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 |
|---|---|---|---|---|
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $121.03 | $151.28 | $30.86 – $65.50 | 6 |
| Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm HCPCS Q4113 | not published | not published | $391.59 – $1,997.50 | 5 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $22,392.80 | $27,991.00 | $2,315.65 – $5,562.11 | 5 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $11,996.23 | $14,995.28 | $3,059.04 – $7,347.69 | 5 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | $76.00 | $95.00 | $44.16 – $65.41 | 6 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $104.00 | $130.00 | $102.78 – $134.90 | 5 |
| Graft repair of spine defect 63710 CPT 63710 | $2,615.20 | $3,269.00 | $956.26 – $2,543.05 | 9 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $277.60 | $347.00 | $136.37 – $331.72 | 6 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | $97.60 | $122.00 | $46.29 – $58.50 | 6 |
| Graft tis hmatrix dermis 10x5 -cost per sq cm HCPCS Q4134 | not published | not published | $149.58 – $162.08 | 2 |
| Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm HCPCS Q4130 | not published | not published | $49.54 – $49.54 | 1 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | $420.77 | $525.96 | $37.50 – $257.72 | 8 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $2,526.29 | $3,157.86 | $644.20 – $1,547.35 | 5 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $312.79 | $390.98 | $79.76 – $191.58 | 5 |
| Granisetron 1 mg tab HCPCS Q0166 | $4.28 | $5.35 | $1.09 – $3.30 | 8 |
| Granisetron hcl injection HCPCS J1626 | $8.76 | $10.95 | $0.26 – $2.80 | 8 |
| Granulocyte pheresis ea unit HCPCS P9050 | not published | not published | $135.60 – $373.51 | 4 |
| Great toe-hand transfer CPT 26551 | not published | not published | $2,041.31 – $7,797.92 | 9 |
| Great toe with reduction 28495 CPT 28495 | $883.20 | $1,104.00 | $71.63 – $301.60 | 13 |
| Grfg autol fat lipo 25 cc/< CPT 15773 | not published | not published | $453.22 – $1,762.37 | 11 |
| Grfg autol fat lipo 50 cc/< CPT 15771 | $1,417.60 | $1,772.00 | $461.50 – $3,527.16 | 11 |
| Grfg autol fat lipo ea addl CPT 15772 | $448.00 | $560.00 | $131.96 – $350.04 | 9 |
| Grfg autol soft tiss dir exc CPT 15769 | $1,188.80 | $1,486.00 | $431.39 – $3,527.16 | 11 |
| Ground mileage HCPCS A0425 | $19.94 | $24.92 | $6.53 – $14.00 | 8 |
| Group behave couns 2-10 HCPCS G0473 | $28.80 | $36.00 | $8.19 – $28.70 | 13 |
| Group health education CPT 99078 | $115.20 | $144.00 | $33.42 – $146.91 | 4 |
| Group mnt 2 or more 30 mins HCPCS G0271 | $37.60 | $47.00 | $14.14 – $37.21 | 9 |
| Group train without patient HCPCS G0543 | not published | not published | $9.95 – $16.00 | 8 |
| Growth hormone antibody CPT 86277 | $40.00 | $50.00 | $9.44 – $24.49 | 9 |
| Growth hormone panel CPT 80428 | $168.00 | $210.00 | $40.02 – $103.78 | 9 |
| Growth hormone panel CPT 80430 | $259.20 | $324.00 | $77.60 – $181.07 | 9 |
| Growth stimulation gene 2 CPT 83006 | $151.20 | $189.00 | $41.55 – $105.84 | 9 |
| Grp adapt bhv tx by phy/qhp CPT 97158 | not published | not published | $6.99 – $29.19 | 8 |
| Grp adapt bhv tx by tech CPT 97154 | not published | not published | $6.99 – $29.19 | 8 |
| Gstrct prtl dstl w/roux-en-y rcnstj 43633 CPT 43633 | $4,717.60 | $5,897.00 | $1,683.27 – $4,486.19 | 9 |
| Gstr rstcv oth/thn v-band CPT 43843 | $3,141.60 | $3,927.00 | $1,125.89 – $3,001.28 | 9 |
| Gstr rstcv px shrt roux-en-y CPT 43846 | $3,987.20 | $4,984.00 | $1,446.37 – $3,855.86 | 9 |
| Gstr rstcv px sm int rcnstj CPT 43847 | $4,424.00 | $5,530.00 | $1,581.59 – $4,217.00 | 9 |
| Gstr rstcv px v-banded gstp CPT 43842 | $2,956.00 | $3,695.00 | $2,160.63 – $3,694.51 | 6 |
| Gstrst open wo constj tube CPT 43830 | $1,722.40 | $2,153.00 | $620.34 – $1,827.66 | 11 |
| G-tube reposition CPT 43761 | $1,952.90 | $2,441.12 | $91.60 – $717.69 | 13 |
| Gu dilat ureter/urethra s&i CPT 74485 | $2,057.58 | $2,571.97 | $36.15 – $1,973.64 | 13 |
| Guided cath fluid drainage 10030 CPT 10030 | $1,507.20 | $1,884.00 | $121.30 – $677.87 | 13 |
| Guide endoanchr sg-64 aaa 62cm HCPCS L8670 | not published | not published | $333.32 – $848.21 | 9 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $282.34 | $352.92 | $72.00 – $172.93 | 5 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $172.71 | $215.88 | $44.04 – $105.78 | 5 |
| Guid loc target vol rad tx CPT 77387 | $1,018.54 | $1,273.17 | $51.28 – $623.85 | 8 |
| Gum graft CPT 41870 | not published | not published | $679.76 – $1,481.30 | 11 |
| Gw stiffened micro access kit HCPCS C1894 | $243.20 | $304.00 | $49.65 – $119.27 | 5 |
| Gynecomastia (males) 19300 CPT 19300 | $2,684.80 | $3,356.00 | $387.22 – $3,689.33 | 11 |
| Hair analysis HCPCS P2031 | $60.80 | $76.00 | $2.97 – $12.87 | 9 |
| Hair removal by electrolysis 17380 CPT 17380 | $184.80 | $231.00 | $83.60 – $599.89 | 9 |
| Hair trnspl 1-15 punch grfts CPT 15775 | $908.00 | $1,135.00 | $227.60 – $603.83 | 9 |
| Hair trnspl >15 punch grafts CPT 15776 | $1,244.80 | $1,556.00 | $311.20 – $826.88 | 9 |
| Hallus-valgus nt dyn pre ots HCPCS L3100 | not published | not published | $25.87 – $65.82 | 9 |
| Halo cervical into body jack HCPCS L0820 | not published | not published | $1,236.82 – $3,147.34 | 9 |
| Halo cervical into jckt vest HCPCS L0810 | not published | not published | $1,546.78 – $3,936.11 | 9 |
| Halo cerv into milwaukee typ HCPCS L0830 | not published | not published | $1,821.07 – $4,634.11 | 9 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | $77.20 | $96.50 | $4.61 – $13.72 | 8 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $79.60 | $99.50 | $0.05 – $1.16 | 8 |
| Halo repl liner/interface HCPCS L0861 | not published | not published | $128.91 – $328.03 | 9 |
| Hand-held pefr meter a4614 HCPCS A4614 | $67.20 | $84.00 | $16.58 – $42.19 | 9 |
| Handle/convey/speciman/office-lab 99000 CPT 99000 | $18.57 | $23.21 | $2.90 – $11.37 | 8 |
| Hand orthosis metacarpal fracture orthosis prefa l3918 HCPCS L3918 | not published | not published | $57.48 – $146.28 | 9 |
| Hand restoration multiple fi HCPCS L6905 | not published | not published | $939.43 – $2,390.57 | 9 |
| Hand restoration no fingers HCPCS L6910 | not published | not published | $1,141.96 – $2,905.96 | 9 |
| Hand restoration replacmnt g HCPCS L6915 | not published | not published | $495.88 – $1,261.86 | 9 |
| Hand restorat thumb/1 finger HCPCS L6900 | not published | not published | $1,182.96 – $3,010.29 | 9 |
| Hands-On Manual Therapy (each 15 minutes) CPT 97140 | $164.20 | $205.24 | $25.87 – $60.34 | 11 |
| Hand tendon/muscle transfer CPT 26494 | $1,992.80 | $2,491.00 | $752.67 – $3,126.02 | 11 |
| Hand tendon reconstruction CPT 26500 | $1,561.60 | $1,952.00 | $614.42 – $6,882.64 | 11 |
| Hand tendon reconstruction CPT 26502 | $1,776.80 | $2,221.00 | $674.44 – $3,126.02 | 11 |
| Hand X-ray CPT 73130 | $389.88 | $487.34 | $7.71 – $143.28 | 13 |
| Hand X-ray (2 views, both hands) CPT 73120 | $320.27 | $400.33 | $7.39 – $117.70 | 13 |
| Haptoglobin quantitative CPT 83010 | $64.28 | $80.35 | $7.55 – $23.62 | 11 |
| Harness chest/shlder saddle HCPCS L6672 | not published | not published | $101.04 – $257.13 | 9 |
| Harness figure of 8 dual con HCPCS L6676 | not published | not published | $77.93 – $198.32 | 9 |
| Harness figure of 8 sing con HCPCS L6675 | not published | not published | $71.91 – $182.99 | 9 |
| Harvest allogeneic stem cell CPT 38205 | $217.60 | $272.00 | $75.99 – $204.63 | 9 |
| Harvest auto stem cells CPT 38206 | $216.80 | $271.00 | $74.81 – $1,579.37 | 11 |
| Harvest cultured skin graft 15040 CPT 15040 | $636.80 | $796.00 | $112.25 – $1,762.37 | 11 |
| Harvest eye tissue alograft CPT 68371 | $2,044.80 | $2,556.00 | $370.34 – $2,247.69 | 11 |
| Harvest femoropopliteal vein 35572 CPT 35572 | $844.00 | $1,055.00 | $291.04 – $778.36 | 9 |
| Harvest stem cell concentrte CPT 38215 | not published | not published | $88.76 – $428.44 | 9 |
| Harvest vein for bypass 35500 CPT 35500 | $780.00 | $975.00 | $269.32 – $721.28 | 9 |
| Hast w/i&r phys/qhp CPT 94452 | $456.28 | $570.35 | $13.13 – $167.68 | 11 |
| Hast w/oxygen titrate CPT 94453 | $456.28 | $570.35 | $16.78 – $167.68 | 11 |
| Hba1/hba2 full gene sequence CPT 81259 | $1,200.00 | $1,500.00 | $188.64 – $840.06 | 11 |
| Hba1/hba2 gene dup/del vrnts CPT 81269 | $404.80 | $506.00 | $63.63 – $283.38 | 11 |
| Hba1/hba2 gene fam vrnt CPT 81258 | $751.20 | $939.00 | $225.15 – $525.38 | 9 |
| Hbb full gene sequence CPT 81364 | $649.60 | $812.00 | $102.05 – $454.45 | 11 |
| Hbb gene com variants CPT 81361 | $350.40 | $438.00 | $54.96 – $244.74 | 11 |
| Hbb gene dup/del variants CPT 81363 | $404.80 | $506.00 | $63.63 – $283.38 | 11 |
| Hbb gene known fam variant CPT 81362 | $751.20 | $939.00 | $117.98 – $525.38 | 11 |
| Hb glycosylated a1c home dev CPT 83037 | $33.57 | $41.96 | $9.71 – $15.10 | 11 |
| Hbot, full body chamber, 30m HCPCS G0277 | $484.21 | $605.26 | $85.88 – $262.08 | 13 |
| Hc ea ha check monaural CPT 92594 | $45.60 | $57.00 | $17.40 – $53.61 | 6 |
| Hc fl sm bowel enteroclss tube w kub double contrast CPT 74251 | $913.60 | $1,142.00 | $50.99 – $234.33 | 13 |
| Hcg free betachain test CPT 84704 | $64.28 | $80.35 | $15.29 – $23.62 | 11 |
| Hcg qualitative CPT 84703 | $33.57 | $41.96 | $4.51 – $12.34 | 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.