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 |
|---|---|---|---|---|
| Esophagoscp guide wire dilat 43196 CPT 43196 | $489.60 | $612.00 | $176.92 – $1,616.83 | 9 |
| Esophagoscp rig trnso biopsy CPT 43193 | $420.80 | $526.00 | $152.86 – $1,616.83 | 9 |
| Esophagoscp rig trnso inject CPT 43192 | $421.60 | $527.00 | $152.86 – $1,616.83 | 9 |
| Esophagoscp rig trnso rem fb CPT 43194 | not published | not published | $173.05 – $1,616.83 | 9 |
| Esophagotomy thrc rmvl fb CPT 43045 | $3,173.60 | $3,967.00 | $1,133.09 – $3,024.98 | 7 |
| Esophagus endoscopy/ligation CPT 43205 | $356.80 | $446.00 | $125.89 – $1,616.83 | 9 |
| Esophagus motility study CPT 91010 | $435.20 | $544.00 | $58.68 – $452.24 | 9 |
| Esoph balloon distension tst CPT 91040 | $1,164.80 | $1,456.00 | $44.37 – $452.24 | 9 |
| Esoph egd dilation <30 mm CPT 43249 | $2,656.80 | $3,321.00 | $136.87 – $1,616.83 | 9 |
| Esoph endoscopy dilation CPT 43226 | $874.40 | $1,093.00 | $116.17 – $1,616.83 | 9 |
| Esoph fundoplasty lap 43327 CPT 43327 | $2,010.40 | $2,513.00 | $732.08 – $1,910.39 | 7 |
| Esoph fundoplasty thor 43328 CPT 43328 | $2,748.00 | $3,435.00 | $968.51 – $2,588.60 | 7 |
| Esophgl motil w/stim/perfus CPT 91013 | $56.80 | $71.00 | $8.33 – $21.94 | 7 |
| Esoph imped function test CPT 91037 | $369.60 | $462.00 | $44.67 – $265.41 | 9 |
| Esoph imped funct test > 1hr CPT 91038 | $944.00 | $1,180.00 | $50.64 – $452.24 | 9 |
| Esoph optical endomicroscopy CPT 43206 | $703.20 | $879.00 | $119.41 – $1,616.83 | 9 |
| Esoph scope w/sclerosis inj CPT 43204 | $341.60 | $427.00 | $121.15 – $1,616.83 | 9 |
| Esoph scope w/submucous inj CPT 43201 | $592.00 | $740.00 | $92.70 – $1,616.83 | 9 |
| Esphg dstl 2/3 w/laps moblj 43287 CPT 43287 | $8,776.00 | $10,970.00 | $3,058.72 – $8,182.30 | 7 |
| Esphg thrsc moblj CPT 43288 | $9,261.60 | $11,577.00 | $3,230.93 – $8,633.97 | 7 |
| Esphg tot w/laps moblj CPT 43286 | $7,796.00 | $9,745.00 | $2,751.48 – $7,321.66 | 7 |
| Esphg tot w/thrcm CPT 43112 | not published | not published | $2,938.21 – $7,969.13 | 7 |
| Esrd home pt serv p mo 12-19 CPT 90965 | $1,016.00 | $1,270.00 | $457.43 – $1,199.67 | 7 |
| Esrd home pt serv p mo 20+ CPT 90966 | $540.80 | $676.00 | $270.40 – $705.48 | 7 |
| Esrd home pt serv p mo 2-11 CPT 90964 | $1,064.00 | $1,330.00 | $475.24 – $1,249.64 | 7 |
| Esrd home pt serv p mo <2yrs CPT 90963 | $1,216.80 | $1,521.00 | $554.54 – $1,458.76 | 7 |
| Esrd serv 1 visit p mo 20+ CPT 90962 | $409.60 | $512.00 | $186.51 – $485.84 | 7 |
| Esrd serv 1 visit p mo <2yrs CPT 90953 | $928.80 | $1,161.00 | $503.77 – $1,314.07 | 7 |
| Esrd serv 1 vst p mo 12-19 CPT 90959 | $660.80 | $826.00 | $299.02 – $782.73 | 7 |
| Esrd serv 2-3 vsts p mo <2yr CPT 90952 | $1,284.00 | $1,605.00 | $616.03 – $1,972.72 | 7 |
| Esrd serv 4 visits p mo <2yr CPT 90951 | $2,130.40 | $2,663.00 | $1,064.94 – $2,813.77 | 7 |
| Esrd serv 4 vsts p mo 2-11 CPT 90954 | $1,838.40 | $2,298.00 | $919.15 – $2,416.83 | 7 |
| Esrd srv 1 visit p mo 2-11 CPT 90956 | $711.20 | $889.00 | $320.66 – $836.58 | 7 |
| Esrd srv 2-3 vsts p mo 12-19 CPT 90958 | $977.60 | $1,222.00 | $458.52 – $1,202.53 | 7 |
| Esrd srv 2-3 vsts p mo 20+ CPT 90961 | $540.80 | $676.00 | $270.40 – $705.48 | 7 |
| Esrd srv 2-3 vsts p mo 2-11 CPT 90955 | $1,023.20 | $1,279.00 | $479.86 – $1,254.06 | 7 |
| Esrd srv 4 visits p mo 20+ CPT 90960 | $652.00 | $815.00 | $325.90 – $850.38 | 7 |
| Esrd srv 4 vsts p mo 12-19 CPT 90957 | $1,440.00 | $1,800.00 | $704.46 – $1,848.29 | 7 |
| Esrd svc pr day pt 12-19 CPT 90969 | $34.40 | $43.00 | $15.40 – $40.53 | 7 |
| Esrd svc pr day pt <2 CPT 90967 | $40.80 | $51.00 | $16.05 – $42.22 | 7 |
| Esrd svc pr day pt 20+ CPT 90970 | $18.40 | $23.00 | $8.92 – $22.70 | 7 |
| Esrd svc pr day pt 2-11 CPT 90968 | $36.00 | $45.00 | $15.72 – $41.39 | 7 |
| Essure 58565 CPT 58565 | $1,116.80 | $1,396.00 | $409.29 – $4,207.41 | 9 |
| Establish access to aorta CPT 36160 | $1,336.00 | $1,670.00 | $108.54 – $289.59 | 7 |
| Establish access to artery CPT 36100 | $2,526.40 | $3,158.00 | $130.63 – $346.46 | 7 |
| Establish brain cavity shunt CPT 62223 | $2,464.00 | $3,080.00 | $897.09 – $2,399.79 | 7 |
| Establish brain cavity shunt CPT 62180 | $3,754.40 | $4,693.00 | $1,375.37 – $3,666.59 | 7 |
| Establish brain cavity shunt CPT 62190 | not published | not published | $808.52 – $2,152.67 | 7 |
| Establish brain cavity shunt CPT 62192 | $2,316.00 | $2,895.00 | $860.72 – $2,298.27 | 7 |
| Establish brain cavity shunt CPT 62200 | not published | not published | $1,185.35 – $3,159.62 | 7 |
| Establish brain cavity shunt CPT 62220 | $2,338.40 | $2,923.00 | $843.19 – $2,253.22 | 7 |
| Established Patient Office Visit (level 1) CPT 99211 | $40.80 | $51.00 | $8.04 – $16.69 | 7 |
| Established Patient Office Visit (level 2) CPT 99212 | $83.20 | $104.00 | $32.24 – $66.60 | 7 |
| Established Patient Office Visit (level 3) CPT 99213 | $160.80 | $201.00 | $60.36 – $124.66 | 7 |
| Established Patient Office Visit (level 4) CPT 99214 | $192.00 | $240.00 | $88.83 – $184.05 | 7 |
| Established Patient Office Visit (level 5) CPT 99215 | $265.60 | $332.00 | $131.48 – $272.53 | 7 |
| Estim aid bone healg invasiv CPT 20975 | $430.40 | $538.00 | $156.32 – $411.81 | 7 |
| Estradiol total CPT 82670 | $70.40 | $88.00 | $16.76 – $58.44 | 9 |
| Estradiol valerate 10 mg inj HCPCS J1380 | $24.00 | $30.00 | $7.30 – $15.29 | 6 |
| Estrogens total-sendout CPT 82672 | $55.20 | $69.00 | $13.02 – $58.44 | 9 |
| Etanercept injection HCPCS J1438 | $740.80 | $926.00 | $178.17 – $1,134.93 | 7 |
| Ethanolamine oleate 100 mg HCPCS J1430 | not published | not published | $432.72 – $616.11 | 7 |
| Eth estr and eton monthly HCPCS J7295 | $132.00 | $165.00 | $126.40 – $138.24 | 4 |
| Ethmoidectomy extranasal total 31205 CPT 31205 | $4,593.60 | $5,742.00 | $846.21 – $2,764.11 | 9 |
| Ethylene glycol -sendout CPT 82693 | $37.60 | $47.00 | $8.94 – $34.15 | 9 |
| Etonogestrel implant system HCPCS J7307 | $1,388.00 | $1,735.00 | $527.87 – $1,214.63 | 8 |
| Etoposide 20 mg/ml intravenous solution HCPCS J9181 | $1.60 | $2.00 | $0.16 – $1.17 | 8 |
| Etoposide 50 mg cap HCPCS J8560 | not published | not published | $75.76 – $99.59 | 6 |
| Euflexxa inj per dose HCPCS J7323 | $647.04 | $808.80 | $116.77 – $687.48 | 9 |
| Euglobulin lysis CPT 85360 | $33.57 | $41.96 | $5.05 – $35.67 | 9 |
| Evacuate mole of uterus CPT 59870 | $1,229.60 | $1,537.00 | $467.27 – $2,709.95 | 9 |
| Eval aud funcj ea addl 15 CPT 92627 | $48.00 | $60.00 | $16.14 – $42.48 | 7 |
| Eval aud rehab status/first hr 92626 CPT 92626 | $201.60 | $252.00 | $68.91 – $179.82 | 9 |
| Eval/fit voice prosthesis iii, st CPT 92607 | $328.27 | $410.33 | $115.07 – $348.78 | 9 |
| Evaluation cervical mucus CPT 89330 | $26.40 | $33.00 | $6.23 – $15.39 | 7 |
| Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen CPT 84112 | $291.41 | $364.26 | $58.87 – $309.62 | 9 |
| Evaluation heart device CPT 93640 | $918.40 | $1,148.00 | $78.01 – $399.20 | 7 |
| Evaluation of speech fluency 92521 CPT 92521 | $298.41 | $373.01 | $124.88 – $317.06 | 9 |
| Evaluation psychiatric diagnostic CPT 90791 | $324.00 | $405.00 | $136.94 – $368.89 | 9 |
| Evasc prlng admn rx agnt 1st CPT 61650 | not published | not published | $500.27 – $1,329.35 | 7 |
| Evasc prlng admn rx agnt add CPT 61651 | not published | not published | $213.54 – $566.89 | 7 |
| Evasc repair of iliac artery; endograft 34718 CPT 34718 | $3,032.80 | $3,791.00 | $1,049.88 – $2,815.20 | 7 |
| Evasc rpr a-ao ndgft 34701 CPT 34701 | $3,042.40 | $3,803.00 | $1,052.90 – $2,813.40 | 7 |
| Evasc rpr a-ao ndgft rpt 34702 CPT 34702 | $4,537.60 | $5,672.00 | $1,522.70 – $4,194.08 | 7 |
| Evasc rpr a-biiliac ndgft rptr CPT 34706 | $5,647.20 | $7,059.00 | $1,934.49 – $5,172.01 | 7 |
| Evasc rpr a-iliac ndgft 34717 CPT 34717 | $1,088.00 | $1,360.00 | $374.43 – $1,003.66 | 7 |
| Evasc rpr a-unilac ndgft 34703 CPT 34703 | $3,355.20 | $4,194.00 | $1,166.10 – $3,123.42 | 7 |
| Evasc rpr a-unilac ndgft rpt CPT 34704 | $5,584.80 | $6,981.00 | $1,938.92 – $5,205.66 | 7 |
| Evasc rpr ilio-iliac ndgft CPT 34707 | $5,684.80 | $7,106.00 | $990.10 – $2,641.39 | 7 |
| Evasc rpr ilio-iliac rpt CPT 34708 | $9,081.60 | $11,352.00 | $1,543.01 – $4,127.38 | 7 |
| Evasc st rpr thrc/aa acrs br CPT 33894 | not published | not published | $838.67 – $2,245.42 | 7 |
| Evasc st rpr thrc/aa x crsg CPT 33895 | not published | not published | $667.20 – $1,787.05 | 7 |
| Event monitor CPT 93270 | $709.86 | $887.32 | $6.94 – $754.22 | 11 |
| Evoked auditory tst complete CPT 92588 | $110.40 | $138.00 | $4.28 – $265.41 | 9 |
| Evoked oa emissions ltd CPT 92587 | $103.71 | $129.63 | $3.10 – $265.41 | 11 |
| Evoked potentials auditory screening automated analysis CPT 92650 | $529.04 | $661.29 | $44.80 – $562.10 | 8 |
| Evoked potentials upper limbs CPT 95925 | $328.80 | $411.00 | $25.00 – $265.41 | 9 |
| Evoked potential visual not glaucoma CPT 95930 | $232.00 | $290.00 | $16.78 – $265.41 | 9 |
| Evok oa screening qual CPT 92558 | $47.20 | $59.00 | $14.20 – $59.56 | 6 |
| Ewhfo w/joint(s) cf HCPCS L3766 | not published | not published | $739.15 – $1,880.91 | 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.