UnityPoint Health - St. Lukes Downtown
2720 Stone Park Blvd, Sioux City, IA · UnityPoint Health · · NPI 1962594622
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 |
|---|---|---|---|---|
| Revision of nose CPT 30120 | $1,258.40 | $1,573.00 | $379.61 – $2,872.13 | 13 |
| Revision of nose CPT 30430 | $2,541.60 | $3,177.00 | $826.02 – $5,239.04 | 13 |
| Revision of nose CPT 30435 | $3,218.40 | $4,023.00 | $1,045.98 – $5,239.04 | 13 |
| Revision of nose CPT 30450 | $4,261.60 | $5,327.00 | $1,385.02 – $5,239.04 | 13 |
| Revision of nose CPT 30460 | $2,044.00 | $2,555.00 | $664.30 – $5,239.04 | 13 |
| Revision of nose CPT 30462 | $3,931.20 | $4,914.00 | $1,277.64 – $5,239.04 | 13 |
| Revision of pelvis CPT 27158 | not published | not published | $1,248.69 – $3,322.38 | 10 |
| Revision of penis CPT 54300 | $1,627.20 | $2,034.00 | $528.84 – $3,054.48 | 13 |
| Revision of penis CPT 54304 | $1,892.00 | $2,365.00 | $614.90 – $3,054.48 | 13 |
| Revision of penis CPT 54420 | $1,777.60 | $2,222.00 | $577.72 – $3,054.48 | 13 |
| Revision of penis CPT 54430 | $1,612.80 | $2,016.00 | $524.16 – $1,546.41 | 11 |
| Revision of penis CPT 54435 | $1,045.60 | $1,307.00 | $339.82 – $3,054.48 | 13 |
| Revision of pharyngeal walls CPT 42892 | $4,636.00 | $5,795.00 | $1,506.70 – $5,239.04 | 13 |
| Revision of pharyngeal walls CPT 42894 | not published | not published | $2,109.05 – $5,658.89 | 10 |
| Revision of pulmonary artery CPT 33788 | not published | not published | $1,317.48 – $3,521.59 | 10 |
| Revision of pulmonary valve CPT 33474 | not published | not published | $1,870.87 – $4,998.96 | 10 |
| Revision of radius CPT 25350 | $3,329.60 | $4,162.00 | $541.06 – $6,326.64 | 13 |
| Revision of radius CPT 25355 | $3,761.60 | $4,702.00 | $611.26 – $2,873.50 | 13 |
| Revision of sciatic nerve CPT 64712 | $2,888.00 | $3,610.00 | $469.30 – $1,729.42 | 13 |
| Revision of scrotum CPT 55175 | $912.80 | $1,141.00 | $296.66 – $3,054.48 | 13 |
| Revision of scrotum CPT 55180 | $1,743.20 | $2,179.00 | $566.54 – $4,502.17 | 13 |
| Revision of spinal shunt CPT 63744 | $1,613.60 | $2,017.00 | $524.42 – $5,671.59 | 13 |
| Revision of testis CPT 54660 | $1,796.80 | $2,246.00 | $291.98 – $872.04 | 11 |
| Revision of thigh muscles CPT 27430 | $3,649.60 | $4,562.00 | $593.06 – $6,326.64 | 13 |
| Revision of toe CPT 28312 | $1,254.40 | $1,568.00 | $324.63 – $2,873.50 | 13 |
| Revision of tricuspid valve CPT 33468 | not published | not published | $2,096.84 – $5,607.53 | 10 |
| Revision of tricuspid valve w/bypass 33460 CPT 33460 | $5,873.60 | $7,342.00 | $1,908.92 – $5,486.19 | 11 |
| Revision of ulna CPT 25360 | $3,222.40 | $4,028.00 | $523.64 – $6,326.64 | 13 |
| Revision of unstable kneecap CPT 27420 | $3,660.80 | $4,576.00 | $594.88 – $6,326.64 | 13 |
| Revision of unstable kneecap CPT 27422 | $3,660.80 | $4,576.00 | $594.88 – $6,326.64 | 13 |
| Revision of upper arm CPT 24940 | not published | not published | $1,015.20 – $2,598.86 | 10 |
| Revision of ureter CPT 50700 | $4,675.20 | $5,844.00 | $759.72 – $2,232.63 | 11 |
| Revision of urethra CPT 53450 | $1,029.60 | $1,287.00 | $334.62 – $3,054.48 | 13 |
| Revision of urethra CPT 53460 | $1,153.60 | $1,442.00 | $374.92 – $3,054.48 | 13 |
| Revision of urethra CPT 57220 | $833.60 | $1,042.00 | $270.92 – $4,371.83 | 13 |
| Revision of urinary tract CPT 51820 | not published | not published | $980.86 – $2,613.40 | 10 |
| Revision open av fistula without thromb CPT 36832 | $1,846.40 | $2,308.00 | $600.08 – $4,787.41 | 13 |
| Revision orbitofacial bones CPT 21275 | $2,089.60 | $2,612.00 | $679.12 – $5,239.04 | 13 |
| Revision/removal of kneecap CPT 27424 | $3,676.80 | $4,596.00 | $597.48 – $6,326.64 | 13 |
| Revision tips CPT 37183 | $15,049.60 | $18,812.00 | $332.33 – $7,293.22 | 15 |
| Revis reconst shoulder joint CPT 23473 | $7,987.20 | $9,984.00 | $1,297.92 – $11,395.13 | 13 |
| Revis reconst shoulder joint CPT 23474 | $4,315.20 | $5,394.00 | $1,402.44 – $4,121.62 | 11 |
| Revitalon 1 square cm HCPCS Q4157 | not published | not published | $49.54 – $202.90 | 4 |
| Revita, per sq cm HCPCS Q4180 | not published | not published | $172.78 – $1,253.58 | 6 |
| Revj fem anast autog vn grf CPT 35884 | $6,035.20 | $7,544.00 | $980.72 – $4,787.41 | 13 |
| Revj fem anast nonautog grf CPT 35883 | $5,864.00 | $7,330.00 | $952.90 – $4,787.41 | 13 |
| Revj mstdc rsltg compl mstdc CPT 69601 | $5,049.60 | $6,312.00 | $820.56 – $5,239.04 | 13 |
| Revj mstdc rsltg tympanplsty CPT 69604 | $5,456.00 | $6,820.00 | $886.60 – $5,239.04 | 13 |
| Revj open gstr rstcv px CPT 43848 | $4,748.80 | $5,936.00 | $1,543.36 – $4,517.32 | 11 |
| Revj prior hypspad repair CPT 54352 | $3,580.00 | $4,475.00 | $1,163.50 – $4,502.17 | 13 |
| Revj/rmvl nea pn w/int nstim CPT 64598 | not published | not published | $752.50 – $5,134.46 | 7 |
| Rev mastoidectomy rsltg modf rad mstdc 69602 CPT 69602 | $5,336.00 | $6,670.00 | $867.10 – $5,239.04 | 13 |
| Rev-rem impl neurostim gen-rec CPT 63688 | $908.00 | $1,135.00 | $266.53 – $3,045.66 | 13 |
| Rev/rmvl gstr nstim eltrd CPT 43882 | $3,552.00 | $4,440.00 | $1,154.40 – $3,317.20 | 11 |
| Rev/rmv perph nstim eltrd ra CPT 64585 | $607.20 | $759.00 | $130.13 – $3,045.66 | 13 |
| Rev/rmv prph sac/gstr npg/r CPT 64595 | $645.60 | $807.00 | $207.51 – $3,045.66 | 13 |
| Rev rplcm arthrp 1ntrspc crv CPT 22861 | $5,440.80 | $6,801.00 | $1,768.26 – $5,286.27 | 11 |
| Rev rplcm rthrp 1ntrspc lmbr CPT 22862 | not published | not published | $1,986.40 – $5,296.58 | 10 |
| Rev/rplcmt sk-mnt crnl nstm CPT 61891 | $3,140.80 | $3,926.00 | $510.38 – $32,016.63 | 13 |
| Rev rplc/rmv thrc vrt tethrg CPT 22838 | $5,033.60 | $6,292.00 | $1,635.92 – $4,666.44 | 10 |
| Rev/rplct hpglsl nstm ary pg CPT 64583 | not published | not published | $779.00 – $11,043.98 | 12 |
| Revsc opn/prq tib/pero stent CPT 37234 | $18,817.60 | $23,522.00 | $240.83 – $12,016.02 | 13 |
| Rezafungin 200 mg intravenous solution HCPCS J0349 | $16.57 | $20.71 | $5.38 – $13.03 | 13 |
| Rf abltj nrv nrvtg si jt CPT 64625 | $2,441.60 | $3,052.00 | $178.91 – $475.60 | 11 |
| Rheumatoid factor qualitative CPT 86430 | $48.57 | $60.71 | $3.68 – $39.46 | 13 |
| Rheumatoid factor quantitative CPT 86431 | $48.57 | $60.71 | $3.40 – $39.46 | 13 |
| Rh ig IV CPT 90386 | not published | not published | $11.31 – $249.50 | 6 |
| Rh ig minidose im CPT 90385 | $80.00 | $100.00 | $26.00 – $106.50 | 7 |
| Rhinp prim lat&alr crtlge&/elvtn nsl tip CPT 30400 | $2,936.00 | $3,670.00 | $954.20 – $5,239.04 | 13 |
| Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe HCPCS J2791 | $9.60 | $12.00 | $3.12 – $6.66 | 8 |
| Rho d immune globulin 50 mcg HCPCS J2788 | $28.00 | $35.00 | $9.10 – $33.87 | 8 |
| Rho(d) immune globulin h, sd HCPCS J2792 | not published | not published | $26.28 – $42.85 | 10 |
| Rho d immune globulin inj HCPCS J2790 | $266.80 | $333.50 | $14.76 – $77.32 | 10 |
| Rho(d) immune globulin (rhig) human full dose im CPT 90384 | $132.00 | $165.00 | $42.90 – $233.19 | 7 |
| R hrt cath chd abnl nt cnj CPT 93594 | not published | not published | $0.03 – $4,802.13 | 12 |
| R hrt cath chd nml nt cnj CPT 93593 | not published | not published | $0.03 – $4,802.13 | 12 |
| Rhythm ecg with report CPT 93040 | $28.00 | $35.00 | $9.10 – $30.65 | 11 |
| Rib and Chest X-ray (3 views, left side) CPT 71101 | $254.62 | $318.27 | $9.88 – $183.96 | 15 |
| Rib and Chest X-ray (4 or more views, both sides) CPT 71111 | $254.62 | $318.27 | $12.22 – $183.96 | 15 |
| Rib cartilage graft CPT 21230 | $1,844.00 | $2,305.00 | $599.30 – $5,239.04 | 13 |
| Rib gusset (elastic) each HCPCS L1280 | not published | not published | $48.49 – $123.38 | 10 |
| Riboflavin 5'phos opth<=3ml HCPCS J2787 | not published | not published | $1,609.44 – $2,280.00 | 4 |
| Rib X-ray (3 views, both sides) CPT 71110 | $254.62 | $318.27 | $10.66 – $183.96 | 15 |
| Rifampin in ns IV syringe 3 mg/ml (neo/ped) - cnr HCPCS J2804 | not published | not published | $0.14 – $0.18 | 3 |
| Right ventric recording CPT 93603 | $1,198.18 | $1,497.72 | $64.48 – $1,075.14 | 15 |
| Rilonacept injection HCPCS J2793 | not published | not published | $26.21 – $33.50 | 6 |
| Ring barrier skin cx 1 9/16 adapt HCPCS A4411 | not published | not published | $3.55 – $9.04 | 10 |
| Ring flange plas/leather mol HCPCS L1110 | not published | not published | $180.86 – $460.23 | 10 |
| Ring flange plastic/leather HCPCS L1100 | not published | not published | $98.30 – $250.15 | 10 |
| Ring fx reform 11-13x17mm HCPCS L8610 | not published | not published | $350.48 – $891.88 | 10 |
| Ring ostmy barr adapt 48mm HCPCS A4385 | not published | not published | $3.55 – $9.04 | 10 |
| Risankizumab-rzaa 60 mg/ml intravenous solution HCPCS J2327 | $27.33 | $34.16 | $8.81 – $19.97 | 13 |
| Risk ascvd tst once pr 12 mo HCPCS G0537 | $34.40 | $43.00 | $8.33 – $44.48 | 10 |
| Risperidone microspheres 12.5 mg/2 ml inj HCPCS J2794 | $13.60 | $17.00 | $4.42 – $15.80 | 11 |
| Rituximab 10 mg/ml concentrate,intravenous HCPCS J9312 | $146.81 | $183.51 | $47.32 – $105.20 | 13 |
| Rituximab 1,400 mg/11.7 ml (120 mg/ml)-hyaluronidase subcutaneous soln HCPCS J9311 | not published | not published | $36.53 – $56.76 | 10 |
| Rituximab-abbs 10 mg/ml intravenous solution HCPCS Q5115 | $131.32 | $164.15 | $31.80 – $94.88 | 13 |
| Rituximab-arrx 10 mg/ml intravenous solution HCPCS Q5123 | $116.09 | $145.11 | $30.52 – $83.37 | 13 |
| Rituximab-pvvr 10 mg/ml intravenous solution HCPCS Q5119 | $112.07 | $140.08 | $2.20 – $27.83 | 13 |
| R&l hrt cath chd abnl nt cnj CPT 93597 | not published | not published | $0.03 – $2,848.53 | 12 |
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.