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 |
|---|---|---|---|---|
| Thoracoscopy w w resect addl 32667 CPT 32667 | $303.00 | $505.00 | $368.65 – $2,679.00 | 3 |
| Thoracoscopy w w resect diag 32668 CPT 32668 | $304.20 | $507.00 | $370.11 – $2,679.00 | 3 |
| Thoracostomy w/flap drng 32036 CPT 32036 | $1,661.40 | $2,769.00 | $928.00 – $2,679.00 | 3 |
| Thoracostomy w/rib resection 32035 CPT 32035 | $1,386.00 | $2,310.00 | $928.00 – $2,679.00 | 3 |
| Thoracotomy opn free adhesions 32124 CPT 32124 | $1,942.80 | $3,238.00 | $928.00 – $2,679.00 | 3 |
| Thoracotomy w/expl CPT 32100 | $1,591.80 | $2,653.00 | $928.00 – $2,679.00 | 3 |
| Thoracotomy with cardiac massage CPT 32160 | $1,506.60 | $2,511.00 | $928.00 – $2,679.00 | 3 |
| Thorcscpy w/biop pleura CPT 32609 | $231.00 | $385.00 | $281.05 – $2,679.00 | 3 |
| Thor rib belt custom fabrica HCPCS L0220 | $53.40 | $89.00 | $64.97 – $2,679.00 | 3 |
| Thrcspy w/diag bp lng inf uni CPT 32607 | $379.20 | $632.00 | $461.36 – $2,679.00 | 3 |
| Thrcspy w/diag bp lng nod uni CPT 32608 | $361.80 | $603.00 | $440.19 – $2,679.00 | 3 |
| Thrombectomy/inf pq dialysis circuit CPT 36904 | $633.60 | $1,056.00 | $770.88 – $2,679.00 | 3 |
| Thrombectomy/inf pq dialysis circuit w/pta CPT 36905 | $796.20 | $1,327.00 | $928.00 – $2,679.00 | 3 |
| Thrombectomy/inf pq dialysis circuit w/stent plcmnt CPT 36906 | $928.80 | $1,548.00 | $928.00 – $2,679.00 | 3 |
| Thromb/endar/neck inc/car/vert/subc35301 CPT 35301 | $2,095.80 | $3,493.00 | $928.00 – $2,679.00 | 3 |
| Thrombin time CPT 85670 | $82.20 | $137.00 | $8.84 – $18.98 | 3 |
| Thromboendarterectomy common femoral CPT 35371 | $1,643.40 | $2,739.00 | $928.00 – $2,679.00 | 3 |
| Thromboendarterectomy including patch graft if preformed; CPT 35321 | $1,786.20 | $2,977.00 | $928.00 – $2,679.00 | 3 |
| Thromboendarterectomy including patch graft; iliac 35351 CPT 35351 | $1,835.40 | $3,059.00 | $928.00 – $2,679.00 | 3 |
| Thromboendarterectomy sfa CPT 35302 | $2,248.20 | $3,747.00 | $928.00 – $2,735.31 | 3 |
| Thromboplastin time partial (ptt) substitution fractions each CPT 85732 | $78.00 | $130.00 | $12.58 – $27.01 | 3 |
| Thymectomy prtl/tot rad medstnl dsj 60522 CPT 60522 | $2,643.00 | $4,405.00 | $928.00 – $3,215.65 | 3 |
| Thymectomy prtl/tot transcervical appr 60520 CPT 60520 | $2,205.60 | $3,676.00 | $928.00 – $2,683.48 | 3 |
| Thymectomy prtl/tot without rad medstnl dsj 60521 CPT 60521 | $2,172.00 | $3,620.00 | $928.00 – $2,679.00 | 3 |
| Thyroglobulin antibody CPT 86800 | $87.00 | $145.00 | $30.60 – $65.70 | 3 |
| Thyroidectomy inc substrnl split/trans approch 60270 CPT 60270 | $2,616.00 | $4,360.00 | $928.00 – $3,182.80 | 3 |
| Thyroid (TSH) Test CPT 84443 | $82.20 | $137.00 | $29.92 – $64.24 | 3 |
| Thyroid Ultrasound CPT 76536 | $351.00 | $585.00 | $198.90 – $307.33 | 3 |
| Thyrotropin alfa 0.9 mg intramuscular solution HCPCS J3240 | $3,594.01 | $5,990.01 | $1,007.71 – $2,163.60 | 3 |
| Thyrotropin releasing hormone CPT 80438 | $174.00 | $290.00 | $98.60 – $211.70 | 3 |
| Thyroxine binding globulin (tbg) CPT 84442 | $82.80 | $138.00 | $27.88 – $59.86 | 3 |
| Tib/per revasc stent & ather 37231 CPT 37231 | $1,274.40 | $2,124.00 | $928.00 – $2,679.00 | 3 |
| Tib/per revasc w/ather add-on 37233 CPT 37233 | $690.60 | $1,151.00 | $840.23 – $2,679.00 | 3 |
| Tigecycline injection HCPCS J3243 | $117.25 | $195.42 | $66.44 – $142.66 | 3 |
| Tilt table study CPT 93660 | $1,339.20 | $2,232.00 | $758.88 – $1,629.36 | 3 |
| Tirofiban 12.5 mg/50 ml HCPCS J3246 | $452.93 | $754.88 | $25.08 – $53.84 | 3 |
| Tisotumab vedotin-tftv 40 mg intravenous solution HCPCS J9273 | $12,657.66 | $21,096.10 | $7,172.67 – $15,400.15 | 3 |
| Tissue exam koh skin/hair/nails CPT 87220 | $47.40 | $79.00 | $18.36 – $20.44 | 3 |
| Tissue transglutaminase iga CPT 86364 | $29.40 | $49.00 | $16.66 – $35.77 | 3 |
| Tl-201 thallium diag per mci HCPCS A9505 | $64.20 | $107.00 | $78.11 – $2,679.00 | 3 |
| Tlh uterus 250 g or less CPT 58570 | $1,805.40 | $3,009.00 | $928.00 – $2,679.00 | 3 |
| Tlh uterus over 250 g CPT 58572 | $2,249.40 | $3,749.00 | $928.00 – $2,736.77 | 3 |
| Tlh w/t/o 250 g or less CPT 58571 | $2,007.00 | $3,345.00 | $928.00 – $2,679.00 | 3 |
| Tlh w/t/o uterus over 250 g CPT 58573 | $2,572.20 | $4,287.00 | $928.00 – $3,129.51 | 3 |
| Tmvr w/prosthetic ring 33426 CPT 33426 | $4,653.00 | $7,755.00 | $928.00 – $5,661.15 | 3 |
| Tmvr w/rad reconst w or without ring 33427 CPT 33427 | $4,785.00 | $7,975.00 | $928.00 – $5,821.75 | 3 |
| Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr HCPCS J3260 | $33.23 | $55.38 | $17.80 – $38.22 | 3 |
| Tobramycin peak therapeutic drug level CPT 80200 | $103.80 | $173.00 | $49.30 – $105.85 | 3 |
| Tocilizumab 162 mg/0.9 ml subcutaneous pen injector HCPCS J3262 | $4,733.60 | $7,889.33 | $549.89 – $1,180.65 | 3 |
| Toe X-ray (both feet) CPT 73660 | $226.20 | $377.00 | $59.13 – $85.34 | 3 |
| Tomosynthesis breast screen bilateral CPT 77063 | $26.40 | $44.00 | $14.96 – $32.12 | 3 |
| Tongue biopsy; posterior one-third 41105 CPT 41105 | $330.60 | $551.00 | $402.23 – $2,679.00 | 3 |
| Tonsillectomy (age 12+) CPT 42826 | $499.20 | $832.00 | $607.36 – $2,679.00 | 3 |
| Tonsillectomy (child under 12) CPT 42825 | $481.80 | $803.00 | $586.19 – $2,679.00 | 3 |
| Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution HCPCS J9351 | $570.18 | $950.30 | $259.32 – $556.79 | 3 |
| Tot abd hyst/par vag/pelv node sam 58200 CPT 58200 | $2,560.80 | $4,268.00 | $928.00 – $3,115.64 | 3 |
| Total Hip Replacement CPT 27130 | $1,771.80 | $2,953.00 | $928.00 – $2,679.00 | 3 |
| Total hysterectomy CPT 58150 | $1,941.00 | $3,235.00 | $928.00 – $2,679.00 | 3 |
| Total Knee Replacement CPT 27447 | $1,770.00 | $2,950.00 | $928.00 – $2,679.00 | 3 |
| Total ob care failed vbac 59618 CPT 59618 | $4,792.80 | $7,988.00 | $928.00 – $5,831.24 | 3 |
| Tot disc arthrp ant appr disc 2nd level cervi 22858 CPT 22858 | $1,095.00 | $1,825.00 | $928.00 – $2,679.00 | 3 |
| Tot esophagectomy without thoracotomy 43107 CPT 43107 | $4,865.40 | $8,109.00 | $928.00 – $5,919.57 | 3 |
| Toxoplasma antibody igg CPT 86777 | $54.60 | $91.00 | $20.74 – $44.53 | 3 |
| Toxoplasma antibody igm CPT 86778 | $55.20 | $92.00 | $20.74 – $44.53 | 3 |
| Tpmt gene com vrnts CPT 81335 | $467.40 | $779.00 | $264.86 – $568.67 | 3 |
| Trabectedin 1 mg intravenous solution HCPCS J9352 | $6,148.46 | $10,247.44 | $3,484.13 – $7,480.63 | 3 |
| Trachelectomy (cervicectomy) 57530 CPT 57530 | $669.60 | $1,116.00 | $814.68 – $2,679.00 | 3 |
| Tracheobrnchsc thru est trachs incisn CPT 31615 | $357.00 | $595.00 | $434.35 – $2,679.00 | 3 |
| Tracheostoma revision; simple, without flap rotation CPT 31613 | $878.40 | $1,464.00 | $928.00 – $2,679.00 | 3 |
| Training self management diabetes individual outpatient department per 30 minutes HCPCS G0108 | $82.80 | $138.00 | $100.74 – $2,679.00 | 3 |
| Transab esoph hiat hern repair 43332 CPT 43332 | $1,930.20 | $3,217.00 | $928.00 – $2,679.00 | 3 |
| Transcath mv repair addl prosthesis CPT 33419 | $949.20 | $1,582.00 | $928.00 – $2,679.00 | 3 |
| Transcath mv repair init prosthesis CPT 33418 | $4,020.60 | $6,701.00 | $928.00 – $4,891.73 | 3 |
| Trans cath replace aortic valve 33366 CPT 33366 | $4,079.40 | $6,799.00 | $928.00 – $4,963.27 | 3 |
| Transcutaneous hgb 88738 CPT 88738 | $13.80 | $23.00 | $16.79 – $2,679.00 | 3 |
| Transferrin CPT 84466 | $81.60 | $136.00 | $25.84 – $55.48 | 3 |
| Transparent film <= 16 sq in HCPCS A6257 | $3.00 | $5.00 | $3.65 – $2,679.00 | 3 |
| Transthor diaphrag hern repair 43334 CPT 43334 | $2,356.80 | $3,928.00 | $928.00 – $2,867.44 | 3 |
| Transvaginal Pelvic Ultrasound (not pregnancy) CPT 76830 | $368.40 | $614.00 | $190.74 – $234.33 | 3 |
| Transvaginal Pregnancy Ultrasound CPT 76817 | $384.00 | $640.00 | $155.49 – $217.60 | 3 |
| Trastuzumab 150 mg intravenous solution HCPCS J9355 | $2,801.66 | $4,669.44 | $1,587.61 – $3,408.69 | 3 |
| Trastuzumab-anns 150 mg intravenous solution HCPCS Q5117 | $6,786.46 | $11,310.76 | $1,388.53 – $2,981.26 | 3 |
| Trastuzumab-qyyp 150 mg intravenous solution HCPCS Q5116 | $6,047.69 | $10,079.48 | $1,239.02 – $2,660.24 | 3 |
| Trauma partial team response w/critical care services level 4 HCPCS G0390 | $4,063.80 | $6,773.00 | $1,867.96 – $4,010.62 | 3 |
| Tray bonemarrw oncontrol 102mm HCPCS C1830 | $832.80 | $1,388.00 | $163.54 – $351.13 | 3 |
| Treat ankle fracture CPT 28445 | $1,521.00 | $2,535.00 | $928.00 – $2,679.00 | 3 |
| Treat big toe fracture CPT 28505 | $1,276.80 | $2,128.00 | $928.00 – $2,679.00 | 3 |
| Treat cheek bone fracturemalar 21360 CPT 21360 | $1,033.80 | $1,723.00 | $928.00 – $2,679.00 | 3 |
| Treat clavicle dislocation 23545 CPT 23545 | $531.60 | $886.00 | $646.78 – $2,679.00 | 3 |
| Treat ectopic pregnancy CPT 59150 | $1,579.80 | $2,633.00 | $928.00 – $2,679.00 | 3 |
| Treat ectopic pregnancy CPT 59151 | $1,538.40 | $2,564.00 | $928.00 – $2,679.00 | 3 |
| Treat elbow dislocation CPT 24605 | $881.40 | $1,469.00 | $928.00 – $2,679.00 | 3 |
| Treat eyelid lesion 67850 CPT 67850 | $531.00 | $885.00 | $646.05 – $2,679.00 | 3 |
| Treat foot bone lesion CPT 28005 | $809.40 | $1,349.00 | $928.00 – $2,679.00 | 3 |
| Treat heel fracture CPT 28415 | $1,572.00 | $2,620.00 | $928.00 – $2,679.00 | 3 |
| Treat hip dislocation CPT 27257 | $637.20 | $1,062.00 | $775.26 – $2,679.00 | 3 |
| Treat knee fracture 27530 CPT 27530 | $580.20 | $967.00 | $705.91 – $2,679.00 | 3 |
| Treat lower jaw fracture 21462 CPT 21462 | $3,153.00 | $5,255.00 | $928.00 – $3,836.15 | 3 |
| Treat lower leg fracture CPT 27827 | $1,559.40 | $2,599.00 | $928.00 – $2,679.00 | 3 |
| Treat lower leg fracture CPT 27828 | $1,843.80 | $3,073.00 | $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.