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 |
|---|---|---|---|---|
| Explore small intestine 44020 CPT 44020 | $1,512.00 | $2,520.00 | $928.00 – $2,679.00 | 3 |
| Explore/treat eye socket 67413 CPT 67413 | $1,639.20 | $2,732.00 | $928.00 – $2,679.00 | 3 |
| Explore wound abdomen 20102 CPT 20102 | $895.80 | $1,493.00 | $928.00 – $2,679.00 | 3 |
| Explore woundchest 20101 CPT 20101 | $831.00 | $1,385.00 | $928.00 – $2,679.00 | 3 |
| Explore wound neck 20100 CPT 20100 | $1,178.40 | $1,964.00 | $928.00 – $2,679.00 | 3 |
| Explor not followed by surg repair artery; low extrem 35703 CPT 35703 | $1,120.20 | $1,867.00 | $928.00 – $2,679.00 | 3 |
| Explor not followed by surg repair artery; up extrem 35702 CPT 35702 | $1,063.20 | $1,772.00 | $928.00 – $2,679.00 | 3 |
| Expose art endoprosth iliac 34820 CPT 34820 | $965.40 | $1,609.00 | $928.00 – $2,679.00 | 3 |
| Expose endoprosth brachial 34834 CPT 34834 | $544.80 | $908.00 | $662.84 – $2,679.00 | 3 |
| Exp w remove/deep fb/forearm/wrist 25248 CPT 25248 | $802.20 | $1,337.00 | $928.00 – $2,679.00 | 3 |
| Ex sq tumor/face or scalp < 2 cm 21011 CPT 21011 | $672.00 | $1,120.00 | $817.60 – $2,679.00 | 3 |
| Ex sq tumor/face or scalp 2 cm/> 21012 CPT 21012 | $650.40 | $1,084.00 | $791.32 – $2,679.00 | 3 |
| Extension drainage tubing HCPCS A4331 | $36.00 | $60.00 | $20.40 – $43.80 | 3 |
| Extensive ear canal surgery 69150 CPT 69150 | $2,051.40 | $3,419.00 | $928.00 – $2,679.00 | 3 |
| Extensive ear/neck surgery 69155 CPT 69155 | $3,192.60 | $5,321.00 | $928.00 – $3,884.33 | 3 |
| Extensive thyroid surgery CPT 60254 | $3,233.40 | $5,389.00 | $928.00 – $3,933.97 | 3 |
| Extractable nuclear antigen/antibody any method each antibody centromere CPT 86235 | $257.40 | $429.00 | $23.80 – $51.10 | 3 |
| Extraction of lens 66920 CPT 66920 | $1,408.80 | $2,348.00 | $928.00 – $2,679.00 | 3 |
| Eye implant band 40 HCPCS C1784 | $5,388.60 | $8,981.00 | $14.96 – $32.12 | 3 |
| Eye Socket (Orbit) X-ray CPT 70200 | $161.40 | $269.00 | $75.92 – $91.46 | 3 |
| Eye Socket, Pituitary or Ear CT Scan (with and without contrast) CPT 70482 | $1,249.80 | $2,083.00 | $708.22 – $1,520.59 | 3 |
| Eye Socket, Pituitary or Ear CT Scan (with contrast) CPT 70481 | $1,222.20 | $2,037.00 | $692.58 – $1,487.01 | 3 |
| Eye Socket, Pituitary or Ear CT Scan (without contrast) CPT 70480 | $988.80 | $1,648.00 | $560.32 – $1,203.04 | 3 |
| Face, Eye Socket and Neck MRI (with and without contrast) CPT 70543 | $2,674.20 | $4,457.00 | $1,515.38 – $3,253.61 | 3 |
| Face, Eye Socket and Neck MRI (without contrast) CPT 70540 | $1,522.20 | $2,537.00 | $862.58 – $1,852.01 | 3 |
| Facial Bones X-ray (1 to 2 views) CPT 70140 | $175.80 | $293.00 | $99.62 – $213.89 | 3 |
| Facial Bones X-ray (complete) CPT 70150 | $294.60 | $491.00 | $75.92 – $166.94 | 3 |
| Factor ix CPT 85250 | $257.40 | $429.00 | $39.44 – $84.68 | 3 |
| Factor ix complex HCPCS J7194 | $13.16 | $21.93 | $7.46 – $16.01 | 3 |
| Factor ix recombinant nos HCPCS J7195 | $13.90 | $23.16 | $7.87 – $16.91 | 3 |
| Factor viii CPT 85240 | $501.00 | $835.00 | $30.60 – $65.70 | 3 |
| Factor viii HCPCS J7190 | $15.34 | $25.57 | $8.69 – $18.67 | 3 |
| Factor viii recombinant nos HCPCS J7192 | $15.89 | $26.49 | $8.95 – $19.21 | 3 |
| Fallopian tube recnl CPT 58345 | $544.80 | $908.00 | $662.84 – $2,679.00 | 3 |
| Family therapy without pt 50min 90846 CPT 90846 | $114.00 | $190.00 | $138.70 – $2,679.00 | 3 |
| Family therapy with patient 50 min 90847 CPT 90847 | $174.00 | $290.00 | $211.70 – $2,679.00 | 3 |
| Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr HCPCS J1308 | $14.11 | $23.51 | $7.93 – $17.03 | 3 |
| Fam-trastuzumab deruxtecan-nxki 100 mg intravenous solution HCPCS J9358 | $5,508.16 | $9,180.26 | $3,121.29 – $6,701.59 | 3 |
| Fat/lipids feces qualitative CPT 82705 | $105.00 | $175.00 | $5.44 – $11.68 | 3 |
| Fatty acids nonesterified CPT 82725 | $47.40 | $79.00 | $26.86 – $57.67 | 3 |
| Fecal microbiota, live-jslm 150 ml rectal suspension enema HCPCS J1440 | $16,432.46 | $27,387.43 | $9,311.73 – $19,992.82 | 3 |
| #fecal-sodium CPT 84302 | $48.60 | $81.00 | $14.96 – $32.12 | 3 |
| Feeding tube reposition CPT 74355 | $294.00 | $490.00 | $166.60 – $357.70 | 3 |
| Felbamate (felbatol(r)) - sendout CPT 80167 | $47.40 | $79.00 | $26.86 – $57.67 | 3 |
| Femoral endovas graft add-on 34813 CPT 34813 | $471.00 | $785.00 | $573.05 – $2,679.00 | 3 |
| Fem/popl revasc w/stent CPT 37226 | $874.80 | $1,458.00 | $928.00 – $2,679.00 | 3 |
| Fem urinary collect pouch HCPCS A4328 | $3.60 | $6.00 | $4.38 – $2,679.00 | 3 |
| Feno poc CPT 95012 | $36.00 | $60.00 | $43.80 – $2,679.00 | 3 |
| Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper) HCPCS J3010 | $59.74 | $99.57 | $7.79 – $16.72 | 3 |
| Fern test HCPCS Q0114 | $26.40 | $44.00 | $32.12 – $2,679.00 | 3 |
| Ferric carboxymaltose 50 mg iron/ml intravenous solution HCPCS J1439 | $2,746.54 | $4,577.57 | $212.32 – $455.87 | 3 |
| Ferritin CPT 82728 | $97.20 | $162.00 | $19.72 – $42.34 | 3 |
| Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution HCPCS Q0138 | $2,064.98 | $3,441.63 | $915.72 – $1,966.10 | 3 |
| Ferumoxytol, esrd use HCPCS Q0139 | $2,064.98 | $3,441.63 | $915.72 – $1,966.10 | 3 |
| Fetal biophys profile w/nst 76818 CPT 76818 | $396.60 | $661.00 | $118.26 – $224.74 | 3 |
| Fetal chrom aneuploidy gsa panel CPT 81420 | $2,027.40 | $3,379.00 | $413.44 – $887.68 | 3 |
| Fetal contract stress test 59020 - 26 CPT 59020 | $60.60 | $101.00 | $73.73 – $2,679.00 | 3 |
| Fetal fibronectin CPT 82731 | $221.40 | $369.00 | $125.46 – $269.37 | 3 |
| Fetal hemoglobin (kleihauer betke) CPT 85460 | $50.40 | $84.00 | $28.56 – $61.32 | 3 |
| Fetal lung maturity assess lam body dnst CPT 83664 | $69.60 | $116.00 | $39.44 – $84.68 | 3 |
| Fetal non stress test CPT 59025 | $376.20 | $627.00 | $88.33 – $213.18 | 3 |
| Fetal scalp blood sampling 59030 CPT 59030 | $282.60 | $471.00 | $343.83 – $2,679.00 | 3 |
| #_fet/norfentcnfrmur CPT 80354 | $306.00 | $510.00 | $173.40 – $372.30 | 3 |
| Fibrin degradation d dimer quantitative CPT 85379 | $80.40 | $134.00 | $26.86 – $57.67 | 3 |
| Fibrinogen activity CPT 85384 | $65.40 | $109.00 | $17.00 – $36.50 | 3 |
| Fibrinolytic plasminogen xcpt antgnc asa CPT 85420 | $22.80 | $38.00 | $12.92 – $27.74 | 3 |
| Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr HCPCS J1442 | $953.68 | $1,589.47 | $323.03 – $693.57 | 3 |
| Filgrastim-sndz 300 mcg/0.5 ml injection syringe HCPCS Q5101 | $789.94 | $1,316.57 | $282.41 – $606.35 | 3 |
| Filleted finger/toe flap CPT 14350 | $954.00 | $1,590.00 | $928.00 – $2,679.00 | 3 |
| Filter spider fx 3mmx320cm HCPCS C1884 | $7,533.00 | $12,555.00 | $337.96 – $725.62 | 3 |
| Filter vena cava fem denali HCPCS C1880 | $3,487.80 | $5,813.00 | $1,083.92 – $2,327.24 | 3 |
| Fimbrioplasty 58760 CPT 58760 | $1,581.60 | $2,636.00 | $928.00 – $2,679.00 | 3 |
| Finasteride, 5 mg HCPCS S0138 | $6.34 | $10.56 | $3.57 – $7.66 | 3 |
| Fine needle aspiration biopsy w/fluor gdn;1st lesion 10007 CPT 10007 | $394.20 | $657.00 | $479.61 – $2,679.00 | 3 |
| Fine needle aspiration biopsy w/fluor gdn; ea addtl 10008 CPT 10008 | $256.80 | $428.00 | $312.44 – $2,679.00 | 3 |
| Fine needle aspiration biopsy without img gdn; ea addtl 10004 CPT 10004 | $174.60 | $291.00 | $212.43 – $2,679.00 | 3 |
| Fine needle aspiration biopsy w/us gdn; ea addtl 10006 CPT 10006 | $436.20 | $727.00 | $247.18 – $264.99 | 3 |
| Fine needle asp without image guide 10021 CPT 10021 | $277.20 | $462.00 | $337.26 – $2,679.00 | 3 |
| Finger X-ray (both hands) CPT 73140 | $211.80 | $353.00 | $64.97 – $80.24 | 3 |
| Fistula repair transperine 57308 CPT 57308 | $1,245.00 | $2,075.00 | $928.00 – $2,679.00 | 3 |
| Fitting of diaphragm/cap 57170 CPT 57170 | $121.20 | $202.00 | $147.46 – $2,679.00 | 3 |
| Fixtn pq skel dstl rad fx/epiphysl sep CPT 25606 | $935.40 | $1,559.00 | $928.00 – $2,679.00 | 3 |
| Flebogamma injection HCPCS J1572 | $2,551.62 | $4,252.70 | $374.07 – $803.15 | 3 |
| Flecainide (tambocor)-sendout CPT 80181 | $47.40 | $79.00 | $26.86 – $57.67 | 3 |
| Fl exam g/colon tube w contrast CPT 49465 | $298.80 | $498.00 | $169.32 – $363.54 | 3 |
| Flexible Sigmoidoscopy CPT 45330 | $103.20 | $172.00 | $125.56 – $2,679.00 | 3 |
| Floor of mouth biopsy 41108 CPT 41108 | $288.00 | $480.00 | $350.40 – $2,679.00 | 3 |
| Flow cytometry interp 16 or more CPT 88189 | $94.80 | $158.00 | $7.82 – $16.79 | 3 |
| Flow cytometry marker each additional CPT 88185 | $61.80 | $103.00 | $7.82 – $16.79 | 3 |
| Flow cytometry one marker technical component CPT 88184 | $67.80 | $113.00 | $7.82 – $16.79 | 3 |
| #flow interp 9 - 15 markers CPT 88188 | $85.20 | $142.00 | $48.28 – $103.66 | 3 |
| Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback HCPCS J1450 | $73.89 | $123.15 | $11.93 – $25.62 | 3 |
| Fludarabine 50 mg intravenous solution HCPCS J9185 | $522.96 | $871.60 | $296.34 – $636.27 | 3 |
| Fluidotherapy charges pt CPT 97022 | $93.00 | $155.00 | $52.70 – $62.05 | 3 |
| Fluid pressure muscle 20950 CPT 20950 | $417.60 | $696.00 | $508.08 – $2,679.00 | 3 |
| Fluorescent antibody titer dna CPT 86256 | $240.60 | $401.00 | $17.68 – $37.96 | 3 |
| Fluoroguide for spine inject 77003-26 CPT 77003 | $334.80 | $558.00 | $79.57 – $189.72 | 3 |
| Fluoroguide needle placement CPT 77002 | $211.80 | $353.00 | $73.00 – $99.96 | 3 |
| Fluoroscopy (Live X-ray Guidance, up to 1 hour) CPT 76000 | $291.00 | $485.00 | $160.14 – $343.83 | 3 |
| Fluorouracil 50 mg/ml intravenous solution (wrapper) HCPCS J9190 | $142.88 | $238.13 | $26.89 – $57.74 | 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.