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 |
|---|---|---|---|---|
| Group behave couns 2-10 HCPCS G0473 | $65.84 | $82.30 | $10.54 – $69.96 | 11 |
| Group health education CPT 99078 | $115.20 | $144.00 | $33.42 – $146.91 | 4 |
| Group mnt 2 or more 30 mins HCPCS G0271 | $37.60 | $47.00 | $14.14 – $37.21 | 7 |
| Group train without patient HCPCS G0543 | not published | not published | $9.95 – $16.00 | 6 |
| Growth hormone antibody CPT 86277 | $40.00 | $50.00 | $9.44 – $24.49 | 7 |
| Growth hormone panel CPT 80428 | $168.00 | $210.00 | $40.02 – $103.78 | 7 |
| Growth hormone panel CPT 80430 | $259.20 | $324.00 | $77.60 – $181.07 | 7 |
| Growth stimulation gene 2 CPT 83006 | $151.20 | $189.00 | $41.55 – $105.84 | 7 |
| Grp adapt bhv tx by phy/qhp CPT 97158 | not published | not published | $6.99 – $28.84 | 6 |
| Grp adapt bhv tx by tech CPT 97154 | not published | not published | $6.99 – $28.84 | 6 |
| Gstrct prtl dstl w/roux-en-y rcnstj 43633 CPT 43633 | $4,717.60 | $5,897.00 | $1,683.27 – $4,486.19 | 7 |
| Gstr rstcv oth/thn v-band CPT 43843 | $3,141.60 | $3,927.00 | $1,125.89 – $3,001.28 | 7 |
| Gstr rstcv px shrt roux-en-y CPT 43846 | $3,987.20 | $4,984.00 | $1,446.37 – $3,855.86 | 7 |
| Gstr rstcv px sm int rcnstj CPT 43847 | $4,424.00 | $5,530.00 | $1,581.59 – $4,217.00 | 7 |
| Gstr rstcv px v-banded gstp CPT 43842 | $2,956.00 | $3,695.00 | $2,160.63 – $3,694.51 | 6 |
| Gstrst open wo constj tube CPT 43830 | $1,722.40 | $2,153.00 | $620.34 – $1,655.00 | 9 |
| G-tube reposition CPT 43761 | $330.25 | $412.81 | $91.60 – $350.89 | 11 |
| Gu dilat ureter/urethra s&i CPT 74485 | $231.20 | $289.00 | $36.15 – $1,745.97 | 9 |
| Guided cath fluid drainage 10030 CPT 10030 | $1,507.20 | $1,884.00 | $121.30 – $1,314.34 | 11 |
| Guide endoanchr sg-64 aaa 62cm HCPCS L8670 | not published | not published | $333.32 – $848.21 | 7 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $297.76 | $372.20 | $43.76 – $94.89 | 5 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $129.80 | $162.25 | $63.60 – $137.91 | 5 |
| Guid loc target vol rad tx CPT 77387 | $333.56 | $416.94 | $51.28 – $354.40 | 8 |
| Gum graft CPT 41870 | not published | not published | $679.76 – $1,481.30 | 9 |
| Gw stiffened micro access kit HCPCS C1894 | $133.84 | $167.29 | $65.58 – $142.20 | 5 |
| Gynecomastia (males) 19300 CPT 19300 | $2,684.80 | $3,356.00 | $387.22 – $3,263.75 | 9 |
| Hair analysis HCPCS P2031 | $60.80 | $76.00 | $2.97 – $12.87 | 7 |
| Hair removal by electrolysis 17380 CPT 17380 | $184.80 | $231.00 | $83.60 – $592.60 | 7 |
| Hair trnspl 1-15 punch grfts CPT 15775 | $908.00 | $1,135.00 | $227.60 – $603.83 | 7 |
| Hair trnspl >15 punch grafts CPT 15776 | $1,244.80 | $1,556.00 | $311.20 – $826.88 | 7 |
| Hallus-valgus nt dyn pre ots HCPCS L3100 | not published | not published | $25.87 – $65.82 | 7 |
| Halo cervical into body jack HCPCS L0820 | not published | not published | $1,236.82 – $3,406.94 | 7 |
| Halo cervical into jckt vest HCPCS L0810 | not published | not published | $1,546.78 – $4,068.33 | 7 |
| Halo cerv into milwaukee typ HCPCS L0830 | not published | not published | $1,821.07 – $4,945.84 | 7 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | $22.40 | $28.00 | $4.61 – $26.01 | 6 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $71.44 | $89.30 | $0.78 – $12.84 | 8 |
| Halo repl liner/interface HCPCS L0861 | not published | not published | $128.91 – $328.03 | 7 |
| Hand-held pefr meter a4614 HCPCS A4614 | $67.20 | $84.00 | $16.58 – $42.19 | 7 |
| Handle/convey/speciman/office-lab 99000 CPT 99000 | $18.57 | $23.21 | $2.90 – $19.73 | 8 |
| Hand orthosis metacarpal fracture orthosis prefa l3918 HCPCS L3918 | not published | not published | $57.48 – $146.28 | 7 |
| Hand restoration multiple fi HCPCS L6905 | not published | not published | $939.43 – $2,467.09 | 7 |
| Hand restoration no fingers HCPCS L6910 | not published | not published | $1,141.96 – $2,905.96 | 7 |
| Hand restoration replacmnt g HCPCS L6915 | not published | not published | $495.88 – $1,261.86 | 7 |
| Hand restorat thumb/1 finger HCPCS L6900 | not published | not published | $1,182.96 – $3,010.29 | 7 |
| Hands-On Manual Therapy (each 15 minutes) CPT 97140 | $107.32 | $134.15 | $25.87 – $114.03 | 9 |
| Hand tendon/muscle transfer CPT 26494 | $1,992.80 | $2,491.00 | $752.67 – $2,765.43 | 9 |
| Hand tendon reconstruction CPT 26500 | $1,561.60 | $1,952.00 | $614.42 – $6,088.70 | 9 |
| Hand tendon reconstruction CPT 26502 | $1,776.80 | $2,221.00 | $674.44 – $2,765.43 | 9 |
| Hand X-ray CPT 73130 | $224.98 | $281.22 | $7.71 – $239.04 | 11 |
| Hand X-ray (2 views, both hands) CPT 73120 | $164.11 | $205.13 | $7.39 – $174.36 | 11 |
| Haptoglobin quantitative CPT 83010 | $64.28 | $80.35 | $7.55 – $68.30 | 9 |
| Harness chest/shlder saddle HCPCS L6672 | not published | not published | $101.04 – $283.33 | 7 |
| Harness figure of 8 dual con HCPCS L6676 | not published | not published | $77.93 – $203.78 | 7 |
| Harness figure of 8 sing con HCPCS L6675 | not published | not published | $71.91 – $201.80 | 7 |
| Harvest allogeneic stem cell CPT 38205 | $217.60 | $272.00 | $75.99 – $204.63 | 7 |
| Harvest auto stem cells CPT 38206 | $216.80 | $271.00 | $74.81 – $1,397.18 | 9 |
| Harvest cultured skin graft 15040 CPT 15040 | $636.80 | $796.00 | $112.25 – $1,559.08 | 9 |
| Harvest eye tissue alograft CPT 68371 | $2,044.80 | $2,556.00 | $370.34 – $1,988.41 | 9 |
| Harvest femoropopliteal vein 35572 CPT 35572 | $844.00 | $1,055.00 | $291.04 – $778.36 | 7 |
| Harvest stem cell concentrte CPT 38215 | not published | not published | $88.76 – $423.23 | 7 |
| Harvest vein for bypass 35500 CPT 35500 | $780.00 | $975.00 | $269.32 – $721.28 | 7 |
| Hast w/i&r phys/qhp CPT 94452 | $113.60 | $142.00 | $13.13 – $33.77 | 7 |
| Hast w/oxygen titrate CPT 94453 | $156.00 | $195.00 | $16.78 – $44.15 | 7 |
| Hba1/hba2 full gene sequence CPT 81259 | $1,200.00 | $1,500.00 | $333.36 – $840.06 | 9 |
| Hba1/hba2 gene dup/del vrnts CPT 81269 | $404.80 | $506.00 | $112.45 – $283.38 | 9 |
| Hba1/hba2 gene fam vrnt CPT 81258 | $751.20 | $939.00 | $225.15 – $525.38 | 7 |
| Hbb full gene sequence CPT 81364 | $649.60 | $812.00 | $180.34 – $454.45 | 9 |
| Hbb gene com variants CPT 81361 | $350.40 | $438.00 | $97.12 – $244.74 | 9 |
| Hbb gene dup/del variants CPT 81363 | $404.80 | $506.00 | $112.45 – $283.38 | 9 |
| Hbb gene known fam variant CPT 81362 | $751.20 | $939.00 | $208.49 – $525.38 | 9 |
| Hb glycosylated a1c home dev CPT 83037 | $33.57 | $41.96 | $9.71 – $35.67 | 9 |
| Hbot, full body chamber, 30m HCPCS G0277 | $413.89 | $517.36 | $85.88 – $439.76 | 11 |
| Hc ea ha check monaural CPT 92594 | $45.60 | $57.00 | $17.40 – $53.61 | 6 |
| Hc fl sm bowel enteroclss tube w kub double contrast CPT 74251 | $913.60 | $1,142.00 | $50.99 – $151.73 | 9 |
| Hcg free betachain test CPT 84704 | $64.28 | $80.35 | $15.29 – $68.30 | 9 |
| Hcg qualitative CPT 84703 | $33.57 | $41.96 | $4.51 – $35.67 | 9 |
| Hcg quantitative CPT 84702 | $55.00 | $68.75 | $15.05 – $58.44 | 9 |
| Hc hearing aid chck binaurl CPT 92593 | $78.40 | $98.00 | $17.40 – $92.48 | 6 |
| Hc hearing aid chck monarl CPT 92592 | $48.00 | $60.00 | $17.40 – $54.94 | 6 |
| Hc hearing aid exam both ears CPT 92591 | $175.20 | $219.00 | $61.00 – $175.26 | 6 |
| Hc hearing aid exam one ear CPT 92590 | $175.20 | $219.00 | $45.30 – $137.78 | 6 |
| Hc i-131 sodium iodide cap dx per mci HCPCS A9528 | $131.50 | $164.37 | $55.60 – $139.71 | 6 |
| Hc metata joint dislocation anes CPT 28635 | $436.80 | $546.00 | $120.55 – $1,364.06 | 9 |
| Hc mohs micrographic h/n/h/f/g 1st stage 5 blocks CPT 17311 | $1,634.40 | $2,043.00 | $321.05 – $854.92 | 9 |
| Hc mohs micrographic h/n/h/f/g each addl stage CPT 17312 | $978.40 | $1,223.00 | $170.98 – $454.71 | 7 |
| Hc mohs trunk/arm/leg 1st stage 5 blocks CPT 17313 | $1,531.20 | $1,914.00 | $288.09 – $766.88 | 9 |
| Hc mohs trunk/arm/leg ea addl block any stage CPT 17315 | $192.80 | $241.00 | $44.98 – $120.26 | 7 |
| Hc mohs trunk/arm/leg ea stage after 1st stage CPT 17314 | $935.20 | $1,169.00 | $158.05 – $421.62 | 7 |
| Hc nm cardiac blood pool planar 1 stdy wal motn eject fract CPT 78481 | $408.80 | $511.00 | $41.89 – $458.77 | 9 |
| Hc nm fusion spect CT unlisted CPT 78999 | $1,034.93 | $1,293.66 | $342.49 – $1,099.61 | 10 |
| Hc nm kidney imaging with flow CPT 78701 | $741.70 | $927.12 | $21.46 – $788.05 | 11 |
| Hc nm myocard infarct avid plnr tomo spect w/wo quant CPT 78469 | $2,354.12 | $2,942.65 | $39.80 – $2,501.25 | 11 |
| Hc pet myocardial imaging metabolic eval single study CPT 78459 | $2,528.80 | $3,161.00 | $67.88 – $1,112.68 | 9 |
| Hc transcatheter placement and sbsq removal cepd perq CPT 33370 | $332.00 | $415.00 | $114.54 – $305.28 | 7 |
| Hdr rdncl ntrstl/icav brchtx CPT 77770 | $629.60 | $787.00 | $96.01 – $591.34 | 9 |
| Hdr rdncl ntrstl/icav brchtx CPT 77771 | $1,099.20 | $1,374.00 | $187.00 – $591.34 | 9 |
| Hdr rdncl ntrstl/icav brchtx CPT 77772 | $1,640.80 | $2,051.00 | $263.86 – $591.34 | 9 |
| Hdr rdncl skn surf brachytx CPT 77767 | $449.60 | $562.00 | $51.68 – $224.14 | 9 |
| Hdr rdncl skn surf brachytx CPT 77768 | $657.60 | $822.00 | $68.76 – $224.14 | 9 |
| Head CT scan (with and without contrast) CPT 70470 | $2,542.60 | $3,178.24 | $55.55 – $2,701.50 | 11 |
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.