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 |
|---|---|---|---|---|
| Adrenalin epinephrine inject HCPCS J0171 | $4.73 | $5.91 | $0.13 – $0.81 | 8 |
| Advance care planning each additional 30 min 99498 CPT 99498 | $134.40 | $168.00 | $65.07 – $137.70 | 7 |
| Adv prim care mgmt lvl 1 HCPCS G0556 | not published | not published | $11.34 – $47.17 | 6 |
| Adv prim care mgmt lvl 2 HCPCS G0557 | not published | not published | $28.02 – $56.10 | 6 |
| Adv prim care mgmt lvl 3 HCPCS G0558 | not published | not published | $75.87 – $146.47 | 6 |
| Aep hearing status deter i&r CPT 92651 | $204.00 | $255.00 | $72.22 – $265.41 | 9 |
| Aep neurodiagnostic i&r CPT 92653 | $198.40 | $248.00 | $73.98 – $265.41 | 9 |
| Aep thrshld est mlt freq i&r CPT 92652 | $270.40 | $338.00 | $99.17 – $269.18 | 9 |
| Afamelanotide implant, 1 mg HCPCS J7352 | not published | not published | $2,873.33 – $3,402.62 | 6 |
| Afamitresgene autoleucel HCPCS Q2057 | not published | not published | $727,000.00 – $809,151.00 | 5 |
| _afb id by dna probe rflx ast CPT 87149 | $50.40 | $63.00 | $12.03 – $40.99 | 9 |
| #afb mycobacteria suscep. #1 CPT 87190 | $38.58 | $48.22 | $4.39 – $40.99 | 9 |
| _afb org id by sequencing rflx ast-sendout CPT 87153 | $289.60 | $362.00 | $69.22 – $179.44 | 9 |
| Aff2 gen aly detc abnl allel CPT 81171 | not published | not published | $82.20 – $191.82 | 7 |
| Aff2 gen alys charac alleles CPT 81172 | not published | not published | $164.90 – $384.78 | 7 |
| Aflibercept injection HCPCS J0178 | $1,065.60 | $1,332.00 | $795.86 – $1,203.59 | 7 |
| Afluria vacc, 3 yrs & >, im HCPCS Q2035 | $18.40 | $23.00 | $16.53 – $27.20 | 6 |
| Afo molded ankle gauntlet HCPCS L1904 | not published | not published | $265.69 – $741.67 | 7 |
| Afo molded plas rig ant tib HCPCS L1945 | not published | not published | $520.28 – $1,460.03 | 7 |
| Afo molded to patient plasti HCPCS L1940 | $1,220.80 | $1,526.00 | $304.39 – $780.01 | 7 |
| Afo rig ant tib tcf/= custom HCPCS L1932 | not published | not published | $533.77 – $1,358.29 | 7 |
| Afo sing bar clasp attach sh HCPCS L1910 | not published | not published | $150.31 – $421.79 | 7 |
| Afo sing solid stirrup calf HCPCS L1980 | not published | not published | $228.81 – $582.26 | 7 |
| Afo sing upright with adjust s HCPCS L1920 | not published | not published | $196.49 – $551.40 | 7 |
| Afo spiral molded to pt plas HCPCS L1950 | not published | not published | $437.50 – $1,174.79 | 7 |
| Afo sprng wir drsflx calf bd HCPCS L1900 | not published | not published | $157.89 – $425.50 | 7 |
| Afo supramalleolar custom HCPCS L1907 | not published | not published | $336.55 – $856.40 | 7 |
| Afo tib fx cast molded to pt HCPCS L2108 | not published | not published | $600.52 – $1,685.19 | 7 |
| Afo tib fx cast plaster mold HCPCS L2106 | not published | not published | $382.15 – $1,072.39 | 7 |
| Afo tib fx semi-rigid l2114 HCPCS L2114 | not published | not published | $344.63 – $915.47 | 7 |
| Afo tibial fracture rigid HCPCS L2116 | $1,698.40 | $2,123.00 | $423.56 – $1,122.82 | 7 |
| Afo tibial fracture soft HCPCS L2112 | $1,052.00 | $1,315.00 | $262.22 – $735.87 | 7 |
| Afo, walk boot type, cus fab HCPCS L4631 | not published | not published | $860.83 – $2,323.97 | 7 |
| Afo w/ankle joint, prefab HCPCS L1971 | not published | not published | $280.36 – $713.44 | 7 |
| After cataract laser surgery CPT 66821 | $1,640.00 | $2,050.00 | $278.82 – $751.91 | 9 |
| Agalsidase beta 35 mg intravenous solution HCPCS J0180 | not published | not published | $211.90 – $283.84 | 7 |
| Ag detect nos ia single CPT 87450 | not published | not published | $10.00 – $10.00 | 2 |
| Air conduction bilat CPT 92552 | $71.20 | $89.00 | $35.29 – $109.87 | 9 |
| Air injection into abdomen 49400 CPT 49400 | $914.08 | $1,142.60 | $81.04 – $971.21 | 9 |
| Airway resistance by impulse oscillometry 94728 CPT 94728 | $279.73 | $349.66 | $11.22 – $297.21 | 11 |
| Ak 4 bar ling w/hydraul swig HCPCS L5613 | not published | not published | $1,786.57 – $4,546.31 | 7 |
| Ak 4 bar link w/fric swing HCPCS L5611 | not published | not published | $1,105.93 – $2,814.29 | 7 |
| Ak/bk self-aligning unit ea HCPCS L5617 | not published | not published | $334.97 – $852.41 | 7 |
| Ak flex inner socket ext fra HCPCS L5651 | not published | not published | $719.09 – $2,017.94 | 7 |
| Ak/knee disartic acrylic soc HCPCS L5631 | not published | not published | $263.09 – $738.31 | 7 |
| Ak/knee disartic pelvic band HCPCS L5697 | not published | not published | $48.07 – $134.89 | 7 |
| Ak/knee disartic pelvic join HCPCS L5696 | not published | not published | $118.26 – $310.89 | 7 |
| Ak/knee disartic silesian ba HCPCS L5698 | not published | not published | $69.44 – $176.70 | 7 |
| Ak open end sach HCPCS L5321 | not published | not published | $1,968.04 – $5,522.78 | 7 |
| Ak pelvic control belt light HCPCS L5692 | not published | not published | $95.42 – $242.81 | 7 |
| Ak pelvic control belt pad/l HCPCS L5694 | not published | not published | $108.63 – $304.84 | 7 |
| Ak sleeve susp neoprene/equa HCPCS L5695 | not published | not published | $97.65 – $274.03 | 7 |
| Ak univ multiplex sys frict HCPCS L5616 | not published | not published | $952.20 – $2,423.07 | 7 |
| Albumin body fluid quantitative each specimen CPT 82042 | $33.57 | $41.96 | $4.67 – $35.67 | 9 |
| Albumin (human), 25%, 50ml HCPCS P9047 | $162.56 | $203.20 | $17.80 – $53.08 | 8 |
| Albumin, human 25 % intravenous solution HCPCS P9046 | not published | not published | $21.23 – $33.84 | 7 |
| Albumin (human), 5%, 250 ml HCPCS P9045 | not published | not published | $53.08 – $82.10 | 7 |
| Albumin, human 5 % intravenous solution HCPCS P9041 | $66.48 | $83.10 | $10.62 – $27.07 | 8 |
| Albumin ischemia modified CPT 82045 | $85.60 | $107.00 | $20.36 – $52.80 | 7 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $25.72 | $32.14 | $3.47 – $27.32 | 9 |
| Albumin serum plasma or whole blood CPT 82040 | $33.57 | $41.96 | $2.97 – $35.67 | 9 |
| Albuterol comp con HCPCS J7610 | $12.80 | $16.00 | $0.17 – $15.79 | 2 |
| Albuterol comp unit HCPCS J7609 | $0.80 | $1.00 | $0.10 – $1.33 | 5 |
| Albuterol ipratrop non-comp HCPCS J7620 | $0.80 | $1.00 | $0.17 – $0.22 | 6 |
| Albuterol non-comp con HCPCS J7611 | $0.80 | $1.00 | $0.16 – $0.19 | 6 |
| Albuterol non-comp unit HCPCS J7613 | $0.60 | $0.75 | $0.05 – $0.22 | 8 |
| Alcohol (ethanol) any specimen except urine/breath CPT 82077 | $72.14 | $90.17 | $10.36 – $76.64 | 9 |
| Alcohols biomarkers 3/more CPT 80322 | $72.14 | $90.17 | $15.52 – $76.64 | 7 |
| Alcohol/sub misuse assess HCPCS G2011 | $31.20 | $39.00 | $15.25 – $40.14 | 7 |
| Alcohol/subs interv 15-30mn HCPCS G0396 | $64.80 | $81.00 | $25.39 – $75.95 | 9 |
| Alcohol/subs interv >30 min HCPCS G0397 | $120.80 | $151.00 | $57.26 – $153.43 | 9 |
| Aldesleukin injection HCPCS J9015 | not published | not published | $911.28 – $6,439.71 | 7 |
| Aldosterone suppression eval CPT 80408 | $315.20 | $394.00 | $75.30 – $195.23 | 7 |
| Alefacept HCPCS J0215 | not published | not published | $31.95 – $57.91 | 4 |
| Alemtuzumab 12 mg/1.2 ml intravenous solution HCPCS J0202 | not published | not published | $2,348.00 – $3,021.65 | 7 |
| Alginate dressing <=16 sq in HCPCS A6196 | $20.80 | $26.00 | $5.13 – $13.05 | 7 |
| Alginate drsg >16 <=48 sq in HCPCS A6197 | not published | not published | $11.46 – $29.17 | 7 |
| Alginate drsg wound filler HCPCS A6199 | not published | not published | $3.68 – $9.36 | 7 |
| Alglucerase injection HCPCS J0205 | not published | not published | $38.09 – $58.48 | 4 |
| Alglucosidase alfa injection HCPCS J0220 | not published | not published | $230.86 – $287.40 | 3 |
| Alkaline phosphatase CPT 84075 | $33.57 | $41.96 | $3.11 – $35.67 | 9 |
| Allergen alpha lactalbumin ige CPT 86008 | $48.57 | $60.71 | $10.76 – $51.60 | 9 |
| Allergen egg white ige CPT 86003 | $48.57 | $60.71 | $3.13 – $51.60 | 9 |
| Allergen specific ige qual multi scrn ea CPT 86005 | $48.57 | $60.71 | $4.78 – $51.60 | 9 |
| Allergy injections; 2 or more 95117 CPT 95117 | $31.20 | $39.00 | $10.78 – $39.32 | 9 |
| Allergy injection; single 95115 CPT 95115 | $27.20 | $34.00 | $9.30 – $39.32 | 9 |
| Allergy Skin Testing CPT 95004 | $12.80 | $16.00 | $3.13 – $867.14 | 9 |
| Allg patch or app # of tests 95044 CPT 95044 | $16.00 | $20.00 | $4.28 – $867.14 | 9 |
| Allgrft implnt knee w/scope CPT 29867 | $6,286.40 | $7,858.00 | $1,146.58 – $10,966.57 | 9 |
| Allograft 160mg placental salera mini membrane HCPCS Q4168 | not published | not published | $13.99 – $20.59 | 3 |
| Allograft allowrap 4x4cm dry 16sqcm HCPCS Q4150 | not published | not published | $77.27 – $405.42 | 6 |
| Allograft amnioexcel plus 17mm disk HCPCS Q4137 | not published | not published | $83.54 – $405.42 | 6 |
| Allograft dermis 20x25x1mm decell w/matracell arthroflex HCPCS Q4125 | $567.24 | $709.04 | $50.30 – $602.68 | 5 |
| Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm HCPCS Q4128 | not published | not published | $24.47 – $66.57 | 6 |
| Allograft epieffect 2x3cm-q4186-cost per sq cm HCPCS Q4186 | $535.80 | $669.75 | $154.67 – $569.29 | 8 |
| Allograft graftjacket 2x12cm-q4107-cost per sq cm HCPCS Q4107 | not published | not published | $91.01 – $169.44 | 6 |
| Allograft membrn amnio 1x2cm hu ambriodry HCPCS V2790 | not published | not published | $847.90 – $1,136.48 | 4 |
| Allograft umbil cord+amniotic membrane-q4148-cost per sq cm HCPCS Q4148 | not published | not published | $49.54 – $129.93 | 4 |
| Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm HCPCS Q4187 | $231.20 | $289.00 | $219.02 – $319.50 | 5 |
| Alloskin HCPCS Q4115 | not published | not published | $11.75 – $17.38 | 6 |
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.