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 |
|---|---|---|---|---|
| Aztreonam 1 gram solution for injection HCPCS J0457 | $159.46 | $265.76 | $42.07 – $90.33 | 3 |
| Baclofen 2,000 mcg/ml intrathecal solution (wrapper) HCPCS J0475 | $3,360.49 | $5,600.81 | $54.47 – $116.95 | 3 |
| Baclofen 50 mcg/ml intrathecal solution (wrapper) HCPCS J0476 | $141.72 | $236.20 | $80.31 – $172.43 | 3 |
| Baclofen eval charges CPT 97750 | $71.40 | $119.00 | $40.46 – $73.73 | 3 |
| Bacterial meningitis antigen CPT 86403 | $78.00 | $130.00 | $24.48 – $52.56 | 3 |
| Bacterial vaginosis pcr CPT 87801 | $219.00 | $365.00 | $105.74 – $227.03 | 3 |
| #bac vag cand-c. albicans naa CPT 87481 | $129.00 | $215.00 | $47.94 – $102.93 | 3 |
| Bag urine leg fbrc strap 32oz flipflo anti-reflux valve HCPCS A4358 | $88.80 | $148.00 | $108.04 – $2,679.00 | 3 |
| Balance and Coordination Retraining (each 15 minutes) CPT 97112 | $81.00 | $135.00 | $20.74 – $44.53 | 3 |
| Barium Enema (Colon X-ray, barium only) CPT 74270 | $327.60 | $546.00 | $185.64 – $398.58 | 3 |
| Barium Swallow (Esophagus X-ray) CPT 74220 | $321.60 | $536.00 | $182.24 – $391.28 | 3 |
| Barrier skin flextend 2.25in floating flang new image HCPCS A4409 | $1.20 | $2.00 | $0.68 – $1.46 | 3 |
| Barrier skin flxtnd ctf 3.5in flt flang 4in w/tape cut to ft HCPCS A4414 | $3.00 | $5.00 | $1.70 – $3.65 | 3 |
| Bartholin gland cyst/marsupializat 56440 CPT 56440 | $411.60 | $686.00 | $500.78 – $2,679.00 | 3 |
| Bartonella dna pcr-sendout CPT 87471 | $219.60 | $366.00 | $113.22 – $243.09 | 3 |
| Basic vestibular evaluation CPT 92540 | $372.00 | $620.00 | $186.15 – $210.80 | 3 |
| B cells total count CPT 86355 | $152.40 | $254.00 | $73.44 – $157.68 | 3 |
| Becaplermin 0.01% gel 15 gm HCPCS S0157 | $1,208.04 | $2,013.40 | $684.56 – $1,469.78 | 3 |
| Behavior counsel obesity 15min medicare g0447 HCPCS G0447 | $34.80 | $58.00 | $42.34 – $2,679.00 | 3 |
| Belatacept 250 mg intravenous solution HCPCS J0485 | $1,730.27 | $2,883.79 | $980.49 – $2,105.17 | 3 |
| Belimumab 120 mg intravenous solution HCPCS J0490 | $3,851.88 | $6,419.80 | $666.61 – $1,431.25 | 3 |
| Belt ostomy lg 34-65in HCPCS A4367 | $1.80 | $3.00 | $1.02 – $2.19 | 3 |
| Bendamustine 100 mg intravenous powder for solution HCPCS J9033 | $5,305.05 | $8,841.75 | $769.14 – $1,651.40 | 3 |
| Bendamustine 25 mg/ml intravenous solution (bendeka) HCPCS J9034 | $4,423.00 | $7,371.66 | $2,506.36 – $5,381.31 | 3 |
| Benign lesion paring 2-4 CPT 11056 | $108.00 | $180.00 | $131.40 – $2,679.00 | 3 |
| Benign lesion paring 4+ CPT 11057 | $135.60 | $226.00 | $164.98 – $2,679.00 | 3 |
| #_benzodiazconfur CPT 80346 | $394.80 | $658.00 | $24.82 – $53.29 | 3 |
| Benztropine 1 mg/ml injection solution HCPCS J0515 | $219.32 | $365.54 | $13.91 – $29.87 | 3 |
| Beta 2 glycoprotein 1 antibody iga CPT 86146 | $92.40 | $154.00 | $36.72 – $78.84 | 3 |
| Beta-2 microglobulin CPT 82232 | $94.20 | $157.00 | $22.10 – $47.45 | 3 |
| Betamethasone acetate and sodium phos 6 mg/ml suspension for injection HCPCS J0702 | $32.44 | $54.07 | $8.91 – $19.14 | 3 |
| Bevacizumab 25 mg/ml intravenous solution HCPCS J9035 | $5,687.56 | $9,479.27 | $823.33 – $1,767.75 | 3 |
| Bevacizumab-awwb 25 mg/ml intravenous solution HCPCS Q5107 | $4,984.63 | $8,307.71 | $723.76 – $1,553.96 | 3 |
| Bevacizumab-bvzr 25 mg/ml intravenous solution HCPCS Q5118 | $4,387.22 | $7,312.03 | $639.12 – $1,372.22 | 3 |
| Bfb train 1st 15min cntct 90912 CPT 90912 | $195.60 | $326.00 | $237.98 – $2,679.00 | 3 |
| Bfb train ea addl 15 min 90913 CPT 90913 | $84.00 | $140.00 | $102.20 – $2,679.00 | 3 |
| Bilateral laminotomy addl lumbar 63044 CPT 63044 | $1,206.00 | $2,010.00 | $928.00 – $2,679.00 | 3 |
| Bilateral n blobk inj pudendal 64430 CPT 64430 | $271.20 | $452.00 | $329.96 – $2,679.00 | 3 |
| Bilateral n block inj occipital 64405 CPT 64405 | $582.60 | $971.00 | $219.98 – $222.65 | 3 |
| Bilateral n block inj trigeminal 64400 CPT 64400 | $363.60 | $606.00 | $206.04 – $273.75 | 3 |
| Bile duct endoscopy add-on 47550 CPT 47550 | $312.60 | $521.00 | $380.33 – $2,679.00 | 3 |
| Bilicheck CPT 88720 | $32.40 | $54.00 | $15.33 – $18.36 | 3 |
| Bilirubin direct CPT 82248 | $36.60 | $61.00 | $20.74 – $44.53 | 3 |
| Bilirubin total CPT 82247 | $36.60 | $61.00 | $13.94 – $29.93 | 3 |
| Bilobectomy 32482 CPT 32482 | $3,069.00 | $5,115.00 | $928.00 – $3,733.95 | 3 |
| Binder abdominal lg 12 x 62-74 HCPCS L0625 | $19.20 | $32.00 | $6.80 – $14.60 | 3 |
| Biofeedback, pt CPT 90901 | $70.20 | $117.00 | $39.78 – $55.48 | 3 |
| Biopsy, bone open deep CPT 20245 | $476.40 | $794.00 | $579.62 – $2,679.00 | 3 |
| Biopsy bone trocar/needle superficial CPT 20220 | $318.00 | $530.00 | $386.90 – $2,679.00 | 3 |
| Biopsy cervixsingle/multiple 57500 CPT 57500 | $248.40 | $414.00 | $302.22 – $2,679.00 | 3 |
| Biopsy/excision of lymph node(s); open deep 38530 CPT 38530 | $486.00 | $810.00 | $591.30 – $2,679.00 | 3 |
| Biopsy external ear 69100 CPT 69100 | $196.20 | $327.00 | $238.71 – $2,679.00 | 3 |
| Biopsy eyelid & lid margin CPT 67810 | $247.80 | $413.00 | $301.49 – $2,679.00 | 3 |
| Biopsy forearm soft tissues CPT 25066 | $667.20 | $1,112.00 | $811.76 – $2,679.00 | 3 |
| Biopsy(ies) & aspiration(s) bone marrow diagnostic (both sides) CPT 38222 | $3,297.60 | $5,496.00 | $1,123.02 – $2,411.19 | 3 |
| Biopsy lower leg soft tissue 27610 CPT 27610 | $901.80 | $1,503.00 | $928.00 – $2,679.00 | 3 |
| Biopsy muscle percutaneous needle CPT 20206 | $466.20 | $777.00 | $567.21 – $2,679.00 | 3 |
| Biopsy needle liver percutaneous CPT 47000 | $1,416.60 | $2,361.00 | $619.77 – $802.74 | 3 |
| Biopsy of inestine 44100 CPT 44100 | $243.60 | $406.00 | $296.38 – $2,679.00 | 3 |
| Biopsy of lip 40490 CPT 40490 | $247.80 | $413.00 | $301.49 – $2,679.00 | 3 |
| Biopsy of nail unit 11755 CPT 11755 | $255.00 | $425.00 | $310.25 – $2,679.00 | 3 |
| Biopsy of ovary(s) 58900 CPT 58900 | $849.00 | $1,415.00 | $928.00 – $2,679.00 | 3 |
| Biopsy of penis 54100 CPT 54100 | $381.60 | $636.00 | $464.28 – $2,679.00 | 3 |
| Biopsy of prostate CPT 55700 | $1,000.20 | $1,667.00 | $566.78 – $1,216.91 | 3 |
| Biopsy of rectum wall anal approach 45100 CPT 45100 | $565.20 | $942.00 | $687.66 – $2,679.00 | 3 |
| Biopsy of salivary gland 42400 CPT 42400 | $210.00 | $350.00 | $255.50 – $2,679.00 | 3 |
| Biopsy of salivary glnd;incisional 42405 CPT 42405 | $583.80 | $973.00 | $710.29 – $2,679.00 | 3 |
| Biopsy of upper nose/throat CPT 42804 | $391.80 | $653.00 | $476.69 – $2,679.00 | 3 |
| Biopsy/removal lymph nodes CPT 38525 | $817.20 | $1,362.00 | $928.00 – $2,679.00 | 3 |
| Biopsy/removal lymph nodes 38520 CPT 38520 | $885.60 | $1,476.00 | $928.00 – $2,679.00 | 3 |
| Biopsy roof of mouth CPT 42100 | $292.20 | $487.00 | $355.51 – $2,679.00 | 3 |
| Biopsy skin incisional single lesion CPT 11106 | $246.00 | $410.00 | $299.30 – $2,679.00 | 3 |
| Biopsy/soft tissue/neck or thorax 21550 CPT 21550 | $496.80 | $828.00 | $604.44 – $2,679.00 | 3 |
| Biopsy tongue anterior two-thirds CPT 41100 | $327.60 | $546.00 | $398.58 – $2,679.00 | 3 |
| Biopsy vaginal mucosa xtnsv CPT 57105 | $261.60 | $436.00 | $318.28 – $2,679.00 | 3 |
| Biopsy vestibule of mouth 40808 CPT 40808 | $262.80 | $438.00 | $319.74 – $2,679.00 | 3 |
| Biotinidase - quest CPT 82261 | $75.60 | $126.00 | $34.00 – $73.00 | 3 |
| Bivalirudin HCPCS J0583 | $1,754.67 | $2,924.45 | $994.31 – $2,134.85 | 3 |
| Bladder Catheter Insertion (simple) CPT 51702 | $141.00 | $235.00 | $62.90 – $135.05 | 3 |
| Bladder irrigate/lavage/instill 51700 CPT 51700 | $355.80 | $593.00 | $199.29 – $201.62 | 3 |
| Bld prd mix CPT 86965 | $48.60 | $81.00 | $27.54 – $59.13 | 3 |
| Bleomycin 15 unit solution for injection HCPCS J9040 | $490.99 | $818.32 | $74.11 – $159.11 | 3 |
| Blepharoplasty lower 15820 CPT 15820 | $1,077.60 | $1,796.00 | $928.00 – $2,679.00 | 3 |
| Blepharoplasty upper 15822 CPT 15822 | $843.00 | $1,405.00 | $928.00 – $2,679.00 | 3 |
| Blepharoplasty upper eyelid 15823 CPT 15823 | $1,318.80 | $2,198.00 | $928.00 – $2,679.00 | 3 |
| Blepharp lwr eyelid fat pad CPT 15821 | $949.20 | $1,582.00 | $928.00 – $2,679.00 | 3 |
| Bln 1.2 mono emrg 15x1.2 HCPCS C1725 | $7,762.80 | $12,938.00 | $11.56 – $24.82 | 3 |
| Bln 30frx10mmx12cm renal nephromax HCPCS C1726 | $6,187.80 | $10,313.00 | $56.44 – $121.18 | 3 |
| Bln dil 900ml preperitnl HCPCS C1727 | $2,508.60 | $4,181.00 | $315.52 – $677.44 | 3 |
| Bln inpact admiral 4x150x130cm HCPCS C2623 | $4,815.00 | $8,025.00 | $1,593.92 – $3,422.24 | 3 |
| Bln ureth 5ml 28f 2wy ltx st HCPCS A4338 | $3.00 | $5.00 | $3.65 – $2,679.00 | 3 |
| Block brachial plexus w/cath plmt w/img CPT 64416 | $274.20 | $457.00 | $333.61 – $2,679.00 | 3 |
| Block femoral nerve cont infusion cath w/img CPT 64448 | $64.20 | $107.00 | $78.11 – $2,679.00 | 3 |
| Block paracervical nrv CPT 64435 | $267.00 | $445.00 | $324.85 – $2,679.00 | 3 |
| Block plantar digital nerve CPT 64455 | $93.60 | $156.00 | $113.88 – $2,679.00 | 3 |
| Block tap inj(s) w/wo img bi CPT 64488 | $166.20 | $277.00 | $202.21 – $2,679.00 | 3 |
| Block tap inj(s) w/wo img uni CPT 64486 | $133.20 | $222.00 | $162.06 – $2,679.00 | 3 |
| Blood Clotting (PT/INR) Test CPT 85610 | $47.40 | $79.00 | $6.46 – $13.87 | 3 |
| Blood Clotting (PTT) Test CPT 85730 | $98.40 | $164.00 | $9.18 – $19.71 | 3 |
| Blood Count (CBC) Test CPT 85025 | $53.40 | $89.00 | $19.72 – $38.69 | 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.