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 |
|---|---|---|---|---|
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $3,052.40 | $4,696.00 | $1,775.09 – $5,285.82 | 40 |
| Culture aerobic additional method definitive id each CPT 87077 | $62.40 | $96.00 | $10.75 – $96.00 | 40 |
| Culture afb any source CPT 87116 | $76.05 | $117.00 | $10.69 – $131.70 | 40 |
| Culture anaerobic except blood CPT 87075 | $82.55 | $127.00 | $48.01 – $142.95 | 40 |
| Culture bact stool aero addl path ea CPT 87046 | $52.65 | $81.00 | $30.62 – $91.17 | 40 |
| Culture body fluid CPT 87070 | $94.90 | $146.00 | $55.19 – $164.34 | 26 |
| Culture fungi other (except blood) CPT 87102 | $92.95 | $143.00 | $54.05 – $160.96 | 40 |
| Culture fungi skin/hair/nail CPT 87101 | $55.25 | $85.00 | $32.13 – $95.68 | 40 |
| Culture mycobacteria definitive id each isolate CPT 87118 | $210.60 | $324.00 | $122.47 – $364.69 | 40 |
| Culture quantitative aerobic other source CPT 87071 | $85.80 | $132.00 | $49.90 – $148.58 | 40 |
| Culture screening strep group a CPT 87081 | $65.65 | $101.00 | $29.48 – $87.80 | 40 |
| Culture typing immunologic CPT 87147 | $29.90 | $46.00 | $17.39 – $51.78 | 40 |
| Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets CPT 87154 | $325.00 | $500.00 | $189.00 – $562.80 | 40 |
| Culture typing nucleic acid probe amplified per culture/isolate each organism CPT 87150 | $157.30 | $242.00 | $34.73 – $272.40 | 40 |
| Cutter lead HCPCS C1773 | $3,329.03 | $5,121.59 | $135.28 – $402.84 | 40 |
| Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution HCPCS J3420 | $3.00 | $3.00 | $1.13 – $3.38 | 40 |
| Cyclic citrullinated peptide antibody CPT 86200 | $97.50 | $150.00 | $56.70 – $168.84 | 40 |
| Cyclophosphamide 1 gram intravenous powder for solution HCPCS J9075 | $5,154.25 | $5,154.25 | $487.09 – $1,450.45 | 40 |
| Cyclophosphamide 25 mg capsule HCPCS J8530 | $17.10 | $17.10 | $2.17 – $12.21 | 111 |
| Cyclosporine 250 mg/5 ml intravenous solution HCPCS J7516 | $137.50 | $137.50 | $51.98 – $154.77 | 40 |
| Cyclosporine 2 hour CPT 80158 | $126.10 | $194.00 | $73.33 – $218.37 | 40 |
| Cyclosporine modified 25 mg capsule HCPCS J7515 | $1.00 | $1.00 | $0.38 – $1.13 | 111 |
| Cyclosporine oral 100 mg HCPCS J7502 | $1.55 | $1.55 | $0.59 – $2.07 | 111 |
| Cylinder pump set 20cm titan zero angl HCPCS C1813 | $15,794.15 | $24,298.69 | $18.90 – $56.28 | 40 |
| Cystatin c CPT 82610 | $72.80 | $112.00 | $42.34 – $126.07 | 40 |
| Cytarabine 20 mg/ml injection solution HCPCS J9100 | $135.00 | $135.00 | $4.40 – $54.48 | 111 |
| Cytomegalovirus (cmv) antibody igg CPT 86644 | $94.90 | $146.00 | $55.19 – $164.34 | 40 |
| Cytomegalovirus (cmv) antibody igm CPT 86645 | $109.85 | $169.00 | $63.88 – $190.23 | 40 |
| Cytopathology cellular enhancement technique non-gyn CPT 88112 | $226.00 | $190.00 | $16.61 – $150.97 | 768 |
| Dacarbazine 100 mg intravenous solution HCPCS J9130 | $56.45 | $56.45 | $4.18 – $62.13 | 111 |
| Dactinomycin 0.5 mg intravenous solution HCPCS J9120 | $13,542.70 | $13,542.70 | $331.50 – $15,243.66 | 111 |
| Daptomycin 500 mg/10 ml intravenous solution HCPCS J0878 | $127.00 | $127.00 | $15.00 – $72.49 | 111 |
| Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln HCPCS J9144 | $33,713.70 | $33,713.70 | $12,743.78 – $37,948.14 | 40 |
| Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe HCPCS J0881 | $18,648.65 | $18,648.65 | $75.00 – $1,049.57 | 111 |
| Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution HCPCS J9153 | $34,410.00 | $34,410.00 | $12,283.04 – $38,731.90 | 111 |
| Daunorubicin 5 mg/ml intravenous solution HCPCS J9150 | $308.50 | $308.50 | $116.61 – $347.25 | 40 |
| Deamidated gliadin antibody iga CPT 86258 | $63.70 | $98.00 | $37.04 – $110.31 | 40 |
| Debridement (>20 cm) charge pt CPT 97598 | $178.10 | $274.00 | $103.57 – $308.41 | 40 |
| Decalcification CPT 88311 | $72.15 | $111.00 | $41.96 – $124.94 | 40 |
| Decitabine 50 mg intravenous solution HCPCS J0894 | $224.90 | $224.90 | $85.01 – $253.15 | 40 |
| Declotting thrombolytic agent implanted vas access device 36 CPT 36593 | $762.45 | $1,173.00 | $443.39 – $1,320.33 | 40 |
| Deferoxamine 500 mg solution for injection HCPCS J0895 | $187.30 | $187.30 | $9.02 – $73.56 | 111 |
| Degarelix 120 mg subcutaneous solution HCPCS J9155 | $4,556.35 | $4,556.35 | $381.60 – $1,643.54 | 111 |
| Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device CPT 94664 | $240.50 | $370.00 | $139.86 – $416.47 | 40 |
| Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution HCPCS J0897 | $15,865.45 | $15,865.45 | $1,754.40 – $12,665.93 | 111 |
| Deodorant ostmy adapt lube 8ml HCPCS A4394 | $0.06 | $0.10 | $0.04 – $0.11 | 40 |
| Desmopressin 4 mcg/ml injection solution HCPCS J2597 | $51.55 | $51.55 | $19.49 – $58.02 | 40 |
| Device ablt adv novasure HCPCS C1886 | $6,237.48 | $9,596.13 | $164.64 – $490.26 | 40 |
| Device hemospray 7frx220cm endo hemostat min access HCPCS C1052 | $2,599.67 | $3,999.50 | $1,233.32 – $3,672.55 | 40 |
| Device intraute mirena HCPCS J7298 | $2,105.82 | $3,239.73 | $1,224.62 – $3,646.64 | 40 |
| Device sut capio slim opn HCPCS C2631 | $1,534.26 | $2,360.40 | $400.44 – $1,192.43 | 40 |
| Device tiss remov myosure reach HCPCS C1782 | $3,961.70 | $6,094.92 | $402.57 – $1,198.75 | 40 |
| Dexamethasone 0.4 mg/0.1 ml intraocular injection - cnr HCPCS J1095 | $21.00 | $21.00 | $7.94 – $23.64 | 40 |
| Dexamethasone 4 mg tablet HCPCS J8540 | $1.00 | $1.00 | $0.04 – $1.13 | 111 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $20.20 | $20.20 | $0.60 – $3.38 | 111 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | $2,752.60 | $2,752.60 | $32.09 – $388.28 | 111 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | $20.00 | $20.00 | $7.56 – $22.51 | 40 |
| Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 | $20.00 | $20.00 | $7.56 – $22.51 | 40 |
| Dextrose 5 % IV bolus HCPCS J7070 | $30.00 | $30.00 | $7.56 – $22.51 | 40 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $185.90 | $286.00 | $108.11 – $321.92 | 40 |
| Diabetes (HbA1c) Test CPT 83036 | $79.30 | $122.00 | $46.12 – $137.32 | 40 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $445.90 | $686.00 | $142.21 – $772.16 | 40 |
| Diagnostic Mammogram (one breast) CPT 77065 | $297.05 | $457.00 | $112.74 – $514.40 | 40 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $68.15 | $68.15 | $25.76 – $76.71 | 40 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $25.30 | $25.30 | $1.19 – $4.00 | 111 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | $13,725.30 | $13,725.30 | $4,968.58 – $15,449.20 | 111 |
| Digoxin total therapeutic drug level CPT 80162 | $91.65 | $141.00 | $13.01 – $141.00 | 40 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | $184.00 | $184.00 | $34.78 – $103.56 | 40 |
| Dilator fascial 10fx20cm HCPCS C2627 | $274.98 | $423.05 | $17.48 – $52.06 | 40 |
| Diltiazem 5 mg/ml intravenous solution HCPCS J1163 | $26.00 | $26.00 | $0.20 – $3.38 | 111 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $3.70 | $3.70 | $0.90 – $4.16 | 111 |
| Dna antibody native/double stranded CPT 86225 | $101.40 | $156.00 | $58.97 – $175.59 | 40 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $183.75 | $183.75 | $7.98 – $43.11 | 111 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | $2,567.60 | $2,567.60 | $8.20 – $151.56 | 111 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $72.50 | $72.50 | $6.60 – $27.30 | 111 |
| Dornhoffer fixed part w/window HCPCS L8614 | $20,628.52 | $31,736.18 | $518.58 – $1,544.21 | 40 |
| Dostarlimab-gxly 50 mg/ml intravenous solution HCPCS J9272 | $36,812.65 | $36,812.65 | $13,341.50 – $41,436.32 | 111 |
| Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 | $1,578.20 | $1,578.20 | $5.96 – $105.13 | 111 |
| Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension HCPCS Q2050 | $7,093.75 | $7,093.75 | $726.12 – $2,162.22 | 40 |
| Doxycycline hyclate 100 mg intravenous powder for solution HCPCS J1271 | $86.65 | $86.65 | $12.00 – $97.53 | 111 |
| Drain blood from under nail 11740 CPT 11740 | $133.00 | $133.00 | $10.01 – $120.37 | 768 |
| Drain chst dry seal exp thorastat HCPCS A7041 | $138.44 | $212.98 | $80.51 – $239.73 | 40 |
| Dress/debride pt-thick burn/<5% bs 16020 CPT 16020 | $182.65 | $281.00 | $106.22 – $316.29 | 40 |
| Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm HCPCS Q4108 | $978.05 | $1,504.70 | $35.01 – $104.24 | 40 |
| Droperidol 2.5 mg/ml injection solution HCPCS J1790 | $32.80 | $32.80 | $5.36 – $36.92 | 111 |
| Drsg interceed 3x4in adh wnd barr absorb HCPCS C1765 | $3,826.54 | $5,886.99 | $257.55 – $766.92 | 40 |
| Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm HCPCS Q4103 | $156.82 | $241.26 | $91.20 – $271.56 | 40 |
| Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm HCPCS Q4102 | $34.84 | $53.60 | $16.50 – $49.13 | 40 |
| Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm HCPCS Q4124 | $41.79 | $64.30 | $22.89 – $68.16 | 40 |
| Drsg sht 5.625x4.625in std HCPCS A6025 | $80.11 | $123.24 | $40.27 – $119.91 | 40 |
| Drsg surg adh 11x11 3/4 occl drap wnd 28x30 HCPCS A6259 | $0.47 | $0.73 | $0.28 – $0.82 | 40 |
| Drsg wnd 8.2x9cm sq bilayer theragenesis ster-74sq cm-cost per sq cm HCPCS A2008 | $94.94 | $146.06 | $42.39 – $126.24 | 40 |
| Drsg wnd hyalomatrix 10x10cm -cost per sq cm HCPCS Q4117 | $46.92 | $72.19 | $17.61 – $52.45 | 40 |
| Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm HCPCS Q4104 | $6,228.55 | $9,582.38 | $28.09 – $83.64 | 40 |
| Drsg wound/burn 18x10cm suprathel resorb cost per sq cm HCPCS A2012 | $16.74 | $25.75 | $1.48 – $4.40 | 40 |
| Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm HCPCS A2007 | $247.88 | $381.35 | $75.43 – $224.60 | 40 |
| Drug test(s) presumptive any class instrument chemistry analyzers CPT 80307 | $137.15 | $211.00 | $61.51 – $237.50 | 40 |
| Duragen 1x1 5ea/bx HCPCS C9354 | $1,503.57 | $2,313.19 | $230.22 – $685.54 | 40 |
| Dura-guard dura repair patch 10x16cm -q4432-cost per sq cm-160sq cm HCPCS Q4432 | $171.82 | $264.34 | $10.30 – $30.67 | 40 |
| Durvalumab 50 mg/ml intravenous solution HCPCS J9173 | $13,206.10 | $13,206.10 | $1,119.48 – $3,567.59 | 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.