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 |
|---|---|---|---|---|
| Particle matristem matrix 1000mg micron-q4118-cost per mg HCPCS Q4118 | $221.06 | $340.09 | $0.35 – $2.13 | 36 |
| Part removal of metatarsal CPT 28110 | $21,880.50 | not published | $31.45 – $6,352.30 | 82 |
| Passy muir valve metal trach HCPCS L8501 | $242.47 | $373.03 | $15.81 – $78.66 | 28 |
| Paste skin barrier .5oz adapt HCPCS A4406 | $0.35 | $0.54 | $0.11 – $0.54 | 28 |
| Pd hl 3.5in 4d med rbr mld 6432 HCPCS L3350 | $94.19 | $144.91 | $29.13 – $144.91 | 28 |
| Ped crit care age 2-5 init CPT 99475 | $1,444.00 | $1,444.00 | $378.34 – $1,376.20 | 768 |
| Ped crit care age 2-5 subsq CPT 99476 | $871.00 | $871.00 | $227.63 – $871.00 | 768 |
| Ped critical care initial CPT 99471 | $2,003.00 | $2,003.00 | $523.70 – $2,003.00 | 768 |
| Ped critical care subsq CPT 99472 | $1,017.00 | $1,017.00 | $268.62 – $1,017.00 | 768 |
| Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector HCPCS J2506 | $17,709.85 | $17,709.85 | $120.38 – $17,709.85 | 109 |
| Pegfilgrastim-apgf 6 mg/0.6 ml subcutaneous syringe HCPCS Q5122 | $10,830.70 | $10,830.70 | $130.39 – $10,830.70 | 109 |
| Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe HCPCS Q5111 | $20,144.40 | $20,144.40 | $158.75 – $20,144.40 | 109 |
| Pegfilgrastim-fpgk 6 mg/0.6 ml subcutaneous syringe HCPCS Q5127 | $11,866.15 | $11,866.15 | $2,385.10 – $11,866.15 | 94 |
| Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe HCPCS Q5108 | $5,037.30 | $5,037.30 | $96.89 – $5,037.30 | 109 |
| Pegfilgrastim-pbbk 6 mg/0.6 ml subcutaneous syringe HCPCS Q5130 | $11,497.50 | $11,497.50 | $124.68 – $11,497.50 | 109 |
| Pegloticase 8 mg/ml intravenous solution HCPCS J2507 | $95,364.75 | $95,364.75 | $3,610.60 – $95,364.75 | 109 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $1,990.95 | $3,063.00 | $165.56 – $3,063.00 | 109 |
| Pelvic CT scan (with contrast) CPT 72193 | $1,810.25 | $2,785.00 | $165.56 – $2,785.00 | 109 |
| Pelvic CT scan (without contrast) CPT 72192 | $1,302.60 | $2,004.00 | $98.68 – $2,004.00 | 109 |
| Pelvic MRI (with and without contrast) CPT 72197 | $3,551.60 | $5,464.00 | $329.29 – $5,464.00 | 109 |
| Pelvic MRI (without contrast) CPT 72195 | $1,974.05 | $3,037.00 | $225.21 – $3,037.00 | 109 |
| Pelvic Ultrasound (complete) CPT 76856 | $2,171.00 | $981.00 | $20.66 – $981.00 | 780 |
| Pelvic Ultrasound (limited) CPT 76857 | $681.85 | $1,049.00 | $15.12 – $1,049.00 | 780 |
| Pelvis X-ray (1 to 2 views) CPT 72170 | $46,779.57 | $562.00 | $5.33 – $562.00 | 780 |
| Pelvis X-ray (complete, 4 or more views) CPT 72190 | $58,170.03 | $726.00 | $3.49 – $726.00 | 109 |
| Pembrolizumab 25 mg/ml intravenous solution HCPCS J9271 | $18,047.05 | $18,047.05 | $57.42 – $18,047.05 | 109 |
| Pemetrexed disodium 100 mg intravenous powder for solution HCPCS J9305 | $130.60 | $130.60 | $3.52 – $82.65 | 109 |
| Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 | $1,928.25 | $1,928.25 | $0.05 – $1,113.35 | 779 |
| Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr HCPCS J2540 | $234.00 | $234.00 | $0.65 – $3.25 | 94 |
| Penile rear tip xtnd 0.5cm HCPCS C2622 | $13,529.89 | $20,815.21 | $10.05 – $50.00 | 28 |
| Pentamidine 300 mg solution for injection HCPCS J2516 | $792.75 | $792.75 | $159.34 – $792.75 | 28 |
| Pentobarbital sodium inj HCPCS J2515 | $3,085.50 | $3,085.50 | $54.57 – $3,085.50 | 31 |
| Pentostatin 10 mg intravenous solution HCPCS J9268 | $14,509.25 | $14,509.25 | $2,486.35 – $14,509.25 | 109 |
| Perc cryo ablate renal tum CPT 50593 | $20,835.10 | $32,054.00 | $4,295.37 – $21,370.00 | 108 |
| Perc d-e cor revasc chro add HCPCS C9608 | $16,715.40 | $25,716.00 | $5,168.92 – $25,716.00 | 27 |
| Perc d-e cor revasc chro sin HCPCS C9607 | $22,922.90 | $35,266.00 | $7,088.47 – $35,589.27 | 108 |
| Perc d-e cor revasc t cabg b HCPCS C9605 | $21,318.70 | $32,798.00 | $6,592.40 – $32,798.00 | 27 |
| Perc d-e cor revasc t cabg s HCPCS C9604 | $15,358.85 | $23,629.00 | $4,749.43 – $23,629.00 | 108 |
| Perc d-e cor stent ather br HCPCS C9603 | $8,215.35 | $12,639.00 | $2,540.44 – $12,639.00 | 27 |
| Perc d-e cor stent ather s HCPCS C9602 | $60,802.63 | $23,629.00 | $0.96 – $35,589.27 | 108 |
| Perc drug-el cor stent bran HCPCS C9601 | $15,358.85 | $23,629.00 | $4,749.43 – $23,629.00 | 27 |
| Perc drug-el cor stent sing HCPCS C9600 | $77,377.81 | $35,266.00 | $0.32 – $35,266.00 | 108 |
| Perflutren lipid microspheres 1.1 mg/ml intravenous suspension HCPCS Q9957 | $393.60 | $393.60 | $79.11 – $393.60 | 28 |
| Pericardiocentesis wwo imaging CPT 33016 | $2,902.25 | $4,465.00 | $6.32 – $4,465.00 | 780 |
| Peri-implt capslc brst compl CPT 19371 | $40,902.16 | $3,224.00 | $183.41 – $7,601.47 | 769 |
| Peripheral vascular rehab CPT 93668 | $244.40 | $376.00 | $55.84 – $376.00 | 105 |
| Peri-proc device eval icd CPT 93287 | $234.00 | $360.00 | $72.36 – $360.00 | 27 |
| Peritoneogram rs&i CPT 74190 | $650.00 | $1,000.00 | $201.00 – $1,132.04 | 109 |
| Perit-vens shunt pat tst CPT 78291 | $427.70 | $658.00 | $132.26 – $874.53 | 109 |
| Perphenazine 4mg oral HCPCS Q0175 | $1.00 | $1.00 | $0.20 – $1.00 | 94 |
| Perq art m-thrombect &/nfs CPT 61645 | $3,772.60 | $5,804.00 | $777.67 – $3,869.00 | 27 |
| Perq clsr tcat l atr apndge CPT 33340 | $49,197.80 | $3,944.00 | $4.56 – $3,944.00 | 780 |
| Perq nl/pl lithotrp cplx>2cm CPT 50081 | $46,617.76 | not published | $9.09 – $18,378.31 | 82 |
| Perq nl/pl lithotrp smpl<2cm CPT 50080 | $39,656.56 | not published | $1.92 – $18,378.31 | 82 |
| Perq plmt bile duct stent CPT 47538 | $6,485.05 | $9,977.00 | $2,005.38 – $11,736.86 | 108 |
| Perq rplcmt g-tube req revsn gstrst trk CPT 43763 | $880.00 | $880.00 | $3.53 – $190.00 | 768 |
| Pertuzumab 30 mg/ml desensitization HCPCS J9306 | $20,666.10 | $20,666.10 | $15.59 – $20,666.10 | 109 |
| Pessary 3.5 in 7 vag sil rng fold HCPCS A4562 | $96.38 | $148.28 | $22.35 – $111.21 | 28 |
| Pet CT skull-mid thgh initial CPT 78815 | $9,778.20 | $10,585.00 | $1,349.71 – $8,010.00 | 109 |
| Pet CT whole body initial CPT 78816 | $7,501.00 | $11,540.00 | $1,349.71 – $11,540.00 | 109 |
| Pet fdg brain metoblic eval sb CPT 78608 | $2,844.40 | $4,376.00 | $879.58 – $4,376.00 | 109 |
| Pet image w/ct lmtd CPT 78814 | $2,939.95 | $4,523.00 | $909.12 – $4,523.00 | 109 |
| Pfc sigma fem post aug sz3 8mm HCPCS C1776 | $54,744.57 | $84,222.41 | $0.01 – $0.01 | 28 |
| Ph1 assmt&mgmt nqhp 11-20 CPT 98967 | $76.00 | $76.00 | $11.89 – $58.95 | 767 |
| Ph1 assmt&mgmt nqhp 5-10 CPT 98966 | $39.00 | $39.00 | $7.28 – $29.69 | 767 |
| Ph body fluid CPT 83986 | $61.75 | $95.00 | $3.47 – $43.00 | 43 |
| Phencyclidine (pcp) CPT 83992 | $54.60 | $84.00 | $16.88 – $116.72 | 40 |
| Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr HCPCS J2560 | $201.80 | $201.80 | $13.16 – $65.45 | 94 |
| Phenobarbital therapeutic drug level CPT 80184 | $154.05 | $237.00 | $14.83 – $194.00 | 43 |
| Phentolaine mesylate inj HCPCS J2760 | $1,621.15 | $1,621.15 | $325.85 – $1,621.15 | 109 |
| Phenylephrine 10 mg/ml injection solution HCPCS J2371 | $11.90 | $11.90 | $0.60 – $3.00 | 28 |
| Phenytoin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1165 | $5.75 | $5.75 | $0.60 – $3.00 | 94 |
| Phenytoin total therapeutic drug level CPT 80185 | $178.10 | $274.00 | $12.84 – $180.00 | 43 |
| Phlebotomy therapeutic CPT 99195 | $100.10 | $154.00 | $30.95 – $258.30 | 109 |
| Phleb veins 1 extrm 10-20 stab CPT 37765 | $24,155.05 | $21,255.00 | $9.09 – $14,170.00 | 780 |
| Phleb veins 1 extrm >20 stab CPT 37766 | $11,360.70 | $17,478.00 | $96.17 – $11,652.00 | 783 |
| Phosphorus CPT 84100 | $80.60 | $124.00 | $4.59 – $123.00 | 43 |
| Phosphorus 24 hour urine CPT 84105 | $69.55 | $107.00 | $5.60 – $107.00 | 43 |
| Physical Therapy Evaluation (high complexity) CPT 97163 | $272.35 | $419.00 | $74.80 – $419.00 | 43 |
| Physical Therapy Evaluation (low complexity) CPT 97161 | $46,267.78 | $407.00 | $9.09 – $407.00 | 780 |
| Physical Therapy Evaluation (moderate complexity) CPT 97162 | $264.55 | $407.00 | $74.80 – $407.00 | 43 |
| Physical Therapy Re-Evaluation CPT 97164 | $1,320.00 | $179.00 | $35.98 – $189.00 | 43 |
| Phytonadione (vitamin k1) 10 mg/ml injection solution HCPCS J3430 | $24.85 | $24.85 | $2.84 – $19.80 | 94 |
| Pillow shldr abduc inflat univ HCPCS L3960 | $781.90 | $1,202.93 | $30.41 – $186.36 | 36 |
| Pin caspar distraction 12mm HCPCS C1821 | $24,304.88 | $37,392.12 | $0.01 – $0.40 | 28 |
| Pinworm exam CPT 87172 | $45.50 | $70.00 | $4.14 – $70.00 | 43 |
| Piperacillin-tazobactam 3.375 gram intravenous solution HCPCS J2543 | $89.80 | $89.80 | $2.22 – $13.80 | 94 |
| Place cath intracranial art CPT 36228 | $555.10 | $854.00 | $114.37 – $569.00 | 27 |
| Place duod/jej tube perc CPT 49441 | $868.00 | $868.00 | $30.80 – $695.29 | 768 |
| Place gastrostomy tube perc CPT 49440 | $1,295.45 | $1,993.00 | $27.54 – $3,725.39 | 780 |
| Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides) CPT 19281 | $31,469.27 | $10,896.00 | $88.76 – $7,264.00 | 108 |
| Placement localization device(s) breast percutaneous mammographic guide ea addl lesion left CPT 19282 | $47,891.53 | $2,381.00 | $44.46 – $12,891.30 | 108 |
| Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides) CPT 19285 | $44,309.37 | $14,439.00 | $75.66 – $9,625.00 | 108 |
| Placement nephrostomy catheter (both sides) CPT 50432 | $46,617.76 | $13,427.00 | $9.09 – $8,951.00 | 108 |
| Placement occlusive device venous/arterial access site post procedure HCPCS G0269 | $76,856.42 | $263.00 | $9.09 – $50,744.36 | 108 |
| Placement of seton CPT 46020 | $16,549.30 | $606.00 | $0.96 – $5,388.70 | 769 |
| Placement stent(s) intravascular transcatheter artery initial CPT 37236 | $40,201.09 | $26,977.00 | $9.09 – $22,412.03 | 780 |
| Place non-slctv cath thoracic arta CPT 36221 | $7,475.00 | $11,500.00 | $2,311.50 – $11,500.00 | 108 |
| Place slctv cath carotd art uni CPT 36224 | $18,686.85 | $28,749.00 | $43.52 – $19,166.00 | 780 |
| Place slctv cath carotid/inom art excrn uni CPT 36222 | $9,478.95 | $14,583.00 | $1,954.12 – $9,722.00 | 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.