MercyOne Dyersville Medical Center
1111 Third St. SW, Dyersville, IA · MercyOne · · NPI 1205816725
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 |
|---|---|---|---|---|
| Warde hepatitis be antibody CPT 86707 | $91.65 | $141.00 | $53.30 – $158.71 | 40 |
| Warde infectious agent antigen immunoassay ql/sq multi step hepatitis be agn CPT 87350 | $92.30 | $142.00 | $53.68 – $159.84 | 40 |
| Warde infectious agent nucleic acid genotype hepatitis c CPT 87902 | $1,573.00 | $2,420.00 | $914.76 – $2,723.95 | 40 |
| Warde lipoprotein (a) CPT 83695 | $96.85 | $149.00 | $56.32 – $167.71 | 40 |
| Warde mitochondrial antibody each CPT 86381 | $110.50 | $170.00 | $64.26 – $191.35 | 40 |
| Warde neutralization rabies CPT 86382 | $93.60 | $144.00 | $16.57 – $144.00 | 40 |
| Warde oxcarbazepine therapeutic drug level CPT 80183 | $130.65 | $201.00 | $75.98 – $226.25 | 40 |
| Warde pancreatic elastase fecal quantitative CPT 82653 | $185.90 | $286.00 | $108.11 – $321.92 | 40 |
| Warde protein c antigen CPT 85302 | $131.95 | $203.00 | $11.77 – $203.00 | 40 |
| Warde sex hormone binding globulin CPT 84270 | $149.50 | $230.00 | $86.94 – $258.89 | 40 |
| Warde somatomedin CPT 84305 | $139.75 | $215.00 | $20.83 – $215.00 | 40 |
| Warde t3 (triiodothyronine) reverse CPT 84482 | $119.60 | $184.00 | $69.55 – $207.11 | 40 |
| Warde thyroid stimulating immunoglobulins CPT 84445 | $222.95 | $343.00 | $129.65 – $386.08 | 40 |
| Warde vitamin a CPT 84590 | $85.80 | $132.00 | $49.90 – $148.58 | 40 |
| Warde vitamin b-1 (thiamine) CPT 84425 | $163.80 | $252.00 | $95.26 – $283.65 | 40 |
| Warde vitamin b6 (pyridoxine) CPT 84207 | $203.45 | $313.00 | $118.31 – $352.31 | 40 |
| Warde vitamin c (ascorbic acid) CPT 82180 | $69.55 | $107.00 | $9.69 – $107.00 | 40 |
| Warde vitamin d (1 25 dihydroxy) CPT 82652 | $209.30 | $322.00 | $121.72 – $362.44 | 40 |
| Warde vitamin e (alpha-tocopherol) CPT 84446 | $147.55 | $227.00 | $85.81 – $255.51 | 40 |
| Warde zinc CPT 84630 | $97.50 | $150.00 | $56.70 – $168.84 | 40 |
| Wbc automated CPT 85048 | $26.65 | $41.00 | $2.49 – $41.00 | 40 |
| Whole blood or red blood cells frozen/deglycerolized/washed leukocytes reduced each unit HCPCS P9054 | $273.65 | $421.00 | $159.14 – $473.88 | 40 |
| Whole blood/red blood cells leukocytes reduced cmv negative each unit HCPCS P9051 | $436.80 | $672.00 | $254.02 – $756.40 | 40 |
| Wipe adh remover univ ostomy adh/barrier remover HCPCS A4456 | $0.01 | $0.02 | $0.01 – $0.02 | 40 |
| Wound Cleaning and Dead Tissue Removal (up to 20 sq cm) CPT 97597 | $450.45 | $693.00 | $261.95 – $780.04 | 40 |
| Wound closure by adhesive HCPCS G0168 | $277.00 | $372.00 | $4.48 – $418.72 | 781 |
| Wound therapy negative pressure per session > 50 sq cm CPT 97608 | $423.80 | $652.00 | $246.46 – $733.89 | 40 |
| Wrist X-ray CPT 73110 | $413.40 | $636.00 | $160.27 – $477.25 | 40 |
| Wrist X-ray (2 views, both wrists) CPT 73100 | $370.50 | $570.00 | $143.64 – $427.73 | 40 |
| Xcapsl ctrc rmvl insj 1+ CPT 66991 | $10,269.95 | not published | $0.32 – $3.44 | 72 |
| X-ray exam thorac spine4/>vw CPT 72074 | $273.00 | $420.00 | $158.76 – $472.75 | 40 |
| X-ray hip uni w/wo pelvis min 4 views CPT 73503 | $273.65 | $421.00 | $159.14 – $473.88 | 40 |
| X-ray hip with pelvis when performed bilateral >= 5 views CPT 73523 | $430.95 | $663.00 | $250.61 – $746.27 | 40 |
| X-ray ribs 2 views left CPT 71100 | $217.75 | $335.00 | $126.63 – $377.08 | 40 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | $156.00 | $240.00 | $90.72 – $270.14 | 40 |
| Yttrium y-90 ibritumomab ther HCPCS A9543 | $55,035.00 | $55,035.00 | $20,803.23 – $66,804.65 | 111 |
| Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr HCPCS J3485 | $83.25 | $83.25 | $18.12 – $93.71 | 111 |
| Ziprasidone 20 mg/ml (final concentration) intramuscular solution HCPCS J3486 | $54.60 | $54.60 | $20.64 – $61.46 | 40 |
| Ziv-aflibercept 25 mg/ml intravenous solution (wrapper) HCPCS J9400 | $8,000.00 | $8,000.00 | $873.00 – $4,502.40 | 111 |
| Zolbetuximab-clzb 100 mg intravenous solution HCPCS J1326 | $4,848.00 | $4,848.00 | $1,678.00 – $5,456.91 | 111 |
| Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 | $43.00 | $43.00 | $16.25 – $48.40 | 40 |
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.