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 |
|---|---|---|---|---|
| Ghs removal intranasal foreign body CPT 30300 | $464.00 | $580.00 | $65.63 – $225.50 | 15 |
| Ghs removal pharyngeal foreign body CPT 42809 | $579.32 | $724.14 | $113.77 – $418.55 | 15 |
| Ghs repair extensor tendon hand, ea tendon CPT 26410 | $1,926.55 | $2,408.18 | $459.68 – $1,450.19 | 15 |
| Ghs repair tendon ext forearm/wrist ea CPT 25270 | $1,212.80 | $1,516.00 | $394.16 – $2,873.50 | 13 |
| Ghs respiratory syncytical virus igg/m CPT 86756 | $48.57 | $60.71 | $9.53 – $39.46 | 13 |
| Ghs reticulocyte count CPT 85044 | $33.57 | $41.96 | $2.59 – $27.27 | 13 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | $38.58 | $48.22 | $8.35 – $31.34 | 13 |
| Ghs sedimentation rate CPT 85651 | $33.57 | $41.96 | $3.38 – $27.27 | 13 |
| Ghs semen analysis fert CPT 89320 | $56.44 | $70.54 | $10.14 – $45.85 | 13 |
| Ghs semen analysis, post-vas CPT 89300 | $56.44 | $70.54 | $8.06 – $45.85 | 13 |
| Ghs sensitivity (per antimicro) CPT 87184 | $38.58 | $48.22 | $4.49 – $31.34 | 13 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $493.58 | $616.97 | $83.07 – $356.61 | 15 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $932.37 | $1,165.46 | $111.95 – $673.64 | 15 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $493.58 | $616.97 | $102.42 – $356.61 | 15 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | $932.37 | $1,165.46 | $124.02 – $673.64 | 15 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $341.60 | $427.00 | $65.56 – $176.65 | 15 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $315.20 | $394.00 | $64.60 – $179.05 | 15 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $412.80 | $516.00 | $78.44 – $189.77 | 15 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | $777.43 | $971.78 | $127.33 – $561.69 | 15 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | $432.00 | $540.00 | $140.40 – $407.17 | 13 |
| Ghs sleep study unattended CPT 95800 | $556.76 | $695.95 | $30.68 – $402.26 | 15 |
| Ghs somatosensory testing lower extremit CPT 95926 | $540.67 | $675.83 | $24.26 – $390.63 | 15 |
| Ghs somatosensory testing upper & lower limbs CPT 95938 | $928.23 | $1,160.28 | $33.80 – $670.64 | 15 |
| Ghs speech-gen aug dev eval iii, st CPT 92608 | $295.08 | $368.85 | $37.44 – $213.20 | 13 |
| Ghs sphenopalatine ganglion block CPT 64505 | $616.00 | $770.00 | $92.87 – $261.43 | 13 |
| Ghs spont nystagmus CPT 92541 | $70.40 | $88.00 | $2.82 – $114.16 | 13 |
| Ghs sp train/fitting sp device - kx CPT 92609 | $240.80 | $301.00 | $65.58 – $158.65 | 13 |
| Ghs st - eval for alt comm CPT 92567 | $35.20 | $44.00 | $9.87 – $34.76 | 13 |
| Ghs strapping shoulder - 29240 CPT 29240 | $254.17 | $317.71 | $16.60 – $183.64 | 15 |
| Ghs st - re-eval for alt comm CPT 92597 | $295.08 | $368.85 | $56.16 – $213.20 | 13 |
| Ghs subcutaneous infus, for therapy ea. add. hr CPT 96370 | $115.72 | $144.65 | $10.92 – $83.61 | 15 |
| Ghs subcutaneous infus. for therapy init 1 hr CPT 96369 | $342.40 | $428.00 | $111.28 – $329.97 | 13 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $738.56 | $923.20 | $170.10 – $542.11 | 15 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | $695.93 | $869.91 | $126.41 – $502.81 | 15 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | $800.00 | $1,000.00 | $260.00 – $1,311.86 | 13 |
| Ghs trypsin (fecal) CPT 84488 | $18.40 | $23.00 | $4.38 – $11.35 | 10 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $797.42 | $996.77 | $212.45 – $626.97 | 15 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | $1,491.20 | $1,864.00 | $212.45 – $571.87 | 13 |
| Ghs urine, hydroxproline total CPT 83505 | $61.60 | $77.00 | $14.58 – $37.81 | 10 |
| Ghs urine, porphyrins quant CPT 84120 | $64.28 | $80.35 | $8.83 – $52.23 | 13 |
| Ghs vaginal delivery only CPT 59409 | $1,640.80 | $2,051.00 | $490.97 – $2,815.86 | 15 |
| Ghs veeg 12-26 hr intmt mont CPT 95715 | $990.36 | $1,237.95 | $321.87 – $804.67 | 15 |
| Ghs windowing of cast CPT 29730 | $152.00 | $190.00 | $39.77 – $139.75 | 13 |
| Giardia ag if CPT 87269 | $38.58 | $48.22 | $8.17 – $31.34 | 13 |
| Giardia lamblia antibody CPT 86674 | $48.57 | $60.71 | $8.83 – $39.46 | 13 |
| Gi endoscopic ultrasound CPT 76975 | $415.20 | $519.00 | $27.82 – $214.07 | 13 |
| Gi inhouse confirmation CPT 87045 | $38.58 | $48.22 | $5.66 – $31.34 | 13 |
| Gingivoplasty each quadrant CPT 41872 | $1,095.20 | $1,369.00 | $276.19 – $2,872.13 | 13 |
| Gi protein loss CPT 78282 | $700.00 | $875.00 | $12.74 – $355.87 | 13 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | $1,981.60 | $2,477.00 | $102.88 – $1,411.60 | 15 |
| Gi trc img intral colon i&r CPT 91113 | $2,124.80 | $2,656.00 | $91.78 – $1,361.19 | 15 |
| Gi trc img intral esophagus CPT 91111 | $1,844.80 | $2,306.00 | $38.22 – $830.32 | 13 |
| Gi wireless capsule measure CPT 91112 | $3,660.00 | $4,575.00 | $96.43 – $830.32 | 13 |
| Gjb2 gene full sequence CPT 81252 | $202.40 | $253.00 | $41.55 – $141.59 | 13 |
| Gjb2 gene known fam variants CPT 81253 | not published | not published | $36.91 – $86.13 | 9 |
| Gjb6 gene com variants CPT 81254 | not published | not published | $21.00 – $48.99 | 9 |
| Glassia injection HCPCS J0257 | $7.20 | $9.00 | $2.34 – $6.96 | 11 |
| Glaucoma scrn hgh risk direc HCPCS G0117 | $115.20 | $144.00 | $24.34 – $151.01 | 11 |
| Glaucoma scrn hgh risk direc HCPCS G0118 | $88.00 | $110.00 | $28.60 – $98.80 | 11 |
| Glaucoma surgery CPT 66150 | $4,344.00 | $5,430.00 | $705.90 – $3,562.73 | 13 |
| Glaucoma surgery CPT 66155 | $4,340.80 | $5,426.00 | $705.38 – $3,562.73 | 13 |
| Glaucoma surgery CPT 66160 | $4,896.00 | $6,120.00 | $795.60 – $2,379.17 | 13 |
| Glaucoma surgery CPT 66170 | $5,425.60 | $6,782.00 | $881.66 – $2,639.24 | 13 |
| Glove finger flexion right lg xl HCPCS L3912 | $259.20 | $324.00 | $64.53 – $164.22 | 11 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $519.28 | $649.10 | $38.08 – $205.58 | 13 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | $474.32 | $592.90 | $21.20 – $152.13 | 13 |
| Glucagon plasma - sendout CPT 82943 | $55.00 | $68.75 | $8.57 – $44.69 | 13 |
| Glucagon tolerance panel CPT 80422 | $116.00 | $145.00 | $27.64 – $71.67 | 10 |
| Glucagon tolerance panel CPT 80424 | $127.20 | $159.00 | $30.30 – $78.55 | 10 |
| Glucagon tolerance test CPT 82946 | $36.00 | $45.00 | $10.66 – $24.89 | 10 |
| Glucose 1 hr post dose CPT 82950 | $33.57 | $41.96 | $3.90 – $27.27 | 13 |
| Glucose-6-phosphate dhydrogenase screen CPT 82960 | $33.57 | $41.96 | $3.63 – $27.27 | 13 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $33.57 | $41.96 | $2.34 – $27.27 | 13 |
| Glucose blood quantitative CPT 82947 | $33.57 | $41.96 | $3.38 – $27.27 | 13 |
| Glucose body fluid CPT 82945 | $33.57 | $41.96 | $3.38 – $27.27 | 13 |
| Glucose monitoring continual min 72hr pt CPT 95249 | $116.00 | $145.00 | $37.70 – $150.80 | 13 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $64.28 | $80.35 | $9.62 – $52.23 | 13 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $33.57 | $41.96 | $3.38 – $27.27 | 13 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | $23.54 | $29.42 | $0.04 – $0.51 | 13 |
| Gold sodium thiomaleate inj HCPCS J1600 | $27.20 | $34.00 | $8.84 – $34.82 | 5 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $64.38 | $80.47 | $10.77 – $46.51 | 13 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $55.00 | $68.75 | $11.15 – $44.69 | 13 |
| Gonadotropin hormone panel CPT 80426 | $372.80 | $466.00 | $89.05 – $230.88 | 10 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $55.00 | $68.75 | $11.11 – $44.69 | 13 |
| Gonioscopy CPT 92020 | $58.40 | $73.00 | $18.61 – $114.16 | 13 |
| Goniotomy CPT 65820 | $3,884.80 | $4,856.00 | $631.28 – $3,562.73 | 13 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | $1,880.82 | $2,351.02 | $216.84 – $1,136.36 | 13 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $61.60 | $77.00 | $20.02 – $44.49 | 8 |
| Graft bone flex 2.5cm x 5cm grafton-cost per sq cm HCPCS Q4205 | not published | not published | $410.80 – $1,902.26 | 6 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | not published | not published | $49.54 – $198.49 | 6 |
| Graft hand or finger tendon CPT 26416 | $2,196.80 | $2,746.00 | $713.96 – $2,873.50 | 13 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | not published | not published | $31.11 – $45.04 | 3 |
| Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm HCPCS Q4113 | not published | not published | $391.59 – $1,997.50 | 5 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $3,385.20 | $4,231.50 | $1,100.19 – $2,750.48 | 7 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $12,905.97 | $16,132.46 | $4,194.44 – $10,486.10 | 7 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | $76.00 | $95.00 | $24.70 – $75.21 | 8 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $104.00 | $130.00 | $33.80 – $134.90 | 7 |
| Graft repair of spine defect 63710 CPT 63710 | $2,615.20 | $3,269.00 | $849.94 – $2,543.05 | 11 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $454.47 | $568.08 | $90.22 – $328.35 | 10 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | $97.60 | $122.00 | $31.72 – $58.50 | 8 |
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.