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 |
|---|---|---|---|---|
| Synch audio-only new low 30 CPT 98009 | $189.60 | $237.00 | $61.62 – $106.00 | 3 |
| Synch audio-only new mod 45 CPT 98010 | $289.60 | $362.00 | $94.12 – $167.10 | 3 |
| Synch audio-only new sf 15 CPT 98008 | $133.60 | $167.00 | $43.42 – $61.10 | 3 |
| Synojoynt, inj., 1 mg HCPCS J7331 | not published | not published | $6.45 – $17.71 | 6 |
| Synthetic sentence id test CPT 92576 | $80.80 | $101.00 | $26.26 – $99.11 | 13 |
| Synvisc or synvisc-one HCPCS J7325 | $26.40 | $33.00 | $8.58 – $14.21 | 11 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $48.57 | $60.71 | $2.64 – $39.46 | 13 |
| System pacing micra av HCPCS C1786 | $16,010.08 | $20,012.59 | $5,203.27 – $13,008.18 | 7 |
| System pcmkr dual chamber leadless micra av2 intrdcr cath HCPCS C1785 | $7,706.80 | $9,633.50 | $2,504.71 – $6,261.78 | 7 |
| T3 (triiodothyronine) free CPT 84481 | $55.00 | $68.75 | $10.16 – $44.69 | 13 |
| T3 (triiodothyronine) total CPT 84480 | $55.00 | $68.75 | $8.51 – $44.69 | 13 |
| T4 (thyroxine) free CPT 84439 | $55.00 | $68.75 | $5.41 – $44.69 | 13 |
| T4 (thyroxine) total CPT 84436 | $55.00 | $68.75 | $4.12 – $44.69 | 13 |
| Tacrol astagraf ex rel oral HCPCS J7508 | not published | not published | $0.53 – $0.72 | 7 |
| Tacrol envarsus ex rel oral HCPCS J7503 | not published | not published | $1.62 – $2.25 | 6 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | $3.23 | $4.03 | $0.06 – $0.24 | 10 |
| Tacrolimus 5 mg/ml intravenous solution HCPCS J7525 | not published | not published | $207.39 – $323.36 | 10 |
| Tacrolimus therapeutic drug level CPT 80197 | $66.43 | $83.03 | $8.24 – $53.97 | 13 |
| Tafasitamab-cxix 200 mg intravenous solution HCPCS J9349 | not published | not published | $13.33 – $17.67 | 10 |
| Tah rad debulk/lymph remove 58954 CPT 58954 | $5,380.00 | $6,725.00 | $1,748.50 – $5,196.36 | 11 |
| Tah rad dissect for debulk 58953 CPT 58953 | $4,964.80 | $6,206.00 | $1,613.56 – $4,804.11 | 11 |
| Tah w/mmk 58152 CPT 58152 | $3,129.60 | $3,912.00 | $1,017.12 – $2,968.87 | 11 |
| Tailbone (Sacrum and Coccyx) X-ray CPT 72220 | $190.96 | $238.70 | $7.02 – $137.97 | 15 |
| Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection HCPCS J9325 | not published | not published | $62.55 – $86.56 | 10 |
| Talquetamab-tgvs 2 mg/ml subcutaneous solution HCPCS J3055 | not published | not published | $67.61 – $83.26 | 8 |
| Talymed HCPCS Q4127 | not published | not published | $67.32 – $149.58 | 7 |
| Tamoxifen 10 mg tabs 60 each bottle HCPCS S0187 | $2.31 | $2.88 | $0.19 – $1.87 | 10 |
| Tap block bilat cont infusion 64489 CPT 64489 | $691.20 | $864.00 | $68.72 – $224.64 | 11 |
| Tap block uni by cont infusion 64487 CPT 64487 | $896.00 | $1,120.00 | $54.56 – $154.57 | 11 |
| Tape plstc 1inx5yd hosp tb pk HCPCS A4452 | not published | not published | $0.27 – $0.78 | 6 |
| Target gsa panel hmtlmph neop CPT 81450 | $1,519.20 | $1,899.00 | $236.97 – $1,063.42 | 13 |
| Target gsa panel organ/hmtlmph neop CPT 81455 | $5,839.20 | $7,299.00 | $910.92 – $4,087.71 | 13 |
| Target gsa panel organ neop CPT 81445 | $1,196.00 | $1,495.00 | $186.55 – $837.13 | 13 |
| Tarlatamab-dlle 10 mg intravenous solution HCPCS J9026 | not published | not published | $1,570.76 – $1,802.61 | 8 |
| Tas congenital car anomal CPT 33741 | $1,882.40 | $2,353.00 | $611.78 – $1,720.01 | 11 |
| Tattooing/intraderm 6.1-20.0 sq cm 11921 CPT 11921 | $520.00 | $650.00 | $116.63 – $542.11 | 13 |
| Tavr perq femoral CPT 33361 | $2,966.40 | $3,708.00 | $964.08 – $2,768.38 | 11 |
| Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe HCPCS J1447 | $1.74 | $2.17 | $0.26 – $1.25 | 13 |
| Tbp gene detc abnor alleles CPT 81344 | not published | not published | $82.20 – $191.82 | 9 |
| Tbs dxa cal w/i&r fx risk CPT 77089 | not published | not published | $35.56 – $76.23 | 10 |
| Tbs i&r fx rsk qhp CPT 77092 | not published | not published | $8.98 – $19.09 | 10 |
| Tbs techl calculation only CPT 77091 | not published | not published | $24.07 – $77.97 | 12 |
| Tbs techl prep&transmis data CPT 77090 | not published | not published | $2.51 – $77.97 | 12 |
| Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells CPT 86481 | $200.00 | $250.00 | $35.75 – $140.00 | 13 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $153.60 | $192.00 | $35.75 – $96.42 | 13 |
| Tc-99m apcitide diag HCPCS A9504 | $1,447.32 | $1,809.15 | $470.38 – $1,175.95 | 8 |
| Tc-99m arcitumomab HCPCS A9568 | not published | not published | $809.51 – $2,793.54 | 9 |
| Tc-99m bicisate HCPCS A9557 | $7,357.29 | $9,196.61 | $554.75 – $5,977.80 | 13 |
| Tc-99m depreotide HCPCS A9536 | not published | not published | $1,038.38 – $1,863.13 | 3 |
| Tc-99m diag per dose HCPCS A4641 | not published | not published | $138.18 – $163.94 | 2 |
| Tc-99m disofenin HCPCS A9510 | not published | not published | $63.98 – $164.79 | 4 |
| Tc-99m exame autol wbc diag per dose HCPCS A9569 | not published | not published | $1,040.32 – $4,170.89 | 8 |
| Tc-99m exametazime diag HCPCS A9521 | not published | not published | $802.34 – $3,729.39 | 9 |
| Tc-99m graphite crucible HCPCS A9506 | not published | not published | $328.60 – $345.03 | 6 |
| Tc-99m labeled rbc HCPCS A9560 | $384.60 | $480.75 | $40.82 – $312.49 | 10 |
| Tc-99m maa HCPCS A9540 | $362.76 | $453.44 | $17.94 – $294.74 | 10 |
| Tc-99m mebrofenin HCPCS A9537 | $168.27 | $210.33 | $8.05 – $136.71 | 10 |
| Tc-99m medronate HCPCS A9503 | $240.38 | $300.47 | $13.00 – $195.31 | 10 |
| Tc-99m mertiatide HCPCS A9562 | $966.40 | $1,208.00 | $240.33 – $883.24 | 10 |
| Tc-99m non-heu per study dose HCPCS Q9969 | $8.00 | $10.00 | $2.60 – $10.50 | 13 |
| Tc-99m oxidronate HCPCS A9561 | $66.20 | $82.75 | $19.50 – $75.70 | 10 |
| Tc-99m pentetate dtpa HCPCS A9539 | $524.46 | $655.57 | $12.22 – $426.12 | 8 |
| Tc-99m pentetate dtpa aerosol HCPCS A9567 | $349.64 | $437.05 | $20.97 – $284.08 | 8 |
| Tc-99m pertechnetate per mci HCPCS A9512 | $8.04 | $10.05 | $1.26 – $6.53 | 10 |
| Tc-99m pyroph diag per dose up to 25 mci HCPCS A9538 | $61.59 | $76.98 | $17.30 – $73.02 | 10 |
| Tc-99m sestamibi p study dose HCPCS A9500 | $373.60 | $467.00 | $69.56 – $450.58 | 10 |
| Tc-99m succimer (dmsa) HCPCS A9551 | $698.97 | $873.71 | $192.81 – $683.34 | 10 |
| Tc-99m sulfur colloid HCPCS A9541 | $515.72 | $644.65 | $80.29 – $419.02 | 10 |
| Tc-99m tetrofosmin p study dose HCPCS A9502 | $487.60 | $609.49 | $97.21 – $396.17 | 10 |
| Tc-99m tilmanocept diag HCPCS A9520 | $725.50 | $906.87 | $235.79 – $754.20 | 10 |
| Tca peel dermal 15789 CPT 15789 | $1,324.80 | $1,656.00 | $374.71 – $993.70 | 13 |
| Tcd emboli detect w/inj CPT 93893 | $764.80 | $956.00 | $43.94 – $142.22 | 13 |
| Tcd emboli detect without inj CPT 93892 | $666.40 | $833.00 | $43.68 – $184.99 | 15 |
| Tcd vasoreactivity study CPT 93890 | not published | not published | $91.20 – $133.92 | 5 |
| T-cell depletion of harvest CPT 38210 | not published | not published | $148.20 – $447.36 | 9 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $110.00 | $137.50 | $28.19 – $89.38 | 13 |
| T cells absolute cd 4 count CPT 86361 | $110.00 | $137.50 | $16.07 – $89.38 | 13 |
| T cells total count CPT 86359 | $110.00 | $137.50 | $22.64 – $89.38 | 13 |
| Tcranial magn stim tx deli CPT 90868 | $312.00 | $390.00 | $39.40 – $387.56 | 13 |
| Tcranial magn stim tx plan CPT 90867 | $513.60 | $642.00 | $114.09 – $604.55 | 13 |
| Tcran magn stim redetemine CPT 90869 | $635.20 | $794.00 | $91.27 – $642.20 | 13 |
| Tdh sdrl/ventr pnxr CPT 61105 | $1,087.20 | $1,359.00 | $353.34 – $1,084.22 | 11 |
| Teaec w/wo patch graft iliofemoral CPT 35355 | $5,030.40 | $6,288.00 | $817.44 – $2,341.06 | 11 |
| Team conf without pat by hc pro CPT 99368 | $67.20 | $84.00 | $21.84 – $83.75 | 7 |
| Team conf without pat by phys CPT 99367 | $102.40 | $128.00 | $33.28 – $127.29 | 7 |
| Team conf w/pat by hc prof CPT 99366 | $78.40 | $98.00 | $25.48 – $95.88 | 7 |
| Tebentafusp-tebn 100 mcg/0.5 ml intravenous solution HCPCS J9274 | not published | not published | $214.56 – $271.60 | 10 |
| Tee w or without fol w/cont,cong HCPCS C8926 | $1,711.58 | $2,139.47 | $556.26 – $1,390.66 | 12 |
| Tee w or without fol w/cont, mon HCPCS C8927 | not published | not published | $785.36 – $1,179.56 | 7 |
| Teflon or equal cable lining HCPCS L6665 | not published | not published | $27.58 – $70.17 | 10 |
| Telavancin injection HCPCS J3095 | not published | not published | $6.34 – $9.16 | 10 |
| Telehealth original site facility fee HCPCS Q3014 | $61.60 | $77.00 | $10.24 – $70.53 | 10 |
| Telethx isodose plan cplx CPT 77307 | $848.72 | $1,060.90 | $79.30 – $613.20 | 15 |
| Telethx isodose plan simple CPT 77306 | $848.72 | $1,060.90 | $43.68 – $613.20 | 15 |
| Temozolomide HCPCS J8700 | not published | not published | $0.23 – $5.53 | 7 |
| Temozolomide 100 mg intravenous solution HCPCS J9328 | not published | not published | $10.23 – $13.52 | 10 |
| Temperature gradient studies CPT 93740 | $19.20 | $24.00 | $2.82 – $160.10 | 12 |
| Temple bne implnt w/stimulat CPT 69715 | not published | not published | $2,418.00 – $2,418.00 | 2 |
| Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln HCPCS J9330 | $77.60 | $97.00 | $25.22 – $77.89 | 11 |
| Tendon lengthening CPT 26476 | $1,493.60 | $1,867.00 | $485.42 – $2,873.50 | 13 |
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.