MercyOne Genesis DeWitt Medical Center
1118 11th Street, DeWitt, IA · MercyOne · · NPI 1407938269
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 |
|---|---|---|---|---|
| 11-desoxycortisol - sendout CPT 82634 | $58.80 | $98.00 | $33.32 – $71.54 | 3 |
| 17-ketosteroids CPT 83586 | $81.00 | $135.00 | $45.90 – $98.55 | 3 |
| 1st hosp/birthing center care per day nml nb 99460 CPT 99460 | $194.40 | $324.00 | $236.52 – $2,679.00 | 3 |
| 1st inpatient critical care pr day age 28 days/less than 99468 CPT 99468 | $1,854.60 | $3,091.00 | $928.00 – $2,679.00 | 3 |
| 24 hr ambulatory b/p monitor CPT 93786 | $285.00 | $475.00 | $93.50 – $200.75 | 3 |
| 2nd order venous cath CPT 36012 | $1,720.80 | $2,868.00 | $928.00 – $2,679.00 | 3 |
| 3d recon without postprocess indpndt CPT 76376 | $264.00 | $440.00 | $149.60 – $321.20 | 3 |
| 5' nucleotidase - sendout CPT 83915 | $37.80 | $63.00 | $21.42 – $45.99 | 3 |
| 88334 ap bill cytologic exam each additional site CPT 88334 | $78.00 | $130.00 | $44.20 – $94.90 | 3 |
| 99381 initial comp preventive med less than 1 year new CPT 99381 | $151.20 | $252.00 | $183.96 – $2,679.00 | 3 |
| 99382 initial comp preventive med 1 to 4 years new CPT 99382 | $164.40 | $274.00 | $200.02 – $2,679.00 | 3 |
| 99383 initial comp preventive med 5 to 11 years new CPT 99383 | $162.00 | $270.00 | $197.10 – $2,679.00 | 3 |
| 99391 periodic comp preventive med less than 1 year est CPT 99391 | $113.40 | $189.00 | $137.97 – $2,679.00 | 3 |
| 99392 periodic comp preventive med 1 to 4 years est CPT 99392 | $130.20 | $217.00 | $158.41 – $2,679.00 | 3 |
| 99393 periodic comp preventive med 5 to 11 years est CPT 99393 | $129.00 | $215.00 | $156.95 – $2,679.00 | 3 |
| 99394 periodic comp preventive med 12 to 17 years est CPT 99394 | $145.80 | $243.00 | $177.39 – $2,679.00 | 3 |
| 99397 periodic comp preventive med 65+ years est CPT 99397 | $184.20 | $307.00 | $108.04 – $2,679.00 | 3 |
| Aa graft w/bp/aortic root replace 33863 CPT 33863 | $6,141.00 | $10,235.00 | $928.00 – $7,471.55 | 3 |
| Abatacept (with maltose) 250 mg intravenous solution HCPCS J0129 | $2,774.97 | $4,624.95 | $1,196.67 – $2,569.33 | 3 |
| #a/b/c/c/h pnl-candida albicans ab CPT 86628 | $43.80 | $73.00 | $19.04 – $40.88 | 3 |
| Abciximab injection HCPCS J0130 | $2,400.32 | $4,000.54 | $1,105.59 – $2,373.77 | 3 |
| Abd aorta w/runoff s&i CPT 75630 | $188.40 | $314.00 | $229.22 – $2,679.00 | 3 |
| Abd exp/postop hem/throm/infec 35840 CPT 35840 | $2,227.20 | $3,712.00 | $928.00 – $2,709.76 | 3 |
| Abd/low ext cath 1st CPT 36245 | $2,121.00 | $3,535.00 | $928.00 – $2,679.00 | 3 |
| Abd/low ext cath 2nd CPT 36246 | $1,953.00 | $3,255.00 | $928.00 – $2,679.00 | 3 |
| Abd/low ext cath 3rd CPT 36247 | $416.40 | $694.00 | $506.62 – $2,679.00 | 3 |
| Abd/low ext cath addl CPT 36248 | $550.80 | $918.00 | $670.14 – $2,679.00 | 3 |
| Abdominal and Pelvic Blood Vessel Ultrasound (complete) CPT 93975 | $701.40 | $1,169.00 | $273.70 – $587.65 | 3 |
| Abdominal and Pelvic Blood Vessel Ultrasound (limited) CPT 93976 | $411.60 | $686.00 | $70.08 – $233.24 | 3 |
| Abdominal CT scan (with and without contrast) CPT 74170 | $1,659.60 | $2,766.00 | $610.64 – $1,311.08 | 3 |
| Abdominal CT scan (with contrast) CPT 74160 | $1,473.60 | $2,456.00 | $835.04 – $1,792.88 | 3 |
| Abdominal CT scan (without contrast) CPT 74150 | $1,077.60 | $1,796.00 | $610.64 – $1,311.08 | 3 |
| Abdominal MRI (with and without contrast) CPT 74183 | $3,073.80 | $5,123.00 | $1,741.82 – $3,739.79 | 3 |
| Abdominal MRI (with contrast) CPT 74182 | $1,061.40 | $1,769.00 | $601.46 – $1,291.37 | 3 |
| Abdominal MRI (without contrast) CPT 74181 | $1,544.40 | $2,574.00 | $875.16 – $1,879.02 | 3 |
| Abdominal paracentesis w/image guidance CPT 49083 | $1,102.20 | $1,837.00 | $597.38 – $753.36 | 3 |
| Abdominal Ultrasound (complete) CPT 76700 | $708.60 | $1,181.00 | $401.54 – $862.13 | 3 |
| Abdominal Ultrasound (limited) CPT 76705 | $438.00 | $730.00 | $75.92 – $248.20 | 3 |
| Abdominal X-ray (2 views) CPT 74019 | $183.60 | $306.00 | $67.16 – $104.04 | 3 |
| Abdominal X-ray Series (acute, with chest view) CPT 74022 | $252.00 | $420.00 | $83.22 – $142.80 | 3 |
| Abdominal X-ray (single view) CPT 74018 | $154.80 | $258.00 | $62.78 – $87.72 | 3 |
| Abdominoplasty 15830 CPT 15830 | $2,235.60 | $3,726.00 | $928.00 – $2,719.98 | 3 |
| Abd paracentesis/w/o image guide 49082 CPT 49082 | $931.20 | $1,552.00 | $103.66 – $504.90 | 3 |
| Ablate atria lmtd endo 33265 CPT 33265 | $2,634.60 | $4,391.00 | $928.00 – $3,205.43 | 3 |
| Ablate atria w/bypass exten 33256 CPT 33256 | $3,813.00 | $6,355.00 | $928.00 – $4,639.15 | 3 |
| Ablate atria x10sv add-on 33258 CPT 33258 | $1,275.60 | $2,126.00 | $928.00 – $2,679.00 | 3 |
| Ablate atria x10sv endo 33266 CPT 33266 | $3,594.00 | $5,990.00 | $928.00 – $4,372.70 | 3 |
| Ablate bone tumor(s) cryo perq 20983 CPT 20983 | $834.00 | $1,390.00 | $928.00 – $2,679.00 | 3 |
| Ablate inf turbinate submuc 30802 CPT 30802 | $565.20 | $942.00 | $687.66 – $2,679.00 | 3 |
| Ablate inf turbinate superf 30801 CPT 30801 | $442.80 | $738.00 | $538.74 – $2,679.00 | 3 |
| Ablation cryo abd perit om CPT 49999 | $1,858.80 | $3,098.00 | $928.00 – $2,679.00 | 3 |
| Ablation cryo pq chest wall tumor(s) w/guid CPT 23929 | $1,291.80 | $2,153.00 | $928.00 – $2,679.00 | 3 |
| Ablation cryo pq liver tumor(s) CPT 47383 | $1,016.40 | $1,694.00 | $928.00 – $2,679.00 | 3 |
| Ablation cryo retro lymph node CPT 38999 | $373.80 | $623.00 | $454.79 – $2,679.00 | 3 |
| Ablation of upper extremity nerves rf CPT 64999 | $206.40 | $344.00 | $251.12 – $2,679.00 | 3 |
| Abobotulinumtoxina HCPCS J0586 | $948.50 | $1,580.83 | $537.48 – $1,154.01 | 3 |
| Abrasion lesions add-on CPT 15787 | $48.00 | $80.00 | $58.40 – $2,679.00 | 3 |
| Abscess drain retroperitoneal surg code CPT 49406 | $1,956.60 | $3,261.00 | $928.00 – $2,328.70 | 3 |
| Absorpt drg >16 <=48 without bdr HCPCS A6252 | $6.60 | $11.00 | $8.03 – $2,679.00 | 3 |
| Absorpt drg <=16 sq in without b HCPCS A6251 | $8.40 | $14.00 | $10.22 – $2,679.00 | 3 |
| Access & clsr pq fem art endogft dlvry w/img uni CPT 34713 | $177.60 | $296.00 | $216.08 – $2,679.00 | 3 |
| Acetaminophen 120 mg rectal suppository HCPCS A9270 | $7.20 | $12.00 | $8.76 – $2,679.00 | 3 |
| Acetaminophen level CPT 80143 | $111.00 | $185.00 | $62.90 – $135.05 | 3 |
| Acetazolamide 500 mg solution for injection HCPCS J1120 | $77.07 | $128.45 | $43.67 – $93.77 | 3 |
| Acetone qualitative CPT 82009 | $43.80 | $73.00 | $15.30 – $32.85 | 3 |
| Acetylcholine receptor modulating antibody CPT 86043 | $75.60 | $126.00 | $19.72 – $42.34 | 3 |
| Acetylcysteine 200 mg/ml (20 %) intravenous solution HCPCS J0132 | $306.72 | $511.20 | $117.44 – $252.16 | 3 |
| Acetylcysteine non-comp unit HCPCS J7608 | $10.48 | $17.46 | $5.94 – $12.75 | 3 |
| Acne surgery 10040 CPT 10040 | $194.40 | $324.00 | $236.52 – $2,679.00 | 3 |
| Aco annual medicare visit (awv), initial g0438aco HCPCS G0438 | $284.40 | $474.00 | $346.02 – $2,679.00 | 3 |
| Aco annual medicare visit (awv), subsq g0439aco HCPCS G0439 | $190.20 | $317.00 | $231.41 – $2,679.00 | 3 |
| Aco ccm; at least 20 min 99490aco CPT 99490 | $80.40 | $134.00 | $97.82 – $2,679.00 | 3 |
| Aco ccm; ea addl 20 min 99439aco CPT 99439 | $51.60 | $86.00 | $62.78 – $2,679.00 | 3 |
| Aco cmplx chron care addl 20 min 99489aco CPT 99489 | $87.00 | $145.00 | $105.85 – $2,679.00 | 3 |
| Aco cmplx chron care without pt visit, 60 min 99487aco CPT 99487 | $171.00 | $285.00 | $208.05 – $2,679.00 | 3 |
| Aco cont gluc mnt phys/qhp eqp 95250aco CPT 95250 | $279.00 | $465.00 | $339.45 – $2,679.00 | 3 |
| Aco depression screen annual medicare g0444aco HCPCS G0444 | $23.40 | $39.00 | $28.47 – $2,679.00 | 3 |
| Aco med nutria tx/group, ea 30 min 97804aco CPT 97804 | $48.60 | $81.00 | $27.54 – $45.99 | 3 |
| Acute hepatitis panel CPT 80074 | $163.80 | $273.00 | $90.10 – $193.45 | 3 |
| Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr HCPCS J0133 | $98.15 | $163.59 | $35.65 – $76.54 | 3 |
| #acylcarnitineprfl CPT 82017 | $235.80 | $393.00 | $32.30 – $69.35 | 3 |
| Adapter b 8 channel 10cm HCPCS C1883 | $760.80 | $1,268.00 | $431.12 – $925.64 | 3 |
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | $590.89 | $984.82 | $13.26 – $28.47 | 3 |
| Adenovirus antibody,serum - quest CPT 86603 | $48.00 | $80.00 | $25.84 – $55.48 | 3 |
| Adhesiolysis tube ovary 58740 CPT 58740 | $1,701.60 | $2,836.00 | $928.00 – $2,679.00 | 3 |
| Adh-sendout CPT 84588 | $205.80 | $343.00 | $56.78 – $121.91 | 3 |
| Adj gastric band via subq port CPT 43999 | $1,609.80 | $2,683.00 | $928.00 – $2,679.00 | 3 |
| Adj tis trans/see area/10.1-30sqcm 14041 CPT 14041 | $1,816.80 | $3,028.00 | $928.00 – $2,679.00 | 3 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $518.35 | $863.92 | $7.31 – $15.70 | 3 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $85.20 | $142.00 | $22.10 – $47.45 | 3 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | $109.80 | $183.00 | $62.22 – $133.59 | 3 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $402.00 | $670.00 | $213.52 – $240.17 | 3 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | $154.20 | $257.00 | $87.38 – $187.61 | 3 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | $128.40 | $214.00 | $72.76 – $156.22 | 3 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $174.60 | $291.00 | $98.94 – $182.50 | 3 |
| Administration immunization each additional component CPT 90461 | $24.60 | $41.00 | $13.94 – $25.55 | 3 |
| Administration immunization each additional vaccine CPT 90472 | $30.60 | $51.00 | $5.11 – $17.34 | 3 |
| Administration immunization first component each vaccine CPT 90460 | $40.20 | $67.00 | $15.33 – $17.68 | 3 |
| Administration immunization intranasal/oral route 1 vaccine CPT 90473 | $39.00 | $65.00 | $47.45 – $2,679.00 | 3 |
| Administration immunization intranasal/oral route each additional vaccine CPT 90474 | $20.40 | $34.00 | $24.82 – $2,679.00 | 3 |
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.