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 |
|---|---|---|---|---|
| Treat lower leg joint CPT 27829 | $989.40 | $1,649.00 | $928.00 – $2,679.00 | 3 |
| Treatment fx radial distal open w/internal fixation 2 frag left (restricted method ii cah) CPT 25608 | $1,155.00 | $1,925.00 | $928.00 – $2,679.00 | 3 |
| Treatment fx radial distal open w/internal fixation 3+ frag left (restricted method ii cah) CPT 25609 | $1,465.20 | $2,442.00 | $928.00 – $2,679.00 | 3 |
| Treatment fx radial distal open w/internal fixation left (restricted method ii cah) CPT 25607 | $1,034.40 | $1,724.00 | $928.00 – $2,679.00 | 3 |
| Treatment incomplete abortion completed surgically any trimester CPT 59812 | $651.60 | $1,086.00 | $792.78 – $2,679.00 | 3 |
| Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour CPT 94644 | $136.20 | $227.00 | $77.18 – $100.74 | 3 |
| Treatment missed abortion completed surgically 1st trimester CPT 59820 | $780.00 | $1,300.00 | $928.00 – $2,679.00 | 3 |
| Treatment of anal fissure w/dilat 46940 CPT 46940 | $437.40 | $729.00 | $532.17 – $2,679.00 | 3 |
| Treatment of ankle fracture CPT 27792 | $901.80 | $1,503.00 | $928.00 – $2,679.00 | 3 |
| Treatment of ankle fracture CPT 27814 | $1,065.60 | $1,776.00 | $928.00 – $2,679.00 | 3 |
| Treatment of ankle fracture CPT 27822 | $1,220.40 | $2,034.00 | $928.00 – $2,679.00 | 3 |
| Treatment of ankle fracture 27786 CPT 27786 | $594.00 | $990.00 | $722.70 – $2,679.00 | 3 |
| Treatment of fibula fracture 27780 CPT 27780 | $571.80 | $953.00 | $695.69 – $2,679.00 | 3 |
| Treatment of foot infection CPT 28003 | $535.20 | $892.00 | $651.16 – $2,679.00 | 3 |
| Treatment of head injury 62010 CPT 62010 | $3,309.00 | $5,515.00 | $928.00 – $4,025.95 | 3 |
| Treatment of heel fracture 28400 CPT 28400 | $468.60 | $781.00 | $570.13 – $2,679.00 | 3 |
| Treatment of miscarriage CPT 59821 | $784.80 | $1,308.00 | $928.00 – $2,679.00 | 3 |
| Treatment of mouth lesion physical 40820 CPT 40820 | $513.60 | $856.00 | $624.88 – $2,679.00 | 3 |
| Treatment of toe fracture 28510 CPT 28510 | $231.60 | $386.00 | $281.78 – $2,679.00 | 3 |
| Treat metatarsal fracture CPT 28485 | $1,018.20 | $1,697.00 | $928.00 – $2,679.00 | 3 |
| Treat skull fracture CPT 62005 | $2,333.40 | $3,889.00 | $928.00 – $2,838.97 | 3 |
| Treat toe fracture CPT 28525 | $1,092.00 | $1,820.00 | $928.00 – $2,679.00 | 3 |
| Treat ulnar fracture CPT 24685 | $913.80 | $1,523.00 | $928.00 – $2,679.00 | 3 |
| Treat vaginal bleeding CPT 57180 | $273.60 | $456.00 | $332.88 – $2,679.00 | 3 |
| Tremelimumab-actl 20 mg/ml intravenous solution HCPCS J9347 | $73,346.25 | $122,243.75 | $41,562.88 – $89,237.94 | 3 |
| Treponema pallidum antibody CPT 86780 | $45.60 | $76.00 | $23.46 – $50.37 | 3 |
| Triamcinolone acetonide 40 mg/ml suspension for injection HCPCS J3301 | $96.56 | $160.94 | $9.46 – $20.32 | 3 |
| Triamcinolone a inj prs-free HCPCS J3300 | $1,684.43 | $2,807.39 | $954.51 – $2,049.39 | 3 |
| #tricyclicantidprssnt CPT 80337 | $208.20 | $347.00 | $117.98 – $253.31 | 3 |
| Triglycerides CPT 84478 | $42.60 | $71.00 | $11.22 – $24.09 | 3 |
| Trimethobenzamide hcl inj HCPCS J3250 | $119.80 | $199.67 | $9.42 – $20.23 | 3 |
| Trim nail(s) HCPCS G0127 | $37.20 | $62.00 | $45.26 – $2,679.00 | 3 |
| Trim nondyst nails CPT 11719 | $42.60 | $71.00 | $51.83 – $2,679.00 | 3 |
| Triptorelin pamoate HCPCS J3315 | $8,654.89 | $14,424.81 | $839.69 – $1,802.87 | 3 |
| Trmt of fracture (femoral shaft) 27500 CPT 27500 | $974.40 | $1,624.00 | $928.00 – $2,679.00 | 3 |
| Trnscath plc stent crv crtd without prtct CPT 37216 | $2,047.80 | $3,413.00 | $928.00 – $2,679.00 | 3 |
| Trnscath plc stent crv crtd w/prtct CPT 37215 | $1,428.00 | $2,380.00 | $928.00 – $2,679.00 | 3 |
| Trnscath plc stnt ante carotid art CPT 37218 | $1,795.80 | $2,993.00 | $928.00 – $2,679.00 | 3 |
| Trnscath plc vas stent w/s&i ea addl vein CPT 37239 | $3,943.20 | $6,572.00 | $928.00 – $4,797.56 | 3 |
| Trnscath plc vas stent w/s&i ini vein CPT 37238 | $504.00 | $840.00 | $613.20 – $2,679.00 | 3 |
| Trnscath retrv pq vasc fb w/guide CPT 37197 | $2,812.20 | $4,687.00 | $928.00 – $3,421.51 | 3 |
| Trnscath tx thromblytc artery non-intracrn ini day CPT 37211 | $658.80 | $1,098.00 | $801.54 – $2,679.00 | 3 |
| Trnscath tx thromblytc art/ven sbsq day CPT 37213 | $352.20 | $587.00 | $428.51 – $2,679.00 | 3 |
| Trnscath tx thromblytc cath rmv sbsq day CPT 37214 | $174.60 | $291.00 | $212.43 – $2,679.00 | 3 |
| Trnscath tx thromblytc vein ini day CPT 37212 | $509.40 | $849.00 | $619.77 – $2,679.00 | 3 |
| Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm CPT 14301 | $2,085.60 | $3,476.00 | $928.00 – $2,679.00 | 3 |
| Trnsfr/rearrngmnt adjcnt tiss defec ea addl 30sqcm/< CPT 14302 | $435.00 | $725.00 | $529.25 – $2,679.00 | 3 |
| Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/< CPT 14060 | $1,493.40 | $2,489.00 | $928.00 – $2,679.00 | 3 |
| Trnsfr/rearrngmnt adjcnt tiss eye/nose/ear/lip 10.1-30sqcm CPT 14061 | $1,948.80 | $3,248.00 | $928.00 – $2,679.00 | 3 |
| Trnsfr/rearrngmnt adjcnt tiss sclp/arm/lg 10.1-30sqcm CPT 14021 | $1,672.20 | $2,787.00 | $928.00 – $2,679.00 | 3 |
| Trnsfr/rearrngmnt adjcnt tiss trnk 10.1-30sqcm CPT 14001 | $1,529.40 | $2,549.00 | $928.00 – $2,679.00 | 3 |
| Trnsfr/rearrngmnt adjcnt tiss trnk 10sqcm/< CPT 14000 | $1,189.20 | $1,982.00 | $928.00 – $2,679.00 | 3 |
| Troponin quantitative CPT 84484 | $112.80 | $188.00 | $44.20 – $94.90 | 3 |
| Tubal Ligation (Laparoscopic) CPT 58670 | $711.00 | $1,185.00 | $865.05 – $2,679.00 | 3 |
| Tube drain vert dev st 5-40f HCPCS A5200 | $198.00 | $330.00 | $95.54 – $205.13 | 3 |
| Tube trach disp innr can 5 xlt HCPCS A7521 | $146.40 | $244.00 | $5.44 – $11.68 | 3 |
| Tube trach disp innr can 6 xlt HCPCS A4623 | $9.60 | $16.00 | $3.40 – $7.30 | 3 |
| Tube trach fen sz 6 uncuffed HCPCS A7520 | $132.00 | $220.00 | $36.38 – $78.11 | 3 |
| Tubing (oxygen) per foot HCPCS A4616 | $20.40 | $34.00 | $24.82 – $2,679.00 | 3 |
| Tvh >250 gms 58290 CPT 58290 | $2,244.00 | $3,740.00 | $928.00 – $2,730.20 | 3 |
| Tvh w/mmk 58267 CPT 58267 | $2,058.60 | $3,431.00 | $928.00 – $2,679.00 | 3 |
| Tx closed hip disl traumatic without anes CPT 27250 | $726.60 | $1,211.00 | $884.03 – $2,679.00 | 3 |
| Tx closed tib fx proximal w/w/o manip w/skel trac CPT 27532 | $1,236.60 | $2,061.00 | $928.00 – $2,679.00 | 3 |
| Tx closed tib shaft fx without manip CPT 27750 | $648.00 | $1,080.00 | $788.40 – $2,679.00 | 3 |
| Tx contour defects 1.1-5.0cc 11951 CPT 11951 | $110.40 | $184.00 | $134.32 – $2,679.00 | 3 |
| Tx ectopic pregnancy abdl pregnancy 59130 CPT 59130 | $1,776.60 | $2,961.00 | $928.00 – $2,679.00 | 3 |
| Tx ectopic pregnancy ntrstl prtl rescj uter 59136 CPT 59136 | $1,792.20 | $2,987.00 | $928.00 – $2,679.00 | 3 |
| Tx open art fx mcp/iphlngl jnt incl int fixtn ea CPT 26746 | $1,038.60 | $1,731.00 | $928.00 – $2,679.00 | 3 |
| Tx open dstl phlngl fx f/t internal fixation ea CPT 26765 | $937.20 | $1,562.00 | $928.00 – $2,679.00 | 3 |
| Tx open iphlngl jt disl internal fixation sngl CPT 26785 | $1,020.60 | $1,701.00 | $928.00 – $2,679.00 | 3 |
| Tx open nsl fx uncomp CPT 21325 | $910.80 | $1,518.00 | $928.00 – $2,679.00 | 3 |
| Tx open nsl sptl fx CPT 21336 | $1,261.20 | $2,102.00 | $928.00 – $2,679.00 | 3 |
| Tx phalangeal shaft fx open prox/middle ea CPT 26735 | $1,123.80 | $1,873.00 | $928.00 – $2,679.00 | 3 |
| Tx septic abortion surgical 59830 CPT 59830 | $896.40 | $1,494.00 | $928.00 – $2,679.00 | 3 |
| Tx tarsal bone fx without manip 28450 CPT 28450 | $410.40 | $684.00 | $499.32 – $2,679.00 | 3 |
| Tympanic membrane repair CPT 69610 | $759.00 | $1,265.00 | $923.45 – $2,679.00 | 3 |
| Tympanolysis transcanal 69450 CPT 69450 | $1,069.80 | $1,783.00 | $928.00 – $2,679.00 | 3 |
| Tympanostomy/ven tube/loc/top anes 69433 CPT 69433 | $779.40 | $1,299.00 | $928.00 – $2,679.00 | 3 |
| Tympp antrt/mastoidotomy prosthesis torp 69637 CPT 69637 | $2,705.40 | $4,509.00 | $928.00 – $3,291.57 | 3 |
| Tympp antrt/mastoid without ossic chain recnst 69635 CPT 69635 | $2,403.60 | $4,006.00 | $928.00 – $2,924.38 | 3 |
| Ua w/micro/comp poc CPT 81000 | $8.40 | $14.00 | $10.22 – $2,679.00 | 3 |
| Ultrasound breast unilateral limited (both sides) CPT 76642 | $516.60 | $861.00 | $185.64 – $398.58 | 3 |
| Ultrasound doppler velocimetry fetal umbilical artery CPT 76820 | $272.40 | $454.00 | $40.15 – $2,679.00 | 3 |
| Ultrasound fetal biophysical profile without non-stress testing CPT 76819 | $324.00 | $540.00 | $85.41 – $183.60 | 3 |
| Ultrasound Guidance for a Needle Procedure CPT 76942 | $844.20 | $1,407.00 | $86.87 – $172.38 | 3 |
| Ultrasound guidance for vascular access CPT 76937 | $72.60 | $121.00 | $43.07 – $2,679.00 | 3 |
| Ultrasound guide intraoperative CPT 76998 | $516.60 | $861.00 | $292.74 – $500.05 | 3 |
| Ultrasound hips infant dynamic CPT 76885 | $245.40 | $409.00 | $139.06 – $298.57 | 3 |
| Ultrasound joint complete left CPT 76881 | $238.80 | $398.00 | $135.32 – $290.54 | 3 |
| Ultrasound ob >=14wks ea addl gest CPT 76810 | $305.40 | $509.00 | $127.75 – $131.58 | 3 |
| Ultrasound pregnant uterus < 14 weeks each additional gestation CPT 76802 | $210.00 | $350.00 | $72.27 – $119.00 | 3 |
| Ultrasound pregnant uterus detailed fetal exam single/1st gestation CPT 76811 | $361.80 | $603.00 | $205.02 – $440.19 | 3 |
| Ultrasound pregnant uterus follow up per fetus CPT 76816 | $275.40 | $459.00 | $142.46 – $155.49 | 3 |
| Ultrasound prostate/transrectal CPT 76872 | $318.60 | $531.00 | $180.54 – $387.63 | 3 |
| Ultrasound spinal canal and contents CPT 76800 | $398.40 | $664.00 | $225.76 – $484.72 | 3 |
| Ultrasound transabd ea addl gest CPT 76812 | $233.40 | $389.00 | $105.74 – $227.03 | 3 |
| Umbilical artery cath newborn 36660 CPT 36660 | $144.00 | $240.00 | $175.20 – $2,679.00 | 3 |
| Umbilicoplasty 15847 CPT 15847 | $655.80 | $1,093.00 | $797.89 – $2,679.00 | 3 |
| Unlisted laparoscopic liver biopy 47379 CPT 47379 | $654.60 | $1,091.00 | $796.43 – $2,679.00 | 3 |
| Unlisted laparoscopic procedure 49659 CPT 49659 | $3,293.40 | $5,489.00 | $928.00 – $4,006.97 | 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.