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 |
|---|---|---|---|---|
| Human epididymis protein 4 (he4) CPT 86305 | $257.40 | $429.00 | $44.88 – $96.36 | 3 |
| Human prothrombin complex concentrate (pcc)-lans 500 unit (400-640 unit) IV solution HCPCS J7165 | $18.00 | $30.00 | $10.20 – $21.90 | 3 |
| Hyaluronidase 150 unit/ml injection solution HCPCS J3470 | $171.83 | $286.38 | $26.35 – $56.58 | 3 |
| Hyaluronidase 200 units/ml inj HCPCS J3471 | $124.75 | $207.91 | $70.69 – $151.77 | 3 |
| Hydralazine 20 mg/ml injection solution HCPCS J0360 | $38.99 | $64.98 | $21.41 – $45.97 | 3 |
| Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J1720 | $91.30 | $152.16 | $10.38 – $22.29 | 3 |
| Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper) HCPCS J1171 | $263.40 | $439.00 | $8.54 – $18.34 | 3 |
| Hydromorphone 20-0.9 mg/100ml-% soln 100 ml cartridge HCPCS J7999 | $27.75 | $46.25 | $15.73 – $33.76 | 3 |
| Hydroxyzine hcl 50 mg/ml intramuscular solution HCPCS J3410 | $69.62 | $116.03 | $39.45 – $84.70 | 3 |
| Hymenotomy CPT 56442 | $93.60 | $156.00 | $113.88 – $2,679.00 | 3 |
| Hymovis injection 1 mg HCPCS J7322 | $1,282.37 | $2,137.28 | $726.68 – $1,560.21 | 3 |
| Hyoscyamine sulfate inj HCPCS J1980 | $43.48 | $72.46 | $24.64 – $52.90 | 3 |
| Hyperbaric oxygen therapy CPT 99183 | $384.60 | $641.00 | $467.93 – $2,679.00 | 3 |
| #hypersens-actinomyces ab CPT 86602 | $34.80 | $58.00 | $18.02 – $38.69 | 3 |
| Hypnotherapy CPT 90880 | $28.20 | $47.00 | $34.31 – $2,679.00 | 3 |
| Hyqvia 100mg immuneglobulin HCPCS J1575 | $13,055.02 | $21,758.36 | $631.87 – $1,356.67 | 3 |
| Hysterectomy/revise vagina 58275 CPT 58275 | $1,918.20 | $3,197.00 | $928.00 – $2,679.00 | 3 |
| Hysterectomy/revise vagina 58280 CPT 58280 | $2,053.20 | $3,422.00 | $928.00 – $2,679.00 | 3 |
| Hysteroplasty 58540 CPT 58540 | $1,770.60 | $2,951.00 | $928.00 – $2,679.00 | 3 |
| Hysterorrhaphy of ruptured uterus 59350 CPT 59350 | $460.20 | $767.00 | $559.91 – $2,679.00 | 3 |
| Hysterosalpingography s&i CPT 74740 | $519.60 | $866.00 | $294.44 – $632.18 | 3 |
| Hysteroscopy ablation CPT 58563 | $3,272.40 | $5,454.00 | $928.00 – $3,981.42 | 3 |
| Hysteroscopy biopsy CPT 58558 | $730.80 | $1,218.00 | $889.14 – $2,679.00 | 3 |
| Hysteroscopy dx sep proc CPT 58555 | $555.00 | $925.00 | $675.25 – $2,679.00 | 3 |
| Hysteroscopy lysis CPT 58559 | $670.20 | $1,117.00 | $815.41 – $2,679.00 | 3 |
| Hysteroscopy remove fb CPT 58562 | $760.80 | $1,268.00 | $925.64 – $2,679.00 | 3 |
| Hysteroscopy remove myoma CPT 58561 | $1,069.80 | $1,783.00 | $928.00 – $2,679.00 | 3 |
| Hysteroscopy resect septum CPT 58560 | $756.00 | $1,260.00 | $919.80 – $2,679.00 | 3 |
| Hysterotomy abdominal 59100 CPT 59100 | $1,639.20 | $2,732.00 | $928.00 – $2,679.00 | 3 |
| Hzv zoster vacc recombinant adjuvanted im inj CPT 90750 | $394.13 | $656.89 | $223.34 – $479.52 | 3 |
| I131 iodide cap, rx HCPCS A9517 | $43.20 | $72.00 | $24.48 – $52.56 | 3 |
| Iaadi respiratory synctial virus CPT 87280 | $34.20 | $57.00 | $19.04 – $40.88 | 3 |
| Iadna legionella pneumophila amplified probe tq CPT 87541 | $150.00 | $250.00 | $85.00 – $182.50 | 3 |
| Ibandronate 3 mg/3 ml intravenous syringe HCPCS J1740 | $790.26 | $1,317.10 | $447.81 – $961.48 | 3 |
| Ibuprofen injection HCPCS J1741 | $63.55 | $105.91 | $36.01 – $77.31 | 3 |
| Ibutilide fumarate 0.1 mg/ml intravenous solution HCPCS J1742 | $1,004.00 | $1,673.33 | $318.91 – $684.73 | 3 |
| Icd cobalt xt dr MRI is1 df1 HCPCS C1721 | $37,575.00 | $62,625.00 | $13,933.20 – $29,915.40 | 3 |
| Icd crtd cobalt hf MRI is1 df1 HCPCS C1882 | $42,525.00 | $70,875.00 | $17,950.64 – $38,541.08 | 3 |
| Icd crtp serena MRI HCPCS C2621 | $15,727.80 | $26,213.00 | $5,536.56 – $11,887.32 | 3 |
| Icd reliance df4 ib 64cm HCPCS C1895 | $9,922.80 | $16,538.00 | $3,314.32 – $7,116.04 | 3 |
| I&d abscess posterior spine l/s/ls-22015 CPT 22015 | $1,403.40 | $2,339.00 | $928.00 – $2,679.00 | 3 |
| I&d abscss rtrphryngl/paraphryngl intraorl apprch CPT 42720 | $894.60 | $1,491.00 | $928.00 – $2,679.00 | 3 |
| Idarubicin hcl injection HCPCS J9211 | $713.88 | $1,189.80 | $106.11 – $227.83 | 3 |
| I&d/bursa/foot 28001 CPT 28001 | $521.40 | $869.00 | $634.37 – $2,679.00 | 3 |
| I&d frarm&/wrst deep absc/hematoma CPT 25028 | $986.40 | $1,644.00 | $928.00 – $2,679.00 | 3 |
| I&d intramural/intramuscular/submuc abscess transanal anes CPT 46045 | $807.00 | $1,345.00 | $928.00 – $2,679.00 | 3 |
| I&d upper arm/elbow deep abscess/hematoma CPT 23930 | $667.20 | $1,112.00 | $811.76 – $2,679.00 | 3 |
| Idursulfase injection HCPCS J1743 | $5,750.41 | $9,584.01 | $3,258.56 – $6,996.33 | 3 |
| I & d vag hematoma non-ob 57023 CPT 57023 | $605.40 | $1,009.00 | $736.57 – $2,679.00 | 3 |
| I&d vag hemtma obst/postpart CPT 57022 | $327.00 | $545.00 | $397.85 – $2,679.00 | 3 |
| Ifosfamide 1 gram intravenous solution HCPCS J9208 | $292.09 | $486.81 | $81.72 – $175.46 | 3 |
| Igh@ var region somatic mutation analy CPT 81263 | $825.00 | $1,375.00 | $467.50 – $1,003.75 | 3 |
| Ihc/icc per specimen each additional single antibody stain CPT 88341 | $73.80 | $123.00 | $41.82 – $89.79 | 3 |
| Ihc/icc per specimen each multiplex antibody stain CPT 88344 | $247.80 | $413.00 | $140.42 – $301.49 | 3 |
| Ihc/icc per specimen initial single antibody stain CPT 88342 | $119.40 | $199.00 | $42.84 – $91.98 | 3 |
| Ileostomy/jejunostomy non-tube 44310 CPT 44310 | $1,976.40 | $3,294.00 | $928.00 – $2,679.00 | 3 |
| Iliac revasc add-on 37222 CPT 37222 | $1,775.40 | $2,959.00 | $928.00 – $2,679.00 | 3 |
| Imatinib 100 mg tab HCPCS S0088 | $207.25 | $345.42 | $27.20 – $58.40 | 3 |
| Imbrication/diaphragm/transthor/transabd 39545 CPT 39545 | $1,728.00 | $2,880.00 | $928.00 – $2,679.00 | 3 |
| Imetelstat 188 mg intravenous solution HCPCS J0870 | $18,478.85 | $30,798.08 | $2,635.44 – $5,658.43 | 3 |
| Immobilizer shldr cntor adlt HCPCS L3670 | $7.20 | $12.00 | $8.76 – $2,679.00 | 3 |
| Immobilizer shldr dlx str 24-36in med HCPCS L1830 | $102.00 | $170.00 | $9.18 – $19.71 | 3 |
| Immobilizer shldr sling med HCPCS L3660 | $44.40 | $74.00 | $54.02 – $2,679.00 | 3 |
| Immt breast prosthesis 19340 CPT 19340 | $1,815.00 | $3,025.00 | $928.00 – $2,679.00 | 3 |
| Immune complex assay CPT 86332 | $68.40 | $114.00 | $38.76 – $83.22 | 3 |
| Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution HCPCS J1569 | $9,307.69 | $15,512.81 | $192.03 – $412.30 | 3 |
| Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution HCPCS J1566 | $4,061.21 | $6,768.69 | $7.04 – $15.11 | 3 |
| Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution HCPCS J1568 | $2,839.91 | $4,733.19 | $414.91 – $890.83 | 3 |
| Immune globulin ig human im use 90281 CPT 90281 | $36.60 | $61.00 | $44.53 – $2,679.00 | 3 |
| Immunoassay tumor antigen quantitative ca 125 CPT 86304 | $189.00 | $315.00 | $39.44 – $84.68 | 3 |
| Immunoassay tumor antigen quantitative ca 19-9 CPT 86301 | $141.60 | $236.00 | $41.82 – $89.79 | 3 |
| Immunodiff gel qual ea antigen/ab CPT 86331 | $45.60 | $76.00 | $21.08 – $45.26 | 3 |
| Immunofixation electrophoresis serum CPT 86334 | $146.40 | $244.00 | $23.46 – $50.37 | 3 |
| Immunofluorescence per specimen initial single antibody stain CPT 88346 | $215.40 | $359.00 | $122.06 – $262.07 | 3 |
| Impedence cardiogram CPT 93701 | $154.20 | $257.00 | $87.38 – $187.61 | 3 |
| Implant biventricular device 33976 CPT 33976 | $3,444.60 | $5,741.00 | $928.00 – $4,190.93 | 3 |
| Implant cartilage 10mm synthetic HCPCS L8699 | $12,203.40 | $20,339.00 | $153.00 – $328.50 | 3 |
| Implant hormone pellet(s) 11980 CPT 11980 | $199.80 | $333.00 | $243.09 – $2,679.00 | 3 |
| Implant open hernia repair w/mesh 49568 CPT 49568 | $557.40 | $929.00 | $678.17 – $2,679.00 | 3 |
| Implant single ventricular device 33975 CPT 33975 | $2,539.80 | $4,233.00 | $928.00 – $3,090.09 | 3 |
| Implant spine infusion pump CPT 62362 | $816.60 | $1,361.00 | $928.00 – $2,679.00 | 3 |
| Implant ureth bulk agent HCPCS L8606 | $2,587.80 | $4,313.00 | $1,466.42 – $3,148.49 | 3 |
| Impl neurostim electr perc CPT 63650 | $2,535.60 | $4,226.00 | $928.00 – $3,084.98 | 3 |
| Implnt bio implnt for soft tiss reinforcement 15777 CPT 15777 | $214.20 | $357.00 | $260.61 – $2,679.00 | 3 |
| Implnt spinl canal catheter 62350 CPT 62350 | $763.20 | $1,272.00 | $928.00 – $2,679.00 | 3 |
| Implt brain chemotx add-on 61517 CPT 61517 | $160.80 | $268.00 | $195.64 – $2,679.00 | 3 |
| Impreg gauze no h20/sal/yard HCPCS A6266 | $9.60 | $16.00 | $11.68 – $2,679.00 | 3 |
| In-111 autol wbc diag per dose HCPCS A9570 | $1,725.00 | $2,875.00 | $977.50 – $2,098.75 | 3 |
| In-111 oxyquinolin per 0.5 mci HCPCS A9547 | $1,725.00 | $2,875.00 | $977.50 – $2,098.75 | 3 |
| Incis 1 vertebral seg lumbar CPT 22214 | $2,073.60 | $3,456.00 | $928.00 – $2,679.00 | 3 |
| Incise perq finger tendon 26060 CPT 26060 | $502.80 | $838.00 | $611.74 – $2,679.00 | 3 |
| Incise tear duct opening 68440 CPT 68440 | $190.80 | $318.00 | $232.14 – $2,679.00 | 3 |
| Incision & drainage hematoma/seroma/fluid collection CPT 10140 | $2,001.00 | $3,335.00 | $370.84 – $1,133.90 | 3 |
| Incision & drainage open of deep abscess (subfascial) pos CPT 22010 | $1,413.60 | $2,356.00 | $928.00 – $2,679.00 | 3 |
| Incision of anal sphincter CPT 46080 | $463.80 | $773.00 | $564.29 – $2,679.00 | 3 |
| Incision of bile duct 47420 CPT 47420 | $2,521.80 | $4,203.00 | $928.00 – $3,068.19 | 3 |
| Incision of breast lesion CPT 19020 | $1,859.40 | $3,099.00 | $928.00 – $1,064.34 | 3 |
| Incision of eardrum CPT 69420 | $375.60 | $626.00 | $456.98 – $2,679.00 | 3 |
| Incision of eardrum CPT 69421 | $295.20 | $492.00 | $359.16 – $2,679.00 | 3 |
| Incision of foot fascia CPT 28008 | $826.20 | $1,377.00 | $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.