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 |
|---|---|---|---|---|
| Brace ortho tlso 2xl 19in strnl y bar wst belt pd shldr HCPCS L0456 | $476.06 | $732.40 | $227.14 – $676.36 | 40 |
| Brace oths wrist hnd fngr without HCPCS L3807 | $432.84 | $665.91 | $1.21 – $3.61 | 40 |
| Brace tlso flex cust HCPCS L0450 | $1,982.56 | $3,050.10 | $1,152.94 – $3,433.19 | 40 |
| Brace wrist classic lft sm HCPCS L3908 | $78.86 | $121.32 | $1.22 – $3.62 | 40 |
| Brachy source i-125 injection HCPCS C2638 | $182.00 | $182.00 | $68.80 – $204.86 | 40 |
| Brachy source iodine-125 nonstranded HCPCS C2639 | $115.00 | $115.00 | $15.12 – $45.02 | 40 |
| Brachy source palladium HCPCS C2640 | $288.70 | $288.70 | $28.35 – $84.42 | 40 |
| Brachy source palladium-103 nonstranded HCPCS C2641 | $275.00 | $275.00 | $43.31 – $128.97 | 40 |
| Brachy source yttrium-90 HCPCS C2616 | $60,990.00 | $60,990.00 | $18.90 – $56.28 | 40 |
| Bra surgical elizabeth pink sm HCPCS L8000 | $161.28 | $248.13 | $35.41 – $105.46 | 40 |
| Breastbone (Sternum) X-ray CPT 71120 | $191.10 | $294.00 | $111.13 – $330.93 | 40 |
| Brentuximab vedotin 50 mg intravenous solution HCPCS J9042 | $39,510.50 | $39,510.50 | $14,145.00 – $44,473.02 | 111 |
| Brush provox 4-10mm HCPCS L8513 | $27.23 | $41.90 | $15.84 – $47.16 | 40 |
| Bumetanide in d5w IV syringe 0.04 mg/ml (neo/ped) - cnr HCPCS J1939 | $15.15 | $15.15 | $1.22 – $11.82 | 111 |
| Bundled special stain group 1 microorganisms CPT 88312 | $222.30 | $342.00 | $129.28 – $384.96 | 40 |
| Bundled special stain group 2 CPT 88313 | $175.50 | $270.00 | $82.03 – $244.26 | 40 |
| Bupivacaine 0.1 % epidural pca - 1 hour dose limit HCPCS J0665 | $741.00 | $741.00 | $1.13 – $3.38 | 40 |
| Buprenorphine 2 mg-naloxone 0.5 mg sublingual tablet HCPCS J0572 | $2.80 | $2.80 | $1.06 – $3.15 | 111 |
| Buprenorphine 8 mg-naloxone 2 mg sublingual tablet HCPCS J0574 | $3.80 | $3.80 | $1.44 – $4.28 | 111 |
| Buprenorphine oral 1mg HCPCS J0571 | $1.70 | $1.70 | $0.64 – $1.91 | 111 |
| Bur rotalink 2.15mm HCPCS C1724 | $4,849.42 | $7,460.65 | $86.19 – $256.65 | 40 |
| Butorphanol tartrate 1 mg HCPCS J0595 | $35.55 | $35.55 | $8.26 – $24.59 | 40 |
| C-1 esterase, berinert HCPCS J0597 | $11,394.30 | $11,394.30 | $3,793.00 – $12,825.42 | 111 |
| Cabazitaxel 10 mg/ml (first dilution) intravenous solution HCPCS J9043 | $44,159.55 | $44,159.55 | $14,911.20 – $49,705.99 | 111 |
| Cable cath 22-pin diag HCPCS C1730 | $8,141.09 | $12,524.75 | $20.60 – $61.35 | 40 |
| Cable centrimag pressure HCPCS Q0508 | $123,355.44 | $189,777.60 | $0.81 – $2.40 | 40 |
| Cabotegravir ER 400 mg/2 ml-rilpivirine ER 600 mg/2ml im suspension,er HCPCS J0741 | $21,398.90 | $21,398.90 | $4,726.00 – $16,057.75 | 111 |
| Caffeine citrate 20 mg/ml inj for po HCPCS J0706 | $46.00 | $46.00 | $17.39 – $51.78 | 40 |
| Calaspargase pegol-mknl 750 unit/ml intravenous solution HCPCS J9118 | $77,352.35 | $77,352.35 | $29,239.19 – $87,067.81 | 40 |
| Calcitonin (salmon) 200 unit/ml injection solution HCPCS J0630 | $2,177.05 | $2,177.05 | $822.92 – $2,450.49 | 40 |
| Calcium 24 hour urine CPT 82340 | $69.55 | $107.00 | $5.97 – $120.44 | 40 |
| Calcium acetate(phosphate binders) 667 mg tablet HCPCS J0615 | $1.00 | $1.00 | $0.29 – $1.13 | 111 |
| Calcium chloride 100 mg/ml (10 %) intravenous syringe HCPCS J0618 | $36.80 | $36.80 | $13.91 – $41.42 | 111 |
| Calcium gluconate 100 mg/ml (10 %) intravenous solution HCPCS J0612 | $90.75 | $90.75 | $16.56 – $49.30 | 40 |
| Calcium gluconate 2 gram/100 ml in sodium chloride,iso-osm IV solution HCPCS J0613 | $83.00 | $83.00 | $31.37 – $93.42 | 40 |
| Calcium ionized CPT 82330 | $105.30 | $162.00 | $13.54 – $182.35 | 40 |
| Calcium total CPT 82310 | $63.70 | $98.00 | $5.06 – $98.00 | 40 |
| Calprotectin fecal CPT 83993 | $160.55 | $247.00 | $93.37 – $278.02 | 40 |
| Camisole mastectomy wht/l post-surg gental touch HCPCS L8015 | $78.94 | $121.45 | $41.08 – $122.33 | 40 |
| Cannula ercp contour 5-4-3 tip HCPCS C1889 | $36,313.87 | $55,867.50 | $18.26 – $54.37 | 40 |
| Cap nerve 2x15mm HCPCS C1763 | $24,158.39 | $37,166.76 | $20.45 – $60.89 | 40 |
| Cap trach decann 15mm HCPCS C1750 | $3,283.80 | $5,052.00 | $1.28 – $3.82 | 40 |
| Carbamazepine total therapeutic drug level CPT 80156 | $124.15 | $191.00 | $72.20 – $214.99 | 40 |
| Carbon dioxide CPT 82374 | $35.75 | $55.00 | $20.79 – $61.91 | 40 |
| Carboplatin 10 mg/ml desensitization HCPCS J9045 | $459.90 | $459.90 | $2.31 – $42.72 | 111 |
| Carboprost tromethamine 250 mcg/ml intramuscular solution HCPCS J0675 | $187.70 | $187.70 | $70.95 – $211.28 | 111 |
| Carboxyhemoglobin quantitative CPT 82375 | $118.30 | $182.00 | $68.80 – $204.86 | 40 |
| Carcinoembryonic ag (cea) CPT 82378 | $165.75 | $255.00 | $96.39 – $287.03 | 40 |
| Cardiac rehabilitation op phase 2 w/continous ecg monitoring CPT 93798 | $260.65 | $401.00 | $151.58 – $451.37 | 40 |
| Cardiolipin antibody iga CPT 86147 | $151.45 | $233.00 | $88.07 – $262.26 | 40 |
| Carfilzomib 10 mg intravenous solution HCPCS J9047 | $11,354.40 | $11,354.40 | $602.90 – $2,130.09 | 111 |
| Carmustine 100 mg intravenous powder for solution HCPCS J9050 | $3,449.25 | $3,449.25 | $1,303.82 – $3,882.48 | 40 |
| Cassette provox xtraflow hme HCPCS A7507 | $2.67 | $4.11 | $1.55 – $4.63 | 40 |
| Cataract Surgery CPT 66984 | $5,699.46 | not published | $0.96 – $3.44 | 72 |
| Cath 2lum 14.5frx43cm maxid kt mahurkar HCPCS C1752 | $1,555.72 | $2,393.42 | $40.76 – $121.38 | 40 |
| Cath ablat bi-d d-d 8fr 115cm HCPCS C2630 | $4,378.40 | $6,736.00 | $519.43 – $1,546.74 | 40 |
| Cath ablt clsfast 7fx100cmx HCPCS C1888 | $1,894.35 | $2,914.39 | $1.84 – $5.48 | 40 |
| Cath ablt rx lasr 2.0mm turbo HCPCS C1885 | $4,679.08 | $7,198.59 | $25.16 – $74.92 | 40 |
| Cath access del ds spyscop 2.0 HCPCS C1748 | $4,008.97 | $6,167.65 | $1,975.30 – $5,882.00 | 40 |
| Cath acuity innr ic130 6f 63cm HCPCS C1887 | $41,900.62 | $64,462.50 | $0.01 – $0.21 | 40 |
| Cath acunav ge 10frx90cm HCPCS C1759 | $5,014.47 | $7,714.57 | $666.20 – $1,983.79 | 40 |
| Cath adherent clot 10mm 6f 10 HCPCS C1757 | $13,681.13 | $21,047.90 | $0.01 – $18.90 | 40 |
| Cath baloon occl urnry 34f 7x2x65 HCPCS C2628 | $4,539.55 | $6,983.93 | $0.01 – $10.36 | 40 |
| Cath bi-dir df smarttouch HCPCS C1732 | $4,908.66 | $7,551.79 | $44.35 – $132.08 | 40 |
| Cath blazer dx/20 2-10-2 space HCPCS C1731 | $2,737.87 | $4,212.11 | $140.24 – $417.60 | 40 |
| Cath council tip 16fr 5cc HCPCS A4344 | $38.93 | $59.90 | $20.47 – $60.96 | 40 |
| Cath cv dl inj 7fx16cm HCPCS C1751 | $10,827.10 | $16,657.08 | $0.57 – $1.70 | 40 |
| Cath del ampltz 12f 45d 80cm HCPCS C1893 | $1,762.57 | $2,711.65 | $0.01 – $21.07 | 40 |
| Cath entrl fd nutri 5fr 40cm HCPCS B4082 | $44.43 | $68.35 | $25.84 – $76.93 | 40 |
| Cath epdrl brevi-stf 12in .043 HCPCS C1755 | $1,561.66 | $2,402.55 | $0.52 – $1.55 | 40 |
| Cath ext adhere actv m 28mm HCPCS A4349 | $0.59 | $0.91 | $0.28 – $0.84 | 40 |
| Cath follower heyman 20f HCPCS A4352 | $234.78 | $361.20 | $0.91 – $2.72 | 40 |
| Cath groshong MRI 8fr plstc port HCPCS C1788 | $1,758.92 | $2,706.03 | $22.55 – $67.14 | 40 |
| Cath hawkone s directional HCPCS C1714 | $4,862.62 | $7,480.96 | $526.67 – $1,568.31 | 40 |
| Cath hemodial 55cm 15.5fr dual lumen straight stacked adlt HCPCS C1881 | $1,270.57 | $1,954.72 | $738.88 – $2,200.23 | 40 |
| Cath imag ivus pv 8.5fx90 .035 HCPCS C1753 | $3,489.04 | $5,367.75 | $469.27 – $1,397.39 | 40 |
| Cath infuse micro 150cm rapidtransit HCPCS A4351 | $1,380.83 | $2,124.36 | $26.42 – $69.90 | 32 |
| Cath intrdsc spnecth 8 pin HCPCS C1754 | $2,045.54 | $3,146.98 | $1,189.56 – $3,542.24 | 40 |
| Cath malecot 28fr 4-wing ltx HCPCS C1729 | $5,636.22 | $8,671.11 | $0.15 – $0.46 | 40 |
| Cath occl flo-rester 2.25x12mm cor internal vessel occluder HCPCS C1817 | $13,846.69 | $21,302.60 | $40.64 – $121.00 | 40 |
| Cath pezzer 34fr drain bardex propor head mushrm ltx HCPCS A4340 | $23.92 | $36.80 | $13.91 – $36.80 | 32 |
| Cath ptca pcltxl agent 3x20mm HCPCS C9610 | $7,730.61 | $11,893.25 | $4,449.90 – $13,250.80 | 40 |
| Cath soaker 5in 400mlx4ml/hr on-q silvr dual 2ml site HCPCS A4306 | $330.23 | $508.05 | $45.35 – $135.04 | 40 |
| Cath steerable flex adv 12f HCPCS C1766 | $2,374.45 | $3,653.00 | $43.18 – $128.59 | 40 |
| Cath suction replogle 8fr neonatal esophageal HCPCS A4624 | $54.83 | $84.35 | $0.07 – $0.18 | 32 |
| Cath symplicity spyral HCPCS C1735 | $17,877.60 | $27,504.00 | $10,396.51 – $30,958.50 | 40 |
| Cath temp pace flo bipol 5fr electrd HCPCS C1779 | $7,413.18 | $11,404.89 | $29.10 – $59.09 | 40 |
| Cath uret open tp 6fx70cm HCPCS C1758 | $926.04 | $1,424.67 | $0.01 – $0.10 | 40 |
| Cefazolin 10 mg/10 ml (dilution #2) IV desensitization - cnr HCPCS J0690 | $29.45 | $29.45 | $0.84 – $3.38 | 111 |
| Cefepime 1 gram solution for injection HCPCS J0692 | $101.65 | $101.65 | $2.46 – $12.78 | 111 |
| Cefoxitin 1 gram intravenous solution HCPCS J0694 | $64.00 | $64.00 | $4.78 – $14.24 | 40 |
| Ceftaroline fosamil 600 mg intravenous solution HCPCS J0712 | $1,224.65 | $1,224.65 | $254.40 – $1,378.47 | 111 |
| Ceftazidime 4.5 mg/0.2 ml intraocular injection - cnr HCPCS J0713 | $27.90 | $27.90 | $5.10 – $15.20 | 40 |
| Ceftriaxone 1 gram solution for injection HCPCS J0696 | $30.80 | $30.80 | $1.13 – $3.38 | 111 |
| Cefuroxime in ns IV syringe 30 mg/ml (neo/ped) - cnr HCPCS J0697 | $33.00 | $33.00 | $2.29 – $11.42 | 111 |
| Cell count body fluid CPT 89050 | $117.00 | $180.00 | $4.63 – $180.00 | 40 |
| Cell count w differential body fluid CPT 89051 | $83.20 | $128.00 | $48.38 – $144.08 | 40 |
| Cemiplimab-rwlc 50 mg/ml intravenous solution HCPCS J9119 | $34,004.00 | $34,004.00 | $10,990.00 – $38,274.90 | 111 |
| Certolizumab pegol 400 mg (200 mg x 2 vials) subcutaneous kit HCPCS J0717 | $18,898.20 | $18,898.20 | $1,796.00 – $20,219.43 | 111 |
| Cetuximab 100 mg/50 ml intravenous solution HCPCS J9055 | $4,685.70 | $4,685.70 | $858.70 – $2,637.11 | 111 |
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.