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 |
|---|---|---|---|---|
| Revision of foot tendon CPT 28238 | $1,301.40 | $2,169.00 | $928.00 – $2,679.00 | 3 |
| Revision of heart veins dir/ptch 33645 CPT 33645 | $3,666.60 | $6,111.00 | $928.00 – $4,461.03 | 3 |
| Revision of ileostomy complicated 44314 CPT 44314 | $1,529.40 | $2,549.00 | $928.00 – $2,679.00 | 3 |
| Revision of ileostomy; simple 44312 CPT 44312 | $864.60 | $1,441.00 | $928.00 – $2,679.00 | 3 |
| Revision of leg vein 37780 CPT 37780 | $508.80 | $848.00 | $619.04 – $2,679.00 | 3 |
| Revision of nose CPT 30430 | $1,792.20 | $2,987.00 | $928.00 – $2,679.00 | 3 |
| Revision of nose CPT 30435 | $2,205.60 | $3,676.00 | $928.00 – $2,683.48 | 3 |
| Revision of nose CPT 30450 | $2,953.80 | $4,923.00 | $928.00 – $3,593.79 | 3 |
| Revision of spinal shunt CPT 63744 | $1,246.20 | $2,077.00 | $928.00 – $2,679.00 | 3 |
| Revision of thigh muscles CPT 27430 | $1,401.60 | $2,336.00 | $928.00 – $2,679.00 | 3 |
| Revision of tricuspid valve w/bypass 33460 CPT 33460 | $4,709.40 | $7,849.00 | $928.00 – $5,729.77 | 3 |
| Revision open av fistula without thromb CPT 36832 | $1,145.40 | $1,909.00 | $928.00 – $2,679.00 | 3 |
| Revj mstdc rsltg compl mstdc CPT 69601 | $2,061.60 | $3,436.00 | $928.00 – $2,679.00 | 3 |
| Revj mstdc rsltg tympanplsty CPT 69604 | $2,196.60 | $3,661.00 | $928.00 – $2,679.00 | 3 |
| Rev mastoidectomy rsltg modf rad mstdc 69602 CPT 69602 | $2,144.40 | $3,574.00 | $928.00 – $2,679.00 | 3 |
| Rev-rem impl neurostim gen-rec CPT 63688 | $772.20 | $1,287.00 | $928.00 – $2,679.00 | 3 |
| Rezafungin 200 mg intravenous solution HCPCS J0349 | $3,713.59 | $6,189.32 | $2,104.37 – $4,518.20 | 3 |
| Rheumatoid factor qualitative CPT 86430 | $49.20 | $82.00 | $27.88 – $59.86 | 3 |
| Rheumatoid factor quantitative CPT 86431 | $59.40 | $99.00 | $8.50 – $18.25 | 3 |
| Rhinp prim lat&alr crtlge&/elvtn nsl tip CPT 30400 | $1,979.40 | $3,299.00 | $928.00 – $2,679.00 | 3 |
| Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe HCPCS J2791 | $313.79 | $522.98 | $177.81 – $381.78 | 3 |
| Rho d immune globulin 50 mcg HCPCS J2788 | $92.66 | $154.43 | $52.51 – $112.73 | 3 |
| Rho(d) immune globulin h, sd HCPCS J2792 | $2,223.29 | $3,705.48 | $79.96 – $171.69 | 3 |
| Rho(d) immune globulin (rhig) human full dose im CPT 90384 | $99.00 | $165.00 | $120.45 – $2,679.00 | 3 |
| Rhythm ecg with report CPT 93040 | $25.20 | $42.00 | $30.66 – $2,679.00 | 3 |
| Rib and Chest X-ray (3 views, left side) CPT 71101 | $323.40 | $539.00 | $66.43 – $183.26 | 3 |
| Rib and Chest X-ray (4 or more views, both sides) CPT 71111 | $345.60 | $576.00 | $93.44 – $195.84 | 3 |
| Rib X-ray (3 views, both sides) CPT 71110 | $280.80 | $468.00 | $141.62 – $159.12 | 3 |
| Rifampin in ns IV syringe 3 mg/ml (neo/ped) - cnr HCPCS J2804 | $144.74 | $241.23 | $82.02 – $176.10 | 3 |
| Ring fx reform 11-13x17mm HCPCS L8610 | $1,912.80 | $3,188.00 | $69.02 – $148.19 | 3 |
| Risankizumab-rzaa 60 mg/ml intravenous solution HCPCS J2327 | $39,645.64 | $66,076.06 | $10,687.92 – $22,947.60 | 3 |
| Risperidone microspheres 12.5 mg/2 ml inj HCPCS J2794 | $2,298.46 | $3,830.76 | $330.91 – $710.47 | 3 |
| Rituximab 10 mg/ml concentrate,intravenous HCPCS J9312 | $8,361.79 | $13,936.32 | $966.44 – $2,075.00 | 3 |
| Rituximab 1,400 mg/11.7 ml (120 mg/ml)-hyaluronidase subcutaneous soln HCPCS J9311 | $13,353.90 | $22,256.50 | $6,624.24 – $14,222.63 | 3 |
| Rituximab-abbs 10 mg/ml intravenous solution HCPCS Q5115 | $7,529.59 | $12,549.32 | $872.12 – $1,872.49 | 3 |
| Rituximab-arrx 10 mg/ml intravenous solution HCPCS Q5123 | $6,389.38 | $10,648.97 | $742.90 – $1,595.04 | 3 |
| Rituximab-pvvr 10 mg/ml intravenous solution HCPCS Q5119 | $6,389.38 | $10,648.97 | $742.90 – $1,595.04 | 3 |
| Rmv anterior spine instrumentation 22855 CPT 22855 | $2,086.20 | $3,477.00 | $928.00 – $2,679.00 | 3 |
| Rmv implant contraceptive capsule 11976 CPT 11976 | $277.20 | $462.00 | $337.26 – $2,679.00 | 3 |
| Rmvl ext fixj sys under anes CPT 20694 | $601.80 | $1,003.00 | $732.19 – $2,679.00 | 3 |
| Rmvl fecal impaction/fb spx under anes CPT 45915 | $615.60 | $1,026.00 | $748.98 – $2,679.00 | 3 |
| Rmvl foreign body upper arm/elbow subcutaneous CPT 24200 | $385.20 | $642.00 | $468.66 – $2,679.00 | 3 |
| Rmvl i-artic rx delivery dev 20705 CPT 20705 | $190.20 | $317.00 | $231.41 – $2,679.00 | 3 |
| Rmvl icd gen w/rplc icd gen mlt lead sys CPT 33264 | $704.40 | $1,174.00 | $857.02 – $2,679.00 | 3 |
| Rmvl icd pulse gen only CPT 33241 | $431.40 | $719.00 | $524.87 – $2,679.00 | 3 |
| Rmvl left heart vent thor inscn ecmo CPT 33989 | $1,086.60 | $1,811.00 | $928.00 – $2,679.00 | 3 |
| Rmvl lung xcp tot pneumonectomy sleeve lob 32486 CPT 32486 | $4,549.20 | $7,582.00 | $928.00 – $5,534.86 | 3 |
| Rmvl ndwellg tun pleural cath CPT 32552 | $352.80 | $588.00 | $429.24 – $2,679.00 | 3 |
| Rmvl ninfct mesh hernia rpr 49623 CPT 49623 | $284.40 | $474.00 | $346.02 – $2,679.00 | 3 |
| Rmvl perm pm pulse gen CPT 33233 | $499.80 | $833.00 | $608.09 – $2,679.00 | 3 |
| Rmvl pq iabp CPT 33968 | $66.60 | $111.00 | $81.03 – $2,679.00 | 3 |
| Rmvl pq vad left hrt vein sep session CPT 33992 | $464.40 | $774.00 | $565.02 – $2,679.00 | 3 |
| Rmvl sq defib electrode CPT 33272 | $777.60 | $1,296.00 | $928.00 – $2,679.00 | 3 |
| Rmvl subq card rhythm mntr CPT 33286 | $199.80 | $333.00 | $243.09 – $2,679.00 | 3 |
| Rmvl tiss expndr without implant insrtn CPT 11971 | $894.60 | $1,491.00 | $928.00 – $2,679.00 | 3 |
| Rmvl tv pm lead dual CPT 33235 | $1,348.80 | $2,248.00 | $928.00 – $2,679.00 | 3 |
| Rmv prosth mat/mesh/abd wall/infec 11008 CPT 11008 | $521.40 | $869.00 | $634.37 – $2,679.00 | 3 |
| Rmv suture/anesthesia/not local 15850 CPT 15850 | $126.00 | $210.00 | $153.30 – $2,679.00 | 3 |
| Romidepsin 10 mg/2 ml intravenous powder for solution HCPCS J9319 | $5,226.07 | $8,710.12 | $2,912.84 – $6,254.05 | 3 |
| Romiplostim 125 mcg subcutaneous solution HCPCS J2802 | $9,764.68 | $16,274.47 | $1,388.63 – $2,981.48 | 3 |
| Romosozumab-aqqg 105 mg/1.17 ml subcutaneous syringe (wrapper) HCPCS J3111 | $4,668.76 | $7,781.27 | $2,645.63 – $5,680.33 | 3 |
| Ropivacaine 0.2 % epidural pca - 1 hour dose limit HCPCS J2795 | $39.34 | $65.57 | $12.06 – $25.89 | 3 |
| Rpl non-tun cvc wo sbq prt/pmp CPT 36580 | $401.40 | $669.00 | $488.37 – $2,679.00 | 3 |
| Rpl tun-cvad w subq port CPT 36582 | $2,045.40 | $3,409.00 | $928.00 – $2,679.00 | 3 |
| Rpl tun-cvad w subq pump CPT 36583 | $2,280.00 | $3,800.00 | $928.00 – $2,774.00 | 3 |
| Rpl tun cvc wo subq port CPT 36581 | $1,462.20 | $2,437.00 | $928.00 – $2,679.00 | 3 |
| Rpm tx mgmt 1st 20 min CPT 99457 | $72.60 | $121.00 | $88.33 – $2,679.00 | 3 |
| Rpm tx mgmt ea addl 20 min CPT 99458 | $59.40 | $99.00 | $72.27 – $2,679.00 | 3 |
| Rpr aa hrn 1st > 10 ncr/strn CPT 49596 | $1,425.00 | $2,375.00 | $928.00 – $2,679.00 | 3 |
| Rpr aa hrn 1st > 10 rdc CPT 49595 | $1,072.80 | $1,788.00 | $928.00 – $2,679.00 | 3 |
| Rpr aa hrn 1st 3-10 ncr/strn CPT 49594 | $1,037.40 | $1,729.00 | $928.00 – $2,679.00 | 3 |
| Rpr aa hrn 1st 3-10 rdc CPT 49593 | $797.40 | $1,329.00 | $928.00 – $2,679.00 | 3 |
| Rpr aa hrn 1st < 3 cm rdc CPT 49591 | $476.40 | $794.00 | $579.62 – $2,679.00 | 3 |
| Rpr aa hrn 1st < 3 ncr/strn CPT 49592 | $661.80 | $1,103.00 | $805.19 – $2,679.00 | 3 |
| Rpr aa hrn rcr > 10 ncr/strn CPT 49618 | $1,726.20 | $2,877.00 | $928.00 – $2,679.00 | 3 |
| Rpr aa hrn rcr > 10 rdc CPT 49617 | $1,233.00 | $2,055.00 | $928.00 – $2,679.00 | 3 |
| Rpr aa hrn rcr 3-10 ncr/strn CPT 49616 | $1,194.60 | $1,991.00 | $928.00 – $2,679.00 | 3 |
| Rpr aa hrn rcr 3-10 rdc CPT 49615 | $890.40 | $1,484.00 | $928.00 – $2,679.00 | 3 |
| Rpr aa hrn rcr < 3 ncr/strn CPT 49614 | $795.60 | $1,326.00 | $928.00 – $2,679.00 | 3 |
| Rpr aa hrn rcr < 3 rdc CPT 49613 | $587.40 | $979.00 | $714.67 – $2,679.00 | 3 |
| Rpr blood ves w/vein graft/up ext 35236 CPT 35236 | $1,951.80 | $3,253.00 | $928.00 – $2,679.00 | 3 |
| Rpr blood vsl grf oth vein lo ex CPT 35286 | $1,866.00 | $3,110.00 | $928.00 – $2,679.00 | 3 |
| Rpr csf leak/pseudomeng/laminectomy63709 CPT 63709 | $1,933.20 | $3,222.00 | $928.00 – $2,679.00 | 3 |
| Rpr diaphragm hernia/chronic/not neonate 39541 CPT 39541 | $1,791.00 | $2,985.00 | $928.00 – $2,679.00 | 3 |
| Rpr diaphragm lac/any approach 39501 CPT 39501 | $1,616.40 | $2,694.00 | $928.00 – $2,679.00 | 3 |
| Rpr fem hernia init blocked CPT 49553 | $1,186.20 | $1,977.00 | $928.00 – $2,679.00 | 3 |
| Rpr hern preemie reduc CPT 49491 | $1,447.80 | $2,413.00 | $928.00 – $2,679.00 | 3 |
| Rpr ing hernia baby blocked CPT 49496 | $1,120.80 | $1,868.00 | $928.00 – $2,679.00 | 3 |
| Rpr ing hernia init reduce CPT 49500 | $767.40 | $1,279.00 | $928.00 – $2,679.00 | 3 |
| Rpr parastomal hernia rdc 49621 CPT 49621 | $1,066.80 | $1,778.00 | $928.00 – $2,679.00 | 3 |
| Rpr parastomal hrna ncr/strn 49622 CPT 49622 | $1,317.00 | $2,195.00 | $928.00 – $2,679.00 | 3 |
| Rpr rem hernia init reduce CPT 49550 | $1,081.80 | $1,803.00 | $928.00 – $2,679.00 | 3 |
| Rpr xtnsr tndn leg prim without grft ea tndn CPT 27664 | $510.60 | $851.00 | $621.23 – $2,679.00 | 3 |
| Rtm 1st set-up&pt educaj eqp CPT 98975 | $149.40 | $249.00 | $84.66 – $181.77 | 3 |
| Rtm dev sply mscskl 16-30 d CPT 98977 | $58.80 | $98.00 | $33.32 – $71.54 | 3 |
| Rtm dev sply resp sys 16-30d CPT 98976 | $58.80 | $98.00 | $33.32 – $71.54 | 3 |
| Rubella antibody igg CPT 86762 | $198.60 | $331.00 | $20.74 – $44.53 | 3 |
| Rubeola antibody igg CPT 86765 | $156.60 | $261.00 | $24.48 – $52.56 | 3 |
| Russell viper venom diluted CPT 85613 | $91.20 | $152.00 | $13.26 – $28.47 | 3 |
| Sacituzumab govitecan-hziy 180 mg intravenous solution HCPCS J9317 | $4,492.85 | $7,488.08 | $2,545.95 – $5,466.30 | 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.