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 |
|---|---|---|---|---|
| Eculizumab 300 mg/30 ml intravenous solution HCPCS J1299 | $18,199.20 | $18,199.20 | $6,715.50 – $20,485.02 | 111 |
| Efgartigimod alfa-fcab 20 mg/ml intravenous solution HCPCS J9332 | $18,942.60 | $18,942.60 | $7,090.00 – $21,321.79 | 111 |
| EKG (Tracing Only) CPT 93005 | $159.25 | $245.00 | $5.46 – $275.77 | 40 |
| Elbow X-ray (2 views, both sides) CPT 73070 | $237.25 | $365.00 | $91.85 – $273.52 | 40 |
| Elbow X-ray (3 or more views, both sides) CPT 73080 | $327.60 | $504.00 | $127.01 – $378.20 | 40 |
| Electrd sq emblem s-icd HCPCS C1896 | $7,374.87 | $11,345.95 | $1,659.39 – $3,369.66 | 40 |
| Electrical Stimulation Therapy (each 15 minutes) CPT 97032 | $81.25 | $125.00 | $47.25 – $125.00 | 34 |
| Electrolyte panel CPT 80051 | $63.05 | $97.00 | $36.67 – $109.18 | 40 |
| Electron microscopy diagnostic CPT 88348 | $455.00 | $700.00 | $264.60 – $787.92 | 40 |
| Elotuzumab 300 mg intravenous solution HCPCS J9176 | $9,470.30 | $9,470.30 | $2,586.00 – $7,994.91 | 111 |
| Elranatamab-bcmm 40 mg/ml subcutaneous solution HCPCS J1323 | $42,858.30 | $42,858.30 | $14,083.56 – $48,241.30 | 111 |
| Enfortumab vedotin-ejfv 20 mg intravenous solution HCPCS J9177 | $12,640.50 | $12,640.50 | $3,185.41 – $9,485.43 | 111 |
| Enoxaparin 30 mg/0.3 ml subcutaneous syringe HCPCS J1650 | $29.70 | $29.70 | $3.02 – $9.00 | 40 |
| Epcoritamab-bysp 48 mg/0.8 ml subcutaneous solution HCPCS J9321 | $50,429.90 | $50,429.90 | $1,522.75 – $4,730.33 | 111 |
| Epinephrine 0.1 mg/ml injection syringe HCPCS J0168 | $58.00 | $58.00 | $21.92 – $65.28 | 40 |
| Epinephrine 1 mg/ml im kit - adult HCPCS J0169 | $50.40 | $50.40 | $13.20 – $41.42 | 111 |
| Epinephrine 1 mg/ml im kit - pediatric HCPCS J0165 | $390.90 | $390.90 | $5.80 – $56.73 | 111 |
| Epinephrine hcl (pf) 1 mg/ml (1 ml) injection solution HCPCS J0166 | $487.50 | $487.50 | $11.40 – $39.62 | 111 |
| Epirubicin 200 mg/100 ml intravenous solution HCPCS J9178 | $1,405.00 | $1,405.00 | $43.50 – $249.04 | 111 |
| Epoetin alfa-epbx 40,000 unit/ml injection solution HCPCS Q5106 | $1,039.50 | $1,039.50 | $151.40 – $1,170.06 | 111 |
| Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr HCPCS J0885 | $152.50 | $152.50 | $15.36 – $171.65 | 111 |
| Epoprostenol (arginine) 1 mg in 50 ml ns inhalation syringe - cnr HCPCS J1325 | $156.15 | $156.15 | $59.02 – $175.76 | 40 |
| Epstein barr early antigen antibody CPT 86663 | $94.25 | $145.00 | $54.81 – $163.21 | 40 |
| Epstein barr nuclear antigen antibody CPT 86664 | $107.90 | $166.00 | $62.75 – $186.85 | 40 |
| Epstein barr viral capsid antigen antibody igm CPT 86665 | $120.90 | $186.00 | $70.31 – $209.36 | 40 |
| Eptifibatide 0.75 mg/ml intravenous solution HCPCS J1327 | $432.30 | $432.30 | $79.19 – $235.81 | 111 |
| Eptinezumab-jjmr 100 mg/ml intravenous solution HCPCS J3032 | $10,020.45 | $10,020.45 | $1,985.00 – $11,279.02 | 111 |
| Eribulin 1 mg/2 ml (0.5 mg/ml) intravenous solution HCPCS J9179 | $7,050.00 | $7,050.00 | $1,144.50 – $7,935.48 | 111 |
| Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr HCPCS J1335 | $66.70 | $66.70 | $1.13 – $18.04 | 111 |
| ER Visit (level 1, minor) CPT 99281 | $341.25 | $525.00 | $20.41 – $60.78 | 40 |
| ER Visit (level 2) CPT 99282 | $487.50 | $750.00 | $25.77 – $117.06 | 781 |
| ER Visit (level 3) CPT 99283 | $602.55 | $927.00 | $44.30 – $175.59 | 781 |
| ER Visit (level 4) CPT 99284 | $1,987.05 | $1,280.00 | $0.35 – $319.67 | 781 |
| ER Visit (level 5, high severity) CPT 99285 | $5,155.41 | $1,908.00 | $2.80 – $970.27 | 781 |
| Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1364 | $908.50 | $908.50 | $47.40 – $141.15 | 111 |
| Esmolol 2,500 mg/250 ml (10 mg/ml) in sterile water intravenous soln HCPCS J1806 | $271.25 | $271.25 | $102.53 – $305.32 | 40 |
| Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only HCPCS J1805 | $427.50 | $427.50 | $2.80 – $10.36 | 111 |
| Established Patient Office Visit (level 1) CPT 99211 | $35.10 | $54.00 | $20.41 – $60.78 | 40 |
| Established Patient Office Visit (level 2) CPT 99212 | $74.10 | $114.00 | $8.04 – $128.32 | 40 |
| Established Patient Office Visit (level 3) CPT 99213 | $118.30 | $182.00 | $60.36 – $204.86 | 40 |
| Established Patient Office Visit (level 4) CPT 99214 | $167.70 | $258.00 | $88.83 – $290.40 | 40 |
| Established Patient Office Visit (level 5) CPT 99215 | $235.30 | $362.00 | $88.83 – $407.47 | 40 |
| Estradiol total CPT 82670 | $154.70 | $238.00 | $89.96 – $267.89 | 40 |
| Etoposide 20 mg/ml intravenous solution HCPCS J9181 | $174.75 | $174.75 | $66.06 – $196.70 | 111 |
| Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen CPT 84112 | $208.65 | $321.00 | $121.34 – $361.32 | 40 |
| Expander breast 300cc mod hght extra proj smth natrelle HCPCS L8600 | $2,420.11 | $3,723.25 | $0.05 – $0.14 | 40 |
| Expander tiss 133s-mv-12-t 300ml natrelle smth HCPCS C1789 | $2,952.42 | $4,542.19 | $9.45 – $28.14 | 40 |
| External pretreatment of serum for use in antibody identification by dilution CPT 86976 | $61.10 | $94.00 | $35.53 – $105.81 | 40 |
| Extractable nuclear antigen/antibody any method each antibody centromere CPT 86235 | $133.25 | $205.00 | $77.49 – $230.75 | 40 |
| Eye implant band 40 HCPCS C1784 | $1,141.56 | $1,756.25 | $20.13 – $59.94 | 40 |
| F-18 fdg pet diag HCPCS A9552 | $1,768.20 | $1,768.20 | $668.38 – $1,990.29 | 40 |
| F-18 florbetapir less than or equal to 10 mci HCPCS A9586 | $15,145.00 | $15,145.00 | $5,724.81 – $17,047.21 | 40 |
| F-18 fluciclovine per mci HCPCS A9588 | $27,455.00 | $27,455.00 | $10,377.99 – $30,903.35 | 40 |
| F-18 sodium fluoride HCPCS A9580 | $1,391.25 | $1,391.25 | $525.89 – $1,565.99 | 40 |
| Factor ix CPT 85250 | $146.25 | $225.00 | $18.66 – $225.00 | 40 |
| Factor viii CPT 85240 | $246.35 | $379.00 | $143.26 – $426.60 | 40 |
| Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr HCPCS J1308 | $4.10 | $4.10 | $0.80 – $3.38 | 111 |
| Fam-trastuzumab deruxtecan-nxki 100 mg intravenous solution HCPCS J9358 | $9,722.40 | $9,722.40 | $3,283.00 – $10,943.53 | 111 |
| Fat/lipids feces qualitative CPT 82705 | $45.50 | $70.00 | $5.00 – $70.00 | 40 |
| Fecal microbiota, live-jslm 150 ml rectal suspension enema HCPCS J1440 | $28,233.45 | $28,233.45 | $9,604.50 – $31,779.57 | 111 |
| Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper) HCPCS J3010 | $165.00 | $165.00 | $1.13 – $3.38 | 40 |
| Fern test HCPCS Q0114 | $40.95 | $63.00 | $23.81 – $70.91 | 40 |
| Ferric carboxymaltose 50 mg iron/ml intravenous solution HCPCS J1439 | $5,262.00 | $5,262.00 | $1,989.04 – $5,922.91 | 40 |
| Ferritin CPT 82728 | $107.25 | $165.00 | $62.37 – $185.72 | 40 |
| Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution HCPCS Q0138 | $1,333.80 | $1,333.80 | $158.10 – $802.38 | 111 |
| Fetal fibronectin CPT 82731 | $442.00 | $680.00 | $257.04 – $765.41 | 40 |
| Fetal hemoglobin (kleihauer betke) CPT 85460 | $48.75 | $75.00 | $28.35 – $84.42 | 40 |
| Fetal hemoglobin rosette CPT 85461 | $81.90 | $126.00 | $47.63 – $141.83 | 40 |
| Fibrin degradation d dimer quantitative CPT 85379 | $145.60 | $224.00 | $84.67 – $252.13 | 40 |
| Fibrinogen activity CPT 85384 | $67.60 | $104.00 | $10.30 – $117.06 | 40 |
| Fibrinolysins/coagulopathy screen interpretation/report CPT 85390 | $222.30 | $342.00 | $15.17 – $342.00 | 40 |
| Filgrastim-aafi 300 mcg/0.5 ml subcutaneous syringe HCPCS Q5110 | $1,611.50 | $1,611.50 | $87.00 – $1,133.70 | 111 |
| Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr HCPCS J1442 | $1,447.95 | $1,447.95 | $297.00 – $1,629.81 | 111 |
| Filgrastim-sndz 300 mcg/0.5 ml injection syringe HCPCS Q5101 | $2,018.90 | $2,018.90 | $111.00 – $1,420.28 | 111 |
| Filter spider fx 3mmx320cm HCPCS C1884 | $17,509.15 | $26,937.16 | $1,010.13 – $3,007.95 | 40 |
| Filter vena cava fem denali HCPCS C1880 | $23,327.77 | $35,888.87 | $137.21 – $408.59 | 40 |
| Finger joint sz00 swanson w/grommets HCPCS L8630 | $2,105.74 | $3,239.60 | $334.59 – $996.32 | 40 |
| Finger X-ray (both hands) CPT 73140 | $282.75 | $435.00 | $109.62 – $326.42 | 40 |
| Flow cytometry marker each additional CPT 88185 | $85.15 | $131.00 | $49.52 – $147.45 | 40 |
| Flow cytometry one marker technical component CPT 88184 | $248.95 | $383.00 | $144.77 – $431.10 | 40 |
| Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback HCPCS J1450 | $74.00 | $74.00 | $6.99 – $20.82 | 40 |
| Fludarabine 50 mg intravenous solution HCPCS J9185 | $434.65 | $434.65 | $78.41 – $489.24 | 111 |
| Fluorescent antibody titer dna CPT 86256 | $79.95 | $123.00 | $46.49 – $138.45 | 40 |
| Fluorouracil 50 mg/ml intravenous solution (wrapper) HCPCS J9190 | $147.00 | $147.00 | $1.88 – $54.76 | 111 |
| Fluphenazine decanoate 25 mg/ml injection solution HCPCS J2680 | $23.10 | $23.10 | $7.53 – $26.00 | 111 |
| Folic acid CPT 82746 | $94.25 | $145.00 | $14.55 – $163.21 | 40 |
| Folic acid 5 mg/ml injection solution HCPCS J1808 | $106.00 | $106.00 | $30.00 – $119.31 | 111 |
| Fomepizole 1 gram/ml intravenous solution HCPCS J1451 | $2,152.35 | $2,152.35 | $813.59 – $2,422.69 | 111 |
| Fondaparinux sodium HCPCS J1652 | $133.70 | $133.70 | $14.40 – $150.49 | 111 |
| Foot drp splt w/exp heel lg HCPCS L4398 | $275.11 | $423.24 | $29.08 – $86.60 | 40 |
| Foot X-ray CPT 73630 | $339.30 | $522.00 | $131.54 – $391.71 | 40 |
| Forearm X-ray (both sides) CPT 73090 | $349.05 | $537.00 | $135.32 – $402.96 | 40 |
| Fosaprepitant 150 mg intravenous powder for solution HCPCS J1453 | $66.70 | $66.70 | $25.21 – $75.08 | 40 |
| Fosphenytoin 50 mg pe/ml injection (wrapper) HCPCS Q2009 | $54.75 | $54.75 | $5.30 – $28.37 | 111 |
| Fresh frozen plasma 8-24 hours collection each unit HCPCS P9059 | $337.35 | $519.00 | $196.18 – $584.19 | 40 |
| Fresh frozen plasma frozen within 8 hours of collection each unit HCPCS P9017 | $144.95 | $223.00 | $84.29 – $251.01 | 40 |
| Fructosamine glycated protein CPT 82985 | $69.55 | $107.00 | $40.45 – $120.44 | 40 |
| Furosemide 10 mg/ml injection solution HCPCS J1938 | $3.00 | $3.00 | $0.80 – $3.38 | 111 |
| Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr HCPCS J1940 | $6.75 | $6.75 | $2.55 – $7.60 | 40 |
| Ga-67 gallium 0.1 mci HCPCS A9556 | $253.10 | $253.10 | $95.67 – $284.89 | 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.