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 |
|---|---|---|---|---|
| Trnscath retrv pq vasc fb w/guide CPT 37197 | $7,973.55 | $12,267.00 | $2,465.67 – $12,267.00 | 108 |
| Trnscath tx thromblytc artery non-intracrn ini day CPT 37211 | $920.40 | $1,416.00 | $189.74 – $10,802.96 | 108 |
| Trnscath tx thromblytc art/ven sbsq day CPT 37213 | $190.45 | $293.00 | $58.89 – $293.00 | 27 |
| Trnscath tx thromblytc cath rmv sbsq day CPT 37214 | $498.00 | $498.00 | $34.19 – $6,129.97 | 780 |
| Trnscath tx thromblytc vein ini day CPT 37212 | $386.75 | $595.00 | $79.80 – $397.00 | 27 |
| Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm CPT 14301 | $36,605.58 | $2,848.00 | $37.48 – $12,891.30 | 769 |
| Trnsfr/rearrngmnt adjcnt tiss defec ea addl 30sqcm/< CPT 14302 | $49,798.62 | $702.00 | $18.64 – $12,891.30 | 769 |
| Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/< CPT 14060 | $2,195.00 | $2,195.00 | $182.86 – $1,711.14 | 768 |
| Trnsfr/rearrngmnt adjcnt tiss eye/nose/ear/lip 10.1-30sqcm CPT 14061 | $22,828.95 | $2,698.00 | $0.96 – $4,005.68 | 769 |
| Trnsfr/rearrngmnt adjcnt tiss sclp/arm/lg 10.1-30sqcm CPT 14021 | $18,038.08 | not published | $0.96 – $5,639.25 | 82 |
| Trnsfr/rearrngmnt adjcnt tiss trnk 10.1-30sqcm CPT 14001 | $28,109.71 | $2,131.00 | $9.09 – $5,639.25 | 769 |
| Troponin quantitative CPT 84484 | $21,503.65 | $281.00 | $12.09 – $3,307.24 | 109 |
| Tte w or without contr, cont ecg HCPCS C8930 | $1,432.60 | $2,204.00 | $443.00 – $2,204.00 | 109 |
| Tte w or without fol w/con,stres HCPCS C8928 | $2,176.20 | $3,348.00 | $530.00 – $3,348.00 | 106 |
| Tte w or without fol w/cont, com HCPCS C8921 | $2,056.60 | $3,164.00 | $530.00 – $3,164.00 | 106 |
| Tte w or without fol w/cont, f/u HCPCS C8922 | $2,298.40 | $3,536.00 | $530.00 – $3,536.00 | 28 |
| Tube drain vert dev st 5-40f HCPCS A5200 | $17.68 | $27.20 | $5.47 – $27.20 | 28 |
| Tube trach disp innr can 5 xlt HCPCS A7521 | $416.99 | $641.52 | $0.68 – $3.39 | 28 |
| Tube trach disp innr can 6 xlt HCPCS A4623 | $2.78 | $4.27 | $0.40 – $1.97 | 28 |
| Tube trach fen sz 6 uncuffed HCPCS A7520 | $128.12 | $197.11 | $0.22 – $1.10 | 28 |
| Tx atrial fib pulm vein isol CPT 93656 | $20,038.20 | $30,828.00 | $257.20 – $50,744.36 | 780 |
| Tx l/r atrial fib addl CPT 93657 | $80,907.67 | $4,624.00 | $2.28 – $50,744.36 | 780 |
| Tympanic membrane repair CPT 69610 | $17,258.40 | $2,050.00 | $0.96 – $3,012.26 | 769 |
| Ublituximab-xiiy 25 mg/ml intravenous solution HCPCS J2329 | $107,599.30 | $35,496.45 | $0.90 – $35,496.45 | 109 |
| Ugt1a1 gene analy common variants CPT 81350 | $271.70 | $418.00 | $84.02 – $470.34 | 40 |
| Ultrasound breast unilateral limited (both sides) CPT 76642 | $2,387.00 | $1,219.00 | $20.02 – $813.00 | 780 |
| Ultrasound doppler velocimetry fetal umbilical artery CPT 76820 | $401.05 | $617.00 | $15.34 – $617.00 | 780 |
| Ultrasound elastography parenchyma CPT 76981 | $600.60 | $924.00 | $98.68 – $924.00 | 109 |
| Ultrasound encephalogram CPT 76506 | $738.40 | $1,136.00 | $98.68 – $1,136.00 | 109 |
| Ultrasound exam k transpl w/doppler CPT 76776 | $969.80 | $1,492.00 | $98.68 – $1,492.00 | 109 |
| Ultrasound fetal biophysical profile without non-stress testing CPT 76819 | $2,502.00 | $868.00 | $23.43 – $868.00 | 780 |
| Ultrasound Guidance for a Needle Procedure CPT 76942 | $2,227.90 | $1,189.00 | $1.40 – $1,189.00 | 781 |
| Ultrasound guidance for vascular access CPT 76937 | $20,999.16 | $1,033.00 | $1.40 – $6,129.97 | 780 |
| Ultrasound guide intraoperative CPT 76998 | $1,170.65 | $1,801.00 | $15.22 – $1,801.00 | 779 |
| Ultrasound hips infant dynamic CPT 76885 | $332.15 | $511.00 | $52.84 – $511.00 | 109 |
| Ultrasound infant hips ltd without stress CPT 76886 | $332.15 | $511.00 | $82.14 – $511.00 | 109 |
| Ultrasound joint complete left CPT 76881 | $193.70 | $298.00 | $59.90 – $298.00 | 109 |
| Ultrasound ob >=14wks ea addl gest CPT 76810 | $988.00 | $1,520.00 | $30.03 – $1,520.00 | 779 |
| Ultrasound pregnant uterus < 14 weeks each additional gestation CPT 76802 | $410.80 | $632.00 | $25.13 – $632.00 | 779 |
| Ultrasound pregnant uterus detailed fetal exam single/1st gestation CPT 76811 | $830.05 | $1,277.00 | $57.72 – $1,277.00 | 780 |
| Ultrasound pregnant uterus follow up per fetus CPT 76816 | $461.50 | $710.00 | $25.99 – $710.00 | 780 |
| Ultrasound prostate/transrectal CPT 76872 | $729.30 | $1,122.00 | $98.68 – $1,122.00 | 109 |
| Ultrasound spinal canal and contents CPT 76800 | $417.95 | $643.00 | $98.68 – $643.00 | 109 |
| Ultrasound transabd ea addl gest CPT 76812 | $714.35 | $1,099.00 | $54.53 – $1,099.00 | 779 |
| Unit mobile power mpu HCPCS Q0479 | $11,821.68 | $18,187.20 | $3,655.63 – $18,187.20 | 28 |
| Unlisted chemotherapy px CPT 96549 | $83.85 | $129.00 | $25.93 – $427.00 | 109 |
| Unlisted laparoscopic liver biopy 47379 CPT 47379 | $6,504.00 | $6,504.00 | $293.65 – $1,678.00 | 270 |
| Unlisted procedure microbiology CPT 87999 | $422.50 | $650.00 | $130.65 – $650.00 | 28 |
| Unlisted procedure rectum CPT 45999 | $86,785.96 | not published | $69.55 – $1,805.43 | 82 |
| Unlisted px abdomen muscskel CPT 22999 | $19,939.00 | not published | $2,741.72 – $5,639.25 | 81 |
| Unsched dialysis esrd pt hos HCPCS G0257 | $1,737.45 | $2,673.00 | $320.00 – $2,673.00 | 106 |
| Upgrade pm system CPT 33214 | $19,098.30 | $29,382.00 | $5,905.78 – $29,382.00 | 108 |
| Upper Arm (Humerus) X-ray (left side) CPT 73060 | $42,785.25 | $582.00 | $5.11 – $582.00 | 780 |
| Upper Back (Thoracic Spine) CT Scan (with contrast) CPT 72129 | $1,451.45 | $2,233.00 | $165.56 – $2,233.00 | 109 |
| Upper Back (Thoracic Spine) CT Scan (without contrast) CPT 72128 | $1,320.15 | $2,031.00 | $98.68 – $2,031.00 | 109 |
| Upper Back (Thoracic Spine) MRI (with and without contrast) CPT 72157 | $4,310.80 | $6,632.00 | $329.29 – $6,632.00 | 109 |
| Upper Back (Thoracic Spine) MRI (with contrast) CPT 72147 | $1,946.10 | $2,994.00 | $329.29 – $2,994.00 | 109 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | $2,477.80 | $3,812.00 | $225.21 – $3,812.00 | 109 |
| Upper Back (Thoracic Spine) X-ray (2 views) CPT 72070 | $403.65 | $621.00 | $6.18 – $621.00 | 780 |
| Upper Back (Thoracic Spine) X-ray (3 views) CPT 72072 | $442.65 | $681.00 | $6.60 – $681.00 | 780 |
| Upper Endoscopy (EGD, diagnostic) CPT 43235 | $14,673.40 | $446.00 | $1.92 – $1,760.83 | 769 |
| Upper Endoscopy (EGD, with biopsy) CPT 43239 | $20,014.95 | $503.00 | $39.41 – $1,760.83 | 770 |
| Upper GI Barium X-ray (barium and gas) CPT 74246 | $744.25 | $1,145.00 | $165.56 – $1,145.00 | 109 |
| Upper GI Barium X-ray (barium only) CPT 74240 | $672.75 | $1,035.00 | $165.56 – $1,035.00 | 109 |
| Uppr gi scope w/submuc inj CPT 43236 | $19,993.05 | $502.00 | $39.41 – $3,725.39 | 769 |
| Urea nitrogen CPT 84520 | $62.40 | $96.00 | $3.83 – $96.00 | 43 |
| Urea nitrogen 24 hour urine CPT 84540 | $85.80 | $132.00 | $5.39 – $132.00 | 43 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | $721.50 | $1,110.00 | $223.11 – $1,110.00 | 109 |
| Urethrocystography void s&i CPT 74455 | $790.40 | $1,216.00 | $225.21 – $1,216.00 | 109 |
| Uric acid blood CPT 84550 | $83.85 | $129.00 | $4.38 – $129.00 | 43 |
| Uric acid urine CPT 84560 | $84.50 | $130.00 | $4.93 – $130.00 | 43 |
| Urinalysis microscopic only CPT 81015 | $70.00 | $70.00 | $2.96 – $70.00 | 43 |
| Urinalysis (with microscopy) CPT 81001 | $7,291.00 | $168.00 | $3.07 – $608.43 | 109 |
| Urinalysis (without microscopy) CPT 81003 | $5,318.65 | $107.00 | $2.18 – $278.89 | 109 |
| Urine Culture Test CPT 87086 | $5,101.30 | $214.00 | $7.82 – $426.30 | 109 |
| Urine pregnancy test CPT 81025 | $51.35 | $79.00 | $8.34 – $79.00 | 43 |
| Urography, antegrade CPT 74425 | $882.05 | $1,357.00 | $272.76 – $1,357.00 | 109 |
| Ustekinumab 130 mg/26 ml intravenous solution HCPCS J3358 | $6,677.00 | $6,677.00 | $12.24 – $6,677.00 | 109 |
| Ustekinumab 45 mg/0.5 ml subcutaneous solution HCPCS J3357 | $45,913.60 | $45,913.60 | $3,644.10 – $45,913.60 | 102 |
| Vaccine Administration (one shot) CPT 90471 | $39.65 | $61.00 | $3.96 – $139.78 | 779 |
| Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml CPT 91322 | $286.65 | $441.00 | $88.64 – $441.00 | 109 |
| Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml CPT 91321 | $559.65 | $861.00 | $147.06 – $861.00 | 109 |
| Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im CPT 91320 | $103.35 | $159.00 | $31.96 – $226.06 | 109 |
| Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im CPT 91319 | $68.90 | $106.00 | $21.31 – $127.28 | 109 |
| Vaccine covid-19 pfizer tris-sucrose 6mos-4yrs 3mcg/0.3ml im CPT 91318 | $52.00 | $80.00 | $16.08 – $95.05 | 109 |
| Vaccine dtap < 7 years im CPT 90700 | $142.05 | $142.05 | $10.85 – $54.00 | 94 |
| Vaccine dtap-hep b-ipv im CPT 90723 | $513.00 | $513.00 | $30.80 – $165.02 | 102 |
| Vaccine dtap-ipv 4-6 years im CPT 90696 | $57.20 | $88.00 | $17.69 – $221.23 | 94 |
| Vaccine dtap-ipv-hib-hepb im CPT 90697 | $135.20 | $208.00 | $41.60 – $542.58 | 102 |
| Vaccine dtap-ipv/hib im CPT 90698 | $103.35 | $159.00 | $31.96 – $195.74 | 94 |
| Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im CPT 90647 | $39.00 | $60.00 | $12.06 – $60.00 | 94 |
| Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im CPT 90648 | $37.05 | $57.00 | $11.46 – $57.00 | 94 |
| Vaccine hepatitis a (hepa) adult im CPT 90632 | $157.00 | $219.00 | $44.02 – $219.00 | 778 |
| Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im CPT 90636 | $124.80 | $192.00 | $38.59 – $192.00 | 94 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im CPT 90633 | $45.50 | $70.00 | $14.07 – $70.00 | 94 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 3 dose im CPT 90634 | $48.10 | $74.00 | $14.87 – $74.00 | 28 |
| Vaccine hepatitis b (hepb) adolescent 2 dose im CPT 90743 | $57.20 | $88.00 | $17.69 – $108.97 | 109 |
| Vaccine hepatitis b (hepb) adult 3 dose im CPT 90746 | $345.70 | $345.70 | $44.42 – $221.00 | 779 |
| Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im CPT 90739 | $326.30 | $502.00 | $100.90 – $502.00 | 109 |
| Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 | $138.80 | $138.80 | $19.10 – $95.00 | 109 |
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.