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 |
|---|---|---|---|---|
| Slp ther svc non-spch gen CPT 92606 | $186.40 | $233.00 | $72.23 – $164.27 | 7 |
| Sm-153 lexidron ther HCPCS A9604 | not published | not published | $4,314.91 – $16,282.88 | 7 |
| Small animal inoculation CPT 87003 | $42.40 | $53.00 | $10.10 – $26.19 | 7 |
| Small Bowel Barium X-ray (Follow-Through) CPT 74250 | $387.90 | $484.87 | $35.36 – $412.14 | 11 |
| Small bowel endoscopy CPT 44360 | $363.20 | $454.00 | $128.24 – $1,616.83 | 9 |
| Small bowel endoscopy CPT 44364 | $517.60 | $647.00 | $182.25 – $1,616.83 | 9 |
| Small bowel endoscopy CPT 44366 | $608.00 | $760.00 | $213.81 – $1,616.83 | 9 |
| Small bowel endoscopy CPT 44369 | $623.20 | $779.00 | $219.00 – $1,616.83 | 9 |
| Small bowel endoscopy CPT 44376 | $720.00 | $900.00 | $253.42 – $1,616.83 | 9 |
| Small bowel endoscopy CPT 44378 | $975.20 | $1,219.00 | $342.26 – $1,616.83 | 9 |
| Small bowel endoscopy CPT 44382 | $698.40 | $873.00 | $66.35 – $799.09 | 9 |
| Small bowel endoscopy CPT 44384 | $388.00 | $485.00 | $136.93 – $1,616.83 | 9 |
| Small bowel endoscopy >2nd w/remove 44363 CPT 44363 | $484.80 | $606.00 | $170.79 – $1,616.83 | 9 |
| Small bowel endoscopy 44365 CPT 44365 | $460.00 | $575.00 | $162.46 – $1,616.83 | 9 |
| Small bowel endoscopy/biopsy CPT 44361 | $400.80 | $501.00 | $141.73 – $1,616.83 | 9 |
| Small bowel endoscopy/biopsy CPT 44377 | $756.80 | $946.00 | $265.84 – $1,616.83 | 9 |
| Small bowel endoscopy br/wa CPT 44380 | $447.20 | $559.00 | $51.77 – $799.09 | 9 |
| Small bowel endoscopy br/wa CPT 44381 | $2,381.60 | $2,977.00 | $75.50 – $1,616.83 | 9 |
| Small bowel endoscopy/stent 44370 CPT 44370 | $673.60 | $842.00 | $237.80 – $5,073.66 | 9 |
| Smallpox&monkeypox vac 0.5ml CPT 90611 | not published | not published | $0.01 – $270.00 | 5 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $38.58 | $48.22 | $3.23 – $40.99 | 9 |
| Smear gram stain CPT 87205 | $38.58 | $48.22 | $2.56 – $40.99 | 9 |
| Smear nasal eosinophil CPT 89190 | $56.44 | $70.54 | $5.79 – $59.96 | 9 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $38.58 | $48.22 | $3.59 – $40.99 | 9 |
| Smear wet mount CPT 87210 | $38.58 | $48.22 | $5.82 – $40.99 | 9 |
| Smn1 gene full gene sequence CPT 81336 | $289.30 | $361.62 | $167.43 – $421.92 | 9 |
| Smn1 gen nown famil seq vrnt CPT 81337 | $177.80 | $222.24 | $102.90 – $259.30 | 9 |
| Smpd1 gene common variants CPT 81330 | $127.86 | $159.82 | $28.20 – $135.85 | 9 |
| Snrpn/ube3a gene CPT 81331 | $127.86 | $159.82 | $30.64 – $135.85 | 9 |
| So airplane w/wo joint cf HCPCS L3674 | not published | not published | $643.47 – $1,637.44 | 7 |
| So cap design without jnts cf HCPCS L3671 | not published | not published | $490.49 – $1,248.17 | 7 |
| Socket insert above knee HCPCS L5658 | not published | not published | $262.13 – $667.06 | 7 |
| Socket insert below knee HCPCS L5655 | not published | not published | $158.83 – $445.69 | 7 |
| Socket insert knee articulat HCPCS L5656 | not published | not published | $251.69 – $640.47 | 7 |
| Socket insert symes HCPCS L5654 | not published | not published | $212.27 – $557.28 | 7 |
| Socket insert without lock mech HCPCS L5679 | not published | not published | $373.79 – $951.21 | 7 |
| Socket insert w lock mech HCPCS L5673 | not published | not published | $448.55 – $1,141.44 | 7 |
| Sock fracture or equal each HCPCS L3995 | $72.80 | $91.00 | $17.98 – $50.46 | 7 |
| Sock wool above knee HCPCS L8430 | not published | not published | $14.63 – $37.23 | 7 |
| Sodium 24 hour urine CPT 84300 | $33.57 | $41.96 | $3.04 – $35.67 | 9 |
| Sodium chloride 0.9 % intravenous solution HCPCS J7030 | $48.00 | $60.00 | $2.09 – $51.00 | 8 |
| Sodium chloride 0.9 % IV bolus HCPCS J7040 | $48.00 | $60.00 | $1.04 – $51.00 | 8 |
| Sodium chloride 0.9 % IV bolus HCPCS J7050 | $4.00 | $5.00 | $0.51 – $0.87 | 6 |
| Sodium chloride 3 % ivpb HCPCS J7131 | not published | not published | $0.09 – $0.15 | 5 |
| Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous HCPCS J2916 | $17.18 | $21.47 | $1.94 – $14.54 | 8 |
| Sodium hyaluronate 20 mg/2 ml syringe HCPCS J7321 | $354.92 | $443.64 | $73.96 – $377.09 | 8 |
| Sodium serum/plasma/whole blood CPT 84295 | $33.57 | $41.96 | $2.89 – $35.67 | 9 |
| Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution HCPCS J0209 | not published | not published | $0.84 – $0.93 | 3 |
| Soft interface below knee se HCPCS L2820 | $196.00 | $245.00 | $48.81 – $136.96 | 7 |
| Software meas of cardiac vol HCPCS G0183 | not published | not published | $82.81 – $85.24 | 4 |
| So gsap cl fr cpy nmbr&mcrst CPT 81463 | $323.55 | $404.43 | $187.25 – $3,054.39 | 9 |
| So gsap cll fr dna/dna&rna CPT 81462 | not published | not published | $1,195.83 – $2,715.01 | 6 |
| So gsap cll fr mcrstl ins CPT 81464 | not published | not published | $3,288.51 – $7,466.24 | 6 |
| So gsap dna cpy nmbr&mcrstl CPT 81458 | not published | not published | $1,046.35 – $2,375.63 | 6 |
| Solid skin barrier HCPCS A4362 | not published | not published | $2.42 – $6.16 | 7 |
| Solid skin barrier 6x6 HCPCS A5121 | not published | not published | $5.20 – $13.22 | 7 |
| Somatosensory testing CPT 95927 | $357.60 | $447.00 | $24.85 – $265.41 | 9 |
| Somatropin injection HCPCS J2941 | not published | not published | $48.92 – $155.10 | 7 |
| So neo gsap dna/dna&rna CPT 81459 | $2,869.97 | $3,587.46 | $1,660.99 – $6,787.48 | 9 |
| So neo gsap dna mcrstl ins CPT 81457 | $861.00 | $1,076.24 | $498.30 – $2,036.25 | 9 |
| Sotalol hydrochloride IV HCPCS C9482 | not published | not published | $22.78 – $26.30 | 5 |
| So vest canvas/web pre ots HCPCS L3675 | not published | not published | $95.52 – $243.09 | 7 |
| Spacer bag/reservoir HCPCS A4627 | not published | not published | $6.68 – $28.30 | 6 |
| Sp bone agrft morsel add-on CPT 20937 | $406.40 | $508.00 | $144.30 – $383.93 | 7 |
| Sp bone agrft struct add-on CPT 20938 | $442.40 | $553.00 | $156.77 – $418.97 | 7 |
| Sp bone algrft morsel add-on CPT 20930 | $291.20 | $364.00 | $207.30 – $363.06 | 6 |
| Special casting material HCPCS A4590 | $47.20 | $59.00 | $1.80 – $60.63 | 6 |
| Special physics consult CPT 77370 | $528.14 | $660.17 | $113.16 – $561.14 | 11 |
| Special pump services CPT 99190 | $928.00 | $1,160.00 | $695.70 – $1,070.13 | 6 |
| Special pump services CPT 99191 | $649.60 | $812.00 | $501.00 – $749.04 | 6 |
| Special pump services CPT 99192 | $464.80 | $581.00 | $346.30 – $535.75 | 6 |
| Special radiation dosimetry CPT 77331 | $528.76 | $660.95 | $16.98 – $561.81 | 11 |
| Special radiation treatment CPT 77470 | $1,633.84 | $2,042.30 | $30.46 – $1,735.96 | 11 |
| Special supplies phys/qhp CPT 99070 | $90.40 | $113.00 | $70.00 – $115.24 | 4 |
| Special teletx port plan CPT 77321 | $952.97 | $1,191.21 | $39.72 – $1,012.53 | 11 |
| Specific gravity body fluid CPT 84315 | $33.57 | $41.96 | $1.97 – $35.67 | 9 |
| Specimen fat stain CPT 89125 | $56.44 | $70.54 | $3.53 – $59.96 | 9 |
| Speech and Language Evaluation (comprehensive) CPT 92523 | $432.00 | $540.00 | $172.70 – $392.10 | 9 |
| Speech audiometry complete CPT 92556 | $83.20 | $104.00 | $41.49 – $104.55 | 9 |
| Speech evaluation complex CPT 70371 | $228.00 | $285.00 | $38.84 – $206.02 | 9 |
| Speech recep thresh CPT 92555 | $53.60 | $67.00 | $26.73 – $67.24 | 9 |
| Speech Therapy Session (one-on-one) CPT 92507 | $265.43 | $331.78 | $71.73 – $282.01 | 9 |
| Sperm antibody test CPT 89325 | $56.44 | $70.54 | $6.40 – $59.96 | 9 |
| Sperm evaluation test CPT 89329 | $49.60 | $62.00 | $11.75 – $30.46 | 7 |
| Sperm identification CPT 89257 | $109.60 | $137.00 | $50.25 – $104.00 | 6 |
| Sperm isolation complex CPT 89261 | $140.80 | $176.00 | $50.25 – $134.00 | 6 |
| Sperm isolation simple CPT 89260 | $104.80 | $131.00 | $50.25 – $100.00 | 6 |
| Sperm washing 58323 CPT 58323 | $38.40 | $48.00 | $10.69 – $28.67 | 7 |
| Sphenoid sinus surgery CPT 31051 | $3,276.80 | $4,096.00 | $618.74 – $5,042.00 | 9 |
| Sphincteroplasty inc/prolapse adult 46750 CPT 46750 | $1,876.80 | $2,346.00 | $670.79 – $2,337.38 | 9 |
| Spinal bone allograftstructural 20931 CPT 20931 | $266.40 | $333.00 | $94.59 – $251.75 | 7 |
| Spinal bone autograftlocal 20936 CPT 20936 | $309.60 | $387.00 | $220.80 – $386.44 | 6 |
| Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance CPT 62328 | $1,255.16 | $1,568.95 | $77.23 – $1,333.61 | 11 |
| Spine device implant surgery HCPCS C9757 | not published | not published | $10,966.57 – $20,373.29 | 7 |
| Spine X-ray (single view, one level) CPT 72020 | $161.88 | $202.34 | $7.10 – $171.99 | 11 |
| Spirmtry w/brnchdil inf-2 yr CPT 94012 | $316.00 | $395.00 | $125.56 – $332.02 | 9 |
| Spirometry up to 2 yrs old CPT 94011 | $194.40 | $243.00 | $77.13 – $203.40 | 9 |
| Spleen imaging CPT 78185 | $463.20 | $579.00 | $15.15 – $342.49 | 9 |
| Splenectomy total open 38100 CPT 38100 | $2,828.80 | $3,536.00 | $1,009.28 – $2,690.84 | 7 |
| Splice spleen/kidney veins CPT 37181 | not published | not published | $2,018.01 – $5,383.37 | 7 |
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.