Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm at MercyOne West Des Moines Medical Center

1755 59th Place, West Des Moines, IA · MercyOne · · NPI 1538395975

Source: hospital's published price file ↗ · Published Mar 31, 2026 · Ingested Aug 3, 2026

$756.96

Cash price

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Discounted cash price

What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge.

Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.

Full explanation →

What you pay up front if you don't use insurance.

$756.96

Gross charge

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Gross charge (chargemaster price)

The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this.

Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.

Full explanation →

The hospital's undiscounted list price — almost no one pays this.

$49.92 with IOWA TOTAL CARE vs $305.89 with IOWA DEPT OF PUBLIC HEALTH — same scan, same building. Share

Negotiated rates by payer
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Negotiated rate

The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.

Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.

Full explanation →

Payer
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Payer

The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on.

Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509.

Full explanation →
Plan
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Plan

The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates.

Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible.

Full explanation →
Negotiated rate vs. cash
IOWA TOTAL CARE IOWA TOTAL CARE MEDICAID $49.92 ↓ -93%
MOLINA MEDICAID MOLINA MEDICAID $50.41 ↓ -93%
WELLPOINT MEDICAID WELLPOINT MEDICAID $50.61 ↓ -93%
AETNA MEDICARE ADVANTAGE AETNA MEDICARE ADVANTAGE $61.18 ↓ -92%
MEDICAL ASSOCIATES MEDICAL ASSOCIATES $61.48 ↓ -92%
HEALTH CHOICES MEDICAL ASSOCIATES $61.48 ↓ -92%
CENTIVO CENTIVO $80.75 ↓ -89%
OSCAR OSCAR $82.59 ↓ -89%
TRUSTMARK SMALL BUSINESS BENEFITS AETNA $106.14 ↓ -86%
LUCENT HEALTH AETNA $106.14 ↓ -86%
AETNA AETNA $106.14 ↓ -86%
ASR HEALTH BENEFITS AETNA $106.14 ↓ -86%
1199 NATIONAL BENEFIT FUND AETNA $106.14 ↓ -86%
FIRST HEALTH AETNA $106.14 ↓ -86%
AETNA DOMESTIC AETNA $106.14 ↓ -86%
CHRISTIAN BROTHER SERVICES AETNA $106.14 ↓ -86%
COVENTRY AETNA $106.14 ↓ -86%
ALLIED BENEFIT SYSTEMS AETNA $106.14 ↓ -86%
MERITAIN AETNA $106.14 ↓ -86%
LUMINARE HEALTH AETNA $106.14 ↓ -86%
WEBTPA AETNA $106.14 ↓ -86%
MEDICAL MUTUAL AETNA $106.14 ↓ -86%
UNITED HEALTHCARE UNITED HEALTHCARE $152.95 ↓ -80%
GEHA UNITED HEALTHCARE $152.95 ↓ -80%
CIGNA CIGNA $183.53 ↓ -76%
CIGNA EAP CIGNA $183.53 ↓ -76%
NOVA CLAIMDOC $183.53 ↓ -76%
CLAIMDOC CLAIMDOC $183.53 ↓ -76%
HEALTH PARTNERS HEALTH PARTNERS $194.24 ↓ -74%
AUXIANT MIDLANDS CHOICE PPO $198.83 ↓ -74%
MEDICA MIDLANDS CHOICE PPO $198.83 ↓ -74%
MIDLANDS MIDLANDS CHOICE PPO $198.83 ↓ -74%
MIDLANDS CHOICE MIDLANDS CHOICE PPO $198.83 ↓ -74%
USA MANAGED CARE USA MANAGED CARE $260.01 ↓ -66%
CRIME VICTIM ASSISTANCE CRIME VICTIMS $305.89 ↓ -60%
IOWA DEPT OF PUBLIC HEALTH CARE FOR YOURSELF $305.89 ↓ -60%

Visitor-reported prices

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Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm at other Iowa hospitals

Hospital City Cash price Negotiated range
MercyOne Genesis Davenport West Medical Center Davenport $2,767.80 not published
MercyOne Dubuque Medical Center Dubuque $414.05 $59.28 – $305.89
MercyOne New Hampton Medical Center New Hampton $515.72 $125.78 – $317.70
MercyOne Dyersville Medical Center Dyersville $414.05 $115.63 – $344.31
MercyOne Clinton Medical Center Clinton $414.05 $59.28 – $305.89
MercyOne Oelwein Medical Center Oelwein $3,657.34 $116.91 – $305.89
MercyOne Cedar Falls Medical Center Cedar Falls $414.05 $53.04 – $305.89
MercyOne Elkader Medical Center Elkader $414.05 $157.44 – $319.72

All Iowa hospitals for this procedure →