UnityPoint Health - Iowa Lutheran Hospital
1200 Pleasant St, Des Moines, IA · UnityPoint Health · · NPI 1356433049
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 |
|---|---|---|---|---|
| So vest canvas/web pre ots HCPCS L3675 | not published | not published | $95.52 – $243.09 | 9 |
| Spacer bag/reservoir HCPCS A4627 | not published | not published | $6.68 – $28.30 | 6 |
| Sp bone agrft morsel add-on CPT 20937 | $406.40 | $508.00 | $144.30 – $383.93 | 9 |
| Sp bone agrft struct add-on CPT 20938 | $442.40 | $553.00 | $156.77 – $418.97 | 9 |
| Sp bone algrft morsel add-on CPT 20930 | $291.20 | $364.00 | $207.30 – $363.06 | 6 |
| Special casting material HCPCS A4590 | $47.20 | $59.00 | $1.80 – $60.63 | 6 |
| Special physics consult CPT 77370 | $839.03 | $1,048.78 | $126.40 – $308.34 | 13 |
| Special pump services CPT 99190 | $928.00 | $1,160.00 | $695.70 – $1,070.13 | 6 |
| Special pump services CPT 99191 | $649.60 | $812.00 | $501.00 – $749.04 | 6 |
| Special pump services CPT 99192 | $464.80 | $581.00 | $346.30 – $535.75 | 6 |
| Special radiation dosimetry CPT 77331 | $490.14 | $612.67 | $16.98 – $180.12 | 13 |
| Special radiation treatment CPT 77470 | $2,284.92 | $2,856.15 | $30.46 – $839.71 | 13 |
| Special supplies phys/qhp CPT 99070 | $90.40 | $113.00 | $70.00 – $115.24 | 4 |
| Special teletx port plan CPT 77321 | $2,030.70 | $2,538.37 | $39.72 – $746.28 | 13 |
| Specific gravity body fluid CPT 84315 | $33.57 | $41.96 | $1.97 – $12.34 | 11 |
| Specimen fat stain CPT 89125 | $56.44 | $70.54 | $3.53 – $20.74 | 11 |
| Speech and Language Evaluation (comprehensive) CPT 92523 | $432.00 | $540.00 | $77.44 – $392.10 | 11 |
| Speech audiometry complete CPT 92556 | $83.20 | $104.00 | $25.96 – $80.00 | 13 |
| Speech evaluation complex CPT 70371 | $228.00 | $285.00 | $38.84 – $232.88 | 11 |
| Speech recep thresh CPT 92555 | $53.60 | $67.00 | $14.43 – $57.22 | 13 |
| Speech Therapy Session (one-on-one) CPT 92507 | $309.55 | $386.93 | $71.73 – $167.54 | 11 |
| Sperm antibody test CPT 89325 | $56.44 | $70.54 | $6.40 – $20.74 | 11 |
| Sperm evaluation test CPT 89329 | $49.60 | $62.00 | $11.75 – $30.46 | 9 |
| Sperm identification CPT 89257 | $109.60 | $137.00 | $50.87 – $104.00 | 8 |
| Sperm isolation complex CPT 89261 | $140.80 | $176.00 | $50.87 – $134.00 | 8 |
| Sperm isolation simple CPT 89260 | $104.80 | $131.00 | $50.87 – $100.00 | 8 |
| Sperm washing 58323 CPT 58323 | $38.40 | $48.00 | $10.69 – $28.67 | 9 |
| Sphenoid sinus surgery CPT 31051 | $3,276.80 | $4,096.00 | $618.74 – $5,699.45 | 11 |
| Sphincteroplasty inc/prolapse adult 46750 CPT 46750 | $1,876.80 | $2,346.00 | $670.79 – $2,642.16 | 11 |
| Spinal bone allograftstructural 20931 CPT 20931 | $266.40 | $333.00 | $94.59 – $251.75 | 9 |
| Spinal bone autograftlocal 20936 CPT 20936 | $309.60 | $387.00 | $220.80 – $386.44 | 6 |
| Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance CPT 62328 | $1,349.48 | $1,686.85 | $77.23 – $667.21 | 13 |
| Spine device implant surgery HCPCS C9757 | not published | not published | $12,249.30 – $16,631.67 | 9 |
| Spine X-ray (single view, one level) CPT 72020 | $318.84 | $398.54 | $7.10 – $117.17 | 13 |
| Spirmtry w/brnchdil inf-2 yr CPT 94012 | $316.00 | $395.00 | $72.61 – $306.79 | 13 |
| Spirometry up to 2 yrs old CPT 94011 | $194.40 | $243.00 | $56.42 – $188.94 | 13 |
| Spleen imaging CPT 78185 | $554.90 | $693.62 | $15.15 – $387.14 | 13 |
| Splenectomy total open 38100 CPT 38100 | $2,828.80 | $3,536.00 | $1,009.28 – $2,690.84 | 9 |
| Splice spleen/kidney veins CPT 37181 | not published | not published | $2,018.01 – $5,383.37 | 9 |
| Splicing of ureters CPT 50770 | not published | not published | $1,040.53 – $2,773.46 | 9 |
| Splint arm vnyl coated padded lft med HCPCS Q4051 | $48.00 | $60.00 | not published | 0 |
| Splint dorsal bloc wh med perf 3.2mm lf polyflex ii HCPCS L3906 | $881.60 | $1,102.00 | $127.54 – $462.67 | 11 |
| Splint extn xsm w sof-stretch rolyan HCPCS L3925 | not published | not published | $34.95 – $88.95 | 9 |
| Splint finger 4 prong foam sm HCPCS A4570 | $20.80 | $26.00 | $2.90 – $27.20 | 6 |
| Splint finger fold over sm HCPCS L3924 | $77.89 | $97.36 | $25.51 – $102.81 | 11 |
| Splint finger frog med HCPCS L3927 | not published | not published | $19.05 – $48.46 | 9 |
| Splint fing stax assort 1-7in HCPCS Q4049 | $5.60 | $7.00 | $1.31 – $3.34 | 9 |
| Splint rstrc wrst/cmc right med HCPCS L3923 | $196.00 | $245.00 | $48.85 – $124.31 | 9 |
| Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 % CPT 15120 | $2,092.80 | $2,616.00 | $621.01 – $3,527.16 | 11 |
| Split blood or products CPT 86985 | $164.99 | $206.23 | $14.53 – $167.93 | 13 |
| Split flat caliper stirr & p HCPCS L2230 | not published | not published | $44.40 – $112.98 | 9 |
| Splt agrft f/s/n/h/f/g/m ea CPT 15121 | $516.00 | $645.00 | $115.50 – $309.84 | 9 |
| Spontaneous nystagmus study CPT 92531 | $52.80 | $66.00 | $30.60 – $41.55 | 6 |
| Sprchoroidal spc njx rx agt CPT 67516 | $313.60 | $392.00 | $87.74 – $428.74 | 9 |
| Spring-ass rot wrst with latch HCPCS L6623 | not published | not published | $434.90 – $1,106.69 | 9 |
| Sputum specimen collection CPT 89220 | $180.00 | $224.99 | $8.93 – $66.15 | 11 |
| Sr-89 stront chlor ther / mci HCPCS A9600 | not published | not published | $918.74 – $4,353.65 | 9 |
| Srs cranial lesion complex CPT 61798 | $3,244.00 | $4,055.00 | $1,187.67 – $3,166.22 | 9 |
| Srs cranial lesion simple CPT 61796 | $2,384.00 | $2,980.00 | $881.41 – $2,345.83 | 9 |
| Srs cran les complex addl CPT 61799 | $711.20 | $889.00 | $253.96 – $679.70 | 9 |
| Srs cran les simple addl CPT 61797 | $719.20 | $899.00 | $183.91 – $491.76 | 9 |
| Srsf2 gene common variants CPT 81348 | not published | not published | $105.24 – $265.27 | 9 |
| Srs linear based CPT 77372 | $20,464.09 | $25,580.11 | $822.33 – $7,520.55 | 13 |
| Srs multisource CPT 77371 | $2,114.40 | $2,643.00 | $1,722.40 – $7,491.65 | 11 |
| Srs spinal lesion CPT 63620 | $2,631.20 | $3,289.00 | $971.62 – $2,587.83 | 9 |
| Srs spinal lesion addl CPT 63621 | $591.20 | $739.00 | $211.51 – $565.03 | 9 |
| Staggered spondaic word test CPT 92572 | $100.80 | $126.00 | $50.35 – $150.74 | 11 |
| Staging lapro hodgkins disease/lymphoma 49220 CPT 49220 | not published | not published | $1,768.00 – $1,768.00 | 2 |
| Stainless steel any wrist HCPCS L6630 | not published | not published | $129.05 – $328.39 | 9 |
| St analysis behavior qualitative voice/resonance CPT 92524 | $236.46 | $295.57 | $77.44 – $187.20 | 11 |
| Stance phase only HCPCS L5858 | not published | not published | $11,138.25 – $28,343.69 | 9 |
| Standard control cable extra HCPCS L6655 | not published | not published | $53.84 – $137.01 | 9 |
| Staph a dna amp probe CPT 87640 | $87.20 | $109.00 | $21.05 – $54.59 | 11 |
| Static or dynami afo pre ots HCPCS L4397 | $389.44 | $486.80 | $96.80 – $210.78 | 11 |
| Stationary o2 contents, gas HCPCS E0441 | not published | not published | $34.58 – $95.95 | 9 |
| Stationary o2 contents, liq HCPCS E0442 | not published | not published | $34.58 – $95.95 | 9 |
| St cognitve performance testing healthcare professional each hour CPT 96125 | $272.27 | $340.33 | $89.17 – $167.60 | 11 |
| Stem cells total count CPT 86367 | $156.00 | $195.00 | $34.84 – $108.90 | 11 |
| Stenger test pure tone CPT 92565 | $39.20 | $49.00 | $19.34 – $57.22 | 11 |
| Stenger test speech CPT 92577 | $40.80 | $51.00 | $20.23 – $511.21 | 11 |
| Stent/athrectomy/fem/pop/unilat 37227 CPT 37227 | $70,321.60 | $87,902.00 | $611.31 – $17,300.43 | 13 |
| Stent axios caut enh 15x10mm electrocaut HCPCS C1874 | $16,551.22 | $20,689.02 | $985.32 – $2,366.71 | 5 |
| Stent bili dbl pgtl 10fx5cm HCPCS C2617 | $522.24 | $652.79 | $133.17 – $319.87 | 5 |
| Stent bili rx wallflx 10x80 uncvr HCPCS C1876 | $7,128.43 | $8,910.53 | $1,737.88 – $4,174.32 | 5 |
| Stent bronch dumon sil 10x40mm HCPCS C1875 | $9,724.42 | $12,155.52 | $2,479.73 – $5,956.20 | 5 |
| Stent iliac/open or perc/uni/init 37221 CPT 37221 | $25,101.33 | $31,376.66 | $419.22 – $10,926.09 | 13 |
| Stent iliac/open/perc/ea ad/ipsila 37223 CPT 37223 | $18,239.80 | $22,799.75 | $180.02 – $6,703.13 | 11 |
| Stent placemt retro carotid CPT 37217 | $11,133.77 | $13,917.21 | $923.62 – $4,091.66 | 11 |
| Stent/tib/peroneal/unilat/initial 37230 CPT 37230 | $49,374.40 | $61,718.00 | $592.65 – $17,300.43 | 13 |
| Stereoscopic x-ray guidance HCPCS G6002 | $136.00 | $170.00 | $19.11 – $49.53 | 9 |
| Stereotactic bx aspir/exc burr intracranial les 61750 CPT 61750 | $3,308.00 | $4,135.00 | $1,212.87 – $3,229.05 | 9 |
| Stereotactic radiation trmt CPT 77432 | $845.60 | $1,057.00 | $393.37 – $823.05 | 9 |
| Sterile gauze <= 16 sq in HCPCS A6402 | not published | not published | $0.08 – $0.20 | 9 |
| Sterile needle HCPCS A4215 | not published | not published | $0.22 – $0.52 | 4 |
| Sterile water/saline, 10 ml HCPCS A4216 | $1.20 | $1.50 | $0.31 – $0.84 | 9 |
| Sterile water/saline, 500 ml HCPCS A4217 | not published | not published | $2.18 – $5.86 | 9 |
| Sternal debridement CPT 21627 | $1,318.40 | $1,648.00 | $488.07 – $1,298.58 | 9 |
| Sternal pad HCPCS L1050 | not published | not published | $46.79 – $119.08 | 9 |
| St evaluate speech sound production CPT 92522 | $236.46 | $295.57 | $77.44 – $190.60 | 11 |
| St evaluation motion fluoroscopic swallow function cine/video CPT 92611 | $668.35 | $835.43 | $84.25 – $245.62 | 11 |
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.