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 |
|---|---|---|---|---|
| Wound therapy negative pressure per session > 50 sq cm CPT 97608 | $616.00 | $770.00 | $21.67 – $384.93 | 13 |
| Wound therapy negative pressure per session <= 50 sq cm dme CPT 97605 | $213.02 | $266.27 | $22.96 – $191.44 | 13 |
| Wound therapy negative pressure per session > 50 sq cm dme CPT 97606 | $276.94 | $346.17 | $24.87 – $384.93 | 13 |
| Wrist arthroscopy CPT 29840 | $2,222.40 | $2,778.00 | $414.69 – $3,126.02 | 11 |
| Wrist arthroscopy/surgery CPT 29843 | $2,382.40 | $2,978.00 | $442.89 – $3,126.02 | 11 |
| Wrist arthroscopy/surgery CPT 29844 | $2,464.00 | $3,080.00 | $456.31 – $3,126.02 | 11 |
| Wrist arthroscopy/surgery CPT 29845 | $2,875.20 | $3,594.00 | $532.72 – $3,126.02 | 11 |
| Wrist arthroscopy/surgery CPT 29846 | $2,576.00 | $3,220.00 | $476.13 – $3,126.02 | 11 |
| Wrist arthroscopy/surgery CPT 29847 | $2,672.00 | $3,340.00 | $493.30 – $6,882.64 | 11 |
| Wrist/elbow bowden cable mol HCPCS L6580 | not published | not published | $1,007.18 – $2,562.99 | 9 |
| Wrist/elbow bowden cbl dir f HCPCS L6582 | not published | not published | $856.34 – $2,179.13 | 9 |
| Wrist endoscopy/surgery CPT 29848 | $2,512.00 | $3,140.00 | $468.22 – $1,541.92 | 11 |
| Wrist X-ray CPT 73110 | $386.76 | $483.44 | $7.71 – $142.13 | 13 |
| Wrist X-ray (2 views, both wrists) CPT 73100 | $315.81 | $394.76 | $7.39 – $116.06 | 13 |
| Wrst mld sck flx hng tri pad HCPCS L6050 | not published | not published | $1,364.02 – $3,471.03 | 9 |
| Xcapsl ctrc rmvl cplx w/ecp CPT 66987 | not published | not published | $700.88 – $3,875.83 | 10 |
| Xcapsl ctrc rmvl cplx wo ecp CPT 66982 | $3,724.80 | $4,656.00 | $669.56 – $2,197.37 | 11 |
| Xcapsl ctrc rmvl insj 1+ CPT 66991 | not published | not published | $615.01 – $4,971.13 | 11 |
| Xcapsl ctrc rmvl w/ecp CPT 66988 | not published | not published | $572.27 – $3,875.83 | 10 |
| Xcellistem, 1 mg HCPCS A2004 | not published | not published | $13.00 – $1,219.56 | 4 |
| Xcpsl ctrc rmvl cplx insj 1+ CPT 66989 | not published | not published | $769.21 – $4,971.13 | 11 |
| Xe133 xenon 10mci HCPCS A9558 | $616.08 | $770.10 | $90.39 – $333.45 | 8 |
| Xfer tis f/c/c/m/n/a/g/h/f 10sq cm/< CPT 14040 | $2,884.71 | $3,605.88 | $565.99 – $1,762.37 | 13 |
| Xfer tis s/a/l 10 sq cm/< CPT 14020 | $1,708.80 | $2,136.00 | $513.38 – $1,762.37 | 11 |
| X-linked intellectual dblt CPT 81470 | not published | not published | $548.40 – $1,279.68 | 9 |
| X-linked intellectual dblt CPT 81471 | not published | not published | $548.40 – $1,279.68 | 9 |
| Xm archive tissue molec anal CPT 88363 | $70.00 | $87.49 | $17.28 – $33.20 | 13 |
| Xpos opn axillary/sbclvn art w/cndt crtn CPT 34716 | $2,338.44 | $2,923.05 | $317.36 – $859.38 | 11 |
| Xpos opn fmrl eprst aor uni add-on CPT 34812 | $1,246.40 | $1,558.00 | $174.07 – $666.36 | 9 |
| X-ray abdomen >=3 views CPT 74021 | $357.56 | $446.94 | $11.83 – $131.40 | 13 |
| X-ray arthrogram shoulder supervision & interpretation (both sides) CPT 73040 | $962.40 | $1,203.00 | $24.70 – $353.68 | 13 |
| X-ray assay calculus CPT 82370 | $64.28 | $80.35 | $7.51 – $23.62 | 11 |
| X-ray bone length studies CPT 77073 | $537.77 | $672.21 | $11.95 – $197.63 | 13 |
| X-ray bone survey infant CPT 77076 | $303.87 | $379.83 | $30.91 – $111.67 | 13 |
| X-ray consultation CPT 76140 | $36.00 | $45.00 | $2.70 – $45.56 | 4 |
| Xray endovasc thor ao repr CPT 75956 | $2,688.80 | $3,361.00 | $0.01 – $684.57 | 9 |
| Xray endovasc thor ao repr CPT 75957 | $3,960.80 | $4,951.00 | $0.01 – $1,455.59 | 11 |
| X-ray exam entire spi 4/5 vw CPT 72083 | $600.52 | $750.64 | $15.90 – $220.69 | 13 |
| X-ray exam entire spi 6/> vw CPT 72084 | $610.52 | $763.15 | $18.58 – $224.37 | 13 |
| X-ray exam of arm infant CPT 73092 | $444.48 | $555.59 | $7.10 – $163.34 | 13 |
| X-ray exam of femur 1 CPT 73551 | $385.98 | $482.47 | $7.39 – $141.85 | 13 |
| X-ray exam of jaw joint CPT 70328 | $383.20 | $479.00 | $8.04 – $140.83 | 13 |
| X-ray exam of jaw joint CPT 70332 | $176.80 | $221.00 | $23.82 – $232.88 | 11 |
| X-ray exam of mastoids CPT 70120 | $382.64 | $478.30 | $8.04 – $140.62 | 13 |
| X-ray exam of middle ear CPT 70134 | $114.40 | $143.00 | $15.87 – $528.26 | 11 |
| X-ray exam of penis CPT 74445 | $606.40 | $758.00 | $46.12 – $110.87 | 11 |
| X-ray exam of perineum CPT 74775 | $588.00 | $735.00 | $27.29 – $232.88 | 11 |
| X-ray exam of salivary gland CPT 70380 | $82.40 | $103.00 | $7.42 – $84.83 | 11 |
| X-ray exam of tear duct CPT 70170 | $728.80 | $911.00 | $13.25 – $232.88 | 11 |
| X-ray exam of teeth CPT 70300 | $32.00 | $40.00 | $4.56 – $84.83 | 11 |
| X-ray exam of teeth CPT 70310 | $218.52 | $273.14 | $7.39 – $232.88 | 13 |
| X-ray exam si joints CPT 72200 | $282.94 | $353.67 | $7.71 – $103.98 | 13 |
| X-ray exam thorac spine4/>vw CPT 72074 | $556.98 | $696.22 | $10.89 – $204.69 | 13 |
| X-ray eye detection foreign body (both sides) CPT 70030 | $270.46 | $338.07 | $8.04 – $99.39 | 13 |
| X-ray fallopian tube CPT 74742 | $264.00 | $330.00 | $26.67 – $60.35 | 9 |
| X-ray head for orthodontia CPT 70350 | $41.60 | $52.00 | $7.83 – $84.83 | 11 |
| X-ray hip uni w/wo pelvis min 4 views CPT 73503 | $475.41 | $594.26 | $12.28 – $174.71 | 13 |
| X-ray hip with pelvis when performed bilateral >= 5 views CPT 73523 | $661.20 | $826.50 | $13.87 – $242.99 | 13 |
| X-ray joint survey 1 view CPT 77077 | $448.92 | $561.15 | $15.10 – $164.98 | 13 |
| X-ray lower extremities infant > 2 views (both sides) CPT 73592 | $113.68 | $142.10 | $7.10 – $84.83 | 13 |
| X-ray l/s-spine bend vw only 2-3 vw CPT 72120 | $573.32 | $716.65 | $9.92 – $210.70 | 13 |
| X-ray male genital tract CPT 74440 | $182.40 | $228.00 | $16.57 – $232.88 | 11 |
| X-ray mandible ltd <4 views CPT 70100 | $311.90 | $389.87 | $8.04 – $114.62 | 13 |
| X-ray measurement of pelvis CPT 74710 | not published | not published | $28.00 – $34.03 | 3 |
| X-ray nose to rectum for foreign body child CPT 76010 | $272.95 | $341.18 | $8.04 – $100.31 | 13 |
| X-ray of mammary ducts CPT 77054 | $939.28 | $1,174.10 | $19.58 – $345.19 | 13 |
| X-ray optic foramina CPT 70190 | $371.13 | $463.91 | $9.89 – $136.39 | 13 |
| Xray place dist ext thor ao CPT 75959 | $4,111.20 | $5,139.00 | $0.01 – $337.94 | 9 |
| Xray place prox ext thor ao CPT 75958 | $3,684.00 | $4,605.00 | $0.01 – $390.00 | 9 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | $740.79 | $925.98 | $22.73 – $344.08 | 13 |
| X-ray ribs 2 views left CPT 71100 | $413.84 | $517.29 | $9.92 – $152.08 | 13 |
| X-ray sella turcica CPT 70240 | $204.97 | $256.21 | $8.36 – $84.83 | 13 |
| X-ray sinus tract/fistula/abscess CPT 76080 | $595.33 | $744.16 | $22.78 – $528.26 | 13 |
| X-ray slg plne bdy sect without urogr CPT 76100 | $315.48 | $394.34 | $25.41 – $115.94 | 13 |
| X-ray small intestine follow-through study CPT 74248 | $959.90 | $1,199.87 | $30.62 – $352.76 | 11 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | $306.35 | $382.93 | $9.63 – $112.58 | 13 |
| X-ray surgical specimen CPT 76098 | $562.58 | $703.22 | $13.87 – $528.26 | 13 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | $359.25 | $449.06 | $11.51 – $132.02 | 13 |
| X-ray upper gi delay w/kub CPT 74241 | not published | not published | $63.00 – $63.00 | 2 |
| X-ray upper gi&small intest CPT 74245 | not published | not published | $83.00 – $83.00 | 2 |
| X-ray xm phrnx&/crv esoph c+ CPT 74210 | $400.13 | $500.16 | $25.73 – $171.51 | 13 |
| Xtrnl ecg rec>48hr<7d CPT 93241 | not published | not published | $207.48 – $604.55 | 9 |
| Xtrnl ecg rec up to 48 hrs CPT 93224 | $253.60 | $317.00 | $62.97 – $169.62 | 9 |
| Xwrap 1 sq cm HCPCS Q4204 | not published | not published | $2,850.00 – $2,935.50 | 3 |
| Xylose absorption test blood &/or urine CPT 84620 | $64.28 | $80.35 | $7.75 – $23.62 | 11 |
| Xyntha inj HCPCS J7185 | not published | not published | $1.42 – $1.68 | 9 |
| Yersinia antibody CPT 86793 | $33.60 | $42.00 | $7.91 – $20.52 | 9 |
| Yttrium y-90 ibritumomab ther HCPCS A9543 | not published | not published | $56,824.55 – $110,513.94 | 9 |
| Zenith amniotic membrane psc HCPCS Q4253 | not published | not published | $71.50 – $687.19 | 5 |
| Ziconotide injection HCPCS J2278 | not published | not published | $9.66 – $11.75 | 9 |
| Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr HCPCS J3485 | $15.98 | $19.97 | $1.34 – $2.08 | 8 |
| Zidovudine, oral, 100 mg HCPCS S0104 | not published | not published | $1.51 – $3.12 | 6 |
| Zika virus dna/rna amp probe CPT 87662 | $103.20 | $129.00 | $21.99 – $79.84 | 11 |
| Zika virus igm antibody CPT 86794 | $48.57 | $60.71 | $10.11 – $26.21 | 11 |
| Zinc paste band w >=3"<5"/yd HCPCS A6456 | $4.00 | $5.00 | $0.88 – $2.22 | 9 |
| Ziprasidone 20 mg/ml (final concentration) intramuscular solution HCPCS J3486 | $96.24 | $120.30 | $1.13 – $8.08 | 8 |
| Ziv-aflibercept 25 mg/ml intravenous solution (wrapper) HCPCS J9400 | not published | not published | $7.09 – $10.31 | 9 |
| Zolbetuximab-clzb 100 mg intravenous solution HCPCS J1326 | not published | not published | $34.23 – $35.23 | 6 |
| Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 | $126.00 | $157.50 | $5.73 – $18.15 | 8 |
| Zoster vaccine-live inj CPT 90736 | $204.80 | $256.00 | $221.79 – $319.46 | 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.