $51.00 | 43 |
| Ghs protoporphyrins fract CPT 84202 | $127.40 | $196.00 | $13.90 – $196.00 | 43 |
| Ghs pr without cont pulse ox CPT 94625 | $253.50 | $390.00 | $55.68 – $390.00 | 109 |
| Ghs refill of implantable pump CPT 95990 | $473.20 | $728.00 | $146.33 – $728.00 | 109 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $420.00 | $420.00 | $23.01 – $298.09 | 768 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $389.00 | $389.00 | $23.01 – $286.22 | 768 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $531.00 | $531.00 | $28.76 – $346.56 | 768 |
| Ghs sleep study unattended CPT 95800 | $666.90 | $1,026.00 | $24.71 – $1,026.00 | 780 |
| Ghs somatosensory testing upper & lower limbs CPT 95938 | $1,617.85 | $2,489.00 | $190.00 – $2,489.00 | 109 |
| Ghs sp train/fitting sp device - kx CPT 92609 | $189.15 | $291.00 | $49.33 – $291.00 | 43 |
| Ghs st - re-eval for alt comm CPT 92597 | $331.50 | $510.00 | $67.21 – $510.00 | 43 |
| Ghs subcutaneous infus, for therapy ea. add. hr CPT 96370 | $120.90 | $186.00 | $37.39 – $427.00 | 109 |
| Ghs subcutaneous infus. for therapy init 1 hr CPT 96369 | $559.00 | $860.00 | $172.86 – $860.00 | 109 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | $1,009.00 | $1,009.00 | $88.82 – $749.90 | 768 |
| Ghs urine, porphyrins quant CPT 84120 | $92.30 | $142.00 | $14.25 – $142.00 | 43 |
| Ghs vaginal delivery only CPT 59409 | $2,587.00 | $2,587.00 | $37.48 – $274.88 | 768 |
| Ghs veeg 12-26 hr intmt mont CPT 95715 | $1,061.45 | $1,633.00 | $328.23 – $1,633.00 | 109 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | $6,362.20 | $9,788.00 | $856.09 – $9,788.00 | 108 |
| Glassia injection HCPCS J0257 | $2,200.00 | $2,200.00 | $5.58 – $2,200.00 | 109 |
| Glove finger flexion right lg xl HCPCS L3912 | $53.03 | $81.59 | $11.75 – $58.47 | 28 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $655.40 | $655.40 | $131.74 – $655.40 | 31 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | $567.40 | $567.40 | $114.05 – $567.40 | 31 |
| Glucagon plasma - sendout CPT 82943 | $48.75 | $75.00 | $13.85 – $75.00 | 43 |
| Glucose 1 hr post dose CPT 82950 | $111.80 | $172.00 | $4.60 – $172.00 | 43 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $70.85 | $109.00 | $2.30 – $109.00 | 780 |
| Glucose blood quantitative CPT 82947 | $124,717.35 | $116.00 | $3.80 – $15,245.60 | 109 |
| Glucose body fluid CPT 82945 | $77.35 | $119.00 | $3.80 – $67.00 | 43 |
| Glucose monitoring continual min 72hr pt CPT 95249 | $98.80 | $152.00 | $30.55 – $190.00 | 109 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $90.35 | $139.00 | $12.47 – $139.00 | 43 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $73.45 | $113.00 | $3.79 – $113.00 | 43 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | $37,619.43 | $7.00 | $0.55 – $14,087.30 | 109 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $5,516.60 | $5,516.60 | $11.40 – $5,516.60 | 109 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $157.30 | $242.00 | $18.00 – $242.00 | 43 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $150.80 | $232.00 | $17.94 – $232.00 | 43 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | $16,064.55 | $16,064.55 | $761.95 – $5,895.10 | 106 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $93.34 | $143.60 | $23.44 – $143.60 | 36 |
| Graft axiofill 1000mg HCPCS J3590 | $6,300.79 | $9,693.53 | $325.33 – $1,618.56 | 28 |
| Graft bone flex 2.5cm x 5cm grafton-cost per sq cm HCPCS Q4205 | $1.41 | $2.17 | $0.44 – $2.17 | 28 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | $1,885.86 | $2,901.33 | $15.71 – $96.28 | 36 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $4,970.86 | $7,647.47 | $0.08 – $0.46 | 36 |
| Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm HCPCS Q4113 | $1,548.87 | $2,382.88 | $478.96 – $2,382.88 | 28 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $16,761.06 | $25,786.25 | $0.09 – $0.43 | 28 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $35,755.20 | $55,008.00 | $0.01 – $0.74 | 28 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | $304.44 | $468.37 | $0.25 – $1.56 | 36 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $397.96 | $612.24 | $38.96 – $238.70 | 36 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $414.05 | $637.00 | $49.92 – $305.89 | 36 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | $476.79 | $733.52 | $13.29 – $81.42 | 36 |
| Graft tis hmatrix dermis 10x5 -cost per sq cm HCPCS Q4134 | $58.05 | $89.31 | $17.95 – $89.31 | 28 |
| Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm HCPCS Q4130 | $1,705.66 | $2,624.09 | $0.01 – $0.05 | 28 |
| Graft viashield 2layer amnion patch 2x2cm-cost per sq cm HCPCS Q4211 | $593.61 | $913.25 | $57.12 – $350.01 | 36 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | $312.02 | $480.03 | $12.48 – $62.10 | 28 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $25,506.74 | $39,241.14 | $10.05 – $50.00 | 28 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $17,074.23 | $26,268.04 | $21.98 – $109.36 | 28 |
| Granulocyte pheresis ea unit HCPCS P9050 | $456.95 | $703.00 | $141.30 – $703.00 | 28 |
| Grfg autol fat lipo 50 cc/< CPT 15771 | $42,590.30 | $1,661.00 | $2.28 – $14,087.30 | 769 |
| Grfg autol fat lipo ea addl CPT 15772 | $45,515.30 | $483.00 | $1.92 – $14,087.30 | 769 |
| Grfg autol soft tiss dir exc CPT 15769 | $37,104.40 | not published | $2.28 – $14,087.30 | 82 |
| Gstrst open wo constj tube CPT 43830 | $2,524.00 | $2,524.00 | $23.28 – $246.88 | 768 |
| G-tube reposition CPT 43761 | $2,468.05 | $3,797.00 | $235.83 – $3,797.00 | 108 |
| Guided cath fluid drainage 10030 CPT 10030 | $1,892.15 | $2,911.00 | $585.11 – $2,911.00 | 108 |
| Guide endoanchr sg-64 aaa 62cm HCPCS L8670 | $2,554.53 | $3,930.04 | $789.94 – $3,930.04 | 28 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $4,580.54 | $7,046.99 | $0.01 – $0.31 | 28 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $747.95 | $1,150.70 | $0.01 – $29.80 | 28 |
| Guid loc target vol rad tx CPT 77387 | $403.00 | $614.00 | $19.11 – $614.00 | 778 |
| Gw stiffened micro access kit HCPCS C1894 | $81,138.42 | $15,124.43 | $0.01 – $20,291.63 | 109 |
| Gynecomastia (males) 19300 CPT 19300 | $32,797.27 | $2,822.00 | $31.45 – $7,601.47 | 769 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | $70.40 | $70.40 | $7.83 – $38.95 | 28 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $3.65 | $3.65 | $0.73 – $3.65 | 28 |
| Handpiece aquabeam hp2000 HCPCS C2596 | $14,876.30 | $22,886.61 | $1,485.33 – $7,389.71 | 28 |
| Hands-On Manual Therapy (each 15 minutes) CPT 97140 | $2,085.00 | $186.00 | $17.68 – $179.00 | 780 |
| Hand X-ray CPT 73130 | $1,246.00 | $935.00 | $5.54 – $623.00 | 780 |
| Hand X-ray (2 views, both hands) CPT 73120 | $498.00 | $747.00 | $5.11 – $498.00 | 780 |
| Haptoglobin quantitative CPT 83010 | $191.10 | $294.00 | $12.19 – $294.00 | 43 |
| Harvest vein for bypass 35500 CPT 35500 | $1,016.00 | $1,016.00 | $182.97 – $859.33 | 768 |
| Hast w/i&r phys/qhp CPT 94452 | $1,531.00 | $1,531.00 | $13.13 – $450.00 | 779 |
| Hast w/oxygen titrate CPT 94453 | $217.10 | $334.00 | $16.43 – $334.00 | 779 |
| Hba1/hba2 full gene sequence CPT 81259 | $1,537.25 | $2,365.00 | $475.37 – $2,365.00 | 40 |
| Hba1/hba2 gene dup/del vrnts CPT 81269 | $568.75 | $875.00 | $175.88 – $875.00 | 40 |
| Hbb full gene sequence CPT 81364 | $1,066.00 | $1,640.00 | $318.09 – $1,640.00 | 40 |
| Hbb gene dup/del variants CPT 81363 | $455.00 | $700.00 | $140.70 – $700.00 | 28 |
| Hbot, full body chamber, 30m HCPCS G0277 | $475.80 | $732.00 | $129.88 – $2,536.00 | 109 |
| Hcg qualitative CPT 84703 | $145.60 | $224.00 | $7.28 – $224.00 | 43 |
| Hcg quantitative CPT 84702 | $219.70 | $338.00 | $14.59 – $338.00 | 43 |
| Hc nm kidney imaging with flow CPT 78701 | $1,023.75 | $1,575.00 | $316.58 – $1,575.00 | 109 |
| Hc pet myocardial imaging metabolic eval single study CPT 78459 | $4,268.55 | $6,567.00 | $45.16 – $6,567.00 | 780 |
| Hdr rdncl ntrstl/icav brchtx CPT 77770 | $1,094.00 | $1,244.00 | $64.97 – $1,352.14 | 780 |
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.