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 |
|---|---|---|---|---|
| Monthly tx for dmht 20mins HCPCS G0553 | not published | not published | $28.03 – $166.57 | 8 |
| Mopath procedure level 1 CPT 81400 | $128.00 | $160.00 | $38.38 – $89.54 | 11 |
| Mopath procedure level 3 CPT 81402 | $300.80 | $376.00 | $50.29 – $210.48 | 11 |
| Mopath procedure level 5 CPT 81404 | $550.40 | $688.00 | $86.41 – $384.78 | 11 |
| Mopath procedure level 6 CPT 81405 | $603.20 | $754.00 | $94.74 – $421.92 | 11 |
| Mopath procedure level 7 CPT 81406 | $566.40 | $708.00 | $88.94 – $396.06 | 11 |
| Mopath procedure level 8 CPT 81407 | $1,692.80 | $2,116.00 | $266.07 – $1,184.85 | 11 |
| Mopath procedure level 9 CPT 81408 | $4,000.00 | $5,000.00 | $628.80 – $2,800.18 | 11 |
| Morphine 4 mg/ml injection (wrapper) HCPCS J2270 | $76.91 | $96.13 | $0.56 – $4.63 | 8 |
| Morphine 4 mg/ml injection (wrapper)|discarded drug not administered HCPCS J2272 | $76.92 | $96.15 | $0.12 – $6.64 | 8 |
| Morphine 500 mg HCPCS S0093 | not published | not published | $8.01 – $412.72 | 6 |
| Morphine (pf) 0.25 mg/0.5 ml injection (neo/ped) - cnr HCPCS J2274 | $88.53 | $110.66 | $3.93 – $10.48 | 8 |
| Morphometric analysis in situ hybridization computer-assisted per specimen each multiplex stain CPT 88374 | $491.20 | $614.00 | $38.20 – $165.10 | 13 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain computer-assisted CPT 88361 | $328.79 | $410.98 | $39.44 – $346.57 | 13 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain manual CPT 88360 | $311.20 | $389.00 | $37.68 – $165.10 | 13 |
| Mosunetuzumab-axgb 1 mg/ml intravenous solution HCPCS J9350 | not published | not published | $637.19 – $818.53 | 9 |
| Motion analysis video/3d CPT 96000 | $209.60 | $262.00 | $77.42 – $511.21 | 11 |
| Motion test w/ft press meas CPT 96001 | $248.00 | $310.00 | $97.46 – $980.21 | 11 |
| Motor &/ sens nrve cndj test CPT 95905 | $124.80 | $156.00 | $2.36 – $384.46 | 11 |
| Mouth piece HCPCS A4617 | $8.80 | $11.00 | $2.16 – $5.50 | 9 |
| Mouth vestibule bx/w complex rpr 40814 CPT 40814 | $941.60 | $1,177.00 | $259.02 – $3,124.54 | 11 |
| M/phmtrc alys ishquant/semiq CPT 88373 | $292.13 | $365.16 | $23.19 – $107.36 | 11 |
| M/phmtrc alys ishquant/semiq CPT 88377 | $694.40 | $868.00 | $59.02 – $165.10 | 13 |
| M/phmtrc alysishquant/semiq CPT 88369 | $292.13 | $365.16 | $31.06 – $107.36 | 11 |
| M/phmtrc alys skeletal musc CPT 88355 | $380.80 | $476.00 | $48.93 – $165.10 | 11 |
| Mpl gene analysis common variants CPT 81338 | $300.80 | $376.00 | $50.29 – $185.01 | 11 |
| M.pneumon dna dir probe CPT 87580 | $50.40 | $63.00 | $12.03 – $31.19 | 9 |
| M.pneumon dna quant CPT 87582 | $605.60 | $757.00 | $80.40 – $423.70 | 9 |
| Mpsv4 vaccine subq CPT 90733 | $148.80 | $186.00 | $166.84 – $237.56 | 4 |
| MRA abdomen post contrast CPT 74185 | $945.60 | $1,182.00 | $78.01 – $187.60 | 9 |
| MRA aorta thoracic w/wo contrast CPT 71555 | $945.60 | $1,182.00 | $78.34 – $187.60 | 9 |
| MRA chest w IV cont HCPCS C8909 | $3,007.65 | $3,759.56 | $339.99 – $1,627.89 | 12 |
| MRA chest wo IV cont HCPCS C8910 | $2,784.88 | $3,481.09 | $230.12 – $1,507.31 | 12 |
| MRA chest wwo IV cont HCPCS C8911 | $3,007.65 | $3,759.56 | $339.99 – $1,627.89 | 12 |
| MRA ext low(run-off)pst cntrst CPT 73725 | $945.60 | $1,182.00 | $78.66 – $189.10 | 9 |
| MRA pelvis CPT 72198 | $945.60 | $1,182.00 | $78.31 – $188.30 | 9 |
| MRA pelvis w IV cont HCPCS C8918 | $2,443.29 | $3,054.11 | $339.99 – $1,322.43 | 12 |
| MRA pelvis wo IV cont HCPCS C8919 | $733.60 | $917.00 | $230.12 – $312.45 | 9 |
| MRA spinal canal CPT 72159 | $996.00 | $1,245.00 | $78.60 – $188.30 | 9 |
| MRA upper extremity post contrast-bil CPT 73225 | $968.00 | $1,210.00 | $73.98 – $177.20 | 9 |
| MRA w/cont, abd HCPCS C8900 | $2,378.29 | $2,972.86 | $339.99 – $1,287.25 | 12 |
| MRA w/cont, lwr ext HCPCS C8912 | $3,013.66 | $3,767.07 | $339.99 – $1,631.14 | 12 |
| Mra, w/dye, spinal canal HCPCS C8931 | $2,772.69 | $3,465.86 | $339.99 – $1,500.72 | 12 |
| Mra, w/dye, upper extremity HCPCS C8934 | $3,180.04 | $3,975.05 | $339.99 – $1,721.20 | 12 |
| MRA without cont, abd HCPCS C8901 | $2,378.29 | $2,972.86 | $230.12 – $1,287.25 | 12 |
| MRA without cont, lwr ext HCPCS C8913 | $2,679.84 | $3,349.80 | $230.12 – $1,450.46 | 12 |
| Mra, without dye, spinal canal HCPCS C8932 | $2,772.69 | $3,465.86 | $230.12 – $1,500.72 | 12 |
| Mra, without dye, upper extr HCPCS C8935 | $3,180.04 | $3,975.05 | $230.12 – $1,721.20 | 12 |
| MRA without fol w/cont, abd HCPCS C8902 | $2,378.29 | $2,972.86 | $339.99 – $1,287.25 | 12 |
| MRA without fol w/cont, lwr ext HCPCS C8914 | $5,059.20 | $6,323.99 | $339.99 – $2,738.29 | 12 |
| MRA without fol w/cont, pelvis HCPCS C8920 | $733.60 | $917.00 | $339.99 – $461.63 | 9 |
| Mra, w/o&w/dye, spinal canal HCPCS C8933 | not published | not published | $339.99 – $461.63 | 9 |
| Mra, w/o&w/dye, upper extr HCPCS C8936 | $3,180.04 | $3,975.05 | $339.99 – $1,721.20 | 12 |
| Mr elastography CPT 76391 | $488.80 | $611.00 | $48.13 – $232.88 | 11 |
| Mrgfus strtctc ablt trgt icr CPT 61715 | $2,038.40 | $2,548.00 | $1,019.16 – $16,119.15 | 8 |
| MRI brain w/dye CPT 70558 | $3,514.40 | $4,393.00 | $153.86 – $326.15 | 11 |
| MRI brain without dye CPT 70557 | $3,324.00 | $4,155.00 | $139.14 – $528.26 | 11 |
| MRI brain without & w/dye CPT 70559 | $3,313.60 | $4,142.00 | $144.27 – $303.56 | 11 |
| MRI breast c- unilateral CPT 77046 | $636.00 | $795.00 | $63.15 – $232.88 | 11 |
| MRI breast c-+ w/cad uni CPT 77048 | $710.40 | $888.00 | $92.15 – $221.80 | 9 |
| MRI breast without cont bi CPT 77047 | $779.20 | $974.00 | $69.92 – $232.88 | 11 |
| MRI breast w IV cont bi CPT 77049 | $847.20 | $1,059.00 | $100.83 – $242.70 | 9 |
| MRI cardiac morph & func wo IV cont CPT 75557 | $2,606.08 | $3,257.59 | $102.00 – $957.73 | 13 |
| MRI cardiac morph & func wwo IV cont CPT 75561 | $3,055.57 | $3,819.46 | $113.04 – $1,122.92 | 13 |
| MRI cardiac morph & func wwo IV cont w/stress img CPT 75563 | $1,209.60 | $1,512.00 | $129.53 – $761.18 | 11 |
| MRI chest without contrast CPT 71550 | $2,227.89 | $2,784.86 | $63.91 – $818.75 | 13 |
| MRI chest without & w/contrast CPT 71552 | $4,378.92 | $5,473.64 | $98.95 – $1,609.25 | 13 |
| MRI chest w IV cont CPT 71551 | $2,784.88 | $3,481.09 | $75.45 – $1,023.44 | 13 |
| MRI compatible system HCPCS L0859 | not published | not published | $684.70 – $1,742.36 | 9 |
| MRI fetal ea addl gestation CPT 74713 | $3,856.15 | $4,820.18 | $81.40 – $1,417.13 | 11 |
| MRI fetal sngl/1st gestation CPT 74712 | $3,856.15 | $4,820.18 | $131.89 – $1,417.13 | 13 |
| MRI guid ndl plc s&i CPT 77021 | $2,581.53 | $3,226.91 | $65.50 – $948.71 | 11 |
| MRI guid parenchymal tiss ablation CPT 77022 | $2,527.20 | $3,159.00 | $183.22 – $440.70 | 9 |
| MRI hyperpolarized xenon129 HCPCS C9791 | not published | not published | $1,190.48 – $1,616.39 | 7 |
| MRI loex nonjt w IV cont CPT 73719 | $3,550.74 | $4,438.42 | $70.86 – $1,304.90 | 13 |
| MRI lower extremity other than joint without contrast (both sides) CPT 73718 | $3,012.32 | $3,765.40 | $59.03 – $1,107.03 | 13 |
| MRI lower extremity other than joint without & w/contrast (both sides) CPT 73720 | $4,257.51 | $5,321.88 | $94.35 – $1,564.63 | 13 |
| MRI orbit fac&nck w IV cont CPT 70542 | $4,121.61 | $5,152.01 | $70.86 – $1,514.69 | 13 |
| MRI tmj CPT 70336 | $3,007.68 | $3,759.60 | $64.26 – $1,105.32 | 13 |
| MRI upper extremity other than joint without contrast (both sides) CPT 73218 | $2,547.16 | $3,183.95 | $59.32 – $936.08 | 13 |
| MRI upper extremity other than joint without & w/contrast (both sides) CPT 73220 | $3,798.68 | $4,748.34 | $94.35 – $1,396.01 | 13 |
| MRI upper extremity w/dye CPT 73219 | $945.60 | $1,182.00 | $70.86 – $344.08 | 11 |
| MRI w/cont, breast, bi HCPCS C8906 | $625.60 | $782.00 | $339.99 – $461.63 | 7 |
| MRI w/cont, breast, uni HCPCS C8903 | $508.00 | $635.00 | $169.48 – $230.11 | 7 |
| MRI without fol w/cont, breast HCPCS C8908 | $625.60 | $782.00 | $339.99 – $461.63 | 7 |
| MRI without fol w/cont, brst, un HCPCS C8905 | $508.00 | $635.00 | $339.99 – $461.63 | 7 |
| Mr safety determination physician/other qhp CPT 76016 | $132.80 | $166.00 | $26.05 – $113.81 | 8 |
| Mr safety implant elec prepj CPT 76018 | $207.20 | $259.00 | $32.68 – $118.65 | 8 |
| Mr safety implant&/fb assmt clin staff ea add 30 CPT 76015 | $92.80 | $116.00 | $46.22 – $90.80 | 7 |
| Mr safety implt pos&/immoblj CPT 76019 | $268.00 | $335.00 | $25.46 – $76.77 | 8 |
| Mr sfty implt&/fb asmt stf 1 CPT 76014 | $19.20 | $24.00 | $9.60 – $31.66 | 8 |
| Mr sfty med physics xm cstmz CPT 76017 | $402.40 | $503.00 | $33.15 – $312.45 | 8 |
| Mr spectroscopy CPT 76390 | $2,450.28 | $3,062.84 | $83.82 – $900.47 | 13 |
| Msh2 gene dup/delete variant CPT 81297 | $427.20 | $534.00 | $67.06 – $298.65 | 11 |
| Msh2 gene full seq CPT 81295 | $764.00 | $955.00 | $120.01 – $534.42 | 11 |
| Msh2 gene known variants CPT 81296 | $676.00 | $845.00 | $182.28 – $472.86 | 9 |
| Msh6 gene dup/delete variant CPT 81300 | $476.00 | $595.00 | $74.83 – $333.23 | 11 |
| Msh6 gene full seq CPT 81298 | $1,284.00 | $1,605.00 | $201.80 – $898.64 | 11 |
| Msh6 gene known variants CPT 81299 | $616.00 | $770.00 | $96.84 – $431.24 | 11 |
| Mt bone graft microvasc CPT 20957 | not published | not published | $2,440.26 – $6,496.69 | 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.