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 |
|---|---|---|---|---|
| Unlisted px small intestine CPT 44799 | $4,445.29 | $5,556.61 | $892.56 – $2,406.01 | 12 |
| Unlisted px temporal bone CPT 69979 | not published | not published | $221.08 – $300.17 | 9 |
| Unlisted px ther rad tx plng CPT 77299 | not published | not published | $126.40 – $171.62 | 9 |
| Unlisted px tongue flr mouth CPT 41599 | $208.00 | $260.00 | $66.88 – $300.17 | 12 |
| Unlisted px vestibule mouth CPT 40899 | not published | not published | $221.08 – $300.17 | 9 |
| Unlisted reprod med lab proc CPT 89398 | $70.00 | $87.49 | $22.92 – $69.06 | 12 |
| Unlisted resp px dx nuc med CPT 78599 | not published | not published | $382.54 – $519.41 | 9 |
| Unlisted spec derm svc/px CPT 96999 | not published | not published | $189.16 – $256.85 | 9 |
| Unlisted special svc px/rprt CPT 99199 | $25.60 | $32.00 | not published | 0 |
| Unlisted surgical path px CPT 88399 | not published | not published | $50.87 – $69.06 | 9 |
| Unlisted transfusion med px CPT 86999 | $57.14 | $71.42 | $18.71 – $31.66 | 12 |
| Unlisted ultrasound procedure CPT 76999 | $369.60 | $462.00 | $83.82 – $113.81 | 9 |
| Unlisted urinalysis px CPT 81099 | $25.72 | $32.14 | $6.56 – $15.75 | 5 |
| Unlisted vasc endoscopy px CPT 37501 | not published | not published | $588.59 – $799.17 | 9 |
| Unlstd hematop ret/endo lymp CPT 78199 | not published | not published | $382.54 – $519.41 | 9 |
| Unlstd laps px mat care&dlvr CPT 59898 | not published | not published | $5,554.35 – $7,541.51 | 9 |
| Unlstd laps px sprmatic cord CPT 55559 | not published | not published | $5,554.35 – $7,541.51 | 9 |
| Unsched dialysis esrd pt hos HCPCS G0257 | $1,292.33 | $1,615.41 | $423.24 – $699.72 | 11 |
| Upgrade pm system CPT 33214 | $15,468.80 | $19,336.00 | $415.05 – $10,082.84 | 13 |
| Upper Arm (Humerus) X-ray (left side) CPT 73060 | $371.71 | $464.63 | $7.10 – $136.60 | 13 |
| Upper Back (Thoracic Spine) CT Scan (with contrast) CPT 72129 | $2,630.41 | $3,288.01 | $53.34 – $966.67 | 13 |
| Upper Back (Thoracic Spine) CT Scan (without contrast) CPT 72128 | $2,245.72 | $2,807.15 | $43.57 – $825.30 | 13 |
| Upper Back (Thoracic Spine) MRI (with and without contrast) CPT 72157 | $5,086.24 | $6,357.79 | $100.51 – $1,869.19 | 13 |
| Upper Back (Thoracic Spine) MRI (with contrast) CPT 72147 | $4,053.38 | $5,066.72 | $77.96 – $1,489.62 | 13 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | $3,090.60 | $3,863.24 | $64.86 – $1,135.79 | 13 |
| Upper Back (Thoracic Spine) X-ray (2 views) CPT 72070 | $423.31 | $529.13 | $8.98 – $155.56 | 13 |
| Upper Back (Thoracic Spine) X-ray (3 views) CPT 72072 | $490.52 | $613.15 | $9.95 – $180.27 | 13 |
| Upper Endoscopy (EGD, diagnostic) CPT 43235 | $1,610.37 | $2,012.96 | $109.69 – $903.29 | 13 |
| Upper Endoscopy (EGD, with biopsy) CPT 43239 | $3,996.55 | $4,995.68 | $123.53 – $1,468.73 | 13 |
| Upper ext fx orthosis rad/ul HCPCS L3982 | $857.60 | $1,072.00 | $213.91 – $544.34 | 9 |
| Upper ext harvest for cabg1 seg 35600 CPT 35600 | $627.20 | $784.00 | $158.52 – $497.76 | 9 |
| Upper GI Barium X-ray (barium and gas) CPT 74246 | $706.70 | $883.37 | $39.15 – $259.71 | 13 |
| Upper GI Barium X-ray (barium only) CPT 74240 | $640.09 | $800.11 | $35.33 – $235.23 | 13 |
| Uppr gi scope w/submuc inj CPT 43236 | $916.80 | $1,146.00 | $123.53 – $903.29 | 11 |
| Urachal cyst/sinus excision 51500 CPT 51500 | $1,605.60 | $2,007.00 | $579.39 – $5,621.13 | 11 |
| Urea nitrogen CPT 84520 | $33.57 | $41.96 | $2.37 – $12.34 | 11 |
| Urea nitrogen 24 hour urine CPT 84540 | $33.57 | $41.96 | $3.34 – $12.34 | 11 |
| Urea nitrogen clearance CPT 84545 | $33.57 | $41.96 | $4.32 – $12.34 | 11 |
| Urea nitrogen semi-quant CPT 84525 | $10.40 | $13.00 | $3.08 – $7.18 | 9 |
| Ureteral embolization/occl CPT 50705 | $9,249.60 | $11,562.00 | $159.01 – $2,649.55 | 11 |
| Ureteral reflux study CPT 78740 | $986.29 | $1,232.86 | $24.93 – $387.14 | 13 |
| Ureter endoscopy CPT 50970 | $1,875.20 | $2,344.00 | $331.65 – $3,322.91 | 11 |
| Ureter endoscopy & biopsy CPT 50955 | $2,140.80 | $2,676.00 | $315.49 – $4,897.82 | 11 |
| Ureter endoscopy & biopsy CPT 50974 | $2,392.00 | $2,990.00 | $422.71 – $4,897.82 | 11 |
| Ureter endoscopy & catheter CPT 50972 | $1,812.80 | $2,266.00 | $320.46 – $3,322.91 | 11 |
| Ureter endoscopy & treatment CPT 50957 | $2,161.60 | $2,702.00 | $317.07 – $4,897.82 | 11 |
| Ureter endoscopy & treatment CPT 50961 | $1,947.20 | $2,434.00 | $282.65 – $4,897.82 | 11 |
| Ureter endoscopy & treatment CPT 50976 | $2,358.40 | $2,948.00 | $417.03 – $4,897.82 | 11 |
| Ureter endoscopy & treatment CPT 50980 | $1,803.20 | $2,254.00 | $318.42 – $4,897.82 | 11 |
| Ureteroneocystostomy 50780 CPT 50780 | $5,564.80 | $6,956.00 | $999.01 – $2,662.91 | 9 |
| Ureteroureterostomy 50760 CPT 50760 | $5,649.60 | $7,062.00 | $1,010.13 – $2,696.30 | 9 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | $658.01 | $822.51 | $14.37 – $241.82 | 13 |
| Urethrlys transvag with scope CPT 53500 | $1,883.20 | $2,354.00 | $673.18 – $3,322.91 | 11 |
| Urethrocystography void s&i CPT 74455 | $657.24 | $821.54 | $14.37 – $241.53 | 13 |
| Uric acid blood CPT 84550 | $33.57 | $41.96 | $2.71 – $12.34 | 11 |
| Uric acid urine CPT 84560 | $33.57 | $41.96 | $3.05 – $12.34 | 11 |
| Urinalysis glass test CPT 81020 | $11.20 | $14.00 | $4.70 – $6.58 | 9 |
| Urinalysis microscopic only CPT 81015 | $25.72 | $32.14 | $3.05 – $9.45 | 11 |
| Urinalysis qual/semiquant excpt ia CPT 81005 | $25.72 | $32.14 | $2.17 – $9.45 | 11 |
| Urinalysis (with microscopy) CPT 81001 | $25.72 | $32.14 | $3.17 – $9.45 | 11 |
| Urinalysis (without microscopy) CPT 81003 | $25.72 | $32.14 | $2.25 – $9.45 | 11 |
| Urinary bldr retent nuc study CPT 78730 | $688.36 | $860.44 | $6.92 – $252.97 | 11 |
| Urinary pouch on barr w/flng HCPCS A5073 | not published | not published | $2.18 – $5.56 | 9 |
| Urinary pouch w/barrier HCPCS A5071 | not published | not published | $4.19 – $10.66 | 9 |
| Urinary reflex study CPT 51792 | $605.60 | $757.00 | $50.05 – $132.69 | 11 |
| Urinary suspensory HCPCS A5105 | not published | not published | $28.42 – $72.32 | 9 |
| Urine Culture Test CPT 87086 | $38.58 | $48.22 | $4.84 – $14.18 | 11 |
| Urine flow measurement 51736 CPT 51736 | $34.40 | $43.00 | $4.87 – $124.19 | 11 |
| Urine ost pouch w faucet/tap HCPCS A4428 | not published | not published | $4.54 – $11.57 | 9 |
| Urine pregnancy test CPT 81025 | $25.72 | $32.14 | $8.42 – $12.05 | 11 |
| Urine screen for bacteria CPT 81007 | $60.00 | $75.00 | $4.70 – $41.97 | 9 |
| Urine shunt to intestine CPT 50815 | not published | not published | $1,106.06 – $2,947.70 | 9 |
| Urine specimen collect mult HCPCS P9615 | $18.40 | $23.00 | $1.80 – $22.96 | 9 |
| Urofollitropin, 75 iu HCPCS J3355 | not published | not published | $74.95 – $184.50 | 4 |
| Urography, antegrade CPT 74425 | $756.19 | $945.23 | $22.26 – $344.08 | 13 |
| Urography inf drip &/or bolus CPT 74410 | $822.32 | $1,027.90 | $21.46 – $302.20 | 13 |
| Urokinase 250,000 iu inj HCPCS J3365 | $522.40 | $653.00 | $518.18 – $636.63 | 3 |
| Urokinase 5000 iu injection HCPCS J3364 | not published | not published | $10.36 – $12.74 | 3 |
| Use 1st target lesion CPT 76982 | $408.76 | $510.95 | $26.03 – $150.22 | 13 |
| User adjustable heel height HCPCS L5990 | not published | not published | $1,087.26 – $2,766.75 | 9 |
| Ustekinumab 130 mg/26 ml intravenous solution HCPCS J3358 | $24.40 | $30.49 | $6.22 – $13.95 | 11 |
| Ustekinumab 45 mg/0.5 ml subcutaneous solution HCPCS J3357 | $253.60 | $317.00 | $152.39 – $323.91 | 9 |
| U/s trtmt, not leiomyomata HCPCS C9734 | not published | not published | $12,249.30 – $16,631.67 | 7 |
| Vaccine Administration (one shot) CPT 90471 | $116.23 | $145.28 | $13.83 – $68.57 | 13 |
| Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml CPT 91322 | $233.60 | $292.00 | $144.64 – $189.70 | 9 |
| Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml CPT 91321 | $233.60 | $292.00 | $144.64 – $189.70 | 9 |
| Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im CPT 91320 | $255.20 | $319.00 | $147.69 – $170.43 | 9 |
| Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im CPT 91319 | $171.20 | $214.00 | $83.16 – $114.11 | 9 |
| Vaccine covid-19 pfizer tris-sucrose 6mos-4yrs 3mcg/0.3ml im CPT 91318 | $128.00 | $160.00 | $62.10 – $85.22 | 9 |
| Vaccine dtap < 7 years im CPT 90700 | $116.08 | $145.10 | $29.59 – $49.74 | 8 |
| Vaccine dtap-hep b-ipv im CPT 90723 | $92.00 | $115.00 | $90.37 – $146.12 | 6 |
| Vaccine dtap-ipv 4-6 years im CPT 90696 | $89.60 | $112.00 | $62.82 – $98.73 | 5 |
| Vaccine dtap-ipv-hib-hepb im CPT 90697 | $320.60 | $400.75 | $81.68 – $196.19 | 8 |
| Vaccine dtap-ipv/hib im CPT 90698 | $107.20 | $134.00 | $102.29 – $150.02 | 6 |
| Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im CPT 90647 | $118.96 | $148.70 | $30.33 – $56.73 | 8 |
| Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im CPT 90648 | $32.80 | $41.00 | $13.17 – $52.86 | 6 |
| Vaccine hepatitis a (hepa) adult im CPT 90632 | $77.60 | $97.00 | $71.60 – $92.77 | 6 |
| Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im CPT 90636 | $119.20 | $149.00 | $116.82 – $182.65 | 6 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im CPT 90633 | $40.00 | $50.00 | $37.96 – $66.85 | 6 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 3 dose im CPT 90634 | $42.40 | $53.00 | $27.44 – $69.97 | 4 |
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.