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 |
|---|---|---|---|---|
| Clsd tx pelvic ring fx CPT 27198 | $760.00 | $950.00 | $212.45 – $753.66 | 13 |
| Clsd tx prox fib/shaft fx w/manip 27781 CPT 27781 | $2,842.32 | $3,552.90 | $344.50 – $2,053.58 | 15 |
| Clsd tx/prox/mid phalnx fx/no manp 26720 CPT 26720 | $797.42 | $996.77 | $157.30 – $576.13 | 15 |
| Clsd tx/radial head/neck fx/no manip 24650 CPT 24650 | $1,281.60 | $1,602.00 | $208.26 – $522.84 | 15 |
| Clsd tx radius fracture w/manip 24655 CPT 24655 | $2,163.20 | $2,704.00 | $226.18 – $1,417.36 | 15 |
| Clsd tx/scapular fx without manip 23570 CPT 23570 | $1,140.80 | $1,426.00 | $185.38 – $602.90 | 13 |
| Clsd tx shoulder dislc/fx 23665 CPT 23665 | $2,102.40 | $2,628.00 | $303.02 – $1,417.36 | 15 |
| Clsd tx shoulder disloc w/anatom neck fx w/manip 23675 CPT 23675 | $2,708.80 | $3,386.00 | $440.18 – $1,859.08 | 15 |
| Clsd tx/shoulder dislo/manip/anest 23655 CPT 23655 | $1,985.60 | $2,482.00 | $322.66 – $1,417.36 | 15 |
| Clsd tx/talotarsal dislocat/anes 28575 CPT 28575 | $1,814.40 | $2,268.00 | $294.84 – $2,873.50 | 13 |
| Clsd tx temporomandibular dislocat 21480 CPT 21480 | $1,208.93 | $1,511.16 | $27.85 – $873.45 | 15 |
| Clsd tx toe dislocation without anes28660 CPT 28660 | $797.42 | $996.77 | $85.56 – $576.13 | 15 |
| Clsd tx trimall ankle fx without manip 27816 CPT 27816 | $1,600.00 | $2,000.00 | $55.06 – $596.80 | 15 |
| Clsd tx trimall ankle fx w/manip 27818 CPT 27818 | $2,387.20 | $2,984.00 | $375.27 – $1,417.36 | 15 |
| Clsd tx/ulnar shaft fx without manip 25530 CPT 25530 | $1,283.20 | $1,604.00 | $208.52 – $522.84 | 15 |
| Clsd tx vert body fx without manip req &w/csting/bracing CPT 22310 | $2,836.02 | $3,545.02 | $212.45 – $2,049.02 | 15 |
| Clsd tx wrist carpal fx without manip 25630 CPT 25630 | $1,497.60 | $1,872.00 | $212.45 – $580.10 | 15 |
| Clsd tx wrist scaphoid fx without manip 25622 CPT 25622 | $1,496.00 | $1,870.00 | $212.45 – $579.50 | 15 |
| Clsd tx wrist trans-scaph fx w/manip 25680 CPT 25680 | $2,572.80 | $3,216.00 | $212.45 – $1,293.25 | 13 |
| Clsd tx wrist ulnar styloid fx 25650 CPT 25650 | $1,596.80 | $1,996.00 | $212.45 – $621.90 | 15 |
| Clsd/ulnar fx/prox end without manip 24670 CPT 24670 | $1,425.60 | $1,782.00 | $212.45 – $547.17 | 15 |
| Clsr 1 vsd w/wo patch w/vlvt CPT 33684 | not published | not published | $1,618.36 – $4,325.57 | 10 |
| Clsr 1vsd w/wo ptch rmvl bnd CPT 33688 | not published | not published | $1,609.54 – $4,305.46 | 10 |
| Cls tx of heel fracture w/manip 28405 CPT 28405 | $1,921.60 | $2,402.00 | $137.66 – $816.30 | 15 |
| Cltx carpl scphd fx w/mnpj CPT 25624 | $2,368.00 | $2,960.00 | $384.80 – $1,417.36 | 15 |
| Cltx craniofacial separation CPT 21431 | not published | not published | $629.43 – $1,675.04 | 10 |
| Cltx gr hmrl tbrs fx w/mnpj CPT 23625 | $1,865.60 | $2,332.00 | $303.16 – $1,417.36 | 13 |
| Cltx hum epcndylr fx wo mnpj CPT 24560 | $1,609.60 | $2,012.00 | $137.66 – $599.40 | 15 |
| Cltx humrl cndylr fx w/mnpj CPT 24577 | $2,886.72 | $3,608.40 | $439.92 – $2,085.66 | 15 |
| Cltx humrl cndylr fx wo mnpj CPT 24576 | $1,692.80 | $2,116.00 | $137.66 – $637.90 | 15 |
| Cltx lunate dislc w/mnpj CPT 25690 | $2,384.00 | $2,980.00 | $387.40 – $1,417.36 | 15 |
| Cltx mndblr fx ntrdntl fixj CPT 21453 | $2,468.80 | $3,086.00 | $802.36 – $5,239.04 | 13 |
| Cltx mndblr fx w/mnpj CPT 21451 | $1,864.80 | $2,331.00 | $577.32 – $1,543.94 | 13 |
| Cltx mndblr/max alv ridge fx CPT 21440 | $2,466.88 | $3,083.60 | $501.54 – $2,872.13 | 15 |
| Cltx palatal/max fx wire fix CPT 21421 | $1,664.00 | $2,080.00 | $497.59 – $2,872.13 | 13 |
| Cltx post ankle fx CPT 27767 | $1,408.00 | $1,760.00 | $212.45 – $718.71 | 13 |
| Cltx post ankle fx w/mnpj CPT 27768 | $2,172.80 | $2,716.00 | $89.92 – $1,417.36 | 15 |
| Cltx scap fx w/mnpj +-tractj CPT 23575 | $1,985.60 | $2,482.00 | $322.66 – $1,417.36 | 13 |
| Cltx strnclav dislc w/mnpj CPT 23525 | $1,908.80 | $2,386.00 | $155.45 – $736.70 | 15 |
| Cltx thigh fx CPT 27267 | $2,148.80 | $2,686.00 | $349.18 – $2,873.50 | 13 |
| Cltx thigh fx w/mnpj CPT 27268 | $2,659.20 | $3,324.00 | $432.12 – $1,315.04 | 11 |
| Cltx tmprmand dislc comp CPT 21485 | $4,342.40 | $5,428.00 | $689.43 – $1,876.39 | 13 |
| Cmbn ant pst colprhy CPT 57260 | $1,937.60 | $2,422.00 | $629.72 – $4,371.83 | 13 |
| C motor evoked lwr limbs CPT 95929 | $985.86 | $1,232.32 | $58.76 – $712.28 | 15 |
| C motor evoked uppr limbs CPT 95928 | $985.86 | $1,232.32 | $58.76 – $901.02 | 15 |
| C motor evoked upr&lwr limbs CPT 95939 | $1,478.32 | $1,847.90 | $87.88 – $1,068.09 | 15 |
| Cmp rpr tof wo plm atrs ptch CPT 33694 | not published | not published | $1,671.21 – $4,467.71 | 10 |
| Cmptr ophth dx img ant segmt CPT 92132 | $65.60 | $82.00 | $9.62 – $52.60 | 13 |
| Cmptr ophth img optic nerve CPT 92133 | $80.80 | $101.00 | $9.62 – $52.60 | 13 |
| #cms hgb-carboxyhemoglobin CPT 82376 | $64.28 | $80.35 | $5.36 – $52.23 | 13 |
| #cms hgb-sulfhemoglobin CPT 83060 | $33.57 | $41.96 | $5.28 – $27.27 | 13 |
| #cmvcul-virus inoculation shell CPT 87254 | $39.20 | $49.00 | $11.74 – $31.34 | 13 |
| Cmv ig IV CPT 90291 | not published | not published | $30.26 – $2,044.80 | 5 |
| Cmv pcr-sendout CPT 87496 | $88.80 | $111.00 | $21.05 – $54.59 | 13 |
| Cnbp gene detc abnor allele CPT 81187 | not published | not published | $82.20 – $191.82 | 9 |
| Cntct lens hydrophil photoch HCPCS V2524 | not published | not published | $87.59 – $317.48 | 10 |
| Co2 monitor per day CPT 94681 | $115.20 | $144.00 | $7.80 – $275.78 | 13 |
| Coagulation factor viia 1,000 mcg/ml inj 1 ml HCPCS J7189 | not published | not published | $2.44 – $3.16 | 10 |
| Coagulation time activated teg CPT 85347 | $32.85 | $41.06 | $2.57 – $26.69 | 13 |
| Coagulation time lee & white CPT 85345 | $11.20 | $14.00 | $2.81 – $6.72 | 10 |
| Coagulation time otr method CPT 85348 | $11.20 | $14.00 | $2.69 – $6.28 | 10 |
| Cocaine 4 % nasal solution HCPCS C9046 | not published | not published | $1.68 – $1.68 | 2 |
| Cocaine hcl nasal (numbrino) HCPCS C9143 | $1.77 | $2.21 | $0.57 – $2.24 | 9 |
| Coccidioidomycosis skin test CPT 86490 | not published | not published | $13.15 – $92.70 | 5 |
| Coch imp ext proc/contr rplc HCPCS L8619 | not published | not published | $4,877.11 – $12,410.85 | 10 |
| Coch implant headset replace HCPCS L8615 | not published | not published | $270.29 – $687.82 | 10 |
| Coch implant microphone repl HCPCS L8616 | not published | not published | $62.96 – $160.21 | 10 |
| Coch implant tran cable repl HCPCS L8618 | not published | not published | $15.72 – $40.00 | 10 |
| Coch implant trans coil repl HCPCS L8617 | not published | not published | $54.98 – $139.92 | 10 |
| Cochlear implt f/up exam <7 CPT 92601 | $369.60 | $462.00 | $113.23 – $296.09 | 13 |
| Cochlear implt f/up exam 7/> CPT 92603 | $345.60 | $432.00 | $110.14 – $287.95 | 13 |
| Cocm by rhc/fqhc 60 min mo HCPCS G0512 | $304.00 | $380.00 | $75.10 – $172.77 | 10 |
| Codeine 15 mg/ml inj 2 ml HCPCS J0745 | not published | not published | $1.23 – $2.21 | 4 |
| Cogenex amnio memb per sq cm HCPCS Q4229 | not published | not published | $137.82 – $896.43 | 6 |
| Cold agglutinin screen (arc) CPT 86156 | $48.57 | $60.71 | $4.84 – $39.46 | 13 |
| Cold agglutinin titer CPT 86157 | $48.57 | $60.71 | $4.84 – $39.46 | 13 |
| Colectomy/end colost/close dis seg 44143 CPT 44143 | $4,085.60 | $5,107.00 | $1,327.82 – $3,859.49 | 11 |
| Colectomy/ ileostomy without prctect 44150 CPT 44150 | $4,586.40 | $5,733.00 | $1,490.58 – $4,340.99 | 11 |
| Colectomy/ ileostomy w/prctect 44155 CPT 44155 | $5,118.40 | $6,398.00 | $1,663.48 – $4,856.68 | 11 |
| Colectomy partial w/anastomosis 44140 CPT 44140 | $3,296.80 | $4,121.00 | $1,071.46 – $3,142.03 | 11 |
| Colectomy prtl abdominal + transanal appr 44147 CPT 44147 | $4,771.20 | $5,964.00 | $1,550.64 – $4,513.29 | 11 |
| Colectomy prtl w/coloproctostomy 44145 CPT 44145 | $4,078.40 | $5,098.00 | $1,325.48 – $3,872.55 | 11 |
| Colectomy prtl w/coloproctostomy + colostomy 44146 CPT 44146 | $5,203.20 | $6,504.00 | $1,691.04 – $4,916.81 | 11 |
| Colectomy prtl w/remove terminal ileum+ileocolos 44160 CPT 44160 | $3,053.60 | $3,817.00 | $992.42 – $2,910.52 | 11 |
| Colectomy prtl w/skin level cecost/colostomy 44141 CPT 44141 | $4,476.80 | $5,596.00 | $1,454.96 – $4,236.77 | 11 |
| Colectomy/w colostomy or ileostomy 44144 CPT 44144 | $4,344.00 | $5,430.00 | $1,411.80 – $4,123.08 | 11 |
| Colectomy w/ileoanal anast CPT 44157 | $5,367.20 | $6,709.00 | $1,744.34 – $5,082.30 | 11 |
| Colectomy w/neo-rectum pouch CPT 44158 | $5,500.80 | $6,876.00 | $1,787.76 – $5,208.31 | 11 |
| Colistimethate sodium inj HCPCS J0770 | not published | not published | $10.90 – $18.09 | 7 |
| Collagenase, clost hist inj HCPCS J0775 | $73.60 | $92.00 | $23.92 – $86.15 | 11 |
| Collagen based wound filler HCPCS A6010 | not published | not published | $15.45 – $54.94 | 10 |
| Collagen dressing <=16 sq in HCPCS A6021 | $59.20 | $74.00 | $14.65 – $37.30 | 11 |
| Collagen drsg>16<=48 sq in HCPCS A6022 | not published | not published | $14.65 – $37.30 | 10 |
| Collagen dsg wound filler HCPCS A6024 | not published | not published | $4.31 – $10.97 | 10 |
| Collagen gel/paste wound fil HCPCS A6011 | not published | not published | $2.00 – $4.06 | 10 |
| Collagen imp urinary 2.5 ml HCPCS L8603 | not published | not published | $262.21 – $667.24 | 10 |
| Collarbone (Clavicle) X-ray (both sides) CPT 73000 | $190.96 | $238.70 | $6.76 – $137.97 | 15 |
| Collar cerv 18.25x3.5in serp firm density sm HCPCS L0120 | $80.00 | $100.00 | $19.89 – $50.61 | 11 |
| Collar cerv adlt perfit ace extric HCPCS L0140 | $192.80 | $241.00 | $47.98 – $122.08 | 11 |
| Collar cerv ascend 172 reg HCPCS L0172 | $289.60 | $362.00 | $72.16 – $183.63 | 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.