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 |
|---|---|---|---|---|
| Baclofen 2,000 mcg/ml intrathecal solution (wrapper) HCPCS J0475 | $3,156.90 | $3,156.90 | $1,193.31 – $3,553.41 | 40 |
| Baclofen 50 mcg/ml intrathecal solution (wrapper) HCPCS J0476 | $164.85 | $164.85 | $62.31 – $185.56 | 40 |
| Bag urine leg fbrc strap 32oz flipflo anti-reflux valve HCPCS A4358 | $63.46 | $97.63 | $26.52 – $78.97 | 40 |
| Balance and Coordination Retraining (each 15 minutes) CPT 97112 | $129.35 | $199.00 | $75.22 – $223.99 | 40 |
| Barrier film 1.0ml wipe HCPCS A5120 | $0.23 | $0.35 | $0.13 – $0.35 | 32 |
| Barrier film 28ml spray no stng cavilon HCPCS A4369 | $19.11 | $29.40 | $11.11 – $33.09 | 40 |
| Barrier skin flat ctf 2.75in HCPCS A4408 | $0.44 | $0.67 | $0.25 – $0.75 | 40 |
| Barrier skin flextend 2.25in floating flang new image HCPCS A4409 | $0.26 | $0.40 | $0.15 – $0.45 | 40 |
| Barrier skin flxtnd ctf 3.5in flt flang 4in w/tape cut to ft HCPCS A4414 | $1.10 | $1.69 | $0.64 – $1.90 | 40 |
| Barrier skn ft cx ff red 2.25 ctf new image w/tape HCPCS A4407 | $47.64 | $73.30 | $0.25 – $0.75 | 40 |
| Bausch health Ultrasound surg HCPCS V2788 | $744.25 | $1,145.00 | $18.90 – $56.28 | 40 |
| B cells total count CPT 86355 | $131.30 | $202.00 | $36.98 – $202.00 | 40 |
| Bcg live 50 mg intravesical suspension HCPCS J9030 | $864.15 | $864.15 | $171.00 – $972.69 | 111 |
| Belatacept 250 mg intravenous solution HCPCS J0485 | $4,849.40 | $4,849.40 | $972.50 – $5,458.48 | 111 |
| Belimumab 120 mg intravenous solution HCPCS J0490 | $11,005.85 | $11,005.85 | $672.12 – $3,716.73 | 111 |
| Belt ostomy lg 34-65in HCPCS A4367 | $0.49 | $0.76 | $0.28 – $0.74 | 32 |
| Bendamustine 100 mg intravenous powder for solution HCPCS J9033 | $14,338.95 | $14,338.95 | $202.00 – $16,139.92 | 111 |
| Bendamustine 25 mg/ml intravenous solution (belrapzo) HCPCS J9036 | $11,945.90 | $11,945.90 | $1,312.00 – $13,446.31 | 111 |
| Bendamustine 25 mg/ml intravenous solution (bendeka) HCPCS J9034 | $8,355.30 | $8,355.30 | $1,436.00 – $9,404.73 | 111 |
| Bendamustine 25 mg/ml intravenous solution (vivimusta) HCPCS J9056 | $19,642.40 | $19,642.40 | $3,070.00 – $22,109.49 | 111 |
| Benztropine 1 mg/ml injection solution HCPCS J0515 | $215.25 | $215.25 | $81.36 – $242.29 | 40 |
| Beta 2 glycoprotein 1 antibody iga CPT 86146 | $108.55 | $167.00 | $63.13 – $187.98 | 40 |
| Beta-2 microglobulin CPT 82232 | $96.20 | $148.00 | $55.94 – $166.59 | 40 |
| Betamethasone acetate and sodium phos 6 mg/ml suspension for injection HCPCS J0702 | $175.75 | $175.75 | $34.45 – $197.82 | 111 |
| Bevacizumab 25 mg/ml intravenous solution HCPCS J9035 | $2,390.85 | $2,390.85 | $799.40 – $2,691.14 | 111 |
| Bevacizumab-awwb 25 mg/ml intravenous solution HCPCS Q5107 | $1,925.35 | $1,925.35 | $288.50 – $2,167.17 | 111 |
| Bevacizumab-bvzr 25 mg/ml intravenous solution HCPCS Q5118 | $6,770.50 | $6,770.50 | $957.20 – $7,620.87 | 111 |
| Bilirubin direct CPT 82248 | $42.90 | $66.00 | $24.95 – $74.29 | 40 |
| Bilirubin total CPT 82247 | $64.35 | $99.00 | $31.75 – $94.55 | 40 |
| Bivalirudin HCPCS J0583 | $481.40 | $481.40 | $181.97 – $541.86 | 40 |
| Bladder Catheter Insertion (simple) CPT 51702 | $202.80 | $312.00 | $117.94 – $351.19 | 40 |
| Bleomycin 15 unit solution for injection HCPCS J9040 | $488.00 | $488.00 | $22.87 – $296.15 | 111 |
| Blinatumomab 35 mcg intravenous solution HCPCS J9039 | $17,670.55 | $17,670.55 | $6,251.00 – $19,889.97 | 111 |
| Bln 1.2 mono emrg 15x1.2 HCPCS C1725 | $9,830.88 | $15,124.43 | $0.01 – $15.69 | 40 |
| Bln 30frx10mmx12cm renal nephromax HCPCS C1726 | $4,840.11 | $7,446.33 | $15.10 – $44.97 | 40 |
| Bln dil 900ml preperitnl HCPCS C1727 | $2,036.55 | $3,133.15 | $253.45 – $754.70 | 40 |
| Bln inpact admiral 4x150x130cm HCPCS C2623 | $3,619.02 | $5,567.73 | $20.22 – $60.22 | 40 |
| Bln press regulation 71-80cm HCPCS C1815 | $10,109.53 | $15,553.13 | $1,714.71 – $5,106.04 | 40 |
| Bln stent lg 19mm diam 10-12mm palmaz gen trnshpat unmtd HCPCS C1877 | $1,815.54 | $2,793.14 | $663.86 – $1,976.84 | 40 |
| Bln ureth 5ml 28f 2wy ltx st HCPCS A4338 | $1.82 | $2.80 | $1.06 – $2.80 | 32 |
| Blood Clotting (PT/INR) Test CPT 85610 | $72.15 | $66.00 | $9.09 – $74.29 | 40 |
| Blood Clotting (PTT) Test CPT 85730 | $378.30 | $99.00 | $9.09 – $111.43 | 40 |
| Blood Count (CBC) Test CPT 85025 | $72.80 | $112.00 | $42.34 – $126.07 | 40 |
| Blood Count (CBC) Test (without differential) CPT 85027 | $56.55 | $87.00 | $6.47 – $97.93 | 40 |
| Blood Culture Test CPT 87040 | $118.95 | $183.00 | $69.17 – $205.98 | 40 |
| Blood Draw (Venipuncture) CPT 36415 | $29.25 | $45.00 | $9.09 – $50.65 | 40 |
| Blood gases o2 saturation direct measurement CPT 82805 | $220.35 | $339.00 | $128.14 – $381.58 | 40 |
| Blood gases ph venous CPT 82800 | $68.25 | $105.00 | $10.78 – $105.00 | 40 |
| Blood occult fecal hemoglobin immunoassay qualitative 1-3 simultaneous determinations diagnostic CPT 82274 | $42.90 | $66.00 | $24.95 – $74.29 | 40 |
| Blood occult peroxidase activity qualitative gastric CPT 82271 | $56.55 | $87.00 | $32.89 – $97.93 | 40 |
| Blood smear microscopic w manual differential wbc count CPT 85007 | $38.35 | $59.00 | $22.30 – $66.41 | 40 |
| Blood typing abo CPT 86900 | $83.85 | $129.00 | $48.76 – $145.20 | 40 |
| Blood typing ag donor ea ag CPT 86902 | $234.00 | $360.00 | $136.08 – $405.22 | 40 |
| Blood typing rbc ag non abo/rh ea CPT 86905 | $90.35 | $139.00 | $52.54 – $156.46 | 40 |
| Blood typing rh (d) CPT 86901 | $44.85 | $69.00 | $26.08 – $77.67 | 40 |
| Blood typing rh phenotype complete reference CPT 86906 | $148.20 | $228.00 | $86.18 – $256.64 | 40 |
| Bone acellular derm matrix 2x4cm 0.4-1.0mm allomend-cost per sq cm-8sq cm HCPCS Q4433 | $1,983.96 | $3,052.25 | $30.36 – $90.40 | 40 |
| Bone Age X-ray (hand and wrist) CPT 77072 | $170.95 | $263.00 | $99.41 – $296.03 | 40 |
| Bone filler cerament 10cc HCPCS C1602 | $10,175.74 | $15,654.99 | $208.90 – $622.05 | 40 |
| Bone tendon board add on HCPCS C9356 | $4,850.45 | $7,462.23 | $197.04 – $586.73 | 40 |
| Bone void filler nanoss 10cc HCPCS C9362 | $3,242.75 | $4,988.85 | $73.25 – $218.12 | 40 |
| Boot cast sandal rocker med HCPCS L3265 | $2.19 | $3.37 | $1.27 – $3.79 | 40 |
| Boot heel care softcare one sz HCPCS E0191 | $132.09 | $203.21 | $1.18 – $3.51 | 40 |
| Boot j walker l HCPCS L4386 | $347.24 | $534.21 | $24.18 – $71.99 | 40 |
| Boot mlti podous univ xlg HCPCS L4396 | $165.01 | $253.86 | $25.47 – $75.83 | 40 |
| Boot softgait shrt m HCPCS L4387 | $41.49 | $63.83 | $9.68 – $28.82 | 40 |
| Boot walker genesis full shell 3-strap s HCPCS L4360 | $81.97 | $126.11 | $24.13 – $71.85 | 40 |
| Boot walker genesis mid-calf full shell s HCPCS L4361 | $81.03 | $124.66 | $47.12 – $140.32 | 40 |
| Borrelia burgdorferi (lyme disease) antibody nonspecific CPT 86618 | $136.50 | $210.00 | $79.38 – $236.38 | 40 |
| Bortezomib 3.5 mg (2.5 mg/ml) solution for subcutaneous injection HCPCS J9041 | $1,800.00 | $1,800.00 | $60.90 – $238.18 | 111 |
| Brace adj motion lerman type HCPCS L2186 | $316.44 | $486.83 | $184.02 – $547.98 | 40 |
| Brace afo dbl upright cust HCPCS L1990 | $748.46 | $1,151.48 | $435.26 – $1,296.11 | 40 |
| Brace afo lg left 6607 HCPCS L1930 | $129.79 | $199.67 | $37.85 – $112.70 | 40 |
| Brace afopos solid ankle cust HCPCS L1960 | $1,145.78 | $1,762.74 | $666.32 – $1,984.14 | 40 |
| Brace afo spiral prefab HCPCS L1951 | $1,741.42 | $2,679.11 | $1,012.70 – $3,015.61 | 40 |
| Brace ank aftr bioskn med lg HCPCS L1906 | $55.82 | $85.87 | $32.46 – $96.66 | 40 |
| Brace ank air stirrup univ HCPCS L4350 | $47.97 | $73.80 | $16.14 – $48.06 | 40 |
| Brace ankle joint dflxn assist HCPCS L2210 | $163.94 | $252.21 | $95.34 – $283.89 | 40 |
| Brace ankle stablizing lg HCPCS L1902 | $33.47 | $51.50 | $19.47 – $57.97 | 40 |
| Brace back epic lo 627 HCPCS L0642 | $140.30 | $215.85 | $81.59 – $242.96 | 40 |
| Brace back epic lso 637 HCPCS L0650 | $186.50 | $286.92 | $108.46 – $322.96 | 40 |
| Brace back epic tslo 456 HCPCS L0457 | $390.58 | $600.89 | $154.53 – $460.15 | 40 |
| Brace back pinnacle lo 627 lumbar HCPCS L0627 | $869.63 | $1,337.90 | $100.94 – $300.58 | 40 |
| Brace back pinnacle tlso 464 HCPCS L0464 | $405.55 | $623.93 | $235.85 – $702.30 | 40 |
| Brace back t-lso custom HCPCS L0486 | $2,912.40 | $4,480.62 | $1,693.67 – $5,043.39 | 40 |
| Brace back vista 464 tlso HCPCS L0648 | $475.16 | $731.02 | $190.91 – $568.47 | 40 |
| Brace cust back lso HCPCS L0631 | $1,821.40 | $2,802.16 | $0.38 – $1.13 | 40 |
| Brace fx hum ovr shldr lg HCPCS L3981 | $103.61 | $159.40 | $60.25 – $179.42 | 40 |
| Brace fx hum ovr shldr sm HCPCS L3980 | $682.51 | $1,050.01 | $26.25 – $78.17 | 40 |
| Brace halo bremer l2830 HCPCS L2830 | $195.59 | $300.91 | $113.74 – $338.70 | 40 |
| Brace kafo dbl upright cust HCPCS L2036 | $2,418.37 | $3,720.57 | $1,406.38 – $4,187.87 | 40 |
| Brace knee 32in univ t-scope short lt/rt HCPCS L1852 | $272.44 | $419.14 | $158.43 – $471.78 | 40 |
| Brace knee extender plus 22-30in HCPCS L1832 | $1,503.03 | $2,312.35 | $43.38 – $129.16 | 40 |
| Brace knee hing pat open med HCPCS L1820 | $47.55 | $73.15 | $27.65 – $82.34 | 40 |
| Brace knee playmaker ii x-rom hook and loop xl HCPCS L1833 | $901.84 | $1,387.44 | $69.06 – $205.64 | 40 |
| Brace knee postop tscope xl HCPCS L1845 | $288.59 | $443.98 | $167.82 – $499.74 | 40 |
| Brace knee support neoprene padded open patella med HCPCS L1810 | $176.49 | $271.52 | $22.62 – $67.37 | 40 |
| Brace m arm board HCPCS L3809 | $45.37 | $69.80 | $13.87 – $41.31 | 40 |
| Brace or Splint Fitting and Training (each 15 minutes) CPT 97760 | $128.70 | $198.00 | $74.84 – $222.87 | 40 |
| Brace ortho exos 28-50in sm HCPCS L0637 | $243.55 | $374.69 | $138.38 – $412.07 | 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.