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 |
|---|---|---|---|---|
| Protamine 10 mg/ml intravenous solution HCPCS J2720 | $28.36 | $47.27 | $16.07 – $34.51 | 3 |
| Protein c activity CPT 85303 | $255.60 | $426.00 | $26.18 – $56.21 | 3 |
| Protein electrophoretic fractionation & quantitation serum CPT 84165 | $85.80 | $143.00 | $15.64 – $33.58 | 3 |
| Protein s total CPT 85305 | $82.20 | $137.00 | $22.78 – $48.91 | 3 |
| Protein total 24 hour urine CPT 84156 | $53.40 | $89.00 | $7.14 – $15.33 | 3 |
| Protein total body fluid CPT 84157 | $49.80 | $83.00 | $7.14 – $15.33 | 3 |
| Protein total serum plasma whole blood CPT 84155 | $73.20 | $122.00 | $6.46 – $13.87 | 3 |
| Prpertl pel pack hemrrg trma 49013 CPT 49013 | $913.80 | $1,523.00 | $928.00 – $2,679.00 | 3 |
| Prp i/hern init block >5 yr CPT 49507 | $1,104.60 | $1,841.00 | $928.00 – $2,679.00 | 3 |
| Pr planning advance care 1st 30 minutes CPT 99497 | $169.20 | $282.00 | $205.86 – $2,679.00 | 3 |
| Pr prolonged e&m service office outpatient each 15 minutes (g2212) HCPCS G2212 | $49.80 | $83.00 | $60.59 – $2,679.00 | 3 |
| Pr removal drug delivery implant CPT 11982 | $291.00 | $485.00 | $354.05 – $2,679.00 | 3 |
| Pr removal foreign body external auditory canal without anesthesia CPT 69200 | $241.20 | $402.00 | $63.58 – $136.51 | 3 |
| Pr removal intrauterine device CPT 58301 | $297.60 | $496.00 | $168.64 – $225.57 | 3 |
| Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm CPT 12032 | $578.40 | $964.00 | $175.44 – $376.68 | 3 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm CPT 12011 | $296.40 | $494.00 | $167.96 – $290.54 | 3 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm CPT 12013 | $310.80 | $518.00 | $176.12 – $285.43 | 3 |
| Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm CPT 12001 | $295.20 | $492.00 | $167.28 – $259.88 | 3 |
| Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm CPT 12002 | $309.60 | $516.00 | $175.44 – $258.42 | 3 |
| Pr split-thickness autograft trunk/arm/leg 1st 100 sq cm/<tbsa infant/child CPT 15100 | $1,642.20 | $2,737.00 | $928.00 – $2,679.00 | 3 |
| Pr subsequent hospital care e/m normal newborn per day CPT 99462 | $87.60 | $146.00 | $106.58 – $2,679.00 | 3 |
| Pr tube thoracostomy w/connection to drainage open CPT 32551 | $909.00 | $1,515.00 | $403.69 – $515.10 | 3 |
| Pr visit complexity e&m service serious/complex condition HCPCS G2211 | $25.20 | $42.00 | $30.66 – $2,679.00 | 3 |
| PSA (Prostate) Test CPT 84153 | $125.40 | $209.00 | $36.38 – $78.11 | 3 |
| Psych/neuropsych test admin automated result 96146 CPT 96146 | $12.60 | $21.00 | $15.33 – $2,679.00 | 3 |
| Psychophysiological therapy CPT 90875 | $106.20 | $177.00 | $129.21 – $2,679.00 | 3 |
| Psychophysiological therapy CPT 90876 | $156.60 | $261.00 | $190.53 – $2,679.00 | 3 |
| Psychotherapy group therapy CPT 90853 | $36.60 | $61.00 | $44.53 – $2,679.00 | 3 |
| Psychotherapy patient individual therapy 30 minutes CPT 90832 | $58.80 | $98.00 | $71.54 – $2,679.00 | 3 |
| Psychotherapy patient individual therapy 45 minutes CPT 90834 | $114.00 | $190.00 | $138.70 – $2,679.00 | 3 |
| Psychotherapy patient individual therapy 60 minutes CPT 90837 | $146.40 | $244.00 | $178.12 – $2,679.00 | 3 |
| Psych test eval svc phys/qhp 1st hr CPT 96130 | $248.40 | $414.00 | $302.22 – $2,679.00 | 3 |
| Psych test eval svc phys/qhp ea addl hr CPT 96131 | $190.20 | $317.00 | $231.41 – $2,679.00 | 3 |
| Psy evaluation of records CPT 90885 | $111.00 | $185.00 | $135.05 – $2,679.00 | 3 |
| Psy/npsy phys/qhp 2> tst 1st 30 min CPT 96136 | $53.40 | $89.00 | $64.97 – $2,679.00 | 3 |
| Psy/npsy phys/qhp 2> tst ea l 30 min CPT 96137 | $45.00 | $75.00 | $54.75 – $2,679.00 | 3 |
| Psytx complex interactive CPT 90785 | $7.20 | $12.00 | $8.76 – $2,679.00 | 3 |
| Psytx pt w/e&m 16-37 min CPT 90833 | $52.80 | $88.00 | $64.24 – $2,679.00 | 3 |
| Psytx pt w/e&m 38-52 min CPT 90836 | $62.40 | $104.00 | $75.92 – $2,679.00 | 3 |
| Psytx pt w/e&m 53+ min CPT 90838 | $113.40 | $189.00 | $137.97 – $2,679.00 | 3 |
| Pt application of modality >=1 area iontophoresis each 15 minutes CPT 97033 | $94.80 | $158.00 | $53.72 – $70.08 | 3 |
| Pt application of modality >=1 area ultrasound each 15 minutes CPT 97035 | $75.60 | $126.00 | $38.76 – $62.05 | 3 |
| Pt application of modality traction mechanical CPT 97012 | $75.00 | $125.00 | $40.80 – $55.48 | 3 |
| Pterygomaxillary fossa surg any appr 31040 CPT 31040 | $1,273.20 | $2,122.00 | $928.00 – $2,679.00 | 3 |
| Pt-focused hlth risk assmt CPT 96160 | $9.00 | $15.00 | $10.95 – $2,679.00 | 3 |
| Pt init/spiromet rec/review/interp 94016 CPT 94016 | $48.60 | $81.00 | $59.13 – $2,679.00 | 3 |
| Pt repositioning canalith procedure(s) per day CPT 95992 | $108.60 | $181.00 | $55.42 – $118.99 | 3 |
| Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan HCPCS G0283 | $79.20 | $132.00 | $44.88 – $96.36 | 3 |
| Pt therapeutic procedure >=1 area massage each 15 minutes CPT 97124 | $58.80 | $98.00 | $17.34 – $37.23 | 3 |
| Pt wheelchair management each 15 minutes CPT 97542 | $54.60 | $91.00 | $30.94 – $35.77 | 3 |
| Pulm endartercomy w/bypass 33916 CPT 33916 | $7,086.00 | $11,810.00 | $928.00 – $8,621.30 | 3 |
| Pulmonary decortication partial 32225 CPT 32225 | $1,741.80 | $2,903.00 | $928.00 – $2,679.00 | 3 |
| Pulse ox continuous overnight monitoring CPT 94762 | $238.80 | $398.00 | $85.41 – $135.32 | 3 |
| Pulse ox multiple CPT 94761 | $153.00 | $255.00 | $8.76 – $65.28 | 3 |
| Pulse ox single CPT 94760 | $77.40 | $129.00 | $5.84 – $32.64 | 3 |
| Punc of shunt for asp or inj CPT 61070 | $415.80 | $693.00 | $505.89 – $2,679.00 | 3 |
| Puncture arterial withdrawal blood for diagnosis CPT 36600 | $60.60 | $101.00 | $8.84 – $18.98 | 3 |
| Puncture aspiration abscess/hematoma/bulla/cyst CPT 10160 | $243.60 | $406.00 | $131.24 – $281.78 | 3 |
| Puncture/clear windpipe 31612 CPT 31612 | $159.60 | $266.00 | $194.18 – $2,679.00 | 3 |
| Puncture spinal lumbar diagnostic CPT 62270 | $1,052.40 | $1,754.00 | $362.81 – $596.36 | 3 |
| Pyloroplasty 43800 CPT 43800 | $1,748.40 | $2,914.00 | $928.00 – $2,679.00 | 3 |
| Pyruvate CPT 84210 | $39.00 | $65.00 | $22.10 – $47.45 | 3 |
| Pyruvate kinase CPT 84220 | $111.60 | $186.00 | $44.88 – $96.36 | 3 |
| Quest t3 uptake CPT 84479 | $45.60 | $76.00 | $12.24 – $26.28 | 3 |
| Quinupristin/dalfopristin HCPCS J2770 | $190.43 | $317.39 | $107.91 – $231.69 | 3 |
| Rabies ig heat-treated human im/subq 90376 CPT 90376 | $188.40 | $314.00 | $229.22 – $2,679.00 | 3 |
| Rabies immune globulin (pf) 300 unit/ml intramuscular solution CPT 90375 | $5,949.85 | $9,916.42 | $275.21 – $719.77 | 3 |
| Radical abdominal hysterectomy 58210 CPT 58210 | $3,429.60 | $5,716.00 | $928.00 – $4,172.68 | 3 |
| Radical resection sternum 21630 CPT 21630 | $2,394.00 | $3,990.00 | $928.00 – $2,912.70 | 3 |
| Radic resect abd tumor<5cm 22904 CPT 22904 | $2,235.60 | $3,726.00 | $928.00 – $2,719.98 | 3 |
| Radic resect shoulder tumor 5cm/> 23078 CPT 23078 | $2,884.20 | $4,807.00 | $928.00 – $3,509.11 | 3 |
| Rad resec soft tis tum/ft/toe/<3cm 28046 CPT 28046 | $1,437.60 | $2,396.00 | $928.00 – $2,679.00 | 3 |
| Rad resect abd tumor 5 cm/> CPT 22905 | $2,826.00 | $4,710.00 | $928.00 – $3,438.30 | 3 |
| Rad resect tumor/neck/ant thor/<5cm21557 CPT 21557 | $1,776.00 | $2,960.00 | $928.00 – $2,679.00 | 3 |
| Ramucirumab 10 mg/ml intravenous solution HCPCS J9308 | $13,320.57 | $22,200.95 | $1,523.09 – $3,270.17 | 3 |
| Rapid Strep Test CPT 87880 | $36.60 | $61.00 | $19.38 – $41.61 | 3 |
| Rasburicase 1.5 mg intravenous solution HCPCS J2783 | $9,833.13 | $16,388.55 | $1,118.10 – $2,400.63 | 3 |
| Ravulizumab-cwvz 100 mg/ml intravenous solution HCPCS J1303 | $42,463.34 | $70,772.23 | $6,579.58 – $14,126.74 | 3 |
| Rbc count only automated CPT 85041 | $27.00 | $45.00 | $5.10 – $10.95 | 3 |
| Rebuild eardrum structures CPT 69633 | $2,050.80 | $3,418.00 | $928.00 – $2,679.00 | 3 |
| Rebuild outer ear canal CPT 69310 | $2,132.40 | $3,554.00 | $928.00 – $2,679.00 | 3 |
| Rechanneling of artery CPT 35361 | $2,314.80 | $3,858.00 | $928.00 – $2,816.34 | 3 |
| Rechanneling of artery 35305 CPT 35305 | $1,867.20 | $3,112.00 | $928.00 – $2,679.00 | 3 |
| Rechanneling of artery 35341 CPT 35341 | $2,109.00 | $3,515.00 | $928.00 – $2,679.00 | 3 |
| Rechanneling w/graft tibioperoneal trunk artery 35304 CPT 35304 | $2,551.80 | $4,253.00 | $928.00 – $3,104.69 | 3 |
| Rechanneling w/wo patch graft abd aorta 35331 CPT 35331 | $2,912.40 | $4,854.00 | $928.00 – $3,543.42 | 3 |
| Rechanneling w/wo patch graft deep profunda fem art 35372 CPT 35372 | $2,197.80 | $3,663.00 | $928.00 – $2,679.00 | 3 |
| Rechanneling w/wo patch grf axillary-brachial 35321 CPT 35303 | $2,474.40 | $4,124.00 | $928.00 – $3,010.52 | 3 |
| Reconst major injured chest 32820 CPT 32820 | $2,913.60 | $4,856.00 | $928.00 – $3,544.88 | 3 |
| Reconst pectus excavatum/carinatum opn 21740 CPT 21740 | $2,286.00 | $3,810.00 | $928.00 – $2,781.30 | 3 |
| Reconstruct ankle joint CPT 27702 | $1,337.40 | $2,229.00 | $928.00 – $2,679.00 | 3 |
| Reconstruct cleft palate CPT 42200 | $1,695.00 | $2,825.00 | $928.00 – $2,679.00 | 3 |
| Reconstruct cleft palate CPT 42210 | $1,813.20 | $3,022.00 | $928.00 – $2,679.00 | 3 |
| Reconstruct extra finger CPT 26587 | $1,749.60 | $2,916.00 | $928.00 – $2,679.00 | 3 |
| Reconstruction of bile ducts 47800 CPT 47800 | $3,009.00 | $5,015.00 | $928.00 – $3,660.95 | 3 |
| Reconstruction of nose CPT 30410 | $2,495.40 | $4,159.00 | $928.00 – $3,036.07 | 3 |
| Reconstruction of nose CPT 30420 | $2,665.80 | $4,443.00 | $928.00 – $3,243.39 | 3 |
| Reconstruction of throat CPT 42950 | $1,564.20 | $2,607.00 | $928.00 – $2,679.00 | 3 |
| Reconstruction tongue fold CPT 41520 | $670.20 | $1,117.00 | $815.41 – $2,679.00 | 3 |
| Reconstruct lip w/local flap 40525 CPT 40525 | $1,247.40 | $2,079.00 | $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.