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 |
|---|---|---|---|---|
| Dexamethasone panel CPT 80420 | $324.00 | $405.00 | $89.94 – $226.65 | 9 |
| Dexmedetomidine film, 1 mcg HCPCS J1105 | not published | not published | $0.58 – $0.67 | 5 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | $259.20 | $324.00 | $32.73 – $265.12 | 7 |
| Dextran 40 infusion HCPCS J7100 | not published | not published | $37.73 – $95.85 | 6 |
| Dextran 75 infusion HCPCS J7110 | not published | not published | $14.52 – $30.84 | 3 |
| Dextroamphetamine HCPCS S0160 | not published | not published | $0.78 – $3.41 | 6 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | $2.80 | $3.50 | $0.85 – $2.06 | 6 |
| Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 | $48.00 | $60.00 | $5.68 – $51.00 | 8 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | $5.60 | $7.00 | $1.68 – $2.71 | 6 |
| Dextrose 5 % IV bolus HCPCS J7070 | $48.00 | $60.00 | $3.36 – $51.00 | 8 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $56.00 | $70.00 | $13.34 – $58.44 | 9 |
| Diabetes (HbA1c) Test CPT 83036 | $33.57 | $41.96 | $5.83 – $35.67 | 9 |
| Diabetes training group per 30 min g0109 HCPCS G0136 | $36.00 | $45.00 | $8.33 – $47.17 | 9 |
| Diabetic custom molded shoe HCPCS A5501 | not published | not published | $132.94 – $338.29 | 7 |
| Diabetic shoe with wedge HCPCS A5504 | not published | not published | $21.32 – $57.53 | 7 |
| Diabetic shoe w/off set heel HCPCS A5506 | not published | not published | $21.32 – $57.53 | 7 |
| Diabetic shoe w/roller/rockr HCPCS A5503 | not published | not published | $21.32 – $57.53 | 7 |
| Diab manage trn ind/group HCPCS G0109 | $77.16 | $96.44 | $14.44 – $81.97 | 9 |
| Diab shoe for density insert HCPCS A5500 | $178.40 | $223.00 | $44.32 – $112.80 | 7 |
| Diab shoe w/metatarsal bar HCPCS A5505 | not published | not published | $21.32 – $57.53 | 7 |
| Diag bronchoscope/catheter CPT 31643 | $448.00 | $560.00 | $152.76 – $1,469.79 | 9 |
| Diag laparo separate proc 49320 CPT 49320 | $807.20 | $1,009.00 | $292.53 – $4,972.71 | 9 |
| Diagnostic anoscopy CPT 46601 | $355.20 | $444.00 | $75.71 – $340.11 | 9 |
| Diagnostic anoscopy & biopsy CPT 46607 | $496.80 | $621.00 | $111.48 – $1,004.95 | 9 |
| Diagnostic anoscopy spx 46600 CPT 46600 | $252.00 | $315.00 | $37.28 – $109.87 | 11 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | $382.40 | $478.00 | $63.77 – $138.70 | 6 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | $382.40 | $478.00 | $51.86 – $122.60 | 6 |
| Diagnostic laryngoscopy 31505 CPT 31505 | $212.80 | $266.00 | $44.98 – $165.47 | 11 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $300.80 | $376.00 | $62.16 – $220.29 | 11 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $354.33 | $442.91 | $43.57 – $376.47 | 9 |
| Diagnostic Mammogram (one breast) CPT 77065 | $279.32 | $349.14 | $35.36 – $296.77 | 9 |
| Diagnostic radio unlisted proc CPT 76499 | not published | not published | $75.04 – $139.41 | 7 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | $13,460.70 | $16,825.87 | $174.92 – $14,301.99 | 9 |
| Dialysis one evaluation CPT 90945 | $934.16 | $1,167.70 | $78.81 – $992.55 | 11 |
| Dialysis repeated eval CPT 90947 | $280.00 | $350.00 | $111.79 – $293.05 | 7 |
| Dialysis training complete CPT 90989 | $789.60 | $987.00 | $565.40 – $985.35 | 6 |
| Dialysis training incompl CPT 90993 | $172.00 | $215.00 | $103.20 – $214.60 | 6 |
| Diathermy eg microwave CPT 97024 | $13.60 | $17.00 | $6.52 – $10.89 | 7 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | $0.11 | $0.13 | $0.05 – $0.11 | 8 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $88.06 | $110.07 | $3.27 – $7.10 | 8 |
| Dicyclomine injection HCPCS J0500 | $132.40 | $165.50 | $9.77 – $21.19 | 8 |
| Difelikefalin, esrd on dialy HCPCS J0879 | not published | not published | $0.08 – $0.23 | 5 |
| Diffusing capacity CPT 94729 | $167.69 | $209.61 | $8.07 – $178.17 | 9 |
| Digital analysis of eeg CPT 95957 | $605.60 | $757.00 | $92.55 – $263.87 | 9 |
| Digit nerve surgery add-on CPT 64778 | $450.40 | $563.00 | $158.34 – $421.99 | 7 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $137.60 | $172.00 | $4.88 – $52.06 | 8 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | not published | not published | $3,284.24 – $6,210.67 | 7 |
| Digoxin total therapeutic drug level CPT 80162 | $66.43 | $83.03 | $7.97 – $70.58 | 9 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | $129.80 | $162.25 | $9.60 – $85.75 | 8 |
| Dilate biliary duct/ampulla CPT 47542 | $1,273.60 | $1,592.00 | $120.69 – $320.99 | 7 |
| Dilate esophagus CPT 43453 | $2,142.40 | $2,678.00 | $77.80 – $1,616.83 | 9 |
| Dilate esophagus 1/mult pass CPT 43450 | $420.80 | $526.00 | $71.53 – $799.09 | 9 |
| Dilate ic vasospasm ea add vsl diff territory CPT 61642 | not published | not published | $631.50 – $1,076.17 | 6 |
| Dilate ic vasospasm ea add vsl same territory CPT 61641 | not published | not published | $315.70 – $538.10 | 6 |
| Dilate ic vasospasm init CPT 61640 | not published | not published | $899.10 – $1,531.55 | 6 |
| Dilate tear duct opening CPT 68801 | $454.40 | $568.00 | $71.71 – $340.11 | 9 |
| Dilate urethra stricture CPT 53600 | $212.00 | $265.00 | $57.45 – $207.29 | 9 |
| Dilate urethra stricture CPT 53601 | $200.80 | $251.00 | $48.09 – $127.81 | 9 |
| Dilate urethra stricture CPT 53605 | $164.00 | $205.00 | $57.35 – $2,939.60 | 9 |
| Dilate urethra stricture CPT 53621 | $344.80 | $431.00 | $64.64 – $207.29 | 9 |
| Dilation/female urethra/initial 53660 CPT 53660 | $174.40 | $218.00 | $37.44 – $133.35 | 9 |
| Dilation of anal sphincter CPT 45905 | $416.80 | $521.00 | $153.25 – $1,004.95 | 9 |
| Dilation of cervical canal 57800 CPT 57800 | $172.80 | $216.00 | $43.07 – $2,709.95 | 9 |
| Dilation of rectal stricture 45910 CPT 45910 | $476.80 | $596.00 | $174.00 – $1,004.95 | 9 |
| Dilation of salivary duct CPT 42660 | $1,136.97 | $1,421.21 | $71.40 – $1,208.03 | 11 |
| Dilation of urethra CPT 53661 | $172.00 | $215.00 | $36.29 – $109.87 | 9 |
| Dilation of urethra CPT 53665 | $97.60 | $122.00 | $33.74 – $1,745.97 | 9 |
| Dilation of vagina CPT 57400 | $328.80 | $411.00 | $116.40 – $2,709.95 | 9 |
| Dilation salivary duct 42650 CPT 42650 | $1,654.21 | $2,067.76 | $53.85 – $1,757.60 | 11 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | $720.40 | $900.50 | $78.39 – $765.43 | 11 |
| Dilat xst trc ndurlgc px CPT 50436 | $766.40 | $958.00 | $136.15 – $2,939.60 | 9 |
| Dilat xst trc new access rcs CPT 50437 | $1,286.40 | $1,608.00 | $226.29 – $2,939.60 | 9 |
| Diltiazem 5 mg/ml intravenous solution HCPCS J1163 | $3.60 | $4.49 | $0.22 – $0.47 | 5 |
| Dimecaprol injection HCPCS J0470 | not published | not published | $40.93 – $67.88 | 5 |
| Dimenhydrinate injection HCPCS J1240 | not published | not published | $7.19 – $11.64 | 6 |
| Dimethyl sulfoxide 50% 50 ml HCPCS J1212 | $746.40 | $933.00 | $125.35 – $885.07 | 7 |
| Diphenhydramine 12.5 mg/5 ml oral elixir HCPCS Q0163 | $0.60 | $0.75 | $0.02 – $0.78 | 6 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $74.55 | $93.18 | $0.08 – $0.91 | 8 |
| Diphtheria-tetanus toxoids 0.5 ml (peds) CPT 90702 | $62.40 | $78.00 | $40.43 – $74.68 | 6 |
| Dipyridamole injection HCPCS J1245 | not published | not published | $1.13 – $4.83 | 6 |
| Direct advanced life support CPT 99288 | $236.00 | $295.00 | $239.70 – $301.56 | 4 |
| Dir nsl mucous membrane test CPT 95065 | $76.80 | $96.00 | $25.84 – $67.24 | 9 |
| Disability dlco CPT 94727 | $279.73 | $349.66 | $10.92 – $297.21 | 11 |
| Disaccharidases CPT 82657 | $64.28 | $80.35 | $13.30 – $68.30 | 9 |
| Disarticulation sho sec clsr CPT 23921 | $2,300.80 | $2,876.00 | $429.57 – $1,559.08 | 9 |
| Disarticulation shoulder CPT 23920 | not published | not published | $1,007.45 – $2,678.41 | 7 |
| Discectomy ant dcmprn cord thoracic 1 ntrspc 63077 CPT 63077 | $3,636.00 | $4,545.00 | $1,302.31 – $3,465.03 | 7 |
| Discectomy ant dcmprn cord thoracic ea ntrsp 63078 CPT 63078 | not published | not published | $173.45 – $462.93 | 7 |
| Discography cerv/thor spine CPT 72285 | $1,425.36 | $1,781.69 | $51.70 – $1,664.38 | 11 |
| Disconnect insert locking wr HCPCS L6616 | not published | not published | $38.84 – $108.99 | 7 |
| Disconnect locking wrist uni HCPCS L6615 | not published | not published | $114.18 – $291.90 | 7 |
| Dise eval slp do brth flx dx CPT 42975 | $288.80 | $361.00 | $87.44 – $1,469.79 | 9 |
| Dissect brain w/scope CPT 62161 | not published | not published | $1,312.06 – $3,501.47 | 7 |
| Dis site tele svcs rhc/fqhc HCPCS G2025 | not published | not published | $90.59 – $232.96 | 7 |
| Dissolve clot heart vessel CPT 92975 | $813.60 | $1,017.00 | $320.93 – $842.74 | 7 |
| Dist revas ligation hemo CPT 36838 | $5,588.80 | $6,986.00 | $971.90 – $4,607.36 | 9 |
| Div aberrant vsl w/reanast CPT 33803 | not published | not published | $991.34 – $2,649.47 | 7 |
| Diverticulectomy/hypophar/esoph 43130 CPT 43130 | $1,943.20 | $2,429.00 | $709.37 – $5,042.00 | 9 |
| Division of fallopian tube 58605 CPT 58605 | $832.00 | $1,040.00 | $302.22 – $813.13 | 7 |
| #d/lmeth-l-methamphetamine CPT 80374 | $72.14 | $90.17 | $13.16 – $76.64 | 8 |
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.