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 |
|---|---|---|---|---|
| Rituximab-arrx 10 mg/ml intravenous solution HCPCS Q5123 | $6,568.09 | $13,404.25 | $938.30 – $2,627.24 | 20 |
| Rituximab-pvvr 10 mg/ml intravenous solution HCPCS Q5119 | $6,550.81 | $13,369.00 | $20.28 – $2,620.28 | 20 |
| Rmv implant contraceptive capsule 11976 CPT 11976 | $291.55 | $595.00 | $208.25 – $583.10 | 20 |
| Rmvl fb upr arm/elbow deep CPT 24201 | $748.23 | $1,527.00 | $381.75 – $1,470.00 | 20 |
| Rmvl fecal impaction/fb spx under anes CPT 45915 | $488.53 | $997.00 | $348.95 – $977.06 | 20 |
| Rmvl foreign body upper arm/elbow subcutaneous CPT 24200 | $301.84 | $616.00 | $154.00 – $550.76 | 20 |
| Romiplostim injection HCPCS J2796 | $2,921.34 | $5,961.90 | $96.38 – $5,842.67 | 20 |
| Romosozumab-aqqg 105 mg/1.17 ml subcutaneous syringe (wrapper) HCPCS J3111 | $3,220.43 | $6,572.30 | $10.69 – $6,134.17 | 20 |
| Ropivacaine 0.2 % epidural pca - 1 hour dose limit HCPCS J2795 | $219.52 | $448.00 | $0.07 – $97.51 | 20 |
| Rozanolixizumab-noli 140 mg/ml subcutaneous solution HCPCS J9333 | $14,822.50 | $30,250.00 | $34.83 – $97.51 | 20 |
| Rp loclzj tum 2+area 1+d img CPT 78801 | $886.41 | $1,809.00 | $633.15 – $1,772.82 | 20 |
| Rpr aa hrn 1st 3-10 rdc CPT 49593 | $3,900.89 | $7,961.00 | $2,786.35 – $7,801.78 | 20 |
| Rpr aa hrn 1st < 3 cm rdc CPT 49591 | $2,269.68 | $4,632.00 | $1,621.20 – $4,539.36 | 20 |
| Rpr fem hernia init blocked CPT 49553 | $837.90 | $1,710.00 | $598.50 – $1,675.80 | 20 |
| Rpr rem hernia init reduce CPT 49550 | $763.91 | $1,559.00 | $545.65 – $1,527.82 | 20 |
| Rsv assay w/optic CPT 87807 | $17.64 | $36.00 | $13.10 – $35.28 | 20 |
| Rubella antibody igg CPT 86762 | $86.73 | $177.00 | $14.39 – $173.46 | 20 |
| Rubeola antibody igg CPT 86765 | $57.82 | $118.00 | $12.88 – $115.64 | 20 |
| Russell viper venom diluted CPT 85613 | $113.19 | $231.00 | $9.58 – $26.46 | 20 |
| Sacituzumab govitecan-hziy 180 mg intravenous solution HCPCS J9317 | $6,036.71 | $12,319.80 | $37.32 – $12,073.41 | 20 |
| Sarscov coronavirus ag ia CPT 87426 | $51.45 | $105.00 | $33.97 – $78.43 | 20 |
| Sarscov & inf vir a&b ag ia CPT 87428 | $194.53 | $397.00 | $70.29 – $389.06 | 20 |
| S bowel endoscope w/stent CPT 44379 | $559.09 | $1,141.00 | $399.35 – $1,118.18 | 20 |
| Sbsq nursing facil care/day new problem 25 min CPT 99309 | $124.95 | $255.00 | $63.75 – $249.90 | 20 |
| Sbsq psyc collab care mgmt CPT 99493 | $54.39 | $111.00 | $38.85 – $108.78 | 20 |
| Scan duplex abd/pelvis/retroperitoneal complete CPT 93975 | $700.70 | $1,430.00 | $500.50 – $1,401.40 | 20 |
| Scan duplex abd/pelvis/retroperitoneal limited CPT 93976 | $441.49 | $901.00 | $315.35 – $882.98 | 20 |
| Scan duplex aorta/ivc/iliac or bypass grafts complete CPT 93978 | $1,015.77 | $2,073.00 | $725.55 – $2,031.54 | 20 |
| Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 | $574.28 | $1,172.00 | $410.20 – $1,148.56 | 20 |
| Scan duplex extracranial arteries unilateral/limited study CPT 93882 | $688.45 | $1,405.00 | $491.75 – $1,376.90 | 20 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $610.54 | $1,246.00 | $436.10 – $1,221.08 | 20 |
| Scan duplex lower extremity arteries complete bilateral CPT 93925 | $694.33 | $1,417.00 | $495.95 – $1,388.66 | 20 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $520.87 | $1,063.00 | $372.05 – $1,041.74 | 20 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $398.37 | $813.00 | $284.55 – $796.74 | 20 |
| Sclerotherapy fluid collection pq w/img CPT 49185 | $726.67 | $1,483.00 | $519.05 – $1,453.34 | 20 |
| Scope plantar fasciotomy CPT 29893 | $921.69 | $1,881.00 | $658.35 – $1,843.38 | 20 |
| Scope uretscp lithovue dig disp HCPCS C1747 | $1,653.75 | $3,375.00 | $836.07 – $2,340.98 | 20 |
| Scr c/v cyto,thinlayer,rescr HCPCS G0145 | $78.40 | $160.00 | $26.49 – $156.80 | 20 |
| Screening Colonoscopy (average risk) HCPCS G0121 | $1,046.64 | $2,136.00 | $341.60 – $956.48 | 20 |
| Screening Colonoscopy (high risk) HCPCS G0105 | $478.24 | $976.00 | $341.60 – $956.48 | 20 |
| Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations HCPCS G0328 | $36.75 | $75.00 | $18.05 – $73.50 | 20 |
| Screening Mammogram CPT 77067 | $193.06 | $394.00 | $76.30 – $213.64 | 20 |
| Screening prostate cancer PSA HCPCS G0103 | $102.90 | $210.00 | $19.31 – $54.88 | 20 |
| Screw cortex 2.0 x 10mm HCPCS C1713 | $14,994.62 | $30,601.26 | $0.02 – $0.04 | 20 |
| Sedimentation rate erythrocyte automated CPT 85652 | $54.88 | $112.00 | $2.70 – $7.84 | 20 |
| Semen analysis presence/motility CPT 89321 | $53.41 | $109.00 | $12.05 – $106.82 | 20 |
| Semen analysis w/count CPT 89310 | $124.46 | $254.00 | $8.61 – $248.92 | 20 |
| Sertraline (zoloft) - sendout CPT 80332 | $163.66 | $334.00 | $116.90 – $327.32 | 20 |
| Shave sgl skin lsn f/e/e/n/l/m 0.5cm/< CPT 11310 | $137.69 | $281.00 | $98.35 – $275.38 | 20 |
| Shave sgl skin lsn f/e/e/n/l/m 0.6-1.0cm CPT 11311 | $104.37 | $213.00 | $74.55 – $208.74 | 20 |
| Shave sgl skin lsn f/e/e/n/l/m 1.1-2cm CPT 11312 | $205.80 | $420.00 | $115.50 – $323.40 | 20 |
| Shave sgl skin lsn f/e/e/n/l/m >2cm CPT 11313 | $102.41 | $209.00 | $73.15 – $204.82 | 20 |
| Shave sgl skin lsn s/n/h/f/g 0.5cm/< CPT 11305 | $149.45 | $305.00 | $76.25 – $236.18 | 20 |
| Shave sgl skin lsn s/n/h/f/g 0.6-1.0 cm CPT 11306 | $606.62 | $1,238.00 | $433.30 – $1,213.24 | 20 |
| Shave sgl skin lsn s/n/h/f/g 1.1-2cm CPT 11307 | $668.36 | $1,364.00 | $477.40 – $1,336.72 | 20 |
| Shave sgl skin lsn t/a/l 0.5cm/< CPT 11300 | $237.65 | $485.00 | $169.75 – $475.30 | 20 |
| Shave sgl skin lsn t/a/l 0.6-1.0cm CPT 11301 | $76.44 | $156.00 | $42.35 – $118.58 | 20 |
| Shave sgl skin lsn t/a/l 1.1-2.0cm CPT 11302 | $369.46 | $754.00 | $263.90 – $738.92 | 20 |
| Sheath gldlight lasr 12fx50cm HCPCS C2629 | $4,474.54 | $9,131.70 | $1,779.75 – $4,983.30 | 20 |
| Shoe post-op mens m HCPCS L3260 | $73.95 | $150.90 | $52.82 – $147.89 | 20 |
| Shoulder MRI (with and without contrast) CPT 73223 | $2,110.43 | $4,307.00 | $1,507.45 – $4,220.86 | 20 |
| Shoulder MRI (with contrast) CPT 73222 | $1,855.14 | $3,786.00 | $1,325.10 – $3,710.28 | 20 |
| Shoulder MRI (without contrast) CPT 73221 | $1,701.77 | $3,473.00 | $1,215.55 – $3,403.54 | 20 |
| Shoulder X-ray CPT 73030 | $193.06 | $394.00 | $20.65 – $57.82 | 20 |
| Shunt glaucoma baerveldt 350mm HCPCS C1783 | $2,813.58 | $5,742.00 | $743.75 – $2,082.50 | 20 |
| Shuntogram nonvascular supervision & interpretation CPT 75809 | $299.88 | $612.00 | $214.20 – $599.76 | 20 |
| Sickling rbc CPT 85660 | $56.84 | $116.00 | $5.51 – $113.68 | 20 |
| Sigmoidoscopy and biopsy CPT 45331 | $1,091.72 | $2,228.00 | $292.60 – $819.28 | 20 |
| Sigmoidoscopy flex decompression 45337 CPT 45337 | $156.31 | $319.00 | $111.65 – $312.62 | 20 |
| Sigmoidoscopy for bleeding CPT 45334 | $711.48 | $1,452.00 | $508.20 – $1,422.96 | 20 |
| Sigmoidoscopy/submucosal injection 45335 CPT 45335 | $416.50 | $850.00 | $297.50 – $833.00 | 20 |
| Sigmoidoscopy w/ablation CPT 45346 | $3,365.32 | $6,868.00 | $2,403.80 – $6,730.64 | 20 |
| Sigmoidoscopy w/fb removal 45332 CPT 45332 | $392.98 | $802.00 | $280.70 – $785.96 | 20 |
| Sigmoidoscopy w/plcmt stent CPT 45347 | $210.21 | $429.00 | $150.15 – $420.42 | 20 |
| Sigmoidoscopy w/tumr remove CPT 45338 | $424.83 | $867.00 | $303.45 – $849.66 | 20 |
| Sigmoidoscopy w/ultrasound CPT 45341 | $169.54 | $346.00 | $121.10 – $339.08 | 20 |
| Sigmoidoscopy w/us guide bx CPT 45342 | $231.77 | $473.00 | $165.55 – $463.54 | 20 |
| Sigmoid/rmv tumor/polyp/hot bx for 45333 CPT 45333 | $1,108.38 | $2,262.00 | $335.30 – $938.84 | 20 |
| Sig w/tndsc balloon dilation CPT 45340 | $660.52 | $1,348.00 | $471.80 – $1,321.04 | 20 |
| Sincalide 5 mcg solution for injection HCPCS J2805 | $298.19 | $608.54 | $110.69 – $309.91 | 20 |
| Sinus CT scan (with and without contrast) CPT 70488 | $1,728.72 | $3,528.00 | $1,234.80 – $3,457.44 | 20 |
| Sinus CT scan (with contrast) CPT 70487 | $1,468.04 | $2,996.00 | $1,048.60 – $2,936.08 | 20 |
| Sinus CT scan (without contrast) CPT 70486 | $1,372.00 | $2,800.00 | $980.00 – $2,744.00 | 20 |
| Sirolimus, oral HCPCS J7520 | $5,812.78 | $11,862.80 | $2.46 – $24.38 | 20 |
| Skin Biopsy CPT 11102 | $131.32 | $268.00 | $93.80 – $262.64 | 20 |
| Skyla, 13.5 mg HCPCS J7301 | $1,784.08 | $3,640.96 | $963.22 – $3,568.15 | 20 |
| Sleep study attended CPT 95807 | $954.52 | $1,948.00 | $681.80 – $1,909.04 | 20 |
| Sleep Study (Polysomnography) CPT 95810 | $2,621.99 | $5,351.00 | $1,872.85 – $5,243.98 | 20 |
| Sleep study unattended CPT 95806 | $282.73 | $577.00 | $201.95 – $565.46 | 20 |
| Sling arm deluxe w/pad xs HCPCS A4565 | $47.63 | $97.20 | $4.26 – $11.91 | 20 |
| Sling suprapubic suburetheral HCPCS C1771 | $4,624.50 | $9,437.75 | $215.25 – $602.70 | 20 |
| Slp eval for nonspeech dev ea addl 30 mins CPT 92618 | $131.32 | $268.00 | $54.25 – $151.90 | 20 |
| Slp eval non-spch gen comm dev CPT 92605 | $163.66 | $334.00 | $116.90 – $327.32 | 20 |
| Slp pure tone screening CPT 92551 | $17.15 | $35.00 | $12.25 – $34.30 | 20 |
| Slp stdy unatnd w/anal CPT 95801 | $40.18 | $82.00 | $28.70 – $80.36 | 20 |
| Slp ther svc non-spch gen CPT 92606 | $339.08 | $692.00 | $172.55 – $483.14 | 20 |
| Sm-153 lexidron ther HCPCS A9604 | $20,739.74 | $42,326.00 | $14,814.10 – $41,479.48 | 20 |
| Small bowel endoscopy CPT 44360 | $196.00 | $400.00 | $140.00 – $392.00 | 20 |
| Small bowel endoscopy CPT 44364 | $278.81 | $569.00 | $199.15 – $557.62 | 20 |
| Small bowel endoscopy CPT 44366 | $327.81 | $669.00 | $234.15 – $655.62 | 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.