UnityPoint Health - Trinity Regional Medical Center
802 Kenyon Road, Fort Dodge, IA · UnityPoint Health · · NPI 1487759858
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 |
|---|---|---|---|---|
| Shot (Injection into Muscle or Under the Skin) CPT 96372 | $101.69 | $127.11 | $13.03 – $108.04 | 11 |
| Shoulder abduction joint pai HCPCS L6640 | not published | not published | $172.15 – $470.67 | 7 |
| Shoulder AC Joint X-ray (both sides) CPT 73050 | $283.58 | $354.47 | $8.33 – $301.30 | 11 |
| Shoulder Arthroscopy (Rotator Cuff Repair) CPT 29827 | $5,272.00 | $6,590.00 | $958.10 – $6,088.70 | 9 |
| Shoulder Blade (Scapula) X-ray (both sides) CPT 73010 | $234.44 | $293.05 | $8.01 – $249.09 | 11 |
| Shoulder flexion-abduction j HCPCS L6645 | not published | not published | $202.59 – $536.41 | 7 |
| Shoulder harness HCPCS L5699 | not published | not published | $111.65 – $313.30 | 7 |
| Shoulder lock actuator HCPCS L6647 | not published | not published | $311.18 – $791.88 | 7 |
| Shoulder MRI (with and without contrast) CPT 73223 | $4,476.44 | $5,595.54 | $94.35 – $4,756.21 | 11 |
| Shoulder MRI (with contrast) CPT 73222 | $3,521.31 | $4,401.63 | $71.16 – $3,741.39 | 11 |
| Shoulder MRI (without contrast) CPT 73221 | $2,921.37 | $3,651.71 | $59.32 – $3,103.95 | 11 |
| Shoulder prosthesis removal CPT 23334 | $5,259.20 | $6,574.00 | $954.59 – $2,531.86 | 9 |
| Shoulder prosthesis removal CPT 23335 | not published | not published | $1,133.23 – $3,018.59 | 7 |
| Shoulder universal joint HCPCS L6650 | not published | not published | $202.68 – $568.76 | 7 |
| Shoulder X-ray CPT 73030 | $234.44 | $293.05 | $8.33 – $249.09 | 11 |
| Shoulder X-ray (single view, both shoulders) CPT 73020 | $157.15 | $196.43 | $6.77 – $166.97 | 11 |
| Shrinker prosth above knee HCPCS L8460 | $535.82 | $669.77 | $39.91 – $569.30 | 9 |
| Shrinker prosth below knee HCPCS L8440 | $428.64 | $535.80 | $25.10 – $455.43 | 9 |
| Shrinker upper limb HCPCS L8465 | not published | not published | $29.21 – $81.96 | 7 |
| Shunt as-aort to pulm art CPT 33755 | not published | not published | $1,140.59 – $3,044.66 | 7 |
| Shunt central w/prostc graft CPT 33764 | not published | not published | $1,140.59 – $3,044.66 | 7 |
| Shunt desc aorta to pulm art CPT 33762 | not published | not published | $1,104.56 – $2,951.17 | 7 |
| Shunt glaucoma baerveldt 350mm HCPCS C1783 | $6,613.80 | $8,267.25 | $3,240.76 – $7,027.16 | 5 |
| Shuntogram nonvascular supervision & interpretation CPT 75809 | $216.80 | $271.00 | $20.96 – $216.73 | 11 |
| Shunt subclavian to pulm art CPT 33750 | not published | not published | $1,087.39 – $2,905.54 | 7 |
| Shunt supr v/c p-art 1 lung CPT 33766 | not published | not published | $1,146.86 – $3,065.07 | 7 |
| Shunt supr v/c p-art bth lng CPT 33767 | not published | not published | $1,223.21 – $3,270.26 | 7 |
| Sialidase enzyme assay CPT 87905 | $38.58 | $48.22 | $7.33 – $40.99 | 9 |
| Sialography s&i CPT 70390 | $292.13 | $365.16 | $16.72 – $310.39 | 11 |
| Sialolithotomy 42330 CPT 42330 | $572.00 | $715.00 | $150.19 – $2,764.11 | 9 |
| Sickling rbc CPT 85660 | $33.57 | $41.96 | $3.31 – $35.67 | 9 |
| Sigmoidoscopy and biopsy CPT 45331 | $672.00 | $840.00 | $64.93 – $777.06 | 9 |
| Sigmoidoscopy flex decompression 45337 CPT 45337 | $291.20 | $364.00 | $102.04 – $777.06 | 9 |
| Sigmoidoscopy for bleeding CPT 45334 | $1,288.80 | $1,611.00 | $105.16 – $1,004.95 | 9 |
| Sigmoidoscopy/submucosal injection 45335 CPT 45335 | $649.60 | $812.00 | $60.22 – $777.06 | 9 |
| Sigmoidoscopy w/ablation CPT 45346 | $6,681.60 | $8,352.00 | $143.02 – $1,004.95 | 9 |
| Sigmoidoscopy w/fb removal 45332 CPT 45332 | $648.00 | $810.00 | $94.00 – $1,004.95 | 9 |
| Sigmoidoscopy w/plcmt stent CPT 45347 | $388.80 | $486.00 | $137.45 – $5,073.66 | 9 |
| Sigmoidoscopy w/resection CPT 45349 | $501.60 | $627.00 | $118.64 – $2,337.38 | 9 |
| Sigmoidoscopy w/tumr remove CPT 45338 | $694.40 | $868.00 | $107.51 – $1,004.95 | 9 |
| Sigmoidoscopy w/ultrasound CPT 45341 | $312.00 | $390.00 | $110.96 – $777.06 | 9 |
| Sigmoidoscopy w/us guide bx CPT 45342 | $428.80 | $536.00 | $151.48 – $1,004.95 | 9 |
| Sigmoid/rmv tumor/polyp/hot bx for 45333 CPT 45333 | $764.00 | $955.00 | $83.96 – $777.06 | 9 |
| Signal avg ecg w or without ecg 93278 CPT 93278 | $70.40 | $88.00 | $11.48 – $50.62 | 9 |
| Sig w/tndsc balloon dilation CPT 45340 | $1,105.60 | $1,382.00 | $69.67 – $1,004.95 | 9 |
| Sildenafil citrate, 25 mg HCPCS S0090 | not published | not published | $0.27 – $29.54 | 6 |
| Silicon gel insert w/wo lock HCPCS L6692 | not published | not published | $338.84 – $939.70 | 7 |
| Sim ang w/prs cath rad emb HCPCS C8004 | not published | not published | $10,665.13 – $10,978.81 | 4 |
| Simple cystometrogram 51725 CPT 51725 | $522.40 | $653.00 | $68.04 – $207.29 | 9 |
| Sincalide 5 mcg solution for injection HCPCS J2805 | $214.36 | $267.94 | $105.03 – $227.75 | 8 |
| Single energy x-ray study HCPCS G0130 | $76.80 | $96.00 | $10.22 – $26.10 | 7 |
| Single pivot hinge pair HCPCS L6605 | not published | not published | $110.90 – $311.22 | 7 |
| Single transfer toe-hand CPT 26553 | not published | not published | $786.83 – $7,745.69 | 7 |
| Sinus CT scan (with and without contrast) CPT 70488 | $2,138.20 | $2,672.75 | $55.26 – $2,271.84 | 11 |
| Sinus CT scan (with contrast) CPT 70487 | $2,023.45 | $2,529.31 | $49.40 – $2,149.91 | 11 |
| Sinus CT scan (without contrast) CPT 70486 | $1,608.28 | $2,010.34 | $37.54 – $1,708.79 | 11 |
| Sinus/juglr venogram s&i CPT 75860 | $1,138.51 | $1,423.13 | $48.98 – $2,682.66 | 11 |
| Sinusotomy maxillary sinus 31020 CPT 31020 | $2,321.60 | $2,902.00 | $310.17 – $2,764.11 | 9 |
| Sinusotomy sinus remove polyps 31032 CPT 31032 | $2,859.20 | $3,574.00 | $535.80 – $5,042.00 | 9 |
| Sinusotomy sphenoid w/wo bx 31050 CPT 31050 | $2,446.40 | $3,058.00 | $462.98 – $5,042.00 | 9 |
| Sinus X-ray (complete) CPT 70220 | $349.38 | $436.72 | $9.63 – $371.21 | 11 |
| Sinus X-ray (limited) CPT 70210 | $161.88 | $202.34 | $7.71 – $171.99 | 11 |
| Sio flex pelvisacral custom HCPCS L0622 | not published | not published | $173.51 – $441.56 | 7 |
| Sio rig pnl pelv/sac pre ots HCPCS L0623 | not published | not published | $78.16 – $218.93 | 7 |
| Sipuleucel-t - su HCPCS Q2043 | not published | not published | $45,263.10 – $69,454.65 | 7 |
| Sirolimus, oral HCPCS J7520 | not published | not published | $1.14 – $18.58 | 6 |
| Sirolimus-protein bound 100 mg intravenous suspension HCPCS J9331 | not published | not published | $86.22 – $142.07 | 7 |
| Six volt bat otto bock/eq ea HCPCS L7360 | not published | not published | $136.73 – $382.11 | 7 |
| Skeletal muscle relaxant 1/2 CPT 80369 | $72.14 | $90.17 | $13.16 – $76.64 | 8 |
| Skel musc relaxant 3 or more CPT 80370 | $13.60 | $17.00 | $16.19 – $24.10 | 3 |
| Skin and muscle repair face CPT 15845 | $2,522.40 | $3,153.00 | $953.92 – $3,120.29 | 9 |
| Skin barrier with flange HCPCS A4373 | not published | not published | $4.37 – $11.12 | 7 |
| Skin Biopsy CPT 11102 | $360.13 | $450.16 | $34.05 – $382.64 | 11 |
| Skin full graft 20sq cm less 15200 CPT 15200 | $2,052.80 | $2,566.00 | $604.31 – $1,608.05 | 9 |
| Skin full graft add-on 15241 CPT 15241 | $445.60 | $557.00 | $95.17 – $253.71 | 7 |
| Skin pedicle flap arms/legs CPT 15572 | $2,168.80 | $2,711.00 | $661.68 – $3,120.29 | 9 |
| Skin pedicle flap trunk CPT 15570 | $2,240.00 | $2,800.00 | $650.86 – $1,733.31 | 9 |
| Skin split graft addl 100sq cm 15101 CPT 15101 | $460.00 | $575.00 | $96.84 – $259.38 | 7 |
| Skin test unlisted antigen ea CPT 86486 | $48.57 | $60.71 | $2.84 – $51.60 | 11 |
| Skull base/brainstem surgery CPT 61575 | not published | not published | $2,138.35 – $5,703.83 | 7 |
| Skull base/brainstem surgery CPT 61576 | not published | not published | $3,579.85 – $9,529.98 | 7 |
| Skull X-ray (1 to 3 views) CPT 70250 | $161.88 | $202.34 | $8.04 – $171.99 | 11 |
| Skull X-ray (complete) CPT 70260 | $379.90 | $474.87 | $12.45 – $403.64 | 11 |
| Skyla, 13.5 mg HCPCS J7301 | $1,324.80 | $1,656.00 | $887.04 – $1,011.38 | 5 |
| Slco1b1 gene com variants CPT 81328 | $350.40 | $438.00 | $104.89 – $244.74 | 7 |
| Sleep study attended CPT 95807 | $931.20 | $1,164.00 | $54.10 – $452.24 | 9 |
| Sleep Study (Polysomnography) CPT 95810 | $2,795.98 | $3,494.97 | $108.33 – $2,970.72 | 11 |
| Sleep study unattended CPT 95806 | $556.76 | $695.95 | $40.27 – $591.56 | 11 |
| Sleeve fing rolyan med HCPCS L3933 | $321.50 | $401.87 | $41.35 – $292.58 | 9 |
| Sleeve irr assura 1pc disp HCPCS A4397 | not published | not published | $6.68 – $6.68 | 1 |
| Sleeve pneumonectomy CPT 32442 | not published | not published | $2,613.72 – $6,989.35 | 7 |
| Sling arm deluxe w/pad xs HCPCS A4565 | $21.60 | $27.00 | $5.36 – $13.66 | 7 |
| Sling pelv split sam med HCPCS L0621 | not published | not published | $67.62 – $140.00 | 7 |
| Sling suprapubic suburetheral HCPCS C1771 | $3,497.00 | $4,371.24 | $1,713.53 – $3,715.55 | 5 |
| Slitting of prepuce CPT 54000 | $388.80 | $486.00 | $101.64 – $2,939.60 | 9 |
| Slitting of prepuce CPT 54001 | $480.80 | $601.00 | $128.28 – $1,745.97 | 9 |
| Slp eval for nonspeech dev ea addl 30 mins CPT 92618 | $75.20 | $94.00 | $29.88 – $76.34 | 7 |
| Slp eval non-spch gen comm dev CPT 92605 | $211.20 | $264.00 | $85.15 – $206.13 | 7 |
| Slp pure tone screening CPT 92551 | $24.80 | $31.00 | $21.18 – $29.15 | 6 |
| Slp stdy unatnd w/anal CPT 95801 | $196.00 | $245.00 | $37.39 – $98.41 | 9 |
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.