CHI Health Missouri Valley
631 North 8th Street, Missouri Valley, IA · Chihealth · · NPI 1508964123
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 |
|---|---|---|---|---|
| Lead tachy durata sj4 58cm HCPCS C1777 | $6,635.58 | $13,542.00 | $987.70 – $2,765.56 | 20 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $1,220.59 | $2,491.00 | $871.85 – $2,441.18 | 20 |
| Leishmania antibody CPT 86717 | $97.02 | $198.00 | $12.25 – $194.04 | 20 |
| Lens, intraocular (new tech) HCPCS C1780 | $580.65 | $1,185.00 | $52.50 – $147.00 | 20 |
| Lens iol 23.0 d 1.5 cyl eyhance toric HCPCS V2787 | $242.55 | $495.00 | $11.90 – $33.32 | 20 |
| Lens iol ant bicnvx 24.0 multi HCPCS V2632 | $1,218.88 | $2,487.50 | $22.75 – $63.70 | 20 |
| Lens iol ant chamb 10.5 HCPCS V2630 | $427.94 | $873.33 | $29.75 – $83.30 | 20 |
| Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 | $193.14 | $394.15 | $5.14 – $97.51 | 20 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | $2,380.67 | $4,858.50 | $158.47 – $443.70 | 20 |
| Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 | $12,107.71 | $24,709.60 | $1,576.12 – $8,071.77 | 20 |
| Leuprolide depot cipla 7.5mg HCPCS J1954 | $3,056.65 | $6,238.05 | $2,183.32 – $6,113.29 | 20 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $128.64 | $262.53 | $0.07 – $97.51 | 20 |
| Levetiracetam therapeutic drug level CPT 80177 | $102.90 | $210.00 | $13.25 – $205.80 | 20 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $101.31 | $206.75 | $0.96 – $202.62 | 20 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | $179.42 | $366.15 | $109.19 – $305.72 | 20 |
| Liberta rc ipg HCPCS C1820 | $33,554.52 | $68,478.60 | $472.50 – $1,323.00 | 20 |
| Lidocaine injection HCPCS J2001 | $48.76 | $99.50 | $0.03 – $97.51 | 20 |
| Lidocaine (pf) 10 mg/ml (1 %) injection solution HCPCS J2003 | $48.76 | $99.50 | $34.83 – $97.51 | 20 |
| Lidocaine therapeutic drug level CPT 80176 | $90.65 | $185.00 | $14.69 – $181.30 | 20 |
| Lift heel adj small gl60404sm HCPCS L3332 | $11.53 | $23.52 | $8.24 – $23.05 | 20 |
| Ligation/biopsy of temporal artery 37609 CPT 37609 | $427.77 | $873.00 | $305.55 – $855.54 | 20 |
| Liletta, 52 mg HCPCS J7297 | $1,168.77 | $2,385.24 | $834.84 – $2,337.54 | 20 |
| Lincomycin injection HCPCS J2010 | $380.91 | $777.35 | $10.33 – $761.81 | 20 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $179.34 | $366.00 | $3.62 – $97.51 | 20 |
| Lipase CPT 83690 | $103.88 | $212.00 | $6.89 – $20.58 | 20 |
| Lipoprotein blood quant CPT 83704 | $259.21 | $529.00 | $34.19 – $518.42 | 20 |
| Lipoprotein direct measurement hdl CPT 83718 | $97.02 | $198.00 | $8.19 – $24.50 | 20 |
| Lipoprotein direct measurement ldl CPT 83721 | $108.78 | $222.00 | $10.50 – $28.42 | 20 |
| Lip surgery procedure CPT 40799 | $62.23 | $127.00 | $44.45 – $124.46 | 20 |
| Lithium therapeutic drug level CPT 80178 | $87.71 | $179.00 | $6.61 – $20.58 | 20 |
| Liver abs/cyst dr opn 1-2 stge CPT 47010 | $1,601.81 | $3,269.00 | $1,144.15 – $3,203.62 | 20 |
| Liver Function Test CPT 80076 | $148.96 | $304.00 | $8.17 – $24.50 | 20 |
| Liver imaging CPT 78201 | $257.25 | $525.00 | $183.75 – $514.50 | 20 |
| Liver/spleen imag static only CPT 78215 | $512.05 | $1,045.00 | $365.75 – $1,024.10 | 20 |
| Liver/spleen imag w/vasclr flow CPT 78216 | $345.94 | $706.00 | $247.10 – $691.88 | 20 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $48.76 | $99.50 | $0.96 – $97.51 | 20 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $1,817.90 | $3,710.00 | $1,298.50 – $3,635.80 | 20 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $1,651.30 | $3,370.00 | $1,179.50 – $3,302.60 | 20 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $1,539.58 | $3,142.00 | $1,099.70 – $3,079.16 | 20 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $2,537.22 | $5,178.00 | $1,812.30 – $5,074.44 | 20 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $2,285.85 | $4,665.00 | $1,632.75 – $4,571.70 | 20 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $2,285.85 | $4,665.00 | $1,632.75 – $4,571.70 | 20 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $247.45 | $505.00 | $26.25 – $73.50 | 20 |
| Lso flex no ri stays pre ots HCPCS L0628 | $303.55 | $619.47 | $35.83 – $100.31 | 20 |
| L/s ratio fetal lung CPT 83661 | $304.78 | $622.00 | $21.99 – $609.56 | 20 |
| Lung Function Test (Spirometry) CPT 94010 | $210.70 | $430.00 | $150.50 – $421.40 | 20 |
| Lung perfusion imaging CPT 78580 | $601.23 | $1,227.00 | $429.45 – $1,202.46 | 20 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | $16,900.89 | $34,491.60 | $218.34 – $33,801.77 | 20 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | $29,057.54 | $59,301.10 | $39.98 – $19,371.76 | 20 |
| Lutetium lu 177 dotatat ther HCPCS A9513 | $116,375.00 | $237,500.00 | $279.48 – $232,750.00 | 20 |
| Lymphatics/lymph node imaging CPT 78195 | $824.67 | $1,683.00 | $589.05 – $1,649.34 | 20 |
| Macroscopic exam arthropod CPT 87168 | $36.75 | $75.00 | $4.27 – $73.50 | 20 |
| Macroscopic exam parasite CPT 87169 | $38.71 | $79.00 | $4.31 – $77.42 | 20 |
| Magnesium CPT 83735 | $56.84 | $116.00 | $6.70 – $20.58 | 20 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $101.31 | $206.75 | $0.64 – $97.51 | 20 |
| Mammosite ced HCPCS C1728 | $4,931.85 | $10,065.00 | $57.92 – $162.18 | 20 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $43.12 | $88.00 | $30.80 – $86.24 | 20 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $73.50 | $150.00 | $52.50 – $147.00 | 20 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | $48.76 | $99.50 | $4.52 – $97.51 | 20 |
| Manual diff wbc count b-coat CPT 85009 | $59.78 | $122.00 | $5.07 – $119.56 | 20 |
| Marker biop eviva buckle ss HCPCS A4648 | $3,087.00 | $6,300.00 | $0.34 – $0.94 | 20 |
| Mastectomy partial CPT 19301 | $2,167.27 | $4,423.00 | $624.05 – $1,747.34 | 20 |
| Mast mod rad CPT 19307 | $1,561.14 | $3,186.00 | $1,115.10 – $3,122.28 | 20 |
| Mastoids complete CPT 70130 | $209.72 | $428.00 | $149.80 – $419.44 | 20 |
| Mast radical CPT 19305 | $1,518.02 | $3,098.00 | $1,084.30 – $3,036.04 | 20 |
| Mast rad urban type CPT 19306 | $1,617.00 | $3,300.00 | $1,155.00 – $3,234.00 | 20 |
| Mast simple complete CPT 19303 | $1,264.20 | $2,580.00 | $903.00 – $2,528.40 | 20 |
| Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm HCPCS Q4166 | $4,701.06 | $9,594.00 | $19.21 – $747.74 | 20 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $150.92 | $308.00 | $14.46 – $301.84 | 20 |
| Mayo aathr protein s free CPT 85306 | $279.79 | $571.00 | $15.32 – $559.58 | 20 |
| Mayo activated protein c resistance assay CPT 85307 | $45.57 | $93.00 | $15.32 – $91.14 | 20 |
| Mayo alcohol definitive assay volatile screen CPT 80320 | $147.49 | $301.00 | $19.25 – $53.90 | 20 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $73.50 | $150.00 | $14.78 – $44.10 | 20 |
| Mayo alkaloids definitive assay nicotine/cotinine CPT 80323 | $127.89 | $261.00 | $91.35 – $255.78 | 20 |
| Mayo alpha 1 antitrypsin CPT 82103 | $69.58 | $142.00 | $13.44 – $139.16 | 20 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $88.69 | $181.00 | $15.08 – $177.38 | 20 |
| Mayo amphu amphetamines definitive assay 3 or 4 urine CPT 80325 | $106.82 | $218.00 | $76.30 – $213.64 | 20 |
| Mayo amphu methylenedioxyamphetamines definitive assay urine CPT 80359 | $9.31 | $19.00 | $6.65 – $18.62 | 20 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $518.42 | $1,058.00 | $91.66 – $1,036.84 | 20 |
| Mayo androstenedione CPT 82157 | $142.10 | $290.00 | $29.28 – $284.20 | 20 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | $99.47 | $203.00 | $14.60 – $198.94 | 20 |
| Mayo antithrombin iii antigen CPT 85301 | $135.24 | $276.00 | $10.81 – $270.48 | 20 |
| Mayo aspergillus fumigatus antibody CPT 86606 | $79.38 | $162.00 | $15.05 – $158.76 | 20 |
| Mayo avwpr vw factor activity CPT 85397 | $162.19 | $331.00 | $30.86 – $324.38 | 20 |
| Mayo barbiturates definitive assay confirmation urine CPT 80345 | $121.52 | $248.00 | $86.80 – $243.04 | 20 |
| Mayo bart bartonella henselae antibody igg CPT 86611 | $49.00 | $100.00 | $10.18 – $98.00 | 20 |
| Mayo blastomyces antibody immunodiffusion CPT 86612 | $96.53 | $197.00 | $12.90 – $193.06 | 20 |
| Mayo bordetella pertussis antibody igg CPT 86615 | $86.73 | $177.00 | $13.19 – $173.46 | 20 |
| Mayo brcmg brucella antibody igm CPT 86622 | $60.76 | $124.00 | $8.93 – $121.52 | 20 |
| Mayo c1 esterase inhibitor CPT 83883 | $93.10 | $190.00 | $13.60 – $186.20 | 20 |
| Mayo cannabinoids natural definitive assay thc confirmation urine CPT 80349 | $124.95 | $255.00 | $89.25 – $249.90 | 20 |
| Mayo carnitine total and free quantitative each specimen plasma CPT 82379 | $81.83 | $167.00 | $16.87 – $163.66 | 20 |
| Mayo ceruloplasmin CPT 82390 | $71.05 | $145.00 | $10.74 – $142.10 | 20 |
| Mayo chemiluminescent parathyroid related peptide CPT 82397 | $135.24 | $276.00 | $14.12 – $84.28 | 20 |
| Mayo chikv chikungunya antibodies igg CPT 86790 | $114.66 | $234.00 | $12.88 – $39.20 | 20 |
| Mayo chlap chlamydia pneumoniae antibody igg CPT 86631 | $54.88 | $112.00 | $11.82 – $109.76 | 20 |
| Mayo chlap chlamydia pneumoniae antibody igm CPT 86632 | $61.25 | $125.00 | $8.17 – $28.15 | 20 |
| Mayo chrcb tissue culture non-neoplastic disorders lymphocyte CPT 88230 | $407.68 | $832.00 | $116.49 – $815.36 | 20 |
| Mayo chromium CPT 82495 | $107.80 | $220.00 | $20.28 – $215.60 | 20 |
| Mayo coccidioides antibody CPT 86635 | $52.92 | $108.00 | $11.47 – $105.84 | 20 |
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.