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 |
|---|---|---|---|---|
| Upper Back (Thoracic Spine) X-ray (3 views) CPT 72072 | $254.62 | $318.27 | $9.10 – $183.96 | 15 |
| Upper Endoscopy (EGD, diagnostic) CPT 43235 | $687.20 | $859.00 | $109.69 – $830.32 | 13 |
| Upper Endoscopy (EGD, with biopsy) CPT 43239 | $914.40 | $1,143.00 | $123.53 – $830.32 | 13 |
| Upper ext fx orthosis rad/ul HCPCS L3982 | $857.60 | $1,072.00 | $213.91 – $544.34 | 11 |
| Upper ext harvest for cabg1 seg 35600 CPT 35600 | $627.20 | $784.00 | $158.52 – $497.76 | 11 |
| Upper GI Barium X-ray (barium and gas) CPT 74246 | $468.18 | $585.22 | $25.48 – $338.26 | 15 |
| Upper GI Barium X-ray (barium only) CPT 74240 | $403.15 | $503.93 | $23.66 – $291.27 | 15 |
| Uppr gi scope w/submuc inj CPT 43236 | $916.80 | $1,146.00 | $123.53 – $830.32 | 13 |
| Urachal cyst/sinus excision 51500 CPT 51500 | $1,605.60 | $2,007.00 | $521.82 – $5,167.04 | 13 |
| Urea nitrogen CPT 84520 | $33.57 | $41.96 | $2.37 – $27.27 | 13 |
| Urea nitrogen 24 hour urine CPT 84540 | $33.57 | $41.96 | $3.34 – $27.27 | 13 |
| Urea nitrogen clearance CPT 84545 | $33.57 | $41.96 | $4.32 – $27.27 | 13 |
| Urea nitrogen semi-quant CPT 84525 | $10.40 | $13.00 | $3.08 – $7.18 | 10 |
| Ureteral embolization/occl CPT 50705 | $9,249.60 | $11,562.00 | $159.01 – $1,503.06 | 11 |
| Ureteral reflux study CPT 78740 | $1,422.67 | $1,778.33 | $22.10 – $1,027.87 | 15 |
| Ureter endoscopy CPT 50970 | $1,875.20 | $2,344.00 | $304.72 – $3,054.48 | 13 |
| Ureter endoscopy & biopsy CPT 50955 | $2,140.80 | $2,676.00 | $315.49 – $4,502.17 | 13 |
| Ureter endoscopy & biopsy CPT 50974 | $2,392.00 | $2,990.00 | $388.70 – $4,502.17 | 13 |
| Ureter endoscopy & catheter CPT 50972 | $1,812.80 | $2,266.00 | $294.58 – $3,054.48 | 13 |
| Ureter endoscopy & treatment CPT 50957 | $2,161.60 | $2,702.00 | $317.07 – $4,502.17 | 13 |
| Ureter endoscopy & treatment CPT 50961 | $1,947.20 | $2,434.00 | $282.65 – $4,502.17 | 13 |
| Ureter endoscopy & treatment CPT 50976 | $2,358.40 | $2,948.00 | $383.24 – $4,502.17 | 13 |
| Ureter endoscopy & treatment CPT 50980 | $1,803.20 | $2,254.00 | $293.02 – $4,502.17 | 13 |
| Ureteroneocystostomy 50780 CPT 50780 | $5,564.80 | $6,956.00 | $904.28 – $2,662.91 | 11 |
| Ureteroureterostomy 50760 CPT 50760 | $5,649.60 | $7,062.00 | $918.06 – $2,696.30 | 11 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | $989.31 | $1,236.63 | $12.74 – $714.77 | 15 |
| Urethrlys transvag with scope CPT 53500 | $1,883.20 | $2,354.00 | $612.04 – $3,054.48 | 13 |
| Urethrocystography void s&i CPT 74455 | $667.60 | $834.49 | $10.92 – $482.34 | 15 |
| Uric acid blood CPT 84550 | $33.57 | $41.96 | $2.71 – $27.27 | 13 |
| Uric acid urine CPT 84560 | $33.57 | $41.96 | $3.05 – $27.27 | 13 |
| Urinalysis glass test CPT 81020 | $11.20 | $14.00 | $3.64 – $6.58 | 10 |
| Urinalysis microscopic only CPT 81015 | $25.72 | $32.14 | $2.60 – $20.89 | 13 |
| Urinalysis qual/semiquant excpt ia CPT 81005 | $25.72 | $32.14 | $1.82 – $20.89 | 13 |
| Urinalysis (with microscopy) CPT 81001 | $25.72 | $32.14 | $2.60 – $20.89 | 13 |
| Urinalysis (without microscopy) CPT 81003 | $25.72 | $32.14 | $2.08 – $20.89 | 13 |
| Urinary bldr retent nuc study CPT 78730 | $173.60 | $217.00 | $6.24 – $16.03 | 11 |
| Urinary pouch on barr w/flng HCPCS A5073 | not published | not published | $2.18 – $5.56 | 10 |
| Urinary pouch w/barrier HCPCS A5071 | not published | not published | $4.19 – $10.66 | 10 |
| Urinary reflex study CPT 51792 | $605.60 | $757.00 | $45.76 – $132.69 | 13 |
| Urinary suspensory HCPCS A5105 | not published | not published | $28.42 – $72.32 | 10 |
| Urine Culture Test CPT 87086 | $38.58 | $48.22 | $4.84 – $31.34 | 13 |
| Urine flow measurement 51736 CPT 51736 | $34.40 | $43.00 | $4.16 – $114.16 | 13 |
| Urine ost pouch w faucet/tap HCPCS A4428 | not published | not published | $4.54 – $11.57 | 10 |
| Urine pregnancy test CPT 81025 | $25.72 | $32.14 | $5.98 – $20.89 | 13 |
| Urine screen for bacteria CPT 81007 | $60.00 | $75.00 | $4.70 – $41.97 | 10 |
| Urine shunt to intestine CPT 50815 | not published | not published | $1,106.06 – $2,947.70 | 10 |
| Urine specimen collect mult HCPCS P9615 | $18.40 | $23.00 | $1.80 – $22.96 | 10 |
| Urofollitropin, 75 iu HCPCS J3355 | not published | not published | $74.95 – $184.50 | 4 |
| Urography, antegrade CPT 74425 | $734.36 | $917.94 | $14.82 – $530.57 | 15 |
| Urography inf drip &/or bolus CPT 74410 | $476.28 | $595.35 | $19.24 – $344.11 | 15 |
| Urokinase 250,000 iu inj HCPCS J3365 | $522.40 | $653.00 | $169.78 – $636.63 | 4 |
| Urokinase 5000 iu injection HCPCS J3364 | not published | not published | $10.36 – $12.74 | 3 |
| Use 1st target lesion CPT 76982 | $167.20 | $209.00 | $17.16 – $94.18 | 13 |
| User adjustable heel height HCPCS L5990 | not published | not published | $1,087.26 – $2,766.75 | 10 |
| Ustekinumab 130 mg/26 ml intravenous solution HCPCS J3358 | $24.32 | $30.40 | $7.90 – $17.57 | 13 |
| Ustekinumab 45 mg/0.5 ml subcutaneous solution HCPCS J3357 | $253.60 | $317.00 | $82.42 – $323.91 | 10 |
| U/s trtmt, not leiomyomata HCPCS C9734 | not published | not published | $12,790.28 – $19,210.26 | 7 |
| Vaccine Administration (one shot) CPT 90471 | $91.09 | $113.86 | $13.83 – $65.81 | 15 |
| Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml CPT 91322 | $233.60 | $292.00 | $75.92 – $189.70 | 11 |
| Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml CPT 91321 | $233.60 | $292.00 | $75.92 – $189.70 | 11 |
| Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im CPT 91320 | $255.20 | $319.00 | $82.94 – $179.29 | 11 |
| Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im CPT 91319 | $171.20 | $214.00 | $55.64 – $114.11 | 11 |
| Vaccine covid-19 pfizer tris-sucrose 6mos-4yrs 3mcg/0.3ml im CPT 91318 | $128.00 | $160.00 | $41.60 – $85.22 | 11 |
| Vaccine dtap < 7 years im CPT 90700 | $116.08 | $145.10 | $10.14 – $94.32 | 10 |
| Vaccine dtap-hep b-ipv im CPT 90723 | $92.00 | $115.00 | $29.90 – $146.12 | 7 |
| Vaccine dtap-ipv 4-6 years im CPT 90696 | $89.60 | $112.00 | $29.12 – $98.73 | 6 |
| Vaccine dtap-ipv-hib-hepb im CPT 90697 | $320.60 | $400.75 | $49.40 – $260.49 | 10 |
| Vaccine dtap-ipv/hib im CPT 90698 | $107.20 | $134.00 | $34.84 – $150.02 | 7 |
| Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im CPT 90647 | $36.00 | $45.00 | $11.70 – $56.73 | 7 |
| Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im CPT 90648 | $91.48 | $114.35 | $10.66 – $74.33 | 10 |
| Vaccine hepatitis a (hepa) adult im CPT 90632 | $77.60 | $97.00 | $25.22 – $92.77 | 8 |
| Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im CPT 90636 | $119.20 | $149.00 | $38.74 – $182.65 | 7 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im CPT 90633 | $40.00 | $50.00 | $13.00 – $66.85 | 7 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 3 dose im CPT 90634 | $42.40 | $53.00 | $13.78 – $69.97 | 5 |
| Vaccine hepatitis b (hepb) adolescent 2 dose im CPT 90743 | $105.60 | $132.00 | $33.69 – $97.69 | 11 |
| Vaccine hepatitis b (hepb) adult 3 dose im CPT 90746 | $105.60 | $132.00 | $34.32 – $112.52 | 11 |
| Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im CPT 90739 | $306.24 | $382.80 | $52.78 – $221.26 | 13 |
| Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 | $48.00 | $60.00 | $15.60 – $45.14 | 11 |
| Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im CPT 90651 | $278.40 | $348.00 | $90.48 – $347.67 | 6 |
| Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im CPT 90649 | $230.40 | $288.00 | $74.88 – $216.07 | 5 |
| Vaccine influenza (iiv) preservative free antigen content im CPT 90662 | $78.40 | $98.00 | $19.08 – $103.07 | 13 |
| Vaccine influenza inactivated adjuvant im CPT 90653 | $76.00 | $95.00 | $24.70 – $103.07 | 10 |
| Vaccine influenza nos 0.5ml dose im CPT 90658 | $18.40 | $23.00 | $5.98 – $31.10 | 11 |
| Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im CPT 90656 | $22.40 | $28.00 | $7.28 – $33.19 | 11 |
| Vaccine influenza quadrivalent (iiv4) 0.5ml dose im CPT 90688 | $20.00 | $25.00 | $6.50 – $29.92 | 7 |
| Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im CPT 90694 | $72.80 | $91.00 | $23.66 – $100.57 | 6 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.25ml dose im CPT 90685 | $26.40 | $33.00 | $8.58 – $36.61 | 6 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im CPT 90686 | $21.60 | $27.00 | $7.02 – $31.93 | 7 |
| Vaccine influenza quadrivalent (iiv4) split virus 0.25 ml im CPT 90687 | $16.00 | $20.00 | $5.20 – $15.78 | 7 |
| Vaccine influenza quadrivalent live (laiv4) intranasal CPT 90672 | $28.00 | $35.00 | $9.10 – $36.12 | 7 |
| Vaccine influenza quadrivalent (riv4) rdna antibiotic/preservative free im CPT 90682 | $72.00 | $90.00 | $23.40 – $95.42 | 6 |
| Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im CPT 90661 | $30.40 | $38.00 | $9.88 – $51.97 | 10 |
| Vaccine influenza trivalent (iiv3) 0.25ml dose im CPT 90657 | $33.60 | $42.00 | $8.39 – $31.10 | 11 |
| Vaccine mengingoccocal serogroup b 2 dose im CPT 90620 | $428.00 | $535.00 | $68.12 – $347.75 | 10 |
| Vaccine mengingoccocal serogroup b 2 or 3 dose im CPT 90621 | $177.60 | $222.00 | $57.72 – $214.99 | 5 |
| Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im CPT 90619 | $156.00 | $195.00 | $50.70 – $188.69 | 5 |
| Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im CPT 90734 | $321.80 | $402.25 | $76.44 – $261.46 | 10 |
| Vaccine mmr live subcutaneous CPT 90707 | $222.36 | $277.95 | $28.08 – $180.67 | 10 |
| Vaccine mmrv live subcutaneous CPT 90710 | $288.00 | $360.00 | $93.60 – $637.36 | 7 |
| Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im CPT 90732 | $128.80 | $161.00 | $41.86 – $191.63 | 11 |
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.