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 |
|---|---|---|---|---|
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $2,361.60 | $3,936.00 | $1,338.24 – $2,873.28 | 3 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $1,275.60 | $2,126.00 | $722.84 – $1,551.98 | 3 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $1,750.80 | $2,918.00 | $668.10 – $1,434.45 | 3 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $257.40 | $429.00 | $63.51 – $145.86 | 3 |
| Lower Back (Lumbar Spine) X-ray (4 or more views) CPT 72110 | $355.20 | $592.00 | $87.60 – $201.28 | 3 |
| Lower Back (Lumbar Spine) X-ray (with bending views) CPT 72114 | $438.60 | $731.00 | $124.10 – $248.54 | 3 |
| Lower Leg (Shin) X-ray (both sides) CPT 73590 | $249.00 | $415.00 | $49.64 – $94.18 | 3 |
| Lsh uterus 250 g or less CPT 58541 | $1,679.40 | $2,799.00 | $928.00 – $2,679.00 | 3 |
| Lsh uterus above 250 g CPT 58543 | $1,907.40 | $3,179.00 | $928.00 – $2,679.00 | 3 |
| Lsh w/t/o ut 250 g or less CPT 58542 | $1,875.60 | $3,126.00 | $928.00 – $2,679.00 | 3 |
| Lsh w/t/o uterus above 250 g CPT 58544 | $2,064.60 | $3,441.00 | $928.00 – $2,679.00 | 3 |
| Lumbar Spinal Fusion (single level) CPT 22612 | $2,995.20 | $4,992.00 | $928.00 – $3,644.16 | 3 |
| Lumizyme injection HCPCS J0221 | $1,789.05 | $2,981.75 | $1,013.80 – $2,176.68 | 3 |
| Lung Function Test Before and After an Inhaler CPT 94060 | $444.00 | $740.00 | $31.39 – $99.28 | 3 |
| Lung function test (mbc/mvv) CPT 94200 | $107.40 | $179.00 | $14.60 – $60.86 | 3 |
| Lung Function Test (Spirometry) CPT 94010 | $221.40 | $369.00 | $21.17 – $65.96 | 3 |
| Lung volume reduction 32491 CPT 32491 | $2,248.20 | $3,747.00 | $928.00 – $2,735.31 | 3 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | $14,405.83 | $24,009.72 | $8,163.30 – $17,527.10 | 3 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | $21,867.91 | $36,446.52 | $4,135.31 – $8,878.76 | 3 |
| Lymphadenect/stage/pelv/paraaortic 38562 CPT 38562 | $1,335.60 | $2,226.00 | $928.00 – $2,679.00 | 3 |
| Lymphocyte transformation mitogen CPT 86353 | $229.20 | $382.00 | $129.88 – $278.86 | 3 |
| Lysis intranasal synechia 30560 CPT 30560 | $526.80 | $878.00 | $640.94 – $2,679.00 | 3 |
| Lysis of labial adhesions CPT 56441 | $281.40 | $469.00 | $342.37 – $2,679.00 | 3 |
| Lysis penil circumic lesion CPT 54162 | $511.20 | $852.00 | $621.96 – $2,679.00 | 3 |
| Macroscopic exam arthropod CPT 87168 | $55.20 | $92.00 | $25.16 – $54.02 | 3 |
| Macroscopic exam parasite CPT 87169 | $18.00 | $30.00 | $8.84 – $18.98 | 3 |
| Magnesium CPT 83735 | $64.80 | $108.00 | $12.58 – $27.01 | 3 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $221.80 | $369.67 | $8.24 – $17.70 | 3 |
| Makena, 10 mg HCPCS J1726 | $6,123.06 | $10,205.10 | $3,469.73 – $7,449.72 | 3 |
| Management of liver hemorrhage 47361 CPT 47361 | $4,383.00 | $7,305.00 | $928.00 – $5,332.65 | 3 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | $17.29 | $28.82 | $8.83 – $18.95 | 3 |
| Mapping io sentinel lymph node CPT 38900 | $256.80 | $428.00 | $312.44 – $2,679.00 | 3 |
| Marker biop eviva buckle ss HCPCS A4648 | $616.80 | $1,028.00 | $42.16 – $90.52 | 3 |
| Marsupialization liver lesion 47300 CPT 47300 | $2,128.20 | $3,547.00 | $928.00 – $2,679.00 | 3 |
| Mastectomy partial CPT 19301 | $1,211.40 | $2,019.00 | $928.00 – $2,679.00 | 3 |
| Mast mod rad CPT 19307 | $2,229.60 | $3,716.00 | $928.00 – $2,712.68 | 3 |
| Mastoidectomy complete 69502 CPT 69502 | $1,909.80 | $3,183.00 | $928.00 – $2,679.00 | 3 |
| Mastoids complete CPT 70130 | $235.20 | $392.00 | $133.28 – $286.16 | 3 |
| Mastopexy CPT 19316 | $1,756.80 | $2,928.00 | $928.00 – $2,679.00 | 3 |
| Mast simple complete CPT 19303 | $1,876.80 | $3,128.00 | $864.32 – $2,679.00 | 3 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $49.80 | $83.00 | $28.22 – $60.59 | 3 |
| Mayo aathr protein s free CPT 85306 | $255.60 | $426.00 | $29.24 – $62.78 | 3 |
| Mayo activated protein c resistance assay CPT 85307 | $263.40 | $439.00 | $30.94 – $66.43 | 3 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $109.80 | $183.00 | $62.22 – $133.59 | 3 |
| Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation CPT 80321 | $288.60 | $481.00 | $111.52 – $239.44 | 3 |
| Mayo alcohol definitive assay volatile screen CPT 80320 | $364.20 | $607.00 | $31.96 – $68.62 | 3 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $304.80 | $508.00 | $22.78 – $48.91 | 3 |
| Mayo alkaloids definitive assay nicotine/cotinine CPT 80323 | $208.20 | $347.00 | $40.80 – $87.60 | 3 |
| Mayo alpha 1 antitrypsin CPT 82103 | $82.20 | $137.00 | $24.48 – $52.56 | 3 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $122.40 | $204.00 | $22.10 – $47.45 | 3 |
| Mayo analysis gene calr common variants exon 9 CPT 81219 | $425.40 | $709.00 | $212.16 – $455.52 | 3 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $317.40 | $529.00 | $104.04 – $223.38 | 3 |
| Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 | $1,228.80 | $2,048.00 | $696.32 – $1,495.04 | 3 |
| Mayo androstenedione CPT 82157 | $252.00 | $420.00 | $55.76 – $119.72 | 3 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | $86.40 | $144.00 | $27.54 – $59.13 | 3 |
| Mayo antithrombin iii antigen CPT 85301 | $297.60 | $496.00 | $20.74 – $44.53 | 3 |
| Mayo aspergillus fumigatus antibody CPT 86606 | $78.60 | $131.00 | $24.14 – $51.83 | 3 |
| Mayo avwpr vw factor activity CPT 85397 | $280.80 | $468.00 | $72.08 – $154.76 | 3 |
| Mayo barbiturates definitive assay confirmation urine CPT 80345 | $306.00 | $510.00 | $114.24 – $245.28 | 3 |
| Mayo bart bartonella henselae antibody igg CPT 86611 | $36.60 | $61.00 | $19.72 – $42.34 | 3 |
| Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative CPT 81207 | $513.00 | $855.00 | $206.72 – $443.84 | 3 |
| Mayo blastomyces antibody immunodiffusion CPT 86612 | $238.80 | $398.00 | $17.34 – $37.23 | 3 |
| Mayo bordetella pertussis antibody igg CPT 86615 | $226.80 | $378.00 | $25.16 – $54.02 | 3 |
| Mayo brcmg brucella antibody igm CPT 86622 | $32.40 | $54.00 | $18.36 – $39.42 | 3 |
| Mayo c1 esterase inhibitor CPT 83883 | $235.80 | $393.00 | $24.14 – $51.83 | 3 |
| Mayo cannabinoids natural definitive assay thc confirmation urine CPT 80349 | $288.60 | $481.00 | $111.18 – $238.71 | 3 |
| Mayo carnitine total and free quantitative each specimen plasma CPT 82379 | $178.80 | $298.00 | $34.00 – $73.00 | 3 |
| Mayo cd20b mononuclear cell antigen nos quantitative each CPT 86356 | $92.40 | $154.00 | $52.36 – $112.42 | 3 |
| Mayo ceruloplasmin CPT 82390 | $147.00 | $245.00 | $20.40 – $43.80 | 3 |
| Mayo chemiluminescent parathyroid related peptide CPT 82397 | $200.40 | $334.00 | $26.86 – $57.67 | 3 |
| Mayo chikv chikungunya antibodies igg CPT 86790 | $188.40 | $314.00 | $24.14 – $51.83 | 3 |
| Mayo chlap chlamydia pneumoniae antibody igg CPT 86631 | $121.80 | $203.00 | $20.74 – $44.53 | 3 |
| Mayo chlap chlamydia pneumoniae antibody igm CPT 86632 | $97.80 | $163.00 | $24.48 – $52.56 | 3 |
| Mayo chrcb tissue culture non-neoplastic disorders lymphocyte CPT 88230 | $413.40 | $689.00 | $234.26 – $502.97 | 3 |
| Mayo chromium CPT 82495 | $87.00 | $145.00 | $24.48 – $52.56 | 3 |
| Mayo cocaine definitive assay confirmation urine CPT 80353 | $288.60 | $481.00 | $121.04 – $259.88 | 3 |
| Mayo coccidioides antibody CPT 86635 | $83.40 | $139.00 | $22.10 – $47.45 | 3 |
| Mayo cocou cortisone urine CPT 82542 | $236.40 | $394.00 | $34.34 – $73.73 | 3 |
| Mayo cortisol free CPT 82530 | $142.20 | $237.00 | $31.96 – $68.62 | 3 |
| Mayo covid-19 antibody nucleocapsid total CPT 86769 | $50.40 | $84.00 | $24.14 – $51.83 | 3 |
| Mayo coxiella brunetii (q fever) igg antibody CPT 86638 | $52.20 | $87.00 | $24.48 – $52.56 | 3 |
| Mayo cyanide CPT 82600 | $66.60 | $111.00 | $37.74 – $81.03 | 3 |
| Mayo deoxyribonuclease antibody titer CPT 86215 | $106.80 | $178.00 | $26.52 – $56.94 | 3 |
| Mayo dhea (dehydroepiandrosterone) CPT 82626 | $133.20 | $222.00 | $47.94 – $102.93 | 3 |
| Mayo dihydrotestosterone CPT 82642 | $82.20 | $137.00 | $46.58 – $100.01 | 3 |
| Mayo efpo chloride stool CPT 82438 | $42.60 | $71.00 | $14.96 – $32.12 | 3 |
| Mayo estriol CPT 82677 | $80.40 | $134.00 | $41.82 – $89.79 | 3 |
| Mayo estrone CPT 82679 | $136.80 | $228.00 | $21.42 – $45.99 | 3 |
| Mayo ethosuximide therapeutic drug level CPT 80168 | $124.20 | $207.00 | $32.98 – $70.81 | 3 |
| Mayo everolimus therapeutic drug level CPT 80169 | $47.40 | $79.00 | $19.72 – $42.34 | 3 |
| Mayo factor ii CPT 85210 | $143.40 | $239.00 | $39.44 – $84.68 | 3 |
| Mayo factor v CPT 85220 | $64.80 | $108.00 | $36.72 – $78.84 | 3 |
| Mayo factor vii CPT 85230 | $78.00 | $130.00 | $44.20 – $94.90 | 3 |
| Mayo factor viii vw factor antigen CPT 85246 | $203.40 | $339.00 | $26.86 – $57.67 | 3 |
| Mayo factor viii vw factor ristocetin cofactor CPT 85245 | $104.40 | $174.00 | $32.98 – $70.81 | 3 |
| Mayo factor x CPT 85260 | $66.00 | $110.00 | $37.40 – $80.30 | 3 |
| Mayo factor xi CPT 85270 | $257.40 | $429.00 | $145.86 – $313.17 | 3 |
| Mayo fat/lipids feces quantitative CPT 82710 | $273.00 | $455.00 | $15.98 – $34.31 | 3 |
| Mayo fbl culture fungi blood CPT 87103 | $105.60 | $176.00 | $18.36 – $39.42 | 3 |
| Mayo ffspg allergen clam igg CPT 86001 | $19.20 | $32.00 | $10.88 – $23.36 | 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.