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 |
|---|---|---|---|---|
| Surgical repair stomach bleedin ulcer 43501 CPT 43501 | $2,536.20 | $4,227.00 | $928.00 – $3,085.71 | 3 |
| Surgical repair stomach gastric lac 43502 CPT 43502 | $2,864.40 | $4,774.00 | $928.00 – $3,485.02 | 3 |
| Surg tx anal fistula 2nd stage 46285 CPT 46285 | $1,017.60 | $1,696.00 | $928.00 – $2,679.00 | 3 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $64.80 | $108.00 | $36.72 – $78.84 | 3 |
| Susceptibility mic per plate CPT 87186 | $170.40 | $284.00 | $12.58 – $27.01 | 3 |
| Suscept studies macrobroth dilution ea CPT 87188 | $190.80 | $318.00 | $90.44 – $194.18 | 3 |
| Suspension of uterus 58400 CPT 58400 | $856.80 | $1,428.00 | $928.00 – $2,679.00 | 3 |
| Sutr lg intestine 1/mult perf without colostomy 44604 CPT 44604 | $1,995.00 | $3,325.00 | $928.00 – $2,679.00 | 3 |
| Suture bile duct injury 47900 CPT 47900 | $2,559.60 | $4,266.00 | $928.00 – $3,114.18 | 3 |
| Svc venogram s&i CPT 75827 | $117.60 | $196.00 | $143.08 – $2,679.00 | 3 |
| Swallowing Evaluation (Bedside) CPT 92610 | $234.60 | $391.00 | $67.66 – $135.78 | 3 |
| Swallowing Therapy Session CPT 92526 | $192.60 | $321.00 | $18.70 – $40.15 | 3 |
| Sweat collection by iontophoresis CPT 89230 | $51.60 | $86.00 | $29.24 – $62.78 | 3 |
| Synch audio-only est high 40 CPT 98015 | $196.80 | $328.00 | $239.44 – $2,679.00 | 3 |
| Synch audio-only est low 20 CPT 98013 | $90.60 | $151.00 | $110.23 – $2,679.00 | 3 |
| Synch audio-only est mod 30 CPT 98014 | $132.60 | $221.00 | $161.33 – $2,679.00 | 3 |
| Synch audio-only est sf 10 CPT 98012 | $49.20 | $82.00 | $59.86 – $2,679.00 | 3 |
| Synch audio-only new high 60 CPT 98011 | $241.80 | $403.00 | $294.19 – $2,679.00 | 3 |
| Synch audio-only new low 30 CPT 98009 | $117.00 | $195.00 | $142.35 – $2,679.00 | 3 |
| Synch audio-only new mod 45 CPT 98010 | $183.60 | $306.00 | $223.38 – $2,679.00 | 3 |
| Synch audio-only new sf 15 CPT 98008 | $67.80 | $113.00 | $82.49 – $2,679.00 | 3 |
| Synvisc or synvisc-one HCPCS J7325 | $2,438.29 | $4,063.81 | $465.26 – $998.93 | 3 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $41.40 | $69.00 | $8.84 – $18.98 | 3 |
| System cardiomems hosp electronics HCPCS C2624 | $52,875.00 | $88,125.00 | $29,962.50 – $64,331.25 | 3 |
| System pacing micra av HCPCS C1786 | $25,312.80 | $42,188.00 | $3,166.08 – $6,797.76 | 3 |
| System pcmkr dual chamber leadless micra av2 intrdcr cath HCPCS C1785 | $27,495.00 | $45,825.00 | $2,768.28 – $5,943.66 | 3 |
| T3 (triiodothyronine) free CPT 84481 | $240.60 | $401.00 | $22.10 – $47.45 | 3 |
| T3 (triiodothyronine) total CPT 84480 | $68.40 | $114.00 | $21.08 – $45.26 | 3 |
| T4 (thyroxine) free CPT 84439 | $151.20 | $252.00 | $14.28 – $30.66 | 3 |
| T4 (thyroxine) total CPT 84436 | $46.80 | $78.00 | $12.92 – $27.74 | 3 |
| Tacrol envarsus ex rel oral HCPCS J7503 | $14.21 | $23.68 | $8.05 – $17.29 | 3 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | $50.21 | $83.68 | $3.28 – $7.04 | 3 |
| Tacrolimus 5 mg/ml intravenous solution HCPCS J7525 | $464.12 | $773.54 | $263.00 – $564.68 | 3 |
| Tacrolimus therapeutic drug level CPT 80197 | $58.20 | $97.00 | $26.18 – $56.21 | 3 |
| Tafasitamab-cxix 200 mg intravenous solution HCPCS J9349 | $2,513.77 | $4,189.61 | $1,424.47 – $3,058.42 | 3 |
| Tah rad debulk/lymph remove 58954 CPT 58954 | $4,096.20 | $6,827.00 | $928.00 – $4,983.71 | 3 |
| Tah rad dissect for debulk 58953 CPT 58953 | $3,778.80 | $6,298.00 | $928.00 – $4,597.54 | 3 |
| Tah w/mmk 58152 CPT 58152 | $2,428.80 | $4,048.00 | $928.00 – $2,955.04 | 3 |
| Tailbone (Sacrum and Coccyx) X-ray CPT 72220 | $186.60 | $311.00 | $51.83 – $105.74 | 3 |
| Tap block bilat cont infusion 64489 CPT 64489 | $187.20 | $312.00 | $227.76 – $2,679.00 | 3 |
| Tap block uni by cont infusion 64487 CPT 64487 | $153.00 | $255.00 | $186.15 – $2,679.00 | 3 |
| Tape plstc 1inx5yd hosp tb pk HCPCS A4452 | $16.80 | $28.00 | $20.44 – $2,679.00 | 3 |
| Tarlatamab-dlle 10 mg intravenous solution HCPCS J9026 | $26,609.40 | $44,349.00 | $1,528.98 – $3,282.81 | 3 |
| Tattooing/intraderm 6.1-20.0 sq cm 11921 CPT 11921 | $383.40 | $639.00 | $466.47 – $2,679.00 | 3 |
| Tavr perq femoral CPT 33361 | $1,890.00 | $3,150.00 | $928.00 – $2,679.00 | 3 |
| Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe HCPCS J1447 | $780.64 | $1,301.06 | $235.02 – $504.60 | 3 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $213.60 | $356.00 | $116.96 – $251.12 | 3 |
| Tc-99m pertechnetate per mci HCPCS A9512 | $120.00 | $200.00 | $64.60 – $138.70 | 3 |
| Tc-99m sestamibi p study dose HCPCS A9500 | $120.60 | $201.00 | $146.73 – $2,679.00 | 3 |
| Tca peel dermal 15789 CPT 15789 | $1,062.00 | $1,770.00 | $928.00 – $2,679.00 | 3 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $163.20 | $272.00 | $89.08 – $191.26 | 3 |
| T cells absolute cd 4 count CPT 86361 | $98.40 | $164.00 | $25.84 – $55.48 | 3 |
| T cells total count CPT 86359 | $129.60 | $216.00 | $73.44 – $157.68 | 3 |
| Teaec w/wo patch graft iliofemoral CPT 35355 | $2,322.60 | $3,871.00 | $928.00 – $2,825.83 | 3 |
| Team conf w/pat by hc prof CPT 99366 | $74.40 | $124.00 | $90.52 – $2,679.00 | 3 |
| Telehealth original site facility fee HCPCS Q3014 | $25.20 | $42.00 | $30.66 – $2,679.00 | 3 |
| Temozolomide HCPCS J8700 | $4,671.14 | $7,785.23 | $8.53 – $18.32 | 3 |
| Temozolomide 100 mg intravenous solution HCPCS J9328 | $1,818.11 | $3,030.18 | $1,030.26 – $2,212.03 | 3 |
| Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln HCPCS J9330 | $2,861.96 | $4,769.94 | $1,621.78 – $3,482.06 | 3 |
| Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) HCPCS J3101 | $14,708.53 | $24,514.21 | $8,334.83 – $17,895.37 | 3 |
| Tenolysis extensor tendon hand/finger each CPT 26445 | $1,086.60 | $1,811.00 | $928.00 – $2,679.00 | 3 |
| Tenosynovectomy radic 26145 CPT 26145 | $1,110.00 | $1,850.00 | $928.00 – $2,679.00 | 3 |
| Tenotomy length/rls abductor hallucis musc 28240 CPT 28240 | $840.00 | $1,400.00 | $928.00 – $2,679.00 | 3 |
| Tenotomy open tndn flxr toe sgl tndn spx CPT 28232 | $744.00 | $1,240.00 | $905.20 – $2,679.00 | 3 |
| Terbutaline 1 mg/ml subcutaneous solution HCPCS J3105 | $19.51 | $32.51 | $11.05 – $23.73 | 3 |
| Teriparatide injection HCPCS J3110 | $3,175.78 | $5,292.96 | $1,799.61 – $3,863.86 | 3 |
| Test stress cardiovascular tracing only CPT 93017 | $582.60 | $971.00 | $260.78 – $559.91 | 3 |
| Tetanus immune globulin inj HCPCS J1670 | $997.91 | $1,663.19 | $107.41 – $230.61 | 3 |
| Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe HCPCS J2356 | $7,750.72 | $12,917.87 | $4,392.08 – $9,430.05 | 3 |
| Theophylline therapeutic drug level CPT 80198 | $135.60 | $226.00 | $27.88 – $59.86 | 3 |
| Therapeutic procd strg endur HCPCS G0237 | $69.00 | $115.00 | $24.82 – $53.29 | 3 |
| Therapy Activity Training (each 15 minutes) CPT 97530 | $75.60 | $126.00 | $42.84 – $55.48 | 3 |
| Therapy Exercise Session (each 15 minutes) CPT 97110 | $91.20 | $152.00 | $31.96 – $63.51 | 3 |
| Therapy nutrition individual initial f2f w/patient each 15 minutes CPT 97802 | $88.20 | $147.00 | $23.12 – $23.36 | 3 |
| Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes CPT 97803 | $75.60 | $126.00 | $23.12 – $23.36 | 3 |
| Therapy photodnmc lght dstr lsn skn by staff rx per day CPT 96567 | $755.40 | $1,259.00 | $919.07 – $2,679.00 | 3 |
| Ther fx nasal inf turbinate CPT 30930 | $240.00 | $400.00 | $292.00 – $2,679.00 | 3 |
| Thigh Bone (Femur) X-ray (both sides) CPT 73552 | $231.60 | $386.00 | $75.19 – $87.38 | 3 |
| Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides) CPT 32555 | $1,287.60 | $2,146.00 | $269.37 – $418.88 | 3 |
| Thoracic aortic graft 33875 CPT 33875 | $5,329.20 | $8,882.00 | $928.00 – $6,483.86 | 3 |
| Thoracic lymphadenect/thoracotomy 38746 CPT 38746 | $499.80 | $833.00 | $608.09 – $2,679.00 | 3 |
| Thoracoabdominal graft 33877 CPT 33877 | $6,070.20 | $10,117.00 | $928.00 – $7,385.41 | 3 |
| Thoracoscopy bilobectomy 32670 CPT 32670 | $3,288.00 | $5,480.00 | $928.00 – $4,000.40 | 3 |
| Thoracoscopy diagnostic 32601 CPT 32601 | $600.60 | $1,001.00 | $730.73 – $2,679.00 | 3 |
| Thoracoscopy lymph node exc CPT 32674 | $414.00 | $690.00 | $503.70 – $2,679.00 | 3 |
| Thoracoscopy remove cortex CPT 32651 | $1,672.80 | $2,788.00 | $928.00 – $2,679.00 | 3 |
| Thoracoscopy remove segment CPT 32669 | $2,670.00 | $4,450.00 | $928.00 – $3,248.50 | 3 |
| Thoracoscopy remov fb/fibrin 32653 CPT 32653 | $2,034.00 | $3,390.00 | $928.00 – $2,679.00 | 3 |
| Thoracoscopy resect bullae 32655 CPT 32655 | $1,843.20 | $3,072.00 | $928.00 – $2,679.00 | 3 |
| Thoracoscopy surgical 32650 CPT 32650 | $1,291.80 | $2,153.00 | $928.00 – $2,679.00 | 3 |
| Thoracoscopy surgical with control of traumatic hemorrhage CPT 32654 | $2,301.60 | $3,836.00 | $928.00 – $2,800.28 | 3 |
| Thoracoscopy/thoracic sympathectomy32664 CPT 32664 | $1,818.60 | $3,031.00 | $928.00 – $2,679.00 | 3 |
| Thoracoscopy/tot pulm decortication32652 CPT 32652 | $3,192.00 | $5,320.00 | $928.00 – $3,883.60 | 3 |
| Thoracoscopy w/bx med space CPT 32606 | $895.80 | $1,493.00 | $928.00 – $2,679.00 | 3 |
| Thoracoscopy w/lobectomy CPT 32663 | $2,710.80 | $4,518.00 | $928.00 – $3,298.14 | 3 |
| Thoracoscopy w/mediast exc CPT 32662 | $2,291.40 | $3,819.00 | $928.00 – $2,787.87 | 3 |
| Thoracoscopy w/pleurectomy 32656 CPT 32656 | $1,299.60 | $2,166.00 | $928.00 – $2,679.00 | 3 |
| Thoracoscopy w/sac drng 32659 CPT 32659 | $1,905.00 | $3,175.00 | $928.00 – $2,679.00 | 3 |
| Thoracoscopy w/thymus resect CPT 32673 | $2,319.60 | $3,866.00 | $928.00 – $2,822.18 | 3 |
| Thoracoscopy w/wedge resect CPT 32666 | $1,675.80 | $2,793.00 | $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.