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 |
|---|---|---|---|---|
| Ghs o2 uptake rest & exercise CPT 94680 | $333.00 | $555.00 | $188.70 – $405.15 | 3 |
| Ghs o2 uptake rest & indirect CPT 94690 | $118.20 | $197.00 | $40.12 – $86.14 | 3 |
| Ghs ob unlisted IV or art inj or infusion CPT 96379 | $132.60 | $221.00 | $66.64 – $143.08 | 3 |
| Ghs opcc repair cvp without subq port CPT 36575 | $343.80 | $573.00 | $194.82 – $383.25 | 3 |
| Ghs opcc repair cvp w subq port CPT 36576 | $1,187.40 | $1,979.00 | $672.86 – $884.03 | 3 |
| Ghs optokenetic CPT 92544 | $157.20 | $262.00 | $89.08 – $191.26 | 3 |
| Ghs oscillating trac CPT 92545 | $157.20 | $262.00 | $89.08 – $116.80 | 3 |
| Ghs osteopathic manipulative tx, 1-2 regions CPT 98925 | $61.80 | $103.00 | $21.08 – $45.26 | 3 |
| Ghs osteopathic manipulative tx, 3-4 regions CPT 98926 | $87.60 | $146.00 | $23.80 – $51.10 | 3 |
| Ghs ot dds rom CPT 95851 | $76.80 | $128.00 | $43.52 – $44.53 | 3 |
| Ghs ot group caregiver training CPT 97552 | $33.00 | $55.00 | $18.70 – $40.15 | 3 |
| Ghs ot prosthetic training/15 min CPT 97761 | $66.60 | $111.00 | $37.74 – $56.21 | 3 |
| Ghs ot sensory integrative tech/15min CPT 97533 | $64.80 | $108.00 | $36.72 – $78.84 | 3 |
| Ghs ot work hardening-additional hours CPT 97546 | $59.40 | $99.00 | $33.66 – $62.78 | 3 |
| Ghs pacing - transcutaneous CPT 92953 | $484.20 | $807.00 | $75.92 – $274.38 | 3 |
| Ghs paravert facet/nerve cerv ea add bil CPT 64492 | $931.20 | $1,552.00 | $148.19 – $352.24 | 3 |
| Ghs paravert facet/nerve lumb ea add bil CPT 64495 | $1,212.60 | $2,021.00 | $127.02 – $458.32 | 3 |
| Ghs path - pap (papanicolau) smear - vagina CPT 88141 | $23.40 | $39.00 | $13.26 – $28.47 | 3 |
| Ghs peritonsillar abscess i andd CPT 42700 | $451.20 | $752.00 | $255.68 – $454.06 | 3 |
| Ghs phenylketonurid CPT 84030 | $120.60 | $201.00 | $10.54 – $22.63 | 3 |
| Ghs picc line insert < 5 CPT 36568 | $960.00 | $1,600.00 | $544.00 – $681.09 | 3 |
| Ghs plngl fx pm cl CPT 26725 | $636.60 | $1,061.00 | $131.24 – $281.78 | 3 |
| Ghs plt ct-manual CPT 85032 | $23.40 | $39.00 | $13.26 – $28.47 | 3 |
| Ghs polysom <6 yrs 4/> parameters CPT 95782 | $3,161.40 | $5,269.00 | $305.87 – $1,791.46 | 3 |
| Ghs pos nystagmus CPT 92542 | $157.20 | $262.00 | $89.08 – $191.26 | 3 |
| Ghs ppd (tb intradermal) CPT 86580 | $30.60 | $51.00 | $16.32 – $20.44 | 3 |
| Ghs prostatic acid phosphatase (mayo) CPT 84066 | $103.20 | $172.00 | $18.70 – $40.15 | 3 |
| Ghs protein, misc fluid CPT 84160 | $31.80 | $53.00 | $18.02 – $38.69 | 3 |
| Ghs protoporphyrins fract CPT 84202 | $95.40 | $159.00 | $23.12 – $49.64 | 3 |
| Ghs pr without cont pulse ox CPT 94625 | $119.40 | $199.00 | $67.66 – $145.27 | 3 |
| Ghs pseudocholinesterase,dibucain-inhibi CPT 82638 | $80.40 | $134.00 | $45.56 – $97.82 | 3 |
| Ghs pt - work hardening/int 2hrs CPT 97545 | $144.60 | $241.00 | $81.94 – $139.43 | 3 |
| Ghs quinidine CPT 80194 | $124.20 | $207.00 | $45.56 – $97.82 | 3 |
| Ghs refill of implantable pump CPT 95990 | $311.40 | $519.00 | $176.46 – $195.64 | 3 |
| Ghs removal intranasal foreign body CPT 30300 | $445.80 | $743.00 | $102.34 – $219.73 | 3 |
| Ghs removal pharyngeal foreign body CPT 42809 | $336.60 | $561.00 | $102.34 – $219.73 | 3 |
| Ghs repair extensor tendon hand, ea tendon CPT 26410 | $1,062.00 | $1,770.00 | $340.34 – $730.73 | 3 |
| Ghs repair tendon ext forearm/wrist ea CPT 25270 | $1,148.40 | $1,914.00 | $129.88 – $278.86 | 3 |
| Ghs respiratory syncytical virus igg/m CPT 86756 | $193.80 | $323.00 | $109.82 – $235.79 | 3 |
| Ghs reticulocyte count CPT 85044 | $42.60 | $71.00 | $16.32 – $35.04 | 3 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | $75.60 | $126.00 | $19.04 – $32.12 | 3 |
| Ghs sedimentation rate CPT 85651 | $21.00 | $35.00 | $11.90 – $25.55 | 3 |
| Ghs semen analysis fert CPT 89320 | $124.80 | $208.00 | $43.86 – $94.17 | 3 |
| Ghs semen analysis, post-vas CPT 89300 | $66.00 | $110.00 | $37.40 – $80.30 | 3 |
| Ghs sensitivity (per antimicro) CPT 87184 | $70.80 | $118.00 | $31.96 – $68.62 | 3 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $341.40 | $569.00 | $193.46 – $394.93 | 3 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $418.80 | $698.00 | $204.34 – $438.73 | 3 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $390.60 | $651.00 | $193.46 – $415.37 | 3 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | $578.40 | $964.00 | $204.34 – $438.73 | 3 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $326.40 | $544.00 | $184.96 – $334.34 | 3 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $324.60 | $541.00 | $183.94 – $305.14 | 3 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $343.20 | $572.00 | $194.48 – $411.72 | 3 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | $453.00 | $755.00 | $202.98 – $435.81 | 3 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | $378.00 | $630.00 | $214.20 – $459.90 | 3 |
| Ghs sleep study unattended CPT 95800 | $889.80 | $1,483.00 | $126.29 – $504.22 | 3 |
| Ghs somatosensory testing lower extremit CPT 95926 | $280.80 | $468.00 | $159.12 – $277.40 | 3 |
| Ghs somatosensory testing upper & lower limbs CPT 95938 | $753.60 | $1,256.00 | $427.04 – $916.88 | 3 |
| Ghs speech-gen aug dev eval iii, st CPT 92608 | $172.20 | $287.00 | $36.38 – $78.11 | 3 |
| Ghs sphenopalatine ganglion block CPT 64505 | $511.80 | $853.00 | $290.02 – $346.75 | 3 |
| Ghs spont nystagmus CPT 92541 | $144.00 | $240.00 | $81.60 – $175.20 | 3 |
| Ghs sp train/fitting sp device - kx CPT 92609 | $183.00 | $305.00 | $47.60 – $102.20 | 3 |
| Ghs st - eval for alt comm CPT 92567 | $133.20 | $222.00 | $64.24 – $75.48 | 3 |
| Ghs strapping shoulder - 29240 CPT 29240 | $156.00 | $260.00 | $88.40 – $189.80 | 3 |
| Ghs st - re-eval for alt comm CPT 92597 | $140.40 | $234.00 | $79.56 – $170.82 | 3 |
| Ghs subcutaneous infus, for therapy ea. add. hr CPT 96370 | $42.60 | $71.00 | $24.14 – $51.83 | 3 |
| Ghs subcutaneous infus. for therapy init 1 hr CPT 96369 | $351.60 | $586.00 | $199.24 – $427.78 | 3 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $520.20 | $867.00 | $167.28 – $359.16 | 3 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | $315.00 | $525.00 | $175.44 – $376.68 | 3 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | $1,206.00 | $2,010.00 | $683.40 – $762.12 | 3 |
| Ghs trypsin (fecal) CPT 84488 | $108.60 | $181.00 | $61.54 – $132.13 | 3 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $591.00 | $985.00 | $258.40 – $554.80 | 3 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | $475.80 | $793.00 | $227.80 – $489.10 | 3 |
| Ghs urine, hydroxproline total CPT 83505 | $224.40 | $374.00 | $127.16 – $273.02 | 3 |
| Ghs urine, porphyrins quant CPT 84120 | $160.20 | $267.00 | $21.08 – $45.26 | 3 |
| Ghs vaginal delivery only CPT 59409 | $2,466.60 | $4,111.00 | $928.00 – $2,273.95 | 3 |
| Ghs veeg 12-26 hr intmt mont CPT 95715 | $1,576.80 | $2,628.00 | $893.52 – $1,918.44 | 3 |
| Ghs windowing of cast CPT 29730 | $151.20 | $252.00 | $85.68 – $150.38 | 3 |
| Gi inhouse confirmation CPT 87045 | $62.40 | $104.00 | $3.74 – $8.03 | 3 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | $1,345.80 | $2,243.00 | $928.00 – $2,679.00 | 3 |
| Gi trc img intral esophagus CPT 91111 | $76.20 | $127.00 | $92.71 – $2,679.00 | 3 |
| Glassia injection HCPCS J0257 | $40.24 | $67.06 | $22.80 – $48.95 | 3 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $509.77 | $849.62 | $72.39 – $155.42 | 3 |
| Glucagon plasma - sendout CPT 82943 | $58.20 | $97.00 | $32.98 – $70.81 | 3 |
| Glucose 1 hr post dose CPT 82950 | $30.00 | $50.00 | $9.52 – $20.44 | 3 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $29.40 | $49.00 | $15.64 – $21.90 | 3 |
| Glucose blood quantitative CPT 82947 | $41.40 | $69.00 | $14.96 – $32.12 | 3 |
| Glucose body fluid CPT 82945 | $45.00 | $75.00 | $7.82 – $16.79 | 3 |
| Glucose monitoring continual min 72hr pt CPT 95249 | $179.40 | $299.00 | $218.27 – $2,679.00 | 3 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $75.00 | $125.00 | $42.50 – $91.25 | 3 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $67.80 | $113.00 | $13.94 – $29.93 | 3 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $3,570.58 | $5,950.96 | $2,023.33 – $4,344.20 | 3 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $99.60 | $166.00 | $35.02 – $75.19 | 3 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $105.60 | $176.00 | $35.02 – $75.19 | 3 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | $5,489.50 | $9,149.17 | $1,135.12 – $2,437.18 | 3 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $2,868.60 | $4,781.00 | $1,625.54 – $3,490.13 | 3 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $31,054.80 | $51,758.00 | $433.50 – $930.75 | 3 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $26,257.80 | $43,763.00 | $191.42 – $410.99 | 3 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $10,269.00 | $17,115.00 | $28.22 – $60.59 | 3 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $11,542.80 | $19,238.00 | $573.92 – $1,232.24 | 3 |
| Graft repair of spine defect 63710 CPT 63710 | $2,054.40 | $3,424.00 | $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.