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 |
|---|---|---|---|---|
| Fluphenazine decanoate 25 mg/ml injection solution HCPCS J2680 | $67.31 | $112.19 | $22.70 – $48.73 | 3 |
| Folic acid CPT 82746 | $71.40 | $119.00 | $21.08 – $45.26 | 3 |
| Folic acid 5 mg/ml injection solution HCPCS J1808 | $14.68 | $24.47 | $8.32 – $17.86 | 3 |
| Fomepizole 1 gram/ml intravenous solution HCPCS J1451 | $2,742.73 | $4,571.21 | $1,037.62 – $2,227.82 | 3 |
| Fondaparinux sodium HCPCS J1652 | $244.22 | $407.04 | $79.80 – $171.35 | 3 |
| Foot plas heel stabi pre ots HCPCS L3170 | $19.80 | $33.00 | $24.09 – $2,679.00 | 3 |
| Foot X-ray CPT 73630 | $280.80 | $468.00 | $59.13 – $105.74 | 3 |
| Foot X-ray (2 views, both feet) CPT 73620 | $183.00 | $305.00 | $50.37 – $69.02 | 3 |
| Forearm X-ray (both sides) CPT 73090 | $289.20 | $482.00 | $50.37 – $109.48 | 3 |
| Forehead flap w/vasc pedicle 15731 CPT 15731 | $1,726.80 | $2,878.00 | $928.00 – $2,679.00 | 3 |
| Foreskn manip w/lss preputial ads+stretching 54450 CPT 54450 | $138.00 | $230.00 | $167.90 – $2,679.00 | 3 |
| Fosaprepitant 150 mg intravenous powder for solution HCPCS J1453 | $605.12 | $1,008.54 | $207.61 – $445.76 | 3 |
| Foscarnet sodium injection HCPCS J1455 | $879.58 | $1,465.97 | $90.76 – $194.87 | 3 |
| Fosphenytoin 50 mg pe/ml injection (wrapper) HCPCS Q2009 | $227.26 | $378.76 | $12.53 – $26.90 | 3 |
| _fragile x methylation-sendout CPT 81244 | $286.20 | $477.00 | $104.72 – $224.84 | 3 |
| Freeing of bowel adhesion 44005 CPT 44005 | $2,062.20 | $3,437.00 | $928.00 – $2,679.00 | 3 |
| Free/remove chest lining 32320 CPT 32320 | $3,086.40 | $5,144.00 | $928.00 – $3,755.12 | 3 |
| Frenectomy 41115 CPT 41115 | $487.20 | $812.00 | $592.76 – $2,679.00 | 3 |
| Frenotomy 40806 CPT 40806 | $283.80 | $473.00 | $345.29 – $2,679.00 | 3 |
| Fructosamine glycated protein CPT 82985 | $79.20 | $132.00 | $30.60 – $65.70 | 3 |
| Ft arch suprt premold longit HCPCS L3040 | $16.80 | $28.00 | $20.44 – $2,679.00 | 3 |
| Full Spine X-ray (Scoliosis Survey) CPT 72082 | $268.80 | $448.00 | $103.66 – $152.32 | 3 |
| Full thick gft/nose/ear/lid/lip/20sqcm or< 15260 CPT 15260 | $1,938.00 | $3,230.00 | $928.00 – $2,679.00 | 3 |
| Full thick gft/scalp/arm/leg/20sqcm or< 15220 CPT 15220 | $1,473.60 | $2,456.00 | $928.00 – $2,679.00 | 3 |
| Full thick gft/scalp/arm/leg/add 20sqcm 15221 CPT 15221 | $262.20 | $437.00 | $319.01 – $2,679.00 | 3 |
| Full thick gft w/close donor fccmnaghf <=20sqcm 15240 CPT 15240 | $1,785.00 | $2,975.00 | $928.00 – $2,679.00 | 3 |
| Fundus photography with i&r 92250 CPT 92250 | $135.00 | $225.00 | $164.25 – $2,679.00 | 3 |
| Furosemide 10 mg/ml injection solution HCPCS J1938 | $17.98 | $29.97 | $8.04 – $17.26 | 3 |
| Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr HCPCS J1940 | $56.12 | $93.54 | $8.19 – $17.59 | 3 |
| Fuse bile ducts and bowel 47785 CPT 47785 | $4,978.20 | $8,297.00 | $928.00 – $6,056.81 | 3 |
| Fuse pancreas cyst and bowel 48520 CPT 48520 | $2,059.20 | $3,432.00 | $928.00 – $2,679.00 | 3 |
| Fusion of ankle joint open CPT 27870 | $1,406.40 | $2,344.00 | $928.00 – $2,679.00 | 3 |
| Fusion of big toe joint CPT 28750 | $1,576.20 | $2,627.00 | $928.00 – $2,679.00 | 3 |
| Fusion of big toe joint CPT 28755 | $964.80 | $1,608.00 | $928.00 – $2,679.00 | 3 |
| Fusion of finger joint CPT 26860 | $1,057.20 | $1,762.00 | $928.00 – $2,679.00 | 3 |
| Fusion of foot bones CPT 28730 | $1,020.00 | $1,700.00 | $928.00 – $2,679.00 | 3 |
| Fusion of foot bones CPT 28740 | $1,628.40 | $2,714.00 | $928.00 – $2,679.00 | 3 |
| Fusion of knuckle joint CPT 26516 | $1,323.00 | $2,205.00 | $928.00 – $2,679.00 | 3 |
| G0180 home health certification HCPCS G0180 | $87.00 | $145.00 | $105.85 – $2,679.00 | 3 |
| Gadobutrol 1 mmol/ml intravenous solution (wrapper) HCPCS A9585 | $176.62 | $294.37 | $33.44 – $71.80 | 3 |
| Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper) HCPCS A9579 | $764.66 | $1,274.43 | $20.94 – $44.97 | 3 |
| Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution HCPCS A9575 | $128.80 | $214.66 | $43.38 – $93.13 | 3 |
| Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution HCPCS A9581 | $281.05 | $468.42 | $152.69 – $327.84 | 3 |
| Galac-1-phosphate uridyltran - sendout CPT 82775 | $185.40 | $309.00 | $74.80 – $160.60 | 3 |
| Galactokinase - sendout CPT 82759 | $344.40 | $574.00 | $112.54 – $241.63 | 3 |
| Gallbladder Removal (Laparoscopic) CPT 47562 | $1,407.60 | $2,346.00 | $928.00 – $2,679.00 | 3 |
| Gamma globulin 1 cc inj HCPCS J1460 | $84.56 | $140.94 | $47.92 – $102.89 | 3 |
| Gammaglobulin iga CPT 82784 | $225.60 | $376.00 | $10.54 – $22.63 | 3 |
| Gammaglobulin ige CPT 82785 | $124.20 | $207.00 | $22.44 – $48.18 | 3 |
| Gamma glutamyltransferase CPT 82977 | $54.00 | $90.00 | $13.94 – $29.93 | 3 |
| Gamunex-c/gammaked HCPCS J1561 | $6,873.35 | $11,455.58 | $501.86 – $1,077.52 | 3 |
| Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr HCPCS J1570 | $205.72 | $342.86 | $116.57 – $250.29 | 3 |
| Gastroesophageal reflux test CPT 91034 | $588.60 | $981.00 | $251.60 – $540.20 | 3 |
| Gastrojejunostomy;w/o vagotomy 43820 CPT 43820 | $2,376.00 | $3,960.00 | $928.00 – $2,890.80 | 3 |
| Gauze <=16 in no w/sal without b HCPCS A6222 | $0.60 | $1.00 | $0.73 – $2,679.00 | 3 |
| Gauze <= 16 sq in w/border HCPCS A6219 | $8.40 | $14.00 | $10.22 – $2,679.00 | 3 |
| Gc stocking thighlngth 18-30 HCPCS A6533 | $48.60 | $81.00 | $59.13 – $2,679.00 | 3 |
| Gc stocking waistlngth 18-30 HCPCS A6539 | $25.80 | $43.00 | $31.39 – $2,679.00 | 3 |
| Gel-one HCPCS J7326 | $2,049.30 | $3,415.50 | $1,161.27 – $2,493.32 | 3 |
| Gel-syn injection 0.1 mg HCPCS J7328 | $363.17 | $605.28 | $205.80 – $441.85 | 3 |
| Gemcitabine 1 gram intravenous solution HCPCS J9201 | $95.66 | $159.44 | $16.97 – $36.44 | 3 |
| Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln HCPCS J9203 | $18,100.00 | $30,166.66 | $10,256.66 – $22,021.66 | 3 |
| Generator barostim neo2 2014 HCPCS C1767 | $70,875.00 | $118,125.00 | $40,162.50 – $86,231.25 | 3 |
| Generator emblem MRI sicd subq HCPCS C1722 | $45,000.00 | $75,000.00 | $12,094.82 – $25,968.29 | 3 |
| Generator stim baroreceptor neo legacy implant pulse HCPCS C1825 | $78,750.00 | $131,250.00 | $44,625.00 – $95,812.50 | 3 |
| Gentamicin 10 mg/ml liquid compound - enteral use only HCPCS J1580 | $113.05 | $188.41 | $8.34 – $17.91 | 3 |
| Gentamicin peak therapeutic drug level CPT 80170 | $113.40 | $189.00 | $58.14 – $124.83 | 3 |
| G-esoph reflx tst w/electrod CPT 91035 | $955.20 | $1,592.00 | $928.00 – $2,679.00 | 3 |
| Ghs abscess perianal iandd CPT 46050 | $962.40 | $1,604.00 | $454.06 – $545.36 | 3 |
| Ghs abscess postoperative iandd complex CPT 10180 | $1,352.40 | $2,254.00 | $558.45 – $766.36 | 3 |
| Ghs acetylcholinesterase, rbc CPT 82482 | $113.40 | $189.00 | $20.06 – $43.07 | 3 |
| Ghs alcohol, methyl (methanol)-medtox CPT 84600 | $87.00 | $145.00 | $44.54 – $95.63 | 3 |
| Ghs alpha thalasemia, 7 deletions CPT 81257 | $257.40 | $429.00 | $145.86 – $313.17 | 3 |
| Ghs analysis neurostim without reprogramming CPT 95970 | $122.40 | $204.00 | $45.90 – $98.55 | 3 |
| Ghs antibodies (torch) igm CPT 86694 | $245.40 | $409.00 | $29.24 – $62.78 | 3 |
| Ghs aspiration bladder - needle CPT 51100 | $307.20 | $512.00 | $174.08 – $373.76 | 3 |
| Ghs bladder cath - complex-foley CPT 51703 | $257.40 | $429.00 | $115.94 – $248.93 | 3 |
| Ghs bleeding time (ivy) CPT 85002 | $46.20 | $77.00 | $26.18 – $56.21 | 3 |
| Ghs block ilioinguinal/gentitofemoral CPT 64425 | $610.80 | $1,018.00 | $316.09 – $346.12 | 3 |
| Ghs central line insert < age 5, failed CPT 36555 | $567.00 | $945.00 | $321.30 – $643.86 | 3 |
| Ghs change cysto/gastrost CPT 43762 | $474.60 | $791.00 | $104.39 – $268.94 | 3 |
| Ghs chemo >8 hrs CPT 96416 | $407.40 | $679.00 | $230.86 – $495.67 | 3 |
| Ghs chemo infusion >8 hrs CPT 96425 | $407.40 | $679.00 | $230.86 – $495.67 | 3 |
| Ghs chemo IV push, ea addtl CPT 96411 | $127.80 | $213.00 | $72.42 – $155.49 | 3 |
| Ghs chlamydia pneumoniae by pcr (arup) (306630) CPT 87486 | $398.40 | $664.00 | $53.72 – $115.34 | 3 |
| Ghs closd tx interphalang jt disloc w/ma CPT 26770 | $512.40 | $854.00 | $184.28 – $395.66 | 3 |
| Ghs closed reduction ankle dislocation CPT 27840 | $693.00 | $1,155.00 | $207.06 – $444.57 | 3 |
| Ghs closed tx bimalleolar fracture w/manip CPT 27810 | $891.00 | $1,485.00 | $173.74 – $373.03 | 3 |
| Ghs closed tx radiocarpal disloc w manip CPT 25660 | $306.60 | $511.00 | $173.74 – $373.03 | 3 |
| Ghs closed tx tibial fracture w/manip CPT 27752 | $1,015.20 | $1,692.00 | $184.28 – $395.66 | 3 |
| Ghs closure surg wound/dehiscence-13160 CPT 13160 | $1,542.60 | $2,571.00 | $720.12 – $1,546.14 | 3 |
| Ghs clsd red med malleolus fx without manip CPT 27760 | $628.20 | $1,047.00 | $164.90 – $354.05 | 3 |
| Ghs clsd red med malleolus fx w manip CPT 27762 | $909.00 | $1,515.00 | $173.74 – $373.03 | 3 |
| Ghs clsd tx frac distal tibia w/manipulation CPT 27825 | $1,032.60 | $1,721.00 | $173.74 – $373.03 | 3 |
| Ghs cl tx knee disl; wo anesth CPT 27550 | $935.40 | $1,559.00 | $238.00 – $511.00 | 3 |
| Ghs cl tx metacarpophal disloc without anes CPT 26700 | $601.80 | $1,003.00 | $173.74 – $373.03 | 3 |
| Ghs community re-entry 15 minutes CPT 97537 | $80.40 | $134.00 | $45.56 – $97.82 | 3 |
| Ghs conjunctiva foreign body-embed bil CPT 65210 | $445.80 | $743.00 | $159.87 – $168.64 | 3 |
| Ghs conjunctiva foreign body-superf bil CPT 65205 | $190.80 | $318.00 | $72.08 – $128.48 | 3 |
| Ghs corneal fb without slit lamp bilat CPT 65220 | $474.00 | $790.00 | $179.18 – $384.71 | 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.