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 |
|---|---|---|---|---|
| Perphenazine 4mg oral HCPCS Q0175 | $2.24 | $2.80 | $0.47 – $1.29 | 8 |
| Perphenazine injeciton HCPCS J3310 | not published | not published | $7.51 – $9.24 | 3 |
| Perq art m-thrombect &/nfs CPT 61645 | $4,081.60 | $5,102.00 | $729.79 – $1,941.50 | 9 |
| Perq clsr tcat l atr apndge CPT 33340 | $17,538.28 | $21,922.84 | $668.49 – $6,445.31 | 11 |
| Perq dev breast 1st mr guide CPT 19287 | $3,793.60 | $4,742.00 | $113.20 – $677.87 | 11 |
| Perq dev breast 1st strtctc CPT 19283 | $3,302.14 | $4,127.67 | $89.21 – $1,213.53 | 13 |
| Perq nl/pl lithotrp cplx>2cm CPT 50081 | $6,456.00 | $8,070.00 | $1,014.70 – $8,909.18 | 11 |
| Perq nl/pl lithotrp smpl<2cm CPT 50080 | $4,390.40 | $5,488.00 | $630.76 – $8,909.18 | 11 |
| Perq p-art revsc 1 abnor bi CPT 33903 | $22,672.44 | $28,340.55 | $757.34 – $10,926.09 | 13 |
| Perq p-art revsc 1 abnor uni CPT 33902 | $36,688.36 | $45,860.44 | $642.50 – $17,300.43 | 13 |
| Perq p-art revsc 1 nm nt bi CPT 33901 | $22,672.44 | $28,340.55 | $665.62 – $10,926.09 | 13 |
| Perq p-art revsc 1 nm nt uni CPT 33900 | $22,672.44 | $28,340.55 | $506.40 – $10,926.09 | 13 |
| Perq p-art revsc each addl CPT 33904 | $22,672.44 | $28,340.55 | $253.76 – $8,332.12 | 11 |
| Perq plmt bile duct stent CPT 47538 | $10,412.00 | $13,015.00 | $208.88 – $5,621.13 | 13 |
| Perq plmt bile duct stent CPT 47539 | $11,495.20 | $14,369.00 | $376.37 – $5,621.13 | 11 |
| Perq plmt bile duct stent CPT 47540 | $11,729.60 | $14,662.00 | $389.71 – $5,621.13 | 11 |
| Perq rplcmt g-tube req revsn gstrst trk CPT 43763 | $922.04 | $1,152.55 | $77.51 – $338.85 | 13 |
| Perq skel fix rad/uln dislc CPT 25671 | $2,609.60 | $3,262.00 | $489.68 – $3,126.02 | 11 |
| Perq skel fix ulnar styld fx CPT 25651 | $3,977.88 | $4,972.34 | $449.49 – $3,126.02 | 13 |
| Perqt bx lung/mediastinum 32405 CPT 32405 | not published | not published | $161.00 – $161.00 | 2 |
| Perq transcath closure each CPT 93592 | $893.60 | $1,117.00 | $348.26 – $913.51 | 9 |
| Perq transcath closure pda CPT 93582 | not published | not published | $565.09 – $17,300.43 | 11 |
| Perq transcath cls aortic CPT 93591 | $2,031.20 | $2,539.00 | $795.70 – $17,300.43 | 11 |
| Perq transcath cls mitral CPT 93590 | $34,351.85 | $42,939.81 | $961.09 – $17,300.43 | 13 |
| Perq transcath septal reduxn CPT 93583 | $1,604.00 | $2,005.00 | $633.97 – $1,664.31 | 9 |
| Perq trluml angp nt/recr coa CPT 33897 | not published | not published | $496.19 – $1,328.29 | 9 |
| Perq tx big toe fracture w/manip 28496 CPT 28496 | $2,222.40 | $2,778.00 | $251.66 – $3,126.02 | 11 |
| Perq tx malar fracture CPT 21355 | $2,113.60 | $2,642.00 | $298.26 – $3,124.54 | 11 |
| Perq tx mndblr fx xtrnl fixj CPT 21452 | $1,726.40 | $2,158.00 | $403.08 – $5,699.45 | 11 |
| Perq tx nasoethmoid fx CPT 21340 | $1,848.00 | $2,310.00 | $682.22 – $3,124.54 | 11 |
| Pertussis ag if CPT 87265 | $38.58 | $48.22 | $7.19 – $18.65 | 11 |
| Pertuzumab 30 mg/ml desensitization HCPCS J9306 | $23.96 | $29.94 | $6.11 – $17.76 | 11 |
| Pertuzu, trastuzu, 10 mg HCPCS J9316 | not published | not published | $62.99 – $87.17 | 9 |
| Pessary 3.5 in 7 vag sil rng fold HCPCS A4562 | $141.60 | $177.00 | $35.30 – $89.83 | 9 |
| Pessary reusable rub anytype HCPCS A4561 | $57.60 | $72.00 | $14.19 – $36.11 | 9 |
| Pet CT skull-mid thgh initial CPT 78815 | $6,511.55 | $8,139.43 | $104.62 – $2,392.99 | 13 |
| Pet CT whole body initial CPT 78816 | $6,700.40 | $8,375.50 | $105.68 – $2,462.40 | 13 |
| Pet fdg brain metoblic eval sb CPT 78608 | $4,664.44 | $5,830.54 | $63.73 – $1,714.18 | 13 |
| Pet image full body CPT 78813 | $2,796.00 | $3,495.00 | $84.19 – $1,405.28 | 11 |
| Pet image ltd area CPT 78811 | $2,519.20 | $3,149.00 | $65.76 – $1,257.77 | 11 |
| Pet image skull-thigh CPT 78812 | $2,776.00 | $3,470.00 | $82.51 – $1,405.28 | 11 |
| Pet image w/ct lmtd CPT 78814 | $5,620.98 | $7,026.22 | $93.61 – $2,065.71 | 13 |
| Pet not otherwise specified HCPCS G0235 | not published | not published | $382.54 – $519.41 | 7 |
| Pet scan brain perf study CPT 78609 | not published | not published | $0.01 – $171.56 | 6 |
| Pfc sigma fem post aug sz3 8mm HCPCS C1776 | $5,066.54 | $6,333.17 | $1,291.97 – $3,103.25 | 5 |
| Ph1 assmt&mgmt nqhp 11-20 CPT 98967 | $60.80 | $76.00 | $21.19 – $54.24 | 9 |
| Ph1 assmt&mgmt nqhp 21-30 CPT 98968 | $89.60 | $112.00 | $29.87 – $76.28 | 9 |
| Ph1 assmt&mgmt nqhp 5-10 CPT 98966 | $31.20 | $39.00 | $10.89 – $27.90 | 9 |
| Phalangectomy ea toe 28150 CPT 28150 | $1,053.60 | $1,317.00 | $258.06 – $3,126.02 | 11 |
| Pharmacologic management w/psytx CPT 90863 | $79.50 | $99.37 | $20.27 – $63.47 | 8 |
| Ph body fluid CPT 83986 | $33.57 | $41.96 | $3.58 – $12.34 | 11 |
| Phencyclidine (pcp) CPT 83992 | $43.20 | $54.00 | $8.20 – $23.57 | 8 |
| Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr HCPCS J2560 | $112.16 | $140.20 | $2.72 – $32.77 | 8 |
| Phenobarbital therapeutic drug level CPT 80184 | $66.43 | $83.03 | $9.18 – $24.41 | 11 |
| Phentolaine mesylate inj HCPCS J2760 | $853.96 | $1,067.45 | $52.86 – $458.33 | 11 |
| Phenylephrine 10 mg/ml injection solution HCPCS J2371 | $14.13 | $17.66 | $0.01 – $0.02 | 6 |
| Phenylep ketorolac opth soln HCPCS J1097 | not published | not published | $92.74 – $119.55 | 8 |
| Phenytoin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1165 | $0.80 | $1.00 | $0.50 – $0.90 | 6 |
| Phenytoin total therapeutic drug level CPT 80185 | $66.43 | $83.03 | $7.95 – $24.41 | 11 |
| Phlebotomy therapeutic CPT 99195 | $212.00 | $265.00 | $41.80 – $166.62 | 13 |
| Phleb veins 1 extrm 10-20 stab CPT 37765 | $2,361.60 | $2,952.00 | $232.80 – $3,032.46 | 11 |
| Phleb veins 1 extrm >20 stab CPT 37766 | $2,803.20 | $3,504.00 | $286.69 – $3,032.46 | 11 |
| Phone e/m phys/qhp 11-20 min CPT 99442 | not published | not published | $40.92 – $127.39 | 5 |
| Phone e/m phys/qhp 21-30 min CPT 99443 | not published | not published | $61.53 – $188.54 | 5 |
| Phone e/m phys/qhp 5-10 min CPT 99441 | not published | not published | $20.60 – $67.91 | 5 |
| Phosphorus CPT 84100 | $33.57 | $41.96 | $2.84 – $12.34 | 11 |
| Phosphorus 24 hour urine CPT 84105 | $33.57 | $41.96 | $3.47 – $12.34 | 11 |
| Photchmtx tar&uvb/ptrltm&uvb CPT 96910 | $245.60 | $307.00 | $56.55 – $275.94 | 11 |
| Photochemotherapy puva CPT 96912 | $210.40 | $263.00 | $56.55 – $234.73 | 11 |
| Photochemotherapy uv-a or b CPT 96913 | $304.80 | $381.00 | $133.04 – $384.93 | 11 |
| Photodynamic tx addl 15 min CPT 96571 | $59.20 | $74.00 | $22.81 – $60.03 | 9 |
| Photodynmc tx 30 min add-on CPT 96570 | $124.00 | $155.00 | $48.28 – $120.46 | 9 |
| Photo patch test CPT 95052 | $18.40 | $23.00 | $4.87 – $57.22 | 11 |
| Photopheresis CPT 36522 | $4,664.80 | $5,831.00 | $87.17 – $4,513.93 | 11 |
| Photosensitivity tests CPT 95056 | $137.60 | $172.00 | $46.66 – $124.19 | 11 |
| Phys blood bank serv authrj CPT 86079 | $97.60 | $122.00 | $29.85 – $69.06 | 11 |
| Phys blood bank serv reactj CPT 86078 | $97.60 | $122.00 | $30.04 – $93.39 | 9 |
| Phys blood bank serv xmatch CPT 86077 | $97.60 | $122.00 | $23.31 – $63.70 | 9 |
| Physical Therapy Evaluation (high complexity) CPT 97163 | $375.32 | $469.15 | $82.70 – $154.74 | 11 |
| Physical Therapy Evaluation (low complexity) CPT 97161 | $330.28 | $412.84 | $82.70 – $154.74 | 11 |
| Physical Therapy Evaluation (moderate complexity) CPT 97162 | $350.30 | $437.87 | $82.70 – $154.74 | 11 |
| Physical Therapy Re-Evaluation CPT 97164 | $251.01 | $313.76 | $56.66 – $106.87 | 11 |
| Physician standby services CPT 99360 | $145.60 | $182.00 | $81.90 – $138.72 | 6 |
| Phys review of motion tests CPT 96004 | $252.80 | $316.00 | $97.28 – $257.58 | 9 |
| Phytonadione (vitamin k1) 10 mg/ml injection solution HCPCS J3430 | $109.60 | $137.00 | $0.36 – $2.85 | 8 |
| Pierce earlobes 69090 CPT 69090 | $75.20 | $94.00 | $59.90 – $93.26 | 6 |
| Piflu f-18, dia 1 millicurie HCPCS A9595 | $1,194.20 | $1,492.74 | $304.52 – $646.36 | 11 |
| Pik3ca gene trgt seq alys CPT 81309 | $263.84 | $329.80 | $86.41 – $288.57 | 11 |
| Pild/placebo control clin tr HCPCS G0276 | $840.80 | $1,051.00 | $332.35 – $875.11 | 9 |
| Pillow shldr abduc inflat univ HCPCS L3960 | not published | not published | $443.02 – $1,127.37 | 9 |
| Pinch graft 1/mlt c> sm ulcer tip/oth area 2cm 15050 CPT 15050 | $1,435.20 | $1,794.00 | $413.20 – $1,093.79 | 11 |
| Pin finger dislocation CPT 26776 | $1,097.60 | $1,372.00 | $413.48 – $3,126.02 | 11 |
| Pin finger fracture each CPT 26756 | $5,840.48 | $7,300.60 | $389.74 – $3,126.02 | 13 |
| Pin hand dislocation CPT 26676 | $1,243.20 | $1,554.00 | $468.31 – $3,126.02 | 11 |
| Pin knuckle dislocation CPT 26706 | $1,086.40 | $1,358.00 | $413.50 – $3,126.02 | 11 |
| Pin service 60m per month HCPCS G0023 | $151.20 | $189.00 | $45.34 – $120.51 | 9 |
| Pinworm exam CPT 87172 | $38.58 | $48.22 | $4.27 – $14.18 | 11 |
| Pinworm examinations HCPCS Q0113 | $8.80 | $11.00 | $4.27 – $11.10 | 9 |
| Piperacillin-tazobactam 3.375 gram intravenous solution HCPCS J2543 | $44.38 | $55.47 | $0.01 – $1.18 | 8 |
| Pituitary evaluation panel CPT 80418 | $1,453.60 | $1,817.00 | $347.69 – $901.43 | 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.