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 |
|---|---|---|---|---|
| Above knee cushion socket HCPCS L5648 | not published | not published | $431.38 – $1,106.29 | 7 |
| Above knee flex cover system HCPCS L5964 | not published | not published | $688.78 – $1,752.75 | 7 |
| Above knee hydracadence HCPCS L5610 | not published | not published | $1,652.96 – $4,206.32 | 7 |
| Above knee leather socket HCPCS L5642 | not published | not published | $380.15 – $1,041.09 | 7 |
| Above knee manual lock HCPCS L5925 | not published | not published | $266.25 – $677.55 | 7 |
| Above knee wood socket HCPCS L5644 | not published | not published | $386.60 – $992.48 | 7 |
| Abrasion lesions add-on CPT 15787 | $100.00 | $125.00 | $15.55 – $40.52 | 7 |
| Abrasion lesion single CPT 15786 | $594.40 | $743.00 | $123.25 – $326.67 | 9 |
| Abscess drain retroperitoneal surg code CPT 49406 | $2,903.44 | $3,629.29 | $173.99 – $3,084.90 | 11 |
| Abscess imaging ltd area CPT 78805 | not published | not published | $66.00 – $66.00 | 2 |
| Abscess imaging whole body CPT 78806 | not published | not published | $77.00 – $77.00 | 2 |
| Absorpt drg >16<=48 in w/bdr HCPCS A6255 | not published | not published | $2.12 – $5.40 | 7 |
| Absorpt drg >16 <=48 without bdr HCPCS A6252 | $9.60 | $12.00 | $2.27 – $5.77 | 7 |
| Absorpt drg <=16 sq in w/bdr HCPCS A6254 | not published | not published | $0.83 – $2.12 | 7 |
| Absorpt drg <=16 sq in without b HCPCS A6251 | $5.60 | $7.00 | $1.39 – $3.52 | 7 |
| Absorpt drg > 48 sq in without b HCPCS A6253 | not published | not published | $4.42 – $11.23 | 7 |
| Access & clsr pq fem art endogft dlvry w/img uni CPT 34713 | $2,340.16 | $2,925.20 | $104.50 – $2,486.42 | 9 |
| Access thoracic lymph duct CPT 38794 | $750.40 | $938.00 | $256.06 – $677.39 | 7 |
| Acetaminophen 10 mg/ml soln 100 ml glass cont HCPCS J0131 | not published | not published | $0.05 – $0.51 | 6 |
| Acetaminophen 120 mg rectal suppository HCPCS A9270 | $434.08 | $542.60 | $0.04 – $1.54 | 7 |
| Acetaminophen level CPT 80143 | $66.43 | $83.03 | $11.18 – $70.58 | 9 |
| Acetazolamide 500 mg solution for injection HCPCS J1120 | $133.52 | $166.90 | $17.25 – $128.76 | 8 |
| Acetone qualitative CPT 82009 | $33.57 | $41.96 | $2.71 – $35.67 | 9 |
| Acetylcholine receptor modulating antibody CPT 86043 | $48.57 | $60.71 | $7.23 – $51.60 | 9 |
| Acetylcholinesterase assay CPT 82013 | $64.28 | $80.35 | $7.37 – $68.30 | 9 |
| Acetylcysteine 200 mg/ml (20 %) intravenous solution HCPCS J0132 | $1.89 | $2.36 | $0.15 – $0.57 | 8 |
| Acetylcysteine non-comp unit HCPCS J7608 | not published | not published | $6.17 – $9.11 | 6 |
| Acid perfusion of esophagus CPT 91030 | $304.00 | $380.00 | $41.99 – $452.24 | 9 |
| Acne surgery 10040 CPT 10040 | $269.60 | $337.00 | $47.16 – $169.36 | 9 |
| Aco annual medicare visit (awv), initial g0438aco HCPCS G0438 | $304.00 | $380.00 | $151.44 – $398.97 | 7 |
| Aco annual medicare visit (awv), subsq g0439aco HCPCS G0439 | $239.20 | $299.00 | $118.96 – $313.09 | 7 |
| Aco ccm; at least 20 min 99490aco CPT 99490 | $115.20 | $144.00 | $45.64 – $97.34 | 7 |
| Aco ccm; ea addl 20 min 99439aco CPT 99439 | $87.20 | $109.00 | $31.50 – $67.91 | 7 |
| Aco cmplx chron care addl 20 min 99489aco CPT 99489 | $132.80 | $166.00 | $45.05 – $97.34 | 7 |
| Aco cmplx chron care without pt visit, 60 min 99487aco CPT 99487 | $247.20 | $309.00 | $82.62 – $175.31 | 7 |
| Aco cont gluc mnt phys/qhp eqp 95250aco CPT 95250 | $417.56 | $521.95 | $109.84 – $443.66 | 11 |
| Aco depression screen annual medicare g0444aco HCPCS G0444 | $40.00 | $50.00 | $8.33 – $25.39 | 9 |
| Aco med nutria tx/group, ea 30 min 97804aco CPT 97804 | $37.60 | $47.00 | $14.14 – $23.61 | 7 |
| Acoustic immitance testing CPT 92570 | $74.40 | $93.00 | $26.65 – $133.35 | 9 |
| Acoustic refl threshold tst CPT 92568 | $36.00 | $45.00 | $13.96 – $35.96 | 9 |
| Acromp/acromionectomy prtl CPT 23130 | $3,012.80 | $3,766.00 | $561.60 – $2,765.43 | 9 |
| Acth stimulation panel CPT 80402 | $218.40 | $273.00 | $52.18 – $135.27 | 7 |
| Acth stimulation panel CPT 80406 | $173.60 | $217.00 | $46.96 – $121.74 | 7 |
| Actigraphy testing CPT 95803 | $323.20 | $404.00 | $38.56 – $101.50 | 9 |
| Actinotherapy uv light CPT 96900 | $118.93 | $148.66 | $22.00 – $126.36 | 11 |
| Acup 1/> w/estim 1st 15 min CPT 97813 | $97.60 | $122.00 | $23.03 – $50.90 | 7 |
| Acup 1/> w/estim ea addl 15 CPT 97814 | $74.40 | $93.00 | $22.14 – $47.77 | 7 |
| Acup 1/> without estim ea add 15 CPT 97811 | $62.40 | $78.00 | $21.82 – $43.21 | 7 |
| Acup 1/> wo estim 1st 15 min CPT 97810 | $84.00 | $105.00 | $23.03 – $46.73 | 7 |
| Acute hepatitis panel CPT 80074 | $120.00 | $150.00 | $28.58 – $74.11 | 9 |
| Acute venous thrombus image CPT 78456 | $702.40 | $878.00 | $43.13 – $1,112.68 | 9 |
| Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr HCPCS J0133 | $0.83 | $1.03 | $0.01 – $0.04 | 8 |
| #acylcarnitineprfl CPT 82017 | $64.28 | $80.35 | $10.12 – $68.30 | 9 |
| Acylcarnitines qual CPT 82016 | $64.28 | $80.35 | $9.89 – $68.30 | 9 |
| Adalimumab injection HCPCS J0135 | not published | not published | $323.55 – $3,054.09 | 3 |
| Adapt behavior tx phys/qhp CPT 97155 | not published | not published | $29.15 – $155.54 | 6 |
| Adapter b 8 channel 10cm HCPCS C1883 | $318.87 | $398.58 | $156.24 – $338.79 | 5 |
| Adaptive behavior tx by tech CPT 97153 | not published | not published | $17.48 – $89.55 | 6 |
| Adding walker to prev cast CPT 29440 | $216.00 | $270.00 | $25.53 – $134.49 | 9 |
| Additional switch, ext power HCPCS L6611 | not published | not published | $246.75 – $627.91 | 7 |
| Add le poly knee custom kafo HCPCS L2387 | not published | not published | $93.02 – $261.02 | 7 |
| Add ue prost a/e acrylic HCPCS L7404 | not published | not published | $333.10 – $847.64 | 7 |
| Add ue prost a/e ultlite mat HCPCS L7401 | not published | not published | $205.63 – $523.26 | 7 |
| Add ue prost b/e acrylic HCPCS L7403 | not published | not published | $220.70 – $561.63 | 7 |
| Add ue prost be/wd, ultlite HCPCS L7400 | not published | not published | $183.68 – $467.40 | 7 |
| Add ue prost s/d acrylic HCPCS L7405 | not published | not published | $435.65 – $1,108.59 | 7 |
| Add ue prost s/d ultlite mat HCPCS L7402 | not published | not published | $222.08 – $565.14 | 7 |
| Add up-ex prosthes lock mech HCPCS L6698 | not published | not published | $397.13 – $1,010.58 | 7 |
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | $15.12 | $18.90 | $0.37 – $0.80 | 8 |
| Adenovirus ag ia CPT 87301 | $30.40 | $38.00 | $7.19 – $18.65 | 7 |
| Adenovirus antibody,serum - quest CPT 86603 | $48.57 | $60.71 | $7.72 – $51.60 | 9 |
| Adenovirus assay w/optic CPT 87809 | $44.00 | $55.00 | $13.06 – $30.46 | 7 |
| Adhesiolysis tube ovary 58740 CPT 58740 | $2,226.40 | $2,783.00 | $807.16 – $2,158.53 | 7 |
| Adhesive, liquid or equal HCPCS A4364 | not published | not published | $2.05 – $5.21 | 7 |
| Adh-sendout CPT 84588 | $109.28 | $136.60 | $20.36 – $116.11 | 9 |
| Adj gastric band via subq port CPT 43999 | not published | not published | $799.09 – $1,484.53 | 7 |
| Adjmt/revj ext fixj sys anes CPT 20693 | $1,096.80 | $1,371.00 | $409.85 – $6,088.70 | 9 |
| Adj tis trans/see area/10.1-30sqcm 14041 CPT 14041 | $2,287.20 | $2,859.00 | $691.58 – $1,838.20 | 9 |
| Adjustment gastric band HCPCS S2083 | $56.00 | $70.00 | $59.88 – $357.00 | 4 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $3.00 | $3.75 | $0.03 – $0.22 | 8 |
| Admin ecg contrast agent CPT 93352 | $72.80 | $91.00 | $31.25 – $81.46 | 7 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $101.69 | $127.11 | $23.72 – $108.04 | 11 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | $123.20 | $154.00 | $53.90 – $114.70 | 11 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $488.88 | $611.10 | $108.88 – $519.44 | 11 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | $488.88 | $611.10 | $84.40 – $519.44 | 11 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | $101.69 | $127.11 | $32.13 – $108.04 | 11 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $135.20 | $169.00 | $58.85 – $129.20 | 11 |
| Administration immunization each additional component CPT 90461 | $27.20 | $34.00 | $8.04 – $20.31 | 7 |
| Administration immunization each additional vaccine CPT 90472 | $43.23 | $54.03 | $12.41 – $45.93 | 9 |
| Administration immunization first component each vaccine CPT 90460 | $46.40 | $58.00 | $13.83 – $27.80 | 7 |
| Administration immunization intranasal/oral route 1 vaccine CPT 90473 | $46.40 | $58.00 | $13.83 – $60.66 | 9 |
| Administration immunization intranasal/oral route each additional vaccine CPT 90474 | $27.20 | $34.00 | $10.91 – $20.31 | 7 |
| Administration rsv monoclonal ab seasonal dose im w/counseling CPT 96380 | $46.40 | $58.00 | $20.91 – $54.24 | 6 |
| Administration vaccine hepatitis b HCPCS G0010 | $57.53 | $71.91 | $13.83 – $61.12 | 9 |
| Administration vaccine influenza virus HCPCS G0008 | $46.40 | $58.00 | $9.57 – $44.67 | 11 |
| Administration vaccine pneumococcal HCPCS G0009 | $46.40 | $58.00 | $9.57 – $44.67 | 11 |
| Administration vaccine rsv monoclonal ab seasonal dose im CPT 96381 | $46.40 | $58.00 | $17.75 – $46.72 | 6 |
| Ado-trastuzumab emtansine 100 mg intravenous solution HCPCS J9354 | $40.80 | $51.00 | $39.14 – $49.88 | 7 |
| Adrenal cortex & medulla img CPT 78075 | $1,551.08 | $1,938.85 | $32.50 – $1,648.02 | 11 |
| Adrenalectomy expl w/exc retro tumor 60545 CPT 60545 | $6,081.60 | $7,602.00 | $1,097.92 – $2,942.51 | 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.