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 |
|---|---|---|---|---|
| Suspension of uterus 58400 CPT 58400 | $1,136.00 | $1,420.00 | $415.70 – $1,121.08 | 9 |
| Suspension sleeve lower ext HCPCS L2397 | not published | not published | $75.73 – $192.71 | 9 |
| Sutr lg intestine 1/mult perf without colostomy 44604 CPT 44604 | $2,600.80 | $3,251.00 | $925.03 – $2,468.82 | 9 |
| Suture bile duct injury 47900 CPT 47900 | $3,346.40 | $4,183.00 | $1,207.18 – $3,220.92 | 9 |
| Svc venogram s&i CPT 75827 | $2,693.99 | $3,367.48 | $47.95 – $1,496.66 | 13 |
| Swallowing Evaluation (Bedside) CPT 92610 | $387.91 | $484.88 | $65.97 – $171.31 | 11 |
| Swallowing Therapy Session CPT 92526 | $250.49 | $313.11 | $78.93 – $135.58 | 11 |
| Sweat collection by iontophoresis CPT 89230 | $70.00 | $87.49 | $1.27 – $51.48 | 13 |
| Symes ankle without (sach) foot HCPCS L5703 | not published | not published | $1,259.71 – $3,205.61 | 9 |
| Symes met fr leath socket ar HCPCS L5060 | not published | not published | $1,825.15 – $4,644.50 | 9 |
| Symes type medial opening so HCPCS L5636 | not published | not published | $154.45 – $393.02 | 9 |
| Symes type poster opening so HCPCS L5634 | not published | not published | $195.84 – $498.34 | 9 |
| Symes type ptb brim design s HCPCS L5632 | not published | not published | $150.78 – $383.68 | 9 |
| Syme typ expandabl wall sckt HCPCS L5630 | not published | not published | $345.18 – $878.38 | 9 |
| Sympathectomy cervical CPT 64802 | $3,934.40 | $4,918.00 | $738.77 – $1,966.75 | 11 |
| Sympathectomy digital artery CPT 64820 | $1,808.80 | $2,261.00 | $691.78 – $1,881.40 | 11 |
| Sympathectomy lumbar CPT 64818 | not published | not published | $698.35 – $1,856.75 | 9 |
| Sympathectomy supfc palmar CPT 64823 | $3,880.00 | $4,850.00 | $713.61 – $3,126.02 | 11 |
| Sympathectomy thoracolumbar CPT 64809 | not published | not published | $942.67 – $2,511.78 | 9 |
| Synch audio-only est high 40 CPT 98015 | $265.60 | $332.00 | $178.90 – $178.90 | 2 |
| Synch audio-only est low 20 CPT 98013 | $160.80 | $201.00 | $81.90 – $81.90 | 2 |
| Synch audio-only est mod 30 CPT 98014 | $192.00 | $240.00 | $121.20 – $121.20 | 2 |
| Synch audio-only est sf 10 CPT 98012 | $83.20 | $104.00 | $45.00 – $45.00 | 2 |
| Synch audio-only new high 60 CPT 98011 | $367.20 | $459.00 | $219.60 – $219.60 | 2 |
| Synch audio-only new low 30 CPT 98009 | $189.60 | $237.00 | $106.00 – $106.00 | 2 |
| Synch audio-only new mod 45 CPT 98010 | $289.60 | $362.00 | $167.10 – $167.10 | 2 |
| Synch audio-only new sf 15 CPT 98008 | $133.60 | $167.00 | $61.10 – $61.10 | 2 |
| Synojoynt, inj., 1 mg HCPCS J7331 | not published | not published | $8.43 – $17.71 | 5 |
| Synthetic sentence id test CPT 92576 | $80.80 | $101.00 | $37.37 – $99.11 | 11 |
| Synvisc or synvisc-one HCPCS J7325 | $26.40 | $33.00 | $8.82 – $14.21 | 9 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $48.57 | $60.71 | $2.64 – $17.85 | 11 |
| System cardiomems hosp electronics HCPCS C2624 | $83,764.00 | $104,705.00 | $21,359.82 – $51,305.45 | 5 |
| System pacing micra av HCPCS C1786 | $34,803.67 | $43,504.58 | $8,874.93 – $21,317.24 | 5 |
| System pcmkr dual chamber leadless micra av2 intrdcr cath HCPCS C1785 | $11,015.27 | $13,769.08 | $2,808.89 – $6,746.85 | 5 |
| T3 (triiodothyronine) free CPT 84481 | $55.00 | $68.75 | $10.16 – $26.35 | 11 |
| T3 (triiodothyronine) total CPT 84480 | $55.00 | $68.75 | $8.51 – $22.06 | 11 |
| T4 (thyroxine) free CPT 84439 | $55.00 | $68.75 | $5.41 – $20.21 | 11 |
| T4 (thyroxine) total CPT 84436 | $55.00 | $68.75 | $4.12 – $20.21 | 11 |
| Tacrol astagraf ex rel oral HCPCS J7508 | not published | not published | $0.53 – $0.72 | 6 |
| Tacrol envarsus ex rel oral HCPCS J7503 | $1.95 | $2.43 | $0.43 – $1.81 | 8 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | $3.24 | $4.04 | $0.03 – $0.24 | 8 |
| Tacrolimus 5 mg/ml intravenous solution HCPCS J7525 | not published | not published | $207.39 – $323.36 | 9 |
| Tacrolimus therapeutic drug level CPT 80197 | $66.43 | $83.03 | $8.24 – $24.41 | 11 |
| Tafasitamab-cxix 200 mg intravenous solution HCPCS J9349 | not published | not published | $13.33 – $17.67 | 9 |
| Tah rad debulk/lymph remove 58954 CPT 58954 | $5,380.00 | $6,725.00 | $1,939.58 – $5,196.36 | 9 |
| Tah rad dissect for debulk 58953 CPT 58953 | $4,964.80 | $6,206.00 | $1,792.63 – $4,804.11 | 9 |
| Tah w/mmk 58152 CPT 58152 | $3,129.60 | $3,912.00 | $1,105.84 – $2,968.87 | 9 |
| Tailbone (Sacrum and Coccyx) X-ray CPT 72220 | $399.31 | $499.13 | $7.71 – $146.74 | 13 |
| Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection HCPCS J9325 | not published | not published | $62.55 – $86.56 | 9 |
| Talquetamab-tgvs 2 mg/ml subcutaneous solution HCPCS J3055 | not published | not published | $67.61 – $76.02 | 7 |
| Talymed HCPCS Q4127 | not published | not published | $67.32 – $149.58 | 6 |
| Tamoxifen 10 mg tabs 60 each bottle HCPCS S0187 | $3.00 | $3.75 | $0.19 – $1.25 | 8 |
| Tap block bilat cont infusion 64489 CPT 64489 | $691.20 | $864.00 | $68.72 – $188.28 | 9 |
| Tap block uni by cont infusion 64487 CPT 64487 | $896.00 | $1,120.00 | $54.56 – $154.57 | 9 |
| Tape plstc 1inx5yd hosp tb pk HCPCS A4452 | not published | not published | $0.27 – $0.78 | 6 |
| Target gsa panel hmtlmph neop CPT 81450 | $1,519.20 | $1,899.00 | $238.80 – $1,063.42 | 11 |
| Target gsa panel organ/hmtlmph neop CPT 81455 | $5,839.20 | $7,299.00 | $917.92 – $4,087.71 | 11 |
| Target gsa panel organ neop CPT 81445 | $1,196.00 | $1,495.00 | $187.98 – $837.13 | 11 |
| Tarlatamab-dlle 10 mg intravenous solution HCPCS J9026 | not published | not published | $1,570.76 – $1,718.95 | 7 |
| Tas congenital car anomal CPT 33741 | $1,882.40 | $2,353.00 | $642.50 – $1,720.01 | 9 |
| Tattooing/intraderm 6.1-20.0 sq cm 11921 CPT 11921 | $520.00 | $650.00 | $116.63 – $589.75 | 11 |
| Tavr perq femoral CPT 33361 | $35,076.54 | $43,845.67 | $1,035.38 – $12,890.63 | 11 |
| Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe HCPCS J1447 | $0.80 | $1.00 | $0.30 – $0.71 | 9 |
| Tbp gene detc abnor alleles CPT 81344 | not published | not published | $82.20 – $191.82 | 9 |
| Tbs dxa cal w/i&r fx risk CPT 77089 | not published | not published | $35.56 – $76.23 | 9 |
| Tbs i&r fx rsk qhp CPT 77092 | not published | not published | $8.98 – $19.09 | 9 |
| Tbs techl calculation only CPT 77091 | not published | not published | $24.07 – $84.83 | 11 |
| Tbs techl prep&transmis data CPT 77090 | not published | not published | $2.51 – $84.83 | 11 |
| Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells CPT 86481 | $200.00 | $250.00 | $36.03 – $140.00 | 11 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $153.60 | $192.00 | $36.03 – $96.42 | 11 |
| Tc-99m apcitide diag HCPCS A9504 | not published | not published | $500.00 – $1,162.82 | 4 |
| Tc-99m arcitumomab HCPCS A9568 | not published | not published | $809.51 – $2,793.54 | 9 |
| Tc-99m bicisate HCPCS A9557 | $1,343.95 | $1,679.93 | $342.71 – $727.41 | 11 |
| Tc-99m depreotide HCPCS A9536 | not published | not published | $1,038.38 – $1,863.13 | 3 |
| Tc-99m diag per dose HCPCS A4641 | not published | not published | $138.18 – $163.94 | 2 |
| Tc-99m disofenin HCPCS A9510 | not published | not published | $63.98 – $164.79 | 4 |
| Tc-99m exame autol wbc diag per dose HCPCS A9569 | $4,175.58 | $5,219.47 | $1,040.32 – $2,260.03 | 11 |
| Tc-99m exametazime diag HCPCS A9521 | $3,266.33 | $4,082.91 | $802.34 – $1,767.90 | 11 |
| Tc-99m graphite crucible HCPCS A9506 | not published | not published | $328.60 – $345.03 | 6 |
| Tc-99m labeled rbc HCPCS A9560 | $328.02 | $410.02 | $83.64 – $177.54 | 8 |
| Tc-99m maa HCPCS A9540 | $201.60 | $252.00 | $30.00 – $76.18 | 8 |
| Tc-99m mebrofenin HCPCS A9537 | $139.57 | $174.46 | $8.05 – $85.49 | 8 |
| Tc-99m medronate HCPCS A9503 | $129.23 | $161.53 | $13.00 – $69.94 | 8 |
| Tc-99m mertiatide HCPCS A9562 | $966.40 | $1,208.00 | $133.41 – $883.24 | 8 |
| Tc-99m non-heu per study dose HCPCS Q9969 | $8.00 | $10.00 | $2.04 – $10.50 | 11 |
| Tc-99m oxidronate HCPCS A9561 | $165.40 | $206.75 | $42.18 – $89.52 | 8 |
| Tc-99m pentetate dtpa HCPCS A9539 | $186.08 | $232.60 | $31.44 – $70.72 | 6 |
| Tc-99m pentetate dtpa aerosol HCPCS A9567 | $259.44 | $324.30 | $20.97 – $108.55 | 6 |
| Tc-99m pertechnetate per mci HCPCS A9512 | $24.27 | $30.33 | $1.26 – $13.13 | 8 |
| Tc-99m pyroph diag per dose up to 25 mci HCPCS A9538 | $138.50 | $173.12 | $17.30 – $74.96 | 8 |
| Tc-99m sestamibi p study dose HCPCS A9500 | $373.60 | $467.00 | $83.39 – $450.58 | 8 |
| Tc-99m succimer (dmsa) HCPCS A9551 | $802.24 | $1,002.80 | $192.81 – $683.34 | 8 |
| Tc-99m sulfur colloid HCPCS A9541 | $334.40 | $418.00 | $65.91 – $304.80 | 8 |
| Tc-99m tetrofosmin p study dose HCPCS A9502 | $594.45 | $743.06 | $97.21 – $321.74 | 8 |
| Tc-99m tilmanocept diag HCPCS A9520 | $1,472.78 | $1,840.97 | $375.56 – $902.08 | 8 |
| Tca peel dermal 15789 CPT 15789 | $1,324.80 | $1,656.00 | $374.71 – $993.70 | 11 |
| Tcd emboli detect w/inj CPT 93893 | $764.80 | $956.00 | $53.89 – $159.05 | 13 |
| Tcd emboli detect without inj CPT 93892 | $666.40 | $833.00 | $53.59 – $141.44 | 11 |
| Tcd vasoreactivity study CPT 93890 | not published | not published | $91.20 – $133.92 | 5 |
| T-cell depletion of harvest CPT 38210 | not published | not published | $148.20 – $428.44 | 9 |
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.