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 |
|---|---|---|---|---|
| Chest apical lordotic proj CPT 71047 | $252.85 | $389.00 | $147.04 – $437.86 | 40 |
| Chest CT scan (with contrast) CPT 71260 | $1,812.20 | $2,788.00 | $1,053.86 – $3,138.17 | 40 |
| Chest CT scan (without contrast) CPT 71250 | $1,441.70 | $2,218.00 | $838.40 – $2,496.58 | 40 |
| Chest Physiotherapy (first session) CPT 94667 | $178.75 | $275.00 | $103.95 – $309.54 | 40 |
| Chest Physiotherapy (follow-up session) CPT 94668 | $151.45 | $233.00 | $88.07 – $262.26 | 40 |
| Chest X-ray CPT 71046 | $206.70 | $318.00 | $120.20 – $357.94 | 40 |
| Chest X-ray (single view) CPT 71045 | $167.70 | $258.00 | $97.52 – $290.40 | 40 |
| Chloride CPT 82435 | $39.65 | $61.00 | $23.06 – $68.66 | 40 |
| Chloride 24 hour urine CPT 82436 | $38.35 | $59.00 | $22.30 – $66.41 | 40 |
| Chloroprocaine hcl injection HCPCS J2401 | $92.60 | $92.60 | $35.00 – $104.23 | 40 |
| Chlorothiazide sodium 500 mg intravenous solution HCPCS J1205 | $122.35 | $122.35 | $40.38 – $137.72 | 111 |
| Chlorpromazine 0.125 mg/ml IV syringe - cnr HCPCS J3230 | $116.50 | $116.50 | $1.93 – $27.07 | 111 |
| Chlorpromazine 100 mg tablet HCPCS Q0161 | $3.95 | $3.95 | $1.49 – $7.00 | 111 |
| Cholesterol CPT 82465 | $40.95 | $63.00 | $23.81 – $70.91 | 40 |
| Cholesterol body fluid CPT 84999 | $209.30 | $322.00 | $121.72 – $322.00 | 32 |
| Cholesterol (Lipid) Test CPT 80061 | $110.50 | $170.00 | $64.26 – $191.35 | 40 |
| Cholinesterase CPT 82480 | $73.45 | $113.00 | $42.71 – $127.19 | 40 |
| Cinacalcet 30 mg tablet HCPCS J0604 | $1.00 | $1.00 | $0.38 – $1.13 | 111 |
| Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback HCPCS J0744 | $37.00 | $37.00 | $4.64 – $41.65 | 111 |
| Cisplatin 1 mg/ml desensitization HCPCS J9060 | $379.00 | $379.00 | $10.65 – $105.53 | 111 |
| Cladribine 10 mg/10 ml intravenous solution HCPCS J9065 | $496.70 | $496.70 | $106.40 – $559.09 | 111 |
| Clamp isol transpolr 5mmx6.5cm transpolar HCPCS C1733 | $15,050.75 | $23,155.00 | $13.10 – $39.00 | 40 |
| Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J0736 | $20.75 | $20.75 | $3.34 – $15.76 | 111 |
| Clip ligating vesolock lg HCPCS C1760 | $8,209.50 | $12,630.00 | $1.28 – $3.82 | 40 |
| Clip phn wireless f/baha4 proc HCPCS L9900 | $538.82 | $828.95 | $313.34 – $933.07 | 40 |
| Cllr miami j sm HCPCS L0174 | $607.31 | $934.33 | $21.16 – $63.01 | 40 |
| Clofarabine 1 mg/ml intravenous solution HCPCS J9027 | $17,608.50 | $17,608.50 | $322.20 – $19,820.13 | 111 |
| Clsd/shoulder dislo/manip/no anest 23650 CPT 23650 | $1,053.00 | $1,053.00 | $90.90 – $848.47 | 768 |
| Clsd tx/clavicular fx without manip 23500 CPT 23500 | $807.00 | $807.00 | $54.22 – $661.18 | 768 |
| Clsd tx patella disloc without anes 27560 CPT 27560 | $1,203.00 | $1,203.00 | $73.53 – $1,121.50 | 768 |
| Clsd tx/prox/mid phalnx fx/no manp 26720 CPT 26720 | $302.25 | $465.00 | $175.77 – $523.40 | 40 |
| Coagulation factor viia 1,000 mcg/ml inj 1 ml HCPCS J7189 | $8,628.75 | $8,628.75 | $2,650.00 – $9,712.52 | 111 |
| Coagulation time activated teg CPT 85347 | $50.05 | $77.00 | $29.11 – $86.67 | 40 |
| Cocaine 4 % nasal solution HCPCS C9046 | $3,354.90 | $3,354.90 | $294.40 – $3,776.28 | 111 |
| Coil axium 3d 14mmx40cm qc HCPCS C1770 | $2,948.58 | $4,536.28 | $742.46 – $2,210.89 | 40 |
| Cold agglutinin screen (arc) CPT 86156 | $66.95 | $103.00 | $38.93 – $115.94 | 40 |
| Collarbone (Clavicle) X-ray (both sides) CPT 73000 | $271.05 | $417.00 | $105.08 – $312.92 | 40 |
| Collar cerv 18.25x3.5in serp firm density sm HCPCS L0120 | $44.47 | $68.41 | $0.89 – $2.66 | 40 |
| Collar cerv adlt perfit ace extric HCPCS L0140 | $34.12 | $52.50 | $1.71 – $5.09 | 40 |
| Collar cerv ascend 172 reg HCPCS L0172 | $1,198.73 | $1,844.20 | $0.99 – $2.95 | 40 |
| Collar extrication adult univ HCPCS L0200 | $41.92 | $64.50 | $24.38 – $72.60 | 40 |
| Colonoscopy (diagnostic) CPT 45378 | $4,941.79 | not published | $0.32 – $4.92 | 72 |
| Colonoscopy flex w/rem of tumor(s)/polyp(s)/lesion(s) by hot biopsy(s) forceps (rest meth ii cah) CPT 45384 | $4,749.81 | not published | $4.32 – $31.45 | 72 |
| Colonoscopy (with biopsy) CPT 45380 | $3,872.86 | not published | $4.05 – $31.45 | 72 |
| Colonoscopy (with polyp removal) CPT 45385 | $5,069.38 | $1,672.00 | $4.50 – $1,882.00 | 111 |
| Compatibility test each unit antiglobulin technique CPT 86922 | $144.95 | $223.00 | $84.29 – $251.01 | 40 |
| Compatibility test each unit immediate spin technique CPT 86920 | $107.25 | $165.00 | $62.37 – $185.72 | 40 |
| Complement antigen each component c3 CPT 86160 | $91.00 | $140.00 | $52.92 – $157.58 | 40 |
| Component ankle afo plastic jt mold to pt mdl foot cup HCPCS L1970 | $1,752.13 | $2,695.58 | $1,018.93 – $3,034.14 | 40 |
| Computed tomographic angiography head and neck with contrast CPT 70471 | $694.85 | $1,069.00 | $404.08 – $1,203.27 | 40 |
| Concentration infection agents any type CPT 87015 | $52.65 | $81.00 | $30.62 – $91.17 | 40 |
| Conduit wrap neuomend 3mmx2.5cm HCPCS C9361 | $3,352.21 | $5,157.25 | $154.83 – $461.06 | 40 |
| Conjugated estrogens 25 mg solution for injection HCPCS J1410 | $1,780.10 | $1,780.10 | $390.74 – $2,003.68 | 111 |
| Connect omega .5mm HCPCS L8613 | $22,574.95 | $34,730.69 | $25.48 – $75.87 | 40 |
| Connector tis 2x10mm HCPCS C9352 | $6,756.42 | $10,394.49 | $477.98 – $1,423.32 | 40 |
| Consultation pathology during surgery CPT 88329 | $139.10 | $214.00 | $31.71 – $240.88 | 40 |
| Consultation pathology during surgery cytological exam initial site CPT 88333 | $279.50 | $430.00 | $162.54 – $484.01 | 40 |
| Consultation pathology during surgery frozen section each additional block CPT 88332 | $66.95 | $103.00 | $38.93 – $115.94 | 40 |
| Consultation pathology during surgery frozen section first tissue block CPT 88331 | $173.00 | $197.00 | $33.03 – $221.74 | 781 |
| Consultation/report referred material w/preparation of slides CPT 88323 | $370.50 | $570.00 | $215.46 – $570.00 | 33 |
| Controler lvad heartmate 3 includes ebb HCPCS Q0481 | $9,782.99 | $15,050.75 | $4,376.30 – $13,031.63 | 40 |
| Controller infinity pt dbs HCPCS C1787 | $27,497.09 | $42,303.21 | $18.90 – $56.28 | 40 |
| Control of nosebleedantersmpl 30901 CPT 30901 | $491.40 | $756.00 | $190.51 – $567.30 | 40 |
| Coombs direct CPT 86880 | $91.00 | $140.00 | $43.47 – $129.44 | 40 |
| Coombs indirect qualitative each reagent red cell reference CPT 86885 | $92.30 | $142.00 | $53.68 – $159.84 | 40 |
| Coombs indirect titer reference CPT 86886 | $112.45 | $173.00 | $65.39 – $194.73 | 40 |
| Cornea 1/2moon str split thick HCPCS L8609 | $794.53 | $1,222.35 | $462.05 – $1,375.88 | 40 |
| Cornea pre-cut midwest eye cornea pre-cut midwest eye HCPCS V2785 | $5,705.60 | $8,777.85 | $146.48 – $436.17 | 40 |
| Cortisol total am CPT 82533 | $122.20 | $188.00 | $71.06 – $211.61 | 40 |
| Cosyntropin 0.25 mg solution for injection HCPCS J0834 | $101.75 | $101.75 | $28.02 – $114.53 | 111 |
| Coveredge 32 lead kit 40cm 48 HCPCS C1897 | $9,235.69 | $14,208.75 | $49.60 – $147.71 | 40 |
| Cover wrist HCPCS L3984 | $0.01 | $0.01 | $0.01 – $0.01 | 39 |
| Covid-19 administration immunization im inj 1st/only component CPT 90480 | $71.50 | $110.00 | $7.44 – $22.15 | 40 |
| Covid-19 IV infusion and post admin monitoring tocilizumab 1st dose HCPCS M0249 | $443.95 | $683.00 | $258.17 – $768.78 | 40 |
| Covid-19 IV infusion and post admin monitoring tocilizumab 2nd dose HCPCS M0250 | $443.95 | $683.00 | $258.17 – $768.78 | 40 |
| Covid-19 lab test non-cdc HCPCS U0002 | $146.90 | $226.00 | $85.43 – $254.39 | 40 |
| C-peptide CPT 84681 | $163.80 | $252.00 | $95.26 – $283.65 | 40 |
| CPR (Cardiopulmonary Resuscitation) CPT 92950 | $1,591.20 | $2,448.00 | $367.79 – $1,095.21 | 40 |
| Cr-51 sodium chromate HCPCS A9553 | $7,028.75 | $7,028.75 | $2,656.87 – $7,911.56 | 40 |
| C-reactive protein CPT 86140 | $70.85 | $109.00 | $41.20 – $122.69 | 40 |
| C-reactive protein high sensitivity CPT 86141 | $129.35 | $199.00 | $12.69 – $199.00 | 40 |
| Creatine kinase CPT 82550 | $66.30 | $102.00 | $6.44 – $114.81 | 40 |
| Creatine kinase mb CPT 82553 | $109.20 | $168.00 | $63.50 – $189.10 | 40 |
| Creatinine CPT 82565 | $42.25 | $65.00 | $24.57 – $73.16 | 40 |
| Creatinine 24 hour urine CPT 82570 | $63.05 | $97.00 | $36.67 – $109.18 | 40 |
| Creatinine clearance urine CPT 82575 | $69.55 | $107.00 | $40.45 – $120.44 | 40 |
| Critical care each additional 30 minutes CPT 99292 | $325.00 | $500.00 | $110.75 – $329.80 | 40 |
| Critical Care (first 30 to 74 minutes) CPT 99291 | $1,240.20 | $1,908.00 | $122.23 – $741.77 | 781 |
| Crizanlizumab-tmca 10 mg/ml intravenous solution HCPCS J0791 | $7,358.85 | $7,358.85 | $2,591.60 – $8,283.12 | 111 |
| Crotalidae poly immune fab HCPCS J0840 | $8,824.60 | $8,824.60 | $1,861.13 – $9,932.97 | 111 |
| Cryoprecipitate each unit HCPCS P9012 | $123.50 | $190.00 | $71.82 – $213.86 | 40 |
| Crystal identification light microscopy CPT 89060 | $83.20 | $128.00 | $48.38 – $144.08 | 40 |
| CT Angiogram of Abdomen and Pelvis CPT 74174 | $4,206.80 | $6,472.00 | $2,446.42 – $7,284.88 | 40 |
| CT Angiogram of the Abdomen CPT 74175 | $2,629.90 | $4,046.00 | $1,529.39 – $4,554.18 | 40 |
| CT Angiogram of the Abdomen and Both Legs CPT 75635 | $2,367.95 | $3,643.00 | $1,377.05 – $4,100.56 | 40 |
| CT Angiogram of the Chest (for blood clot) CPT 71275 | $983.45 | $1,513.00 | $571.91 – $1,703.03 | 40 |
| CT Angiogram of the Head CPT 70496 | $2,528.50 | $3,890.00 | $1,470.42 – $4,378.58 | 40 |
| CT Angiogram of the Neck CPT 70498 | $2,558.40 | $3,936.00 | $1,487.81 – $4,430.36 | 40 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $4,115.15 | $6,331.00 | $2,393.12 – $7,126.17 | 40 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $3,664.05 | $5,637.00 | $2,130.79 – $6,345.01 | 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.