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 |
|---|---|---|---|---|
| Splicing of ureters CPT 50770 | not published | not published | $1,040.53 – $2,773.46 | 7 |
| Splint arm vnyl coated padded lft med HCPCS Q4051 | $48.00 | $60.00 | not published | 0 |
| Splint dorsal bloc wh med perf 3.2mm lf polyflex ii HCPCS L3906 | $881.60 | $1,102.00 | $206.73 – $609.85 | 9 |
| Splint extn xsm w sof-stretch rolyan HCPCS L3925 | $71.44 | $89.30 | $34.95 – $76.19 | 9 |
| Splint finger 4 prong foam sm HCPCS A4570 | $20.80 | $26.00 | $2.90 – $27.20 | 6 |
| Splint finger fold over sm HCPCS L3924 | not published | not published | $48.85 – $134.25 | 7 |
| Splint finger frog med HCPCS L3927 | not published | not published | $19.05 – $48.46 | 7 |
| Splint fing stax assort 1-7in HCPCS Q4049 | $5.60 | $7.00 | $1.31 – $3.34 | 7 |
| Splint rstrc wrst/cmc right med HCPCS L3923 | $196.00 | $245.00 | $48.85 – $134.25 | 7 |
| Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 % CPT 15120 | $2,092.80 | $2,616.00 | $621.01 – $3,120.29 | 9 |
| Split blood or products CPT 86985 | $164.99 | $206.23 | $14.53 – $175.30 | 11 |
| Split flat caliper stirr & p HCPCS L2230 | not published | not published | $44.40 – $121.02 | 7 |
| Splt agrft f/s/n/h/f/g/m ea CPT 15121 | $516.00 | $645.00 | $115.50 – $309.84 | 7 |
| Spontaneous nystagmus study CPT 92531 | $52.80 | $66.00 | $30.60 – $41.55 | 6 |
| Sprchoroidal spc njx rx agt CPT 67516 | $313.60 | $392.00 | $87.74 – $525.20 | 7 |
| Spring-ass rot wrst with latch HCPCS L6623 | not published | not published | $434.90 – $1,106.69 | 7 |
| Sputum specimen collection CPT 89220 | $180.00 | $224.99 | $8.93 – $191.24 | 9 |
| Sr-89 stront chlor ther / mci HCPCS A9600 | not published | not published | $918.74 – $4,353.65 | 7 |
| Srs cranial lesion complex CPT 61798 | $3,244.00 | $4,055.00 | $1,187.67 – $3,166.22 | 7 |
| Srs cranial lesion simple CPT 61796 | $2,384.00 | $2,980.00 | $881.41 – $2,345.83 | 7 |
| Srs cran les complex addl CPT 61799 | $711.20 | $889.00 | $253.96 – $679.70 | 7 |
| Srs cran les simple addl CPT 61797 | $719.20 | $899.00 | $183.91 – $491.76 | 7 |
| Srsf2 gene common variants CPT 81348 | not published | not published | $105.24 – $265.27 | 7 |
| Srs linear based CPT 77372 | $15,651.49 | $19,564.36 | $822.33 – $16,629.71 | 11 |
| Srs multisource CPT 77371 | $2,114.40 | $2,643.00 | $1,722.40 – $7,400.63 | 9 |
| Srs spinal lesion CPT 63620 | $2,631.20 | $3,289.00 | $971.62 – $2,587.83 | 7 |
| Srs spinal lesion addl CPT 63621 | $591.20 | $739.00 | $211.51 – $565.03 | 7 |
| Staggered spondaic word test CPT 92572 | $100.80 | $126.00 | $50.35 – $133.35 | 9 |
| Staging lapro hodgkins disease/lymphoma 49220 CPT 49220 | not published | not published | $1,768.00 – $1,768.00 | 2 |
| Stainless steel any wrist HCPCS L6630 | not published | not published | $129.05 – $362.15 | 7 |
| St analysis behavior qualitative voice/resonance CPT 92524 | $298.41 | $373.01 | $102.12 – $317.06 | 9 |
| Stance phase only HCPCS L5858 | not published | not published | $11,138.25 – $28,343.69 | 7 |
| Standard control cable extra HCPCS L6655 | not published | not published | $53.84 – $137.01 | 7 |
| Staph a dna amp probe CPT 87640 | $87.20 | $109.00 | $21.05 – $71.34 | 9 |
| Static or dynami afo pre ots HCPCS L4397 | not published | not published | $96.80 – $252.42 | 7 |
| Stationary o2 contents, gas HCPCS E0441 | not published | not published | $34.58 – $95.95 | 7 |
| Stationary o2 contents, liq HCPCS E0442 | not published | not published | $34.58 – $95.95 | 7 |
| St cognitve performance testing healthcare professional each hour CPT 96125 | $328.26 | $410.32 | $95.01 – $348.77 | 9 |
| Stem cells total count CPT 86367 | $156.00 | $195.00 | $34.84 – $116.88 | 9 |
| Stenger test pure tone CPT 92565 | $39.20 | $49.00 | $19.34 – $50.62 | 9 |
| Stenger test speech CPT 92577 | $40.80 | $51.00 | $20.23 – $452.24 | 9 |
| Stent/athrectomy/fem/pop/unilat 37227 CPT 37227 | $70,321.60 | $87,902.00 | $611.31 – $35,329.21 | 11 |
| Stent axios caut enh 15x10mm electrocaut HCPCS C1874 | $43,757.00 | $54,696.25 | $1,499.32 – $3,251.07 | 5 |
| Stent bili dbl pgtl 10fx5cm HCPCS C2617 | $247.04 | $308.79 | $121.05 – $262.47 | 5 |
| Stent bili rx wallflx 10x80 uncvr HCPCS C1876 | $1,883.40 | $2,354.25 | $922.87 – $2,001.11 | 5 |
| Stent iliac/open or perc/uni/init 37221 CPT 37221 | $18,936.00 | $23,670.00 | $419.22 – $17,470.00 | 11 |
| Stent iliac/open/perc/ea ad/ipsila 37223 CPT 37223 | $9,276.80 | $11,596.00 | $180.02 – $9,342.72 | 9 |
| Stent placemt retro carotid CPT 37217 | $5,328.00 | $6,660.00 | $923.62 – $2,458.67 | 7 |
| Stent/tib/peroneal/unilat/initial 37230 CPT 37230 | $49,374.40 | $61,718.00 | $592.65 – $17,702.58 | 11 |
| Stereoscopic x-ray guidance HCPCS G6002 | $136.00 | $170.00 | $19.11 – $49.53 | 7 |
| Stereotactic bx aspir/exc burr intracranial les 61750 CPT 61750 | $3,308.00 | $4,135.00 | $1,212.87 – $3,229.05 | 7 |
| Stereotactic radiation trmt CPT 77432 | $845.60 | $1,057.00 | $393.37 – $823.05 | 7 |
| Sterile gauze <= 16 sq in HCPCS A6402 | not published | not published | $0.08 – $0.20 | 7 |
| Sterile needle HCPCS A4215 | not published | not published | $0.22 – $0.52 | 4 |
| Sterile water/saline, 10 ml HCPCS A4216 | $1.20 | $1.50 | $0.31 – $0.84 | 7 |
| Sterile water/saline, 500 ml HCPCS A4217 | not published | not published | $2.18 – $5.86 | 7 |
| Sternal debridement CPT 21627 | $1,318.40 | $1,648.00 | $488.07 – $1,298.58 | 7 |
| Sternal pad HCPCS L1050 | not published | not published | $46.79 – $131.32 | 7 |
| St evaluate speech sound production CPT 92522 | $298.41 | $373.01 | $103.75 – $317.06 | 9 |
| St evaluation motion fluoroscopic swallow function cine/video CPT 92611 | $328.27 | $410.33 | $84.25 – $348.78 | 9 |
| Stimulants synthetic CPT 80371 | $36.00 | $45.00 | $13.16 – $28.76 | 5 |
| Stimulation of spinal cord CPT 63610 | $1,359.20 | $1,699.00 | $491.95 – $1,664.38 | 9 |
| Stocking sup grips 4 pre ots HCPCS L0982 | not published | not published | $10.51 – $26.75 | 7 |
| Stoma absorptive cover HCPCS A5083 | not published | not published | $0.45 – $1.14 | 7 |
| Stomach Emptying Scan (Nuclear Medicine) CPT 78264 | $1,295.84 | $1,619.79 | $34.12 – $1,376.82 | 11 |
| Storage/year embryo(s) CPT 89342 | $236.00 | $295.00 | $161.15 – $241.31 | 6 |
| Storage/year oocyte(s) CPT 89346 | $236.00 | $295.00 | $161.15 – $271.34 | 6 |
| Storage/year reprod tissue CPT 89344 | $220.00 | $275.00 | $161.15 – $271.34 | 6 |
| Storage/year sperm/semen CPT 89343 | $236.00 | $295.00 | $161.15 – $271.34 | 6 |
| Stot/tot hysterectomy after cesaren delivery 59525 CPT 59525 | $1,170.40 | $1,463.00 | $411.36 – $1,104.71 | 7 |
| Straight knee joint heavy du HCPCS L2385 | not published | not published | $76.54 – $211.26 | 7 |
| Strap chin dlx f/cpap HCPCS A7036 | not published | not published | $7.37 – $45.89 | 6 |
| Strap montgmry ns 8 hl sht 7.25 x 11.25in HCPCS A4461 | not published | not published | $2.30 – $5.85 | 7 |
| Strapping of ankle and/or ft 29540 CPT 29540 | $180.16 | $225.19 | $16.01 – $191.41 | 11 |
| Strapping of chest CPT 29200 | $82.40 | $103.00 | $16.60 – $134.49 | 9 |
| Strapping of elbow or wrist 29260 CPT 29260 | $180.16 | $225.19 | $17.19 – $191.41 | 11 |
| Strapping of hand or finger CPT 29280 | $180.16 | $225.19 | $17.93 – $191.41 | 11 |
| Strapping of hip CPT 29520 | $176.00 | $220.00 | $17.05 – $109.87 | 9 |
| Strapping of knee CPT 29530 | $153.60 | $192.00 | $16.75 – $119.90 | 11 |
| Strapping of toes 29550 CPT 29550 | $96.00 | $120.00 | $10.15 – $50.62 | 9 |
| Strep a ag ia CPT 87430 | $38.58 | $48.22 | $10.09 – $40.99 | 9 |
| Strep a dna dir probe CPT 87650 | $50.40 | $63.00 | $12.03 – $31.19 | 7 |
| Strep a dna quant CPT 87652 | $104.80 | $131.00 | $25.06 – $64.96 | 7 |
| Strep b assay w/optic CPT 87802 | $32.00 | $40.00 | $7.64 – $18.65 | 7 |
| Strep b dna amp probe CPT 87653 | $87.20 | $109.00 | $21.05 – $71.34 | 9 |
| Streptokinase 1.5 m-units inj HCPCS J2995 | not published | not published | $90.10 – $110.58 | 4 |
| Streptokinase antibody CPT 86590 | $25.60 | $32.00 | $7.60 – $17.72 | 7 |
| Streptomycin injection HCPCS J3000 | $73.60 | $92.00 | $17.74 – $42.27 | 6 |
| Streptozocin injection HCPCS J9320 | not published | not published | $215.02 – $553.78 | 6 |
| Stress test pulmonary CPT 94618 | $148.33 | $185.41 | $11.07 – $157.60 | 11 |
| Stress tte complete CPT 93351 | $1,251.71 | $1,564.63 | $75.66 – $1,329.94 | 11 |
| Str markers spec anal addl CPT 81266 | $610.40 | $763.00 | $169.35 – $426.76 | 9 |
| Str markers specimen anal CPT 81265 | $483.20 | $604.00 | $129.49 – $334.54 | 9 |
| Subdural tap fontanelle/sutur infant init 61000 CPT 61000 | $264.80 | $331.00 | $97.48 – $590.25 | 9 |
| Subq i/p critical care pr day age 28 days/less than 99469 CPT 99469 | $717.60 | $897.00 | $351.48 – $766.40 | 7 |
| Subq njx filling matrl 1cc/< CPT 11950 | $194.40 | $243.00 | $46.37 – $169.36 | 9 |
| Subq njx fil matrl 5.1-10cc CPT 11952 | $353.60 | $442.00 | $90.85 – $521.72 | 9 |
| Subsequent intensive care infant 1500-2500 grams 99479 CPT 99479 | $224.80 | $281.00 | $109.81 – $239.10 | 7 |
| Subsequent intensive care infant 2501-5000 grams 99480 CPT 99480 | $216.00 | $270.00 | $105.69 – $230.40 | 7 |
| Subsequent repair of nerve CPT 64872 | $288.80 | $361.00 | $101.59 – $270.14 | 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.