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 |
|---|---|---|---|---|
| Devise bowel pouch CPT 44316 | $3,464.00 | $4,330.00 | $1,125.80 – $3,301.32 | 11 |
| Devlopment test interpt&rep HCPCS G0451 | $703.61 | $879.51 | $10.19 – $508.36 | 15 |
| Dev tst admin phys/qhp ea addl 30 min CPT 96113 | $137.60 | $172.00 | $44.72 – $137.23 | 11 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | $210.98 | $263.72 | $8.58 – $152.43 | 15 |
| Dexametha opth insert 0.1 mg HCPCS J1096 | not published | not published | $100.88 – $136.76 | 9 |
| Dexamethasone 0.4 mg/0.1 ml intraocular injection - cnr HCPCS J1095 | not published | not published | $1.15 – $1.18 | 3 |
| Dexamethasone 4 mg tablet HCPCS J8540 | $0.40 | $0.50 | $0.01 – $0.07 | 10 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $18.12 | $22.65 | $0.02 – $0.11 | 10 |
| Dexamethasone intra implant HCPCS J7312 | not published | not published | $205.24 – $267.30 | 10 |
| Dexamethasone panel CPT 80420 | $324.00 | $405.00 | $50.51 – $226.65 | 13 |
| Dexmedetomidine film, 1 mcg HCPCS J1105 | not published | not published | $0.58 – $0.67 | 7 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | $259.20 | $324.00 | $32.73 – $265.12 | 11 |
| Dextran 40 infusion HCPCS J7100 | not published | not published | $37.73 – $95.85 | 6 |
| Dextran 75 infusion HCPCS J7110 | not published | not published | $14.52 – $30.84 | 3 |
| Dextroamphetamine HCPCS S0160 | $0.44 | $0.55 | $0.14 – $1.38 | 10 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | $48.00 | $60.00 | $0.85 – $17.34 | 10 |
| Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 | $48.00 | $60.00 | $2.08 – $27.68 | 10 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | $48.00 | $60.00 | $1.68 – $34.68 | 10 |
| Dextrose 5 % IV bolus HCPCS J7070 | $48.00 | $60.00 | $1.56 – $34.68 | 10 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $56.00 | $70.00 | $13.34 – $44.69 | 13 |
| Diabetes (HbA1c) Test CPT 83036 | $33.57 | $41.96 | $5.83 – $27.27 | 13 |
| Diabetes training group per 30 min g0109 HCPCS G0136 | $36.00 | $45.00 | $8.33 – $44.48 | 13 |
| Diabetic custom molded shoe HCPCS A5501 | not published | not published | $132.94 – $338.29 | 10 |
| Diabetic shoe with wedge HCPCS A5504 | not published | not published | $21.32 – $57.53 | 10 |
| Diabetic shoe w/off set heel HCPCS A5506 | not published | not published | $21.32 – $57.53 | 10 |
| Diabetic shoe w/roller/rockr HCPCS A5503 | not published | not published | $21.32 – $57.53 | 10 |
| Diab manage trn ind/group HCPCS G0109 | $41.41 | $51.76 | $11.44 – $32.56 | 13 |
| Diab shoe for density insert HCPCS A5500 | $178.40 | $223.00 | $44.32 – $112.80 | 11 |
| Diab shoe w/metatarsal bar HCPCS A5505 | not published | not published | $21.32 – $57.53 | 10 |
| Diag bronchoscope/catheter CPT 31643 | $448.00 | $560.00 | $145.60 – $1,527.23 | 13 |
| Diag laparo separate proc 49320 CPT 49320 | $807.20 | $1,009.00 | $262.34 – $5,167.04 | 13 |
| Diagnostic anoscopy CPT 46601 | $355.20 | $444.00 | $75.71 – $353.40 | 13 |
| Diagnostic anoscopy & biopsy CPT 46607 | $496.80 | $621.00 | $111.48 – $1,044.22 | 13 |
| Diagnostic anoscopy spx 46600 CPT 46600 | $252.00 | $315.00 | $33.53 – $114.16 | 15 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | $382.40 | $478.00 | $44.46 – $138.70 | 7 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | $382.40 | $478.00 | $44.46 – $122.60 | 7 |
| Diagnostic laryngoscopy 31505 CPT 31505 | $212.80 | $266.00 | $44.98 – $171.93 | 15 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $300.80 | $376.00 | $52.68 – $171.93 | 15 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $285.60 | $357.00 | $28.34 – $184.34 | 13 |
| Diagnostic Mammogram (one breast) CPT 77065 | $226.40 | $283.00 | $23.14 – $147.47 | 13 |
| Diagnostic radio unlisted proc CPT 76499 | not published | not published | $77.97 – $131.45 | 9 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | $9,395.77 | $11,744.71 | $174.92 – $6,788.44 | 13 |
| Dialysis one evaluation CPT 90945 | $500.81 | $626.01 | $62.40 – $377.11 | 15 |
| Dialysis repeated eval CPT 90947 | $280.00 | $350.00 | $91.00 – $293.05 | 11 |
| Dialysis training complete CPT 90989 | $789.60 | $987.00 | $256.62 – $985.35 | 7 |
| Dialysis training incompl CPT 90993 | $172.00 | $215.00 | $55.90 – $214.60 | 7 |
| Diathermy eg microwave CPT 97024 | $13.60 | $17.00 | $4.42 – $10.89 | 11 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | $0.11 | $0.13 | $0.03 – $0.08 | 10 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $98.93 | $123.66 | $0.64 – $5.79 | 10 |
| Dicyclomine injection HCPCS J0500 | $132.40 | $165.50 | $11.96 – $28.94 | 10 |
| Difelikefalin, esrd on dialy HCPCS J0879 | not published | not published | $0.08 – $0.23 | 7 |
| Diffusing capacity CPT 94729 | $157.17 | $196.46 | $6.76 – $113.55 | 13 |
| Digital analysis of eeg CPT 95957 | $605.60 | $757.00 | $57.38 – $198.80 | 13 |
| Digit nerve surgery add-on CPT 64778 | $450.40 | $563.00 | $146.38 – $421.99 | 11 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $137.60 | $172.00 | $4.60 – $53.75 | 10 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | $7,687.80 | $9,609.75 | $2,498.54 – $6,044.53 | 13 |
| Digoxin total therapeutic drug level CPT 80162 | $66.43 | $83.03 | $7.97 – $53.97 | 13 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | $117.60 | $147.00 | $38.22 – $111.63 | 8 |
| Dilate biliary duct/ampulla CPT 47542 | $3,249.14 | $4,061.42 | $120.69 – $2,347.50 | 13 |
| Dilate esophagus CPT 43453 | $2,142.40 | $2,678.00 | $77.80 – $1,680.02 | 13 |
| Dilate esophagus 1/mult pass CPT 43450 | $420.80 | $526.00 | $71.53 – $830.32 | 13 |
| Dilate ic vasospasm ea add vsl diff territory CPT 61642 | not published | not published | $631.50 – $1,076.17 | 6 |
| Dilate ic vasospasm ea add vsl same territory CPT 61641 | not published | not published | $315.70 – $538.10 | 6 |
| Dilate ic vasospasm init CPT 61640 | not published | not published | $899.10 – $1,531.55 | 6 |
| Dilate tear duct opening CPT 68801 | $454.40 | $568.00 | $71.71 – $353.40 | 13 |
| Dilate urethra stricture CPT 53600 | $649.95 | $812.43 | $57.45 – $469.58 | 15 |
| Dilate urethra stricture CPT 53601 | $200.80 | $251.00 | $48.09 – $127.81 | 13 |
| Dilate urethra stricture CPT 53605 | $164.00 | $205.00 | $53.30 – $3,054.48 | 13 |
| Dilate urethra stricture CPT 53621 | $344.80 | $431.00 | $64.64 – $215.39 | 13 |
| Dilation/female urethra/initial 53660 CPT 53660 | $174.40 | $218.00 | $37.44 – $138.56 | 13 |
| Dilation of anal sphincter CPT 45905 | $416.80 | $521.00 | $135.46 – $1,044.22 | 13 |
| Dilation of cervical canal 57800 CPT 57800 | $172.80 | $216.00 | $43.07 – $2,815.86 | 13 |
| Dilation of rectal stricture 45910 CPT 45910 | $476.80 | $596.00 | $154.96 – $1,044.22 | 13 |
| Dilation of salivary duct CPT 42660 | $296.80 | $371.00 | $71.40 – $451.01 | 13 |
| Dilation of urethra CPT 53661 | $172.00 | $215.00 | $36.29 – $114.16 | 13 |
| Dilation of urethra CPT 53665 | $97.60 | $122.00 | $31.72 – $1,814.20 | 13 |
| Dilation of vagina CPT 57400 | $328.80 | $411.00 | $106.86 – $2,815.86 | 13 |
| Dilation salivary duct 42650 CPT 42650 | $193.60 | $242.00 | $53.85 – $1,311.86 | 13 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | $366.40 | $458.00 | $78.39 – $591.12 | 13 |
| Dilat xst trc ndurlgc px CPT 50436 | $2,837.82 | $3,547.27 | $124.54 – $3,054.48 | 15 |
| Dilat xst trc new access rcs CPT 50437 | $4,773.51 | $5,966.88 | $209.04 – $3,448.86 | 15 |
| Diltiazem 5 mg/ml intravenous solution HCPCS J1163 | $2.43 | $3.03 | $0.05 – $0.26 | 7 |
| Dimecaprol injection HCPCS J0470 | not published | not published | $40.93 – $67.88 | 5 |
| Dimenhydrinate injection HCPCS J1240 | not published | not published | $7.19 – $11.64 | 7 |
| Dimethyl sulfoxide 50% 50 ml HCPCS J1212 | $746.40 | $933.00 | $125.35 – $885.07 | 11 |
| Diphenhydramine 12.5 mg/5 ml oral elixir HCPCS Q0163 | $0.60 | $0.75 | $0.02 – $0.78 | 7 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $73.01 | $91.26 | $0.52 – $12.27 | 10 |
| Diphtheria-tetanus toxoids 0.5 ml (peds) CPT 90702 | $62.40 | $78.00 | $20.28 – $74.68 | 7 |
| Dipyridamole injection HCPCS J1245 | not published | not published | $1.13 – $4.83 | 7 |
| Direct advanced life support CPT 99288 | $236.00 | $295.00 | $76.70 – $301.56 | 5 |
| Dir nsl mucous membrane test CPT 95065 | $76.80 | $96.00 | $24.96 – $67.24 | 13 |
| Disability dlco CPT 94727 | $128.29 | $160.36 | $9.10 – $138.56 | 15 |
| Disaccharidases CPT 82657 | $64.28 | $80.35 | $13.30 – $52.23 | 13 |
| Disarticulation sho sec clsr CPT 23921 | $2,300.80 | $2,876.00 | $373.88 – $1,620.01 | 13 |
| Disarticulation shoulder CPT 23920 | not published | not published | $1,007.45 – $2,678.41 | 10 |
| Discectomy ant dcmprn cord thoracic 1 ntrspc 63077 CPT 63077 | $3,636.00 | $4,545.00 | $1,181.70 – $3,465.03 | 11 |
| Discectomy ant dcmprn cord thoracic ea ntrsp 63078 CPT 63078 | not published | not published | $173.45 – $462.93 | 10 |
| Discography cerv/thor spine CPT 72285 | $375.20 | $469.00 | $47.84 – $1,729.42 | 13 |
| Disconnect insert locking wr HCPCS L6616 | not published | not published | $38.84 – $98.84 | 10 |
| Disconnect locking wrist uni HCPCS L6615 | not published | not published | $114.18 – $290.54 | 10 |
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.