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 |
|---|---|---|---|---|
| Injection for tear sac x-ray CPT 68850 | $392.00 | $490.00 | $46.85 – $124.47 | 7 |
| Injection for ureter x-ray CPT 50684 | $1,035.20 | $1,293.99 | $45.85 – $1,099.89 | 9 |
| Injection for ureter x-ray CPT 50690 | $268.80 | $336.00 | $63.66 – $168.01 | 7 |
| Injection, fosphenytoin sodi HCPCS S0078 | not published | not published | $26.50 – $305.47 | 6 |
| Injection, fulvestrant HCPCS J9395 | $119.20 | $149.00 | $6.90 – $122.27 | 7 |
| Injection glatiramer acetate HCPCS J1595 | not published | not published | $57.50 – $1,965.92 | 7 |
| Injection, glucarpidase HCPCS C9293 | not published | not published | $411.74 – $411.74 | 2 |
| Injection, inclisiran, 1 mg HCPCS J1306 | $19.59 | $24.48 | $9.60 – $20.81 | 9 |
| Injection into brain canal CPT 61026 | $261.60 | $327.00 | $98.38 – $590.25 | 9 |
| Injection into brain canal CPT 61055 | $304.00 | $380.00 | $103.81 – $278.49 | 9 |
| Injection into hemorrhoid(s) CPT 46500 | $731.20 | $914.00 | $166.00 – $777.06 | 9 |
| Injection into spinal artery CPT 62294 | $2,231.20 | $2,789.00 | $758.81 – $2,199.58 | 9 |
| Injection into vocal cord CPT 31513 | $323.20 | $404.00 | $117.99 – $330.96 | 9 |
| Injection intraop add-on CPT 48400 | not published | not published | $92.03 – $245.68 | 7 |
| Injection, isavuconazonium HCPCS J1833 | not published | not published | $0.95 – $1.06 | 6 |
| Injection jaw joint x-ray CPT 21116 | $964.80 | $1,206.00 | $40.23 – $107.51 | 7 |
| Injection, khapzory, 0.5 mg HCPCS J0642 | not published | not published | $1.18 – $1.99 | 5 |
| Injection, necitumumab, 1 mg HCPCS J9295 | not published | not published | $5.73 – $7.46 | 7 |
| Injection of HIV prep drug HCPCS G0012 | $33.60 | $42.00 | $13.03 – $112.70 | 9 |
| Injection of sinus tract CPT 20500 | $1,607.31 | $2,009.13 | $82.16 – $1,707.76 | 11 |
| Injection,onabotulinumtoxina HCPCS J0585 | $10.77 | $13.46 | $2.72 – $6.83 | 9 |
| Injection, pentamidine iseth HCPCS S0080 | not published | not published | $97.70 – $189.29 | 6 |
| Injection, peramivir HCPCS J2547 | not published | not published | $1.58 – $1.78 | 6 |
| Injection, piperacillin sodi HCPCS S0081 | not published | not published | $2.09 – $3.12 | 4 |
| Injection px peyronie ds CPT 54200 | $275.20 | $344.00 | $80.06 – $212.00 | 9 |
| Injection radioactive tracer sentinel node (both sides) CPT 38792 | $899.07 | $1,123.83 | $28.85 – $955.26 | 11 |
| Injection, renflexis HCPCS Q5104 | $122.10 | $152.62 | $7.60 – $27.85 | 9 |
| Injection, ruconest HCPCS J0596 | not published | not published | $34.28 – $43.56 | 7 |
| Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides) HCPCS G0260 | $3,283.44 | $4,104.30 | $158.72 – $1,744.33 | 11 |
| Injection(s) anesthetic agent(s) and/or steroid femoral nerve left CPT 64447 | $680.01 | $850.01 | $57.96 – $722.51 | 11 |
| Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides) CPT 64450 | $1,846.13 | $2,307.66 | $37.70 – $980.76 | 11 |
| Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides) CPT 64483 | $2,645.36 | $3,306.70 | $101.33 – $1,405.35 | 11 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level CPT 64491 | $1,783.60 | $2,229.50 | $53.91 – $947.54 | 9 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level CPT 64490 | $2,408.95 | $3,011.18 | $95.94 – $1,279.75 | 11 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance CPT 64494 | $1,741.40 | $2,176.74 | $46.23 – $925.11 | 9 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level CPT 64493 | $2,366.58 | $2,958.22 | $82.54 – $1,257.24 | 11 |
| Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance CPT 62321 | $1,634.36 | $2,042.94 | $97.63 – $1,736.50 | 11 |
| Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance CPT 62323 | $1,621.33 | $2,026.66 | $90.27 – $1,722.66 | 11 |
| Injection, siltuximab HCPCS J2860 | not published | not published | $119.87 – $193.63 | 7 |
| Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 | $364.72 | $455.89 | $35.19 – $387.51 | 11 |
| Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s) CPT 20552 | $364.72 | $455.89 | $33.02 – $387.51 | 11 |
| Injection(s) trigger point(s) single/multiple >= 3 muscle(s) CPT 20553 | $364.72 | $455.89 | $37.55 – $387.51 | 11 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 | $68.59 | $85.73 | $5.88 – $72.87 | 8 |
| Injection, ticarcillin disod HCPCS S0040 | not published | not published | $16.00 – $24.88 | 4 |
| Injection torsemide 10 mg/ml HCPCS J3265 | $4.00 | $5.00 | $3.04 – $3.57 | 3 |
| Injection treatment of eye CPT 66020 | $955.20 | $1,194.00 | $118.46 – $1,943.90 | 9 |
| Injection treatment of eye CPT 66030 | $852.80 | $1,066.00 | $100.23 – $1,943.90 | 9 |
| Injection treatment of nerve CPT 64605 | $3,219.20 | $4,024.00 | $365.75 – $1,664.38 | 9 |
| Injection treatment of nerve CPT 64610 | $3,731.20 | $4,664.00 | $418.25 – $1,664.38 | 9 |
| Injection treatment of nerve CPT 64681 | $1,368.00 | $1,710.00 | $201.28 – $758.81 | 9 |
| Injection treatment of nose CPT 30200 | $273.60 | $342.00 | $54.47 – $434.04 | 9 |
| Inject sacroiliac joint CPT 27096 | $801.60 | $1,002.00 | $75.78 – $201.32 | 7 |
| Inject/treat eye socket CPT 67500 | $366.40 | $458.00 | $58.84 – $254.78 | 9 |
| Inject/treat eye socket CPT 67505 | $414.40 | $518.00 | $65.04 – $254.78 | 9 |
| Inject/treat eye socket CPT 67515 | $342.40 | $428.00 | $42.42 – $254.78 | 9 |
| Inj, eculizumab-aagh, 2 mg HCPCS Q5151 | not published | not published | $31.98 – $32.92 | 4 |
| Inj, eculizumab-aeeb, 2 mg HCPCS Q5152 | not published | not published | $39.14 – $43.56 | 5 |
| Inj efgart-alfa 2mg hya-qvfc HCPCS J9334 | not published | not published | $33.13 – $36.52 | 5 |
| Inj eflapegrastim-xnst 0.1mg HCPCS J1449 | not published | not published | $21.54 – $38.58 | 7 |
| Inj., emapalumab-lzsg, 1 mg HCPCS J9210 | not published | not published | $366.67 – $488.35 | 7 |
| Inj., emicizumab-kxwh 0.5 mg HCPCS J7170 | not published | not published | $51.98 – $65.85 | 7 |
| Inj epidural sgl cerv-thor without img CPT 62320 | $1,634.36 | $2,042.94 | $88.79 – $1,736.50 | 11 |
| Inj epidural sgl lumb-sacral without img CPT 62322 | $1,621.33 | $2,026.66 | $71.11 – $1,722.66 | 11 |
| Inj, epinephrine (belcher) HCPCS J0173 | not published | not published | $1.14 – $2.33 | 5 |
| Inj., eravacycline, 1 mg HCPCS J0122 | not published | not published | $1.02 – $1.47 | 5 |
| Inj, erzofri, 1 mg HCPCS J2428 | not published | not published | $16.65 – $18.01 | 5 |
| Inj, etelcalcetide, 0.1 mg HCPCS J0606 | not published | not published | $3.36 – $4.13 | 4 |
| Inj, eteplirsen, 10 mg HCPCS J1428 | not published | not published | $160.00 – $183.31 | 4 |
| Inj, evinacumab-dgnb, 5mg HCPCS J1305 | not published | not published | $179.14 – $232.88 | 7 |
| Inj., evomela, 1 mg HCPCS J9246 | not published | not published | $15.06 – $21.43 | 7 |
| Inj, exagamglogene autotem HCPCS J3392 | not published | not published | $2,200,000.00 – $2,448,600.00 | 5 |
| Inj, factor x, (human), 1iu HCPCS J7175 | not published | not published | $8.99 – $11.85 | 7 |
| Inj, faricimab-svoa, 0.1mg HCPCS J2777 | not published | not published | $34.72 – $46.92 | 7 |
| Inj fe-based mr contrast,1ml HCPCS Q9953 | not published | not published | $62.05 – $106.71 | 2 |
| Inj. fe derisomaltose 10 mg HCPCS J1437 | not published | not published | $19.33 – $24.94 | 7 |
| Inj fensolvi 0.25 mg HCPCS J1951 | not published | not published | $115.40 – $171.37 | 7 |
| Inj ferric pyrophosphate cit HCPCS J1443 | not published | not published | $0.03 – $0.03 | 3 |
| Inj., fibryga, 1 mg HCPCS J7177 | not published | not published | $1.10 – $1.43 | 7 |
| Inj fluphenazine hcl 1.25 mg HCPCS J2679 | not published | not published | $7.15 – $9.81 | 6 |
| Inj, focinvez, 1mg HCPCS J1434 | not published | not published | $2.93 – $3.02 | 5 |
| Inj follitropin alfa 75 iu HCPCS S0126 | not published | not published | $139.13 – $241.51 | 6 |
| Inj follitropin beta 75 iu HCPCS S0128 | $307.20 | $384.00 | $132.13 – $393.11 | 6 |
| Inj for ext venography CPT 36005 | $1,444.80 | $1,806.00 | $41.66 – $154.94 | 9 |
| Inj for mammo ductogram CPT 19030 | $833.60 | $1,042.00 | $68.25 – $182.29 | 7 |
| Inj, fosaprepitant (teva) HCPCS J1456 | not published | not published | $0.57 – $1.21 | 7 |
| Inj fosnetupitant, palonoset HCPCS J1454 | not published | not published | $618.48 – $902.43 | 7 |
| Inj., fremanezumab-vfrm 1 mg HCPCS J3031 | $3.20 | $4.00 | $2.52 – $3.36 | 4 |
| Inj, fulvestrant (fresenius) HCPCS J9394 | not published | not published | $3.32 – $68.90 | 7 |
| Inj, fulvestrant (teva) HCPCS J9393 | not published | not published | $17.11 – $48.52 | 6 |
| Inj, gadopiclenol, 1 ml HCPCS A9573 | $27.06 | $33.82 | $2.24 – $4.85 | 8 |
| Inj, ganciclovir (exela) HCPCS J1574 | not published | not published | $50.00 – $51.50 | 3 |
| Inj ganirelix acetat 250 mcg HCPCS S0132 | not published | not published | $141.00 – $480.89 | 6 |
| Inj gemcitabine hcl (accord) HCPCS J9196 | not published | not published | $7.78 – $11.41 | 5 |
| Inj givosiran 0.5 mg HCPCS J0223 | not published | not published | $105.00 – $145.70 | 7 |
| Inj glofitamab gxbm, 2.5 mg HCPCS J9286 | not published | not published | $2,706.61 – $3,520.31 | 6 |
| Inj glycopyrrolate fres kabi HCPCS J1598 | $36.80 | $46.00 | $1.66 – $33.64 | 9 |
| Inj glycopyrrolate, glyrx-pf HCPCS J1597 | not published | not published | $1.60 – $1.65 | 3 |
| Inj golodirsen 10 mg HCPCS J1429 | not published | not published | $160.00 – $164.80 | 4 |
| Inj, granisetron, xr, 0.1 mg HCPCS J1627 | not published | not published | $0.88 – $7.38 | 7 |
| Inj., guselkumab, 1 mg HCPCS J1628 | not published | not published | $70.43 – $113.92 | 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.