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 |
|---|---|---|---|---|
| Jaw Joint (TMJ) X-ray (both sides, open and closed) CPT 70330 | $232.20 | $387.00 | $131.58 – $282.51 | 3 |
| Jaw (Mandible) X-ray (complete) CPT 70110 | $232.80 | $388.00 | $69.35 – $131.92 | 3 |
| Jejunstmy tube plcmt CPT 44372 | $364.20 | $607.00 | $443.11 – $2,679.00 | 3 |
| J-tube placement CPT 44015 | $437.40 | $729.00 | $532.17 – $2,679.00 | 3 |
| Ketamine and metabolite screen - quest CPT 80357 | $79.20 | $132.00 | $44.88 – $96.36 | 3 |
| Ketogenic steroids fract CPT 83582 | $82.80 | $138.00 | $44.54 – $95.63 | 3 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $43.80 | $73.00 | $18.70 – $40.15 | 3 |
| Ketorolac (Toradol) Pain Shot, 15 mg HCPCS J1885 | $26.95 | $44.91 | $7.75 – $16.63 | 3 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $486.00 | $810.00 | $275.40 – $591.30 | 3 |
| Kidney (Retroperitoneal) Ultrasound (limited) CPT 76775 | $372.00 | $620.00 | $210.80 – $452.60 | 3 |
| Kit case 4.2mm spinejack HCPCS C1062 | $10,027.20 | $16,712.00 | $5,682.08 – $12,199.76 | 3 |
| Kit cast tcc 3in w/2reg boots total contact cast HCPCS Q4038 | $86.40 | $144.00 | $105.12 – $2,679.00 | 3 |
| Kit cath f 8f w/glv + wipe ster HCPCS A4353 | $6.60 | $11.00 | $8.03 – $2,679.00 | 3 |
| Kit cath ivl 2.5x40mm 135cm shockwave s4 HCPCS C1761 | $10,575.00 | $17,625.00 | $3,506.42 – $7,528.49 | 3 |
| Kit irrigator stoma cone 7721 HCPCS A4398 | $7.20 | $12.00 | $4.08 – $8.76 | 3 |
| Kit lead specify 5-6-5 HCPCS C1778 | $12,555.00 | $20,925.00 | $247.52 – $531.44 | 3 |
| Kit tissue closure sealant adhesive air leak progel 4 ml pleura HCPCS C2615 | $1,969.20 | $3,282.00 | $1,115.54 – $2,395.13 | 3 |
| Kit trach suct cls 30.5cm HCPCS A4605 | $28.20 | $47.00 | $10.88 – $23.36 | 3 |
| Knee Arthroscopy (Meniscus Trimming) CPT 29881 | $755.40 | $1,259.00 | $919.07 – $2,679.00 | 3 |
| Knee arthroscopy/surgery CPT 29880 | $784.20 | $1,307.00 | $928.00 – $2,679.00 | 3 |
| Knee MRI (with and without contrast) CPT 73723 | $3,717.00 | $6,195.00 | $1,390.94 – $2,986.43 | 3 |
| Knee MRI (with contrast) CPT 73722 | $2,693.40 | $4,489.00 | $1,008.10 – $2,164.45 | 3 |
| Knee MRI (without contrast) CPT 73721 | $2,653.20 | $4,422.00 | $992.46 – $2,130.87 | 3 |
| Knee X-ray CPT 73564 | $293.40 | $489.00 | $79.57 – $110.84 | 3 |
| Knee X-ray (1 to 2 views, both knees) CPT 73560 | $238.20 | $397.00 | $55.48 – $90.10 | 3 |
| Knee X-ray (3 views, both knees) CPT 73562 | $288.60 | $481.00 | $69.35 – $109.14 | 3 |
| Knee X-ray (standing, both knees) CPT 73565 | $128.40 | $214.00 | $64.24 – $72.76 | 3 |
| Kyleena, 19.5 mg HCPCS J7296 | $2,161.19 | $3,601.99 | $1,224.68 – $2,629.45 | 3 |
| Lab draw < 3 yrs fem/jugular 36400 CPT 36400 | $53.40 | $89.00 | $64.97 – $2,679.00 | 3 |
| Lab draw <3 yrs scalp vein 36405 CPT 36405 | $49.80 | $83.00 | $60.59 – $2,679.00 | 3 |
| Labetalol 5 mg/ml IV (wrapper) HCPCS J1920 | $120.00 | $200.00 | $9.16 – $19.67 | 3 |
| Labioplasty 56800 CPT 56800 | $468.60 | $781.00 | $570.13 – $2,679.00 | 3 |
| Lactate dehydrogenase (ldh) CPT 83615 | $43.80 | $73.00 | $11.90 – $25.55 | 3 |
| Lactated ringers intravenous solution HCPCS J7120 | $43.74 | $72.90 | $17.70 – $38.00 | 3 |
| Lactic acid CPT 83605 | $84.00 | $140.00 | $38.08 – $81.76 | 3 |
| Lactoferrin fecal qualitative CPT 83630 | $81.00 | $135.00 | $45.90 – $98.55 | 3 |
| Lactoferrin fecal quant CPT 83631 | $66.00 | $110.00 | $37.40 – $80.30 | 3 |
| Lam facetec & foramot crv CPT 63045 | $2,722.80 | $4,538.00 | $928.00 – $3,312.74 | 3 |
| Lam facetec & foramot lumbar CPT 63047 | $2,326.20 | $3,877.00 | $928.00 – $2,830.21 | 3 |
| Lam facetec & foramot thrc CPT 63046 | $2,625.00 | $4,375.00 | $928.00 – $3,193.75 | 3 |
| Lamie bx/exc idrl spine lesn lmbr 63282 CPT 63282 | $3,634.20 | $6,057.00 | $928.00 – $4,421.61 | 3 |
| Lamie bx/exc idrl spine lesn thrc 63281 CPT 63281 | $4,352.40 | $7,254.00 | $928.00 – $5,295.42 | 3 |
| Lamie excise intrspinl lesion thrc 63266 CPT 63266 | $3,180.00 | $5,300.00 | $928.00 – $3,869.00 | 3 |
| Laminotomy single lumbar CPT 63042 | $3,033.00 | $5,055.00 | $928.00 – $3,690.15 | 3 |
| Lamiotoiotiotinotomy addl cervical 63043 CPT 63043 | $985.20 | $1,642.00 | $928.00 – $2,679.00 | 3 |
| Lanreotide 120 mg/0.5 ml subcutaneous syringe HCPCS J1930 | $16,948.63 | $28,247.72 | $3,075.29 – $6,602.82 | 3 |
| Laparo-asst vag hysterectomy CPT 58550 | $2,890.80 | $4,818.00 | $928.00 – $3,517.14 | 3 |
| Laparo cholecystectomy/explr CPT 47564 | $2,120.40 | $3,534.00 | $928.00 – $2,679.00 | 3 |
| Laparo cholecystectomy/graph CPT 47563 | $1,349.40 | $2,249.00 | $928.00 – $2,679.00 | 3 |
| Laparo drng lymphocele 49323 CPT 49323 | $1,219.20 | $2,032.00 | $928.00 – $2,679.00 | 3 |
| Laparo-myomectomy complex CPT 58546 | $2,199.00 | $3,665.00 | $928.00 – $2,679.00 | 3 |
| Laparo partial colectomy 44204 CPT 44204 | $2,917.80 | $4,863.00 | $928.00 – $3,549.99 | 3 |
| Laparo proc abdm/per/oment 49329 CPT 49329 | $1,492.20 | $2,487.00 | $928.00 – $2,679.00 | 3 |
| Laparo radical nephrectomy CPT 50545 | $2,509.20 | $4,182.00 | $928.00 – $3,052.86 | 3 |
| Laparoscopic myomectomy CPT 58545 | $1,741.80 | $2,903.00 | $928.00 – $2,679.00 | 3 |
| Laparoscopic proc CPT 45400 | $2,215.20 | $3,692.00 | $928.00 – $2,695.16 | 3 |
| Laparoscopic salpingostomy 58673 CPT 58673 | $1,560.60 | $2,601.00 | $928.00 – $2,679.00 | 3 |
| Laparoscopy adrenalectomy CPT 60650 | $2,259.00 | $3,765.00 | $928.00 – $2,748.45 | 3 |
| Laparoscopy aspiration CPT 49322 | $706.20 | $1,177.00 | $859.21 – $2,679.00 | 3 |
| Laparoscopy biopsy CPT 49321 | $654.60 | $1,091.00 | $796.43 – $2,679.00 | 3 |
| Laparoscopye procstom 43659 CPT 43659 | $2,683.80 | $4,473.00 | $812.49 – $2,679.00 | 3 |
| Laparoscopy excise lesions CPT 58662 | $1,372.80 | $2,288.00 | $928.00 – $2,679.00 | 3 |
| Laparoscopy fundoplasty CPT 43280 | $2,041.80 | $3,403.00 | $928.00 – $2,679.00 | 3 |
| Laparoscopy gastrostomy CPT 43653 | $1,073.40 | $1,789.00 | $928.00 – $2,679.00 | 3 |
| Laparoscopy lymphadenectomy CPT 38571 | $1,561.20 | $2,602.00 | $928.00 – $2,679.00 | 3 |
| Laparoscopy lymphadenectomy CPT 38572 | $1,836.00 | $3,060.00 | $928.00 – $2,679.00 | 3 |
| Laparoscopy lymph node biop CPT 38570 | $1,032.00 | $1,720.00 | $928.00 – $2,679.00 | 3 |
| Laparoscopy lysis CPT 58660 | $1,306.80 | $2,178.00 | $928.00 – $2,679.00 | 3 |
| Laparoscopy remove adnexa CPT 58661 | $1,254.60 | $2,091.00 | $928.00 – $2,679.00 | 3 |
| Laparoscopy splenectomy CPT 38120 | $2,075.40 | $3,459.00 | $928.00 – $2,679.00 | 3 |
| Laparoscopy surg colpopexy CPT 57425 | $1,546.80 | $2,578.00 | $928.00 – $2,679.00 | 3 |
| Laparoscopy tubal block 58671 CPT 58671 | $710.40 | $1,184.00 | $864.32 – $2,679.00 | 3 |
| Laparo sling operation 51992 CPT 51992 | $1,666.80 | $2,778.00 | $928.00 – $2,679.00 | 3 |
| Laparotomy; inject/aspirate liver cyst 47015 CPT 47015 | $1,699.80 | $2,833.00 | $928.00 – $2,679.00 | 3 |
| Laparo total proctocolectomy CPT 44212 | $2,792.40 | $4,654.00 | $928.00 – $3,397.42 | 3 |
| Laparo urethral suspension CPT 51990 | $1,485.00 | $2,475.00 | $928.00 – $2,679.00 | 3 |
| Laparo-vag hyst incl t/o CPT 58552 | $1,910.40 | $3,184.00 | $928.00 – $2,679.00 | 3 |
| Laparo-vag hyst w/t/o compl CPT 58554 | $4,488.60 | $7,481.00 | $928.00 – $5,461.13 | 3 |
| Laparscpy ablat 1>lvr tum cryo CPT 47371 | $2,394.00 | $3,990.00 | $928.00 – $2,912.70 | 3 |
| Lap close enterostomy with resect 44227 CPT 44227 | $3,582.00 | $5,970.00 | $928.00 – $4,358.10 | 3 |
| Lap colectomy/coloproctostomy 44207 CPT 44207 | $2,662.20 | $4,437.00 | $928.00 – $3,239.01 | 3 |
| Lap colectomy/coloproctostomy w/clst 44208 CPT 44208 | $3,781.80 | $6,303.00 | $928.00 – $4,601.19 | 3 |
| Lap colectomy part w/ileum 44205 CPT 44205 | $2,540.40 | $4,234.00 | $928.00 – $3,090.82 | 3 |
| Lap colectomy w/proctectomy 44211 CPT 44211 | $3,222.00 | $5,370.00 | $928.00 – $3,920.10 | 3 |
| Lap colostomy 44188 CPT 44188 | $2,318.40 | $3,864.00 | $928.00 – $2,820.72 | 3 |
| Lap enterectomy 44202 CPT 44202 | $2,142.00 | $3,570.00 | $928.00 – $2,679.00 | 3 |
| Lap enterolysis CPT 44180 | $1,736.40 | $2,894.00 | $928.00 – $2,679.00 | 3 |
| Lap esophageal lengthening addl 43283 CPT 43283 | $306.60 | $511.00 | $373.03 – $2,679.00 | 3 |
| Lap fimbrioplasty 58672 CPT 58672 | $1,434.60 | $2,391.00 | $928.00 – $2,679.00 | 3 |
| Lap gastric bypass/roux-en-y CPT 43644 | $3,167.40 | $5,279.00 | $928.00 – $3,853.67 | 3 |
| Lap ileo/jejuno-stomy 44187 CPT 44187 | $2,098.20 | $3,497.00 | $928.00 – $2,679.00 | 3 |
| Lap inc hernia repair 49654 CPT 49654 | $1,533.00 | $2,555.00 | $928.00 – $2,679.00 | 3 |
| Lap inc hernia repair recurr 49656 CPT 49656 | $1,657.80 | $2,763.00 | $928.00 – $2,679.00 | 3 |
| Lap inc hern recur comp 49657 CPT 49657 | $2,383.20 | $3,972.00 | $928.00 – $2,899.56 | 3 |
| Lap inc hern repair comp 49655 CPT 49655 | $1,872.60 | $3,121.00 | $928.00 – $2,679.00 | 3 |
| Lap ing hernia repair init CPT 49650 | $802.80 | $1,338.00 | $370.11 – $2,679.00 | 3 |
| Lap ing hernia repair recur CPT 49651 | $1,045.20 | $1,742.00 | $928.00 – $2,679.00 | 3 |
| Lap insert tunnel ip cath CPT 49324 | $744.00 | $1,240.00 | $905.20 – $2,679.00 | 3 |
| Lap jejunostomy 44186 CPT 44186 | $1,230.60 | $2,051.00 | $928.00 – $2,679.00 | 3 |
| Lap mobil splenic fl add-on 44213 CPT 44213 | $360.60 | $601.00 | $438.73 – $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.