MercyOne West Des Moines Medical Center
1755 59th Place, West Des Moines, IA · MercyOne · · NPI 1538395975
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 insertion of needle - bone CPT 36680 | $551.00 | $551.00 | $110.75 – $551.00 | 26 |
| Ghs musc test done w/n test comp CPT 95886 | $712.00 | $712.00 | $95.48 – $475.00 | 28 |
| Ghs nailbed repair/nail removal CPT 11760 | $13,952.85 | not published | $0.96 – $1,434.84 | 83 |
| Ghs nerve block celiac plexus CPT 64530 | $2,925.00 | $2,925.00 | $587.93 – $2,925.00 | 108 |
| Ghs o2 saturation CPT 82810 | $86.00 | $86.00 | $9.47 – $86.00 | 44 |
| Ghs opcc repair cvp without subq port CPT 36575 | $10,978.00 | $10,978.00 | $592.10 – $10,978.00 | 108 |
| Ghs picc line insert < 5 CPT 36568 | $5,648.00 | $5,648.00 | $1,135.25 – $5,648.00 | 108 |
| Ghs strapping shoulder - 29240 CPT 29240 | $347.00 | $347.00 | $46.43 – $231.00 | 28 |
| Ghs subcutaneous infus, for therapy ea. add. hr CPT 96370 | $192.00 | $192.00 | $38.59 – $427.00 | 110 |
| Ghs subcutaneous infus. for therapy init 1 hr CPT 96369 | $860.00 | $860.00 | $172.86 – $860.00 | 110 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | $3,891.00 | $3,891.00 | $782.09 – $3,891.00 | 108 |
| Glove finger flexion right lg xl HCPCS L3912 | $81.59 | $81.59 | $11.75 – $58.47 | 28 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $655.40 | $655.40 | $131.74 – $655.40 | 31 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | $567.40 | $567.40 | $114.05 – $567.40 | 31 |
| Glucose 1 hr post dose CPT 82950 | $172.00 | $172.00 | $4.60 – $172.00 | 44 |
| Glucose blood quantitative CPT 82947 | $120.00 | $120.00 | $3.80 – $116.00 | 44 |
| Glucose body fluid CPT 82945 | $119.00 | $119.00 | $3.80 – $119.00 | 44 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $114.00 | $114.00 | $12.47 – $114.00 | 44 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $76.00 | $76.00 | $3.79 – $76.00 | 44 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | $31,106.81 | $7.00 | $0.55 – $14,396.42 | 110 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $5,516.60 | $5,516.60 | $11.40 – $5,516.60 | 110 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $242.00 | $242.00 | $18.00 – $242.00 | 44 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $232.00 | $232.00 | $17.94 – $232.00 | 44 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | $16,064.55 | $16,064.55 | $761.95 – $5,895.10 | 107 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $143.60 | $143.60 | $23.44 – $143.60 | 36 |
| Graft axiofill 1000mg HCPCS J3590 | $9,693.53 | $9,693.53 | $325.33 – $1,618.56 | 28 |
| Graft bone flex 2.5cm x 5cm grafton-cost per sq cm HCPCS Q4205 | $2.17 | $2.17 | $0.44 – $2.17 | 28 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | $2,901.33 | $2,901.33 | $15.71 – $96.28 | 36 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $7,647.47 | $7,647.47 | $0.08 – $0.46 | 36 |
| Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm HCPCS Q4113 | $2,382.88 | $2,382.88 | $478.96 – $2,382.88 | 28 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $25,786.25 | $25,786.25 | $0.09 – $0.43 | 28 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $55,008.00 | $55,008.00 | $0.01 – $0.74 | 28 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | $468.37 | $468.37 | $0.25 – $1.56 | 36 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $612.24 | $612.24 | $38.96 – $238.70 | 36 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $756.96 | $756.96 | $49.92 – $305.89 | 36 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | $733.52 | $733.52 | $13.29 – $81.42 | 36 |
| Graft tis hmatrix dermis 10x5 -cost per sq cm HCPCS Q4134 | $89.31 | $89.31 | $17.95 – $89.31 | 28 |
| Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm HCPCS Q4130 | $2,624.09 | $2,624.09 | $0.01 – $0.05 | 28 |
| Graft viashield 2layer amnion patch 2x2cm-cost per sq cm HCPCS Q4211 | $913.25 | $913.25 | $57.12 – $350.01 | 36 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | $480.03 | $480.03 | $12.48 – $62.10 | 28 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $39,241.14 | $39,241.14 | $10.05 – $50.00 | 28 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $26,268.04 | $26,268.04 | $21.98 – $109.36 | 28 |
| Granulocyte pheresis ea unit HCPCS P9050 | $703.00 | $703.00 | $141.30 – $703.00 | 28 |
| Grfg autol fat lipo 50 cc/< CPT 15771 | $33,546.03 | not published | $0.96 – $15,867.92 | 83 |
| Grfg autol fat lipo ea addl CPT 15772 | $33,546.03 | not published | $0.96 – $15,867.92 | 83 |
| G-tube reposition CPT 43761 | $1,806.00 | $1,806.00 | $235.83 – $1,806.00 | 108 |
| Guided cath fluid drainage 10030 CPT 10030 | $2,911.00 | $2,911.00 | $585.11 – $2,911.00 | 108 |
| Guide endoanchr sg-64 aaa 62cm HCPCS L8670 | $3,919.83 | $3,919.83 | $782.14 – $3,891.24 | 28 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $7,046.99 | $7,046.99 | $0.01 – $0.31 | 28 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $1,150.70 | $1,150.70 | $0.01 – $29.80 | 28 |
| Gw stiffened micro access kit HCPCS C1894 | $15,124.43 | $15,124.43 | $0.01 – $0.81 | 28 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $3.65 | $3.65 | $0.73 – $3.65 | 28 |
| Handpiece aquabeam hp2000 HCPCS C2596 | $22,886.61 | $22,886.61 | $1,485.33 – $7,389.71 | 28 |
| Hands-On Manual Therapy (each 15 minutes) CPT 97140 | $179.00 | $179.00 | $23.75 – $189.00 | 44 |
| Hand X-ray CPT 73130 | $935.00 | $935.00 | $82.14 – $623.00 | 110 |
| Hand X-ray (2 views, both hands) CPT 73120 | $479.00 | $479.00 | $64.12 – $319.00 | 110 |
| Haptoglobin quantitative CPT 83010 | $294.00 | $294.00 | $12.19 – $294.00 | 44 |
| Hcg qualitative CPT 84703 | $232.00 | $232.00 | $7.28 – $232.00 | 44 |
| Hcg quantitative CPT 84702 | $369.00 | $369.00 | $14.59 – $369.00 | 44 |
| Head CT scan (with and without contrast) CPT 70470 | $3,602.00 | $3,602.00 | $165.56 – $3,602.00 | 110 |
| Head CT scan (with contrast) CPT 70460 | $3,708.00 | $3,708.00 | $165.56 – $3,708.00 | 110 |
| Head CT scan (without contrast) CPT 70450 | $3,530.00 | $3,530.00 | $98.68 – $3,530.00 | 110 |
| Heel (Calcaneus) X-ray (both feet) CPT 73650 | $690.00 | $690.00 | $82.14 – $460.00 | 110 |
| Helicobacter pylori antibody igm CPT 86677 | $139.00 | $139.00 | $16.33 – $139.00 | 44 |
| Hematocrit CPT 85014 | $33,846.55 | $96.00 | $2.30 – $3,657.95 | 110 |
| Hemin 350 mg intravenous powder for solution HCPCS J1640 | $34,281.50 | $34,281.50 | $34.60 – $34,281.50 | 107 |
| Hemodialysis one evaluation CPT 90935 | $2,657.00 | $2,657.00 | $320.00 – $2,657.00 | 110 |
| Hemodialysis repeated eval CPT 90937 | $3,039.00 | $3,039.00 | $610.84 – $3,039.00 | 28 |
| Hemoglobin CPT 85018 | $33,111.77 | $107.00 | $2.30 – $6,176.47 | 110 |
| Hemoglobin fetal qualitative CPT 83033 | $305.00 | $305.00 | $8.00 – $305.00 | 28 |
| Hemoglobin methemoglobin quantitative CPT 83050 | $236.00 | $236.00 | $7.95 – $236.00 | 44 |
| Hemoglobin plasma CPT 83051 | $131.00 | $131.00 | $7.08 – $131.00 | 44 |
| Heparin assay CPT 85520 | $155.00 | $155.00 | $12.69 – $155.00 | 44 |
| Heparin bolus from bag HCPCS J1644 | $45.00 | $45.00 | $1.39 – $6.90 | 94 |
| Heparin neutralization CPT 85525 | $120.00 | $120.00 | $11.48 – $120.00 | 44 |
| Heparin, porcine (pf) 10 unit/ml flush (wrapper) HCPCS J1642 | $3.00 | $3.00 | $0.60 – $3.00 | 28 |
| Hepatitis a antibody igm CPT 86709 | $208.00 | $208.00 | $10.91 – $208.00 | 44 |
| Hepatitis b core antibody igm CPT 86705 | $244.00 | $244.00 | $11.40 – $244.00 | 44 |
| Hepatitis b core antibody total CPT 86704 | $143.00 | $143.00 | $11.68 – $143.00 | 44 |
| Hepatitis b immune globulin greater than 1,560 units/5 ml im solution CPT 90371 | $387.75 | $387.75 | $77.94 – $605.10 | 110 |
| Hepatitis b surface antibody CPT 86706 | $216.00 | $216.00 | $10.40 – $216.00 | 44 |
| Hepatitis c antibody CPT 86803 | $243.00 | $243.00 | $13.83 – $243.00 | 44 |
| Hernia Repair (Inguinal) CPT 49505 | $27,748.96 | $2,314.00 | $0.96 – $6,951.03 | 769 |
| Herpes simplex type 1 antibody igg CPT 86695 | $124.00 | $124.00 | $12.78 – $124.00 | 44 |
| Herpes simplex type 2 antibody igg CPT 86696 | $106.00 | $106.00 | $18.75 – $106.00 | 44 |
| Heterophile antibodies screening CPT 86308 | $146.00 | $146.00 | $5.02 – $146.00 | 44 |
| Hip and Pelvis X-ray (2 views, both hips) CPT 73521 | $557.00 | $557.00 | $98.68 – $557.00 | 110 |
| Hip and Pelvis X-ray (single view, left side) CPT 73501 | $461.00 | $461.00 | $82.14 – $461.00 | 110 |
| Hip X-ray CPT 73502 | $47,217.57 | $641.00 | $9.09 – $641.00 | 110 |
| Histochemical stains add-on CPT 88314 | $86.00 | $86.00 | $17.29 – $86.00 | 28 |
| HIV prep, ftc/tdf 200/300mg HCPCS J0750 | $1.00 | $1.00 | $0.20 – $1.37 | 38 |
| Hla class i high defin qual CPT 86832 | $554.00 | $554.00 | $111.35 – $650.74 | 44 |
| Hla class ii high defin qual CPT 86833 | $554.00 | $554.00 | $111.35 – $654.86 | 44 |
| Hldr trach tb tie ad HCPCS A7526 | $1,626.99 | $1,626.99 | $0.12 – $0.59 | 28 |
| Holder tube cath-secure nonstrl lf disp HCPCS A4333 | $1.20 | $1.20 | $0.24 – $1.20 | 28 |
| Home sleep test/type 4 porta HCPCS G0400 | $1,000.00 | $1,000.00 | $201.00 – $2,984.00 | 107 |
| Homocysteine CPT 83090 | $247.00 | $247.00 | $17.36 – $247.00 | 44 |
| Homogenization tissue CPT 87176 | $100.00 | $100.00 | $5.70 – $100.00 | 44 |
| Human epididymis protein 4 (he4) CPT 86305 | $282.00 | $282.00 | $20.17 – $282.00 | 44 |
| Human prothrombin complex concentrate (pcc)-lans 500 unit (400-640 unit) IV solution HCPCS J7165 | $1,829.90 | $1,829.90 | $1.67 – $1,829.90 | 107 |
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.