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 |
|---|---|---|---|---|
| Administration rsv monoclonal ab seasonal dose im w/counseling CPT 96380 | $33.00 | $55.00 | $40.15 – $2,679.00 | 3 |
| Administration vaccine hepatitis b HCPCS G0010 | $33.00 | $55.00 | $40.15 – $2,679.00 | 3 |
| Administration vaccine influenza virus HCPCS G0008 | $33.00 | $55.00 | $40.15 – $2,679.00 | 3 |
| Administration vaccine pneumococcal HCPCS G0009 | $33.00 | $55.00 | $40.15 – $2,679.00 | 3 |
| Administration vaccine rsv monoclonal ab seasonal dose im CPT 96381 | $28.20 | $47.00 | $34.31 – $2,679.00 | 3 |
| Ado-trastuzumab emtansine 100 mg intravenous solution HCPCS J9354 | $11,347.68 | $18,912.80 | $4,027.77 – $8,647.86 | 3 |
| Adrenalectomy expl w/exc retro tumor 60545 CPT 60545 | $2,321.40 | $3,869.00 | $928.00 – $2,824.37 | 3 |
| Advance care planning each additional 30 min 99498 CPT 99498 | $148.80 | $248.00 | $181.04 – $2,679.00 | 3 |
| _afb id by dna probe rflx ast CPT 87149 | $110.40 | $184.00 | $38.42 – $82.49 | 3 |
| #afb mycobacteria suscep. #1 CPT 87190 | $31.80 | $53.00 | $18.02 – $38.69 | 3 |
| _afb org id by sequencing rflx ast-sendout CPT 87153 | $291.00 | $485.00 | $164.90 – $354.05 | 3 |
| Afo sing upright with adjust s HCPCS L1920 | $16.80 | $28.00 | $20.44 – $2,679.00 | 3 |
| Afo tib fx semi-rigid l2114 HCPCS L2114 | $16.20 | $27.00 | $19.71 – $2,679.00 | 3 |
| Afo tibial fracture rigid HCPCS L2116 | $6.60 | $11.00 | $8.03 – $2,679.00 | 3 |
| Afo tibial fracture soft HCPCS L2112 | $7.80 | $13.00 | $9.49 – $2,679.00 | 3 |
| After cataract laser surgery CPT 66821 | $1,017.00 | $1,695.00 | $384.20 – $824.90 | 3 |
| Agalsidase beta 35 mg intravenous solution HCPCS J0180 | $13,216.24 | $22,027.06 | $1,138.92 – $2,445.32 | 3 |
| Air conduction bilat CPT 92552 | $55.20 | $92.00 | $67.16 – $2,679.00 | 3 |
| Air injection into abdomen 49400 CPT 49400 | $235.80 | $393.00 | $286.89 – $2,679.00 | 3 |
| Airway resistance by impulse oscillometry 94728 CPT 94728 | $114.60 | $191.00 | $43.80 – $61.20 | 3 |
| Albumin body fluid quantitative each specimen CPT 82042 | $62.40 | $104.00 | $10.20 – $21.90 | 3 |
| Albumin (human), 25%, 50ml HCPCS P9047 | $322.92 | $538.20 | $61.89 – $132.88 | 3 |
| Albumin (human), 5%, 250 ml HCPCS P9045 | $322.92 | $538.20 | $82.31 – $176.73 | 3 |
| Albumin, human 5 % intravenous solution HCPCS P9041 | $87.35 | $145.59 | $49.50 – $106.28 | 3 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $184.20 | $307.00 | $10.54 – $22.63 | 3 |
| Albumin serum plasma or whole blood CPT 82040 | $97.20 | $162.00 | $9.86 – $21.17 | 3 |
| Albuterol ipratrop non-comp HCPCS J7620 | $6.62 | $11.03 | $2.15 – $4.61 | 3 |
| Albuterol non-comp unit HCPCS J7613 | $5.83 | $9.71 | $1.79 – $3.83 | 3 |
| Alcohol (ethanol) any specimen except urine/breath CPT 82077 | $96.00 | $160.00 | $24.82 – $53.29 | 3 |
| Aldesleukin injection HCPCS J9015 | $1,496.81 | $2,494.68 | $848.19 – $1,821.12 | 3 |
| Alginate drsg wound filler HCPCS A6199 | $9.00 | $15.00 | $5.10 – $10.95 | 3 |
| Alkaline phosphatase CPT 84075 | $47.40 | $79.00 | $10.20 – $21.90 | 3 |
| Allergen alpha lactalbumin ige CPT 86008 | $259.20 | $432.00 | $24.48 – $52.56 | 3 |
| Allergen egg white ige CPT 86003 | $22.20 | $37.00 | $7.14 – $15.33 | 3 |
| Allergy injections; 2 or more 95117 CPT 95117 | $22.80 | $38.00 | $27.74 – $2,679.00 | 3 |
| Allergy injection; single 95115 CPT 95115 | $19.20 | $32.00 | $23.36 – $2,679.00 | 3 |
| Allg patch or app # of tests 95044 CPT 95044 | $9.00 | $15.00 | $10.95 – $2,679.00 | 3 |
| Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet HCPCS Q4100 | $12,402.00 | $20,670.00 | $190.74 – $409.53 | 3 |
| Allograft dermis 20x25x1mm decell w/matracell arthroflex HCPCS Q4125 | $4,303.20 | $7,172.00 | $2,438.48 – $5,235.56 | 3 |
| Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm HCPCS Q4128 | $23,373.60 | $38,956.00 | $10,973.50 – $23,560.75 | 3 |
| Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution HCPCS J0256 | $38.29 | $63.81 | $17.16 – $36.85 | 3 |
| Alpha-fetoprotein tumor marker CPT 82105 | $124.20 | $207.00 | $22.78 – $48.91 | 3 |
| Alprostadil for injection HCPCS J0270 | $313.41 | $522.35 | $177.60 – $381.32 | 3 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | $15,616.81 | $26,028.01 | $361.04 – $775.17 | 3 |
| Alt/sgpt CPT 84460 | $36.60 | $61.00 | $10.54 – $22.63 | 3 |
| Aluminum - quest CPT 82108 | $94.20 | $157.00 | $51.34 – $110.23 | 3 |
| Amantadine (symmetrel)-sendout CPT 80375 | $196.20 | $327.00 | $111.18 – $238.71 | 3 |
| Ambl bp mntr w/software CPT 93784 | $455.40 | $759.00 | $227.76 – $258.06 | 3 |
| Amikacin 4 mg/ml intravitreal injection - cnr HCPCS J0278 | $129.55 | $215.92 | $23.50 – $50.46 | 3 |
| Amino acid screen, urine CPT 82128 | $102.60 | $171.00 | $58.14 – $124.83 | 3 |
| Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr HCPCS J0281 | $25.31 | $42.19 | $14.34 – $30.80 | 3 |
| Aminolevulinic acid delta CPT 82135 | $264.60 | $441.00 | $149.94 – $321.93 | 3 |
| Aminophylline 25 mg/ml intravenous solution (wrapper) HCPCS J0280 | $63.16 | $105.27 | $7.78 – $16.71 | 3 |
| Amiodarone 50 mg/ml intravenous solution HCPCS J0282 | $168.45 | $280.75 | $8.76 – $18.80 | 3 |
| Amitriptyline (elavil) -sendout CPT 80335 | $288.60 | $481.00 | $54.40 – $116.80 | 3 |
| Amitriptyline injection HCPCS J1320 | $31.10 | $51.84 | $17.63 – $37.84 | 3 |
| Amivantamab-vmjw 50 mg/ml intravenous solution HCPCS J9061 | $6,499.82 | $10,833.03 | $3,683.23 – $7,908.11 | 3 |
| Ammonia CPT 82140 | $95.40 | $159.00 | $27.54 – $59.13 | 3 |
| Amniocentesisdiagnostic 59000 CPT 59000 | $260.40 | $434.00 | $316.82 – $2,679.00 | 3 |
| Amphetamine confirm urine -sendout CPT 80324 | $288.60 | $481.00 | $121.04 – $259.88 | 3 |
| Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J0285 | $100.98 | $168.30 | $57.22 – $122.86 | 3 |
| Amphotericin b lipid complex HCPCS J0287 | $366.66 | $611.10 | $112.42 – $241.38 | 3 |
| Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J0289 | $576.21 | $960.35 | $326.52 – $701.06 | 3 |
| Ampicillin 1 gram solution for injection HCPCS J0290 | $54.34 | $90.56 | $10.07 – $21.62 | 3 |
| Ampicillin-sulbactam 1.5 gram solution for injection HCPCS J0295 | $87.97 | $146.62 | $19.94 – $42.81 | 3 |
| Amp metatarsal w/toe single 28810 CPT 28810 | $849.00 | $1,415.00 | $928.00 – $2,679.00 | 3 |
| Amp thigh through femur re-amp 27596 CPT 27596 | $1,398.00 | $2,330.00 | $928.00 – $2,679.00 | 3 |
| Amputate metacarpal bone 26910 CPT 26910 | $1,351.20 | $2,252.00 | $928.00 – $2,679.00 | 3 |
| Amputate thigh through femur 27590 CPT 27590 | $1,569.60 | $2,616.00 | $928.00 – $2,679.00 | 3 |
| Amputation leg thr tib/fib 27880 CPT 27880 | $1,776.00 | $2,960.00 | $928.00 – $2,679.00 | 3 |
| Amputation leg; tib/fib f/u 27886 CPT 27886 | $1,005.00 | $1,675.00 | $928.00 – $2,679.00 | 3 |
| Amputation of midtarsal 28800 CPT 28800 | $1,071.60 | $1,786.00 | $928.00 – $2,679.00 | 3 |
| Amputation thru metatarsal CPT 28805 | $1,451.40 | $2,419.00 | $928.00 – $2,679.00 | 3 |
| Amputation toe interphalangeal joint CPT 28825 | $1,050.00 | $1,750.00 | $928.00 – $2,679.00 | 3 |
| Amputation toe metatarsophalangeal joint CPT 28820 | $1,092.00 | $1,820.00 | $928.00 – $2,679.00 | 3 |
| Amylase CPT 82150 | $121.20 | $202.00 | $12.58 – $27.01 | 3 |
| Ana ds-dna CPT 86226 | $42.00 | $70.00 | $23.80 – $51.10 | 3 |
| Analgesics non-opioid definitive assay 1 or 2 acetaminophen CPT 80329 | $208.20 | $347.00 | $117.98 – $253.31 | 3 |
| Anal/urinary muscle study CPT 51784 | $90.00 | $150.00 | $109.50 – $2,679.00 | 3 |
| Analysis complx cranial nerve pulse gen prgrmg 95977 CPT 95977 | $338.40 | $564.00 | $411.72 – $2,679.00 | 3 |
| Analysis gene f2 20210g>a variant CPT 81240 | $169.20 | $282.00 | $92.82 – $199.29 | 3 |
| Analysis gene f5 leiden variant CPT 81241 | $210.00 | $350.00 | $115.94 – $248.93 | 3 |
| Analysis; simple cranial nerv pulse gen prgrmg 95976 CPT 95976 | $255.00 | $425.00 | $310.25 – $2,679.00 | 3 |
| Analyze neurostimulator simple w/reprogramming 95971 CPT 95971 | $250.80 | $418.00 | $98.55 – $142.12 | 3 |
| Anastamo/extrahep bil duct/gi trac 47760 CPT 47760 | $4,216.80 | $7,028.00 | $928.00 – $5,130.44 | 3 |
| Anastamo/roux-en-y/extrahep bil/gi 47780 CPT 47780 | $4,623.60 | $7,706.00 | $928.00 – $5,625.38 | 3 |
| Anastomosis of facial/other nerve 64868 CPT 64868 | $2,004.60 | $3,341.00 | $928.00 – $2,679.00 | 3 |
| Anca screen with reflex to titer -quest CPT 86021 | $54.00 | $90.00 | $30.26 – $64.97 | 3 |
| An cholangiogram percutaneous compl CPT 47531 | $1,196.40 | $1,994.00 | $542.30 – $833.66 | 3 |
| Androstanediol CPT 82154 | $120.60 | $201.00 | $68.34 – $146.73 | 3 |
| An fluoro guide for cvp CPT 77001 | $243.60 | $406.00 | $49.64 – $70.04 | 3 |
| Angio balloon ctrl dialysis seg add-on CPT 36907 | $231.60 | $386.00 | $281.78 – $2,679.00 | 3 |
| Angioplasty fem/pop unilat 37224 CPT 37224 | $745.20 | $1,242.00 | $906.66 – $2,679.00 | 3 |
| Angioplasty/iliac/init ves/unilat 37220 CPT 37220 | $544.20 | $907.00 | $662.11 – $2,679.00 | 3 |
| Angioplasty tib/pero/unilat/ea add 37232 CPT 37232 | $2,377.20 | $3,962.00 | $928.00 – $2,892.26 | 3 |
| Angiotensin ii 0.5 mg/ml soln 1 ml vial HCPCS J3490 | $522.83 | $871.39 | $29.72 – $63.82 | 3 |
| Angio tib/peroneal/init ves/unila 37228 CPT 37228 | $910.80 | $1,518.00 | $928.00 – $2,679.00 | 3 |
| Angio trnslmnl balloon same artery ea addl CPT 37247 | $2,116.80 | $3,528.00 | $928.00 – $2,679.00 | 3 |
| Angio trnslmnl balloon same artery ini CPT 37246 | $4,234.20 | $7,057.00 | $928.00 – $5,151.61 | 3 |
| Angio trnslmnl balloon same vein ea addl CPT 37249 | $1,102.80 | $1,838.00 | $928.00 – $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.