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 |
|---|---|---|---|---|
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain manual CPT 88360 | $311.20 | $389.00 | $36.40 – $211.06 | 15 |
| Mosunetuzumab-axgb 1 mg/ml intravenous solution HCPCS J9350 | not published | not published | $637.19 – $818.53 | 10 |
| Motion analysis video/3d CPT 96000 | $209.60 | $262.00 | $68.12 – $469.91 | 13 |
| Motion test w/ft press meas CPT 96001 | $248.00 | $310.00 | $80.60 – $901.02 | 13 |
| Motor &/ sens nrve cndj test CPT 95905 | $124.80 | $156.00 | $2.34 – $353.40 | 13 |
| Mouth piece HCPCS A4617 | $8.80 | $11.00 | $2.16 – $5.50 | 11 |
| Mouth vestibule bx/w complex rpr 40814 CPT 40814 | $941.60 | $1,177.00 | $259.02 – $2,872.13 | 13 |
| M/phmtrc alys ishquant/semiq CPT 88373 | $292.13 | $365.16 | $15.08 – $211.06 | 13 |
| M/phmtrc alys ishquant/semiq CPT 88377 | $694.40 | $868.00 | $38.48 – $211.06 | 15 |
| M/phmtrc alysishquant/semiq CPT 88369 | $292.13 | $365.16 | $20.28 – $211.06 | 13 |
| M/phmtrc alys skeletal musc CPT 88355 | $380.80 | $476.00 | $48.93 – $163.27 | 13 |
| Mpl gene analysis common variants CPT 81338 | $300.80 | $376.00 | $49.91 – $185.01 | 13 |
| M.pneumon dna dir probe CPT 87580 | $50.40 | $63.00 | $12.03 – $31.19 | 10 |
| M.pneumon dna quant CPT 87582 | $605.60 | $757.00 | $80.40 – $423.70 | 10 |
| Mpsv4 vaccine subq CPT 90733 | $148.80 | $186.00 | $48.36 – $237.56 | 5 |
| MRA abdomen post contrast CPT 74185 | $945.60 | $1,182.00 | $68.90 – $187.60 | 11 |
| MRA aorta thoracic w/wo contrast CPT 71555 | $945.60 | $1,182.00 | $68.90 – $187.60 | 11 |
| MRA chest w IV cont HCPCS C8909 | $733.60 | $917.00 | $238.42 – $533.20 | 10 |
| MRA chest wo IV cont HCPCS C8910 | $1,141.14 | $1,426.42 | $214.07 – $927.17 | 14 |
| MRA chest wwo IV cont HCPCS C8911 | $1,730.55 | $2,163.18 | $238.42 – $1,406.07 | 14 |
| MRA ext low(run-off)pst cntrst CPT 73725 | $945.60 | $1,182.00 | $68.90 – $189.10 | 11 |
| MRA pelvis CPT 72198 | $945.60 | $1,182.00 | $68.90 – $188.30 | 11 |
| MRA pelvis w IV cont HCPCS C8918 | $1,269.75 | $1,587.18 | $238.42 – $1,031.67 | 14 |
| MRA pelvis wo IV cont HCPCS C8919 | $733.60 | $917.00 | $214.07 – $360.89 | 10 |
| MRA spinal canal CPT 72159 | $996.00 | $1,245.00 | $75.40 – $188.30 | 11 |
| MRA upper extremity post contrast-bil CPT 73225 | $968.00 | $1,210.00 | $72.54 – $177.20 | 11 |
| MRA w/cont, abd HCPCS C8900 | $1,164.03 | $1,455.03 | $238.42 – $945.77 | 14 |
| MRA w/cont, lwr ext HCPCS C8912 | $733.60 | $917.00 | $238.42 – $533.20 | 10 |
| Mra, w/dye, spinal canal HCPCS C8931 | $1,120.64 | $1,400.80 | $316.28 – $910.52 | 14 |
| Mra, w/dye, upper extremity HCPCS C8934 | $1,269.75 | $1,587.18 | $316.28 – $1,031.67 | 14 |
| MRA without cont, abd HCPCS C8901 | $1,104.48 | $1,380.60 | $214.07 – $897.39 | 14 |
| MRA without cont, lwr ext HCPCS C8913 | $1,243.34 | $1,554.17 | $214.07 – $1,010.21 | 14 |
| Mra, without dye, spinal canal HCPCS C8932 | $853.80 | $1,067.24 | $214.07 – $693.71 | 14 |
| Mra, without dye, upper extr HCPCS C8935 | $1,142.78 | $1,428.47 | $214.07 – $928.51 | 14 |
| MRA without fol w/cont, abd HCPCS C8902 | $1,472.64 | $1,840.80 | $238.42 – $1,196.52 | 14 |
| MRA without fol w/cont, lwr ext HCPCS C8914 | $1,243.34 | $1,554.17 | $238.42 – $1,010.21 | 14 |
| MRA without fol w/cont, pelvis HCPCS C8920 | $1,357.18 | $1,696.47 | $238.42 – $1,102.71 | 14 |
| Mra, w/o&w/dye, spinal canal HCPCS C8933 | not published | not published | $316.28 – $533.20 | 9 |
| Mra, w/o&w/dye, upper extr HCPCS C8936 | $1,396.71 | $1,745.88 | $316.28 – $1,134.82 | 14 |
| Mr elastography CPT 76391 | $488.80 | $611.00 | $48.13 – $214.07 | 13 |
| Mrgfus strtctc ablt trgt icr CPT 61715 | $2,038.40 | $2,548.00 | $662.48 – $18,618.27 | 10 |
| MRI brain w/dye CPT 70558 | $3,514.40 | $4,393.00 | $134.42 – $326.15 | 13 |
| MRI brain without dye CPT 70557 | $3,324.00 | $4,155.00 | $121.16 – $485.59 | 13 |
| MRI brain without & w/dye CPT 70559 | $3,313.60 | $4,142.00 | $125.84 – $303.56 | 13 |
| MRI breast c- unilateral CPT 77046 | $1,634.96 | $2,043.70 | $45.24 – $1,181.26 | 15 |
| MRI breast c-+ w/cad uni CPT 77048 | $2,318.98 | $2,898.72 | $65.78 – $1,675.46 | 13 |
| MRI breast without cont bi CPT 77047 | $1,912.38 | $2,390.47 | $49.92 – $1,381.69 | 15 |
| MRI breast w IV cont bi CPT 77049 | $2,697.94 | $3,372.42 | $72.02 – $1,949.26 | 13 |
| MRI cardiac morph & func wo IV cont CPT 75557 | $769.60 | $962.00 | $97.24 – $244.20 | 13 |
| MRI cardiac morph & func wwo IV cont CPT 75561 | $1,021.60 | $1,277.00 | $107.64 – $316.28 | 13 |
| MRI cardiac morph & func wwo IV cont w/stress img CPT 75563 | $1,209.60 | $1,512.00 | $122.72 – $699.69 | 13 |
| MRI chest without contrast CPT 71550 | $1,128.03 | $1,410.03 | $56.16 – $815.00 | 15 |
| MRI chest without & w/contrast CPT 71552 | $1,935.68 | $2,419.60 | $86.58 – $1,398.53 | 15 |
| MRI chest w IV cont CPT 71551 | $1,697.44 | $2,121.80 | $66.30 – $1,226.40 | 15 |
| MRI compatible system HCPCS L0859 | not published | not published | $684.70 – $1,742.36 | 10 |
| MRI fetal ea addl gestation CPT 74713 | $420.00 | $525.00 | $57.98 – $195.80 | 11 |
| MRI fetal sngl/1st gestation CPT 74712 | $864.00 | $1,080.00 | $94.12 – $317.10 | 13 |
| MRI guid ndl plc s&i CPT 77021 | $931.20 | $1,164.00 | $46.54 – $628.69 | 13 |
| MRI guid parenchymal tiss ablation CPT 77022 | $2,527.20 | $3,159.00 | $164.84 – $440.70 | 11 |
| MRI hyperpolarized xenon129 HCPCS C9791 | not published | not published | $1,243.06 – $1,867.00 | 7 |
| MRI loex nonjt w IV cont CPT 73719 | $1,178.36 | $1,472.94 | $62.40 – $851.36 | 15 |
| MRI lower extremity other than joint without contrast (both sides) CPT 73718 | $1,101.36 | $1,376.70 | $56.42 – $795.73 | 15 |
| MRI lower extremity other than joint without & w/contrast (both sides) CPT 73720 | $1,806.81 | $2,258.51 | $82.68 – $1,305.42 | 15 |
| MRI orbit fac&nck w IV cont CPT 70542 | $1,174.68 | $1,468.34 | $62.40 – $848.70 | 15 |
| MRI tmj CPT 70336 | $1,007.87 | $1,259.83 | $56.68 – $728.18 | 15 |
| MRI upper extremity other than joint without contrast (both sides) CPT 73218 | $1,101.36 | $1,376.70 | $52.00 – $795.73 | 15 |
| MRI upper extremity other than joint without & w/contrast (both sides) CPT 73220 | $1,809.25 | $2,261.56 | $82.68 – $1,307.18 | 15 |
| MRI upper extremity w/dye CPT 73219 | $945.60 | $1,182.00 | $62.40 – $316.28 | 13 |
| MRI w/cont, breast, bi HCPCS C8906 | $625.60 | $782.00 | $203.32 – $533.20 | 8 |
| MRI w/cont, breast, uni HCPCS C8903 | $508.00 | $635.00 | $165.10 – $265.78 | 8 |
| MRI without fol w/cont, breast HCPCS C8908 | $2,602.51 | $3,253.13 | $203.32 – $2,114.53 | 12 |
| MRI without fol w/cont, brst, un HCPCS C8905 | $2,223.54 | $2,779.42 | $165.10 – $1,806.62 | 12 |
| Mr safety determination physician/other qhp CPT 76016 | $132.80 | $166.00 | $17.16 – $131.45 | 10 |
| Mr safety implant elec prepj CPT 76018 | $207.20 | $259.00 | $21.32 – $137.04 | 10 |
| Mr safety implant&/fb assmt clin staff ea add 30 CPT 76015 | $92.80 | $116.00 | $30.16 – $90.80 | 9 |
| Mr safety implt pos&/immoblj CPT 76019 | $268.00 | $335.00 | $16.64 – $88.68 | 10 |
| Mr sfty implt&/fb asmt stf 1 CPT 76014 | $19.20 | $24.00 | $6.24 – $36.57 | 10 |
| Mr sfty med physics xm cstmz CPT 76017 | $402.40 | $503.00 | $21.58 – $360.89 | 10 |
| Mr spectroscopy CPT 76390 | $1,018.40 | $1,273.00 | $44.98 – $149.60 | 12 |
| Msh2 gene dup/delete variant CPT 81297 | $427.20 | $534.00 | $66.55 – $298.65 | 13 |
| Msh2 gene full seq CPT 81295 | $764.00 | $955.00 | $119.09 – $534.42 | 13 |
| Msh2 gene known variants CPT 81296 | $676.00 | $845.00 | $182.28 – $472.86 | 10 |
| Msh6 gene dup/delete variant CPT 81300 | $476.00 | $595.00 | $74.26 – $333.23 | 13 |
| Msh6 gene full seq CPT 81298 | $1,284.00 | $1,605.00 | $200.26 – $898.64 | 13 |
| Msh6 gene known variants CPT 81299 | $616.00 | $770.00 | $96.10 – $431.24 | 13 |
| Mt bone graft microvasc CPT 20957 | not published | not published | $2,440.26 – $6,496.69 | 10 |
| Mthfr gene analy common variants CPT 81291 | $131.20 | $164.00 | $39.20 – $103.88 | 13 |
| M.tuberculo dna dir probe CPT 87555 | $58.40 | $73.00 | $16.13 – $37.64 | 10 |
| M.tuberculo dna quant CPT 87557 | $108.00 | $135.00 | $25.70 – $66.65 | 10 |
| Mucin synovial fluid CPT 83872 | $33.57 | $41.96 | $3.52 – $27.27 | 13 |
| Mucopolysaccharides CPT 83864 | $86.42 | $108.02 | $17.10 – $70.21 | 13 |
| Mucormycosis antibody CPT 86732 | $38.40 | $48.00 | $9.00 – $21.01 | 10 |
| Mult fam adapt bhv tx gdn CPT 97157 | not published | not published | $9.50 – $30.48 | 8 |
| Multi-axial knee/shin system HCPCS L5840 | not published | not published | $2,464.01 – $6,270.21 | 10 |
| Multi-axial rotation unit HCPCS L5986 | not published | not published | $427.75 – $1,088.52 | 10 |
| Multi den insert custom mold HCPCS A5513 | $108.80 | $136.00 | $26.98 – $68.65 | 11 |
| Multi den insert direct form HCPCS A5512 | not published | not published | $18.08 – $46.01 | 10 |
| Multi-durometer below knee HCPCS L5665 | not published | not published | $404.01 – $1,028.09 | 10 |
| Multi-durometer symes HCPCS L5661 | not published | not published | $408.76 – $1,040.17 | 10 |
| Multi family grp psychotherapy CPT 90849 | $80.80 | $101.00 | $26.26 – $142.30 | 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.