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 |
|---|---|---|---|---|
| Hyaluronidase 150 unit/ml injection solution HCPCS J3470 | $154.70 | $154.70 | $31.09 – $154.70 | 94 |
| Hyaluronidase, human recombinant 150 unit/ml injection solution HCPCS J3473 | $236.10 | $236.10 | $47.46 – $236.10 | 94 |
| Hydralazine 20 mg/ml injection solution HCPCS J0360 | $14.05 | $14.05 | $2.82 – $14.05 | 94 |
| Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J1720 | $243.25 | $243.25 | $8.84 – $44.00 | 94 |
| Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper) HCPCS J1171 | $185.75 | $185.75 | $0.84 – $4.20 | 94 |
| Hydroxyzine hcl 50 mg/ml intramuscular solution HCPCS J3410 | $105.00 | $105.00 | $21.11 – $105.00 | 28 |
| Hydroxyzine pamoate 25 mg capsule HCPCS Q0177 | $1.00 | $1.00 | $0.10 – $2.81 | 94 |
| Hysteroscopy ablation CPT 58563 | $20,991.69 | not published | $9.09 – $9,711.82 | 83 |
| Hysteroscopy biopsy CPT 58558 | $19,888.91 | not published | $62.90 – $6,284.60 | 83 |
| Hysteroscopy remove fb CPT 58562 | $16,636.25 | not published | $9.09 – $6,284.60 | 83 |
| Hysteroscopy remove myoma CPT 58561 | $20,265.91 | not published | $31.45 – $9,711.82 | 83 |
| Hzv zoster vacc recombinant adjuvanted im inj CPT 90750 | $273.00 | $273.00 | $54.60 – $273.00 | 100 |
| I-123 iobenguane diag HCPCS A9582 | $24,445.60 | $24,445.60 | $17.29 – $24,445.60 | 110 |
| I-123 ioflupane diag HCPCS A9584 | $12,340.00 | $12,340.00 | $1,359.99 – $12,340.00 | 107 |
| I-123 sod iodide diag per 100 uci HCPCS A9516 | $412.50 | $412.50 | $80.65 – $401.25 | 28 |
| I-131 iobenguane sulf diag mibg HCPCS A9508 | $6,709.35 | $6,709.35 | $1,348.58 – $6,709.35 | 28 |
| I-131 sod iodide sol diag per mci HCPCS A9529 | $417.75 | $417.75 | $83.97 – $417.75 | 26 |
| Ibandronate 3 mg/3 ml intravenous syringe HCPCS J1740 | $1,149.75 | $1,149.75 | $92.40 – $1,149.75 | 94 |
| Ibutilide fumarate 0.1 mg/ml intravenous solution HCPCS J1742 | $2,574.70 | $2,574.70 | $194.54 – $2,574.70 | 110 |
| Icd cobalt xt dr MRI is1 df1 HCPCS C1721 | $30,942.00 | $30,942.00 | $0.01 – $834.66 | 28 |
| Icd crtd cobalt hf MRI is1 df1 HCPCS C1882 | $42,975.00 | $42,975.00 | $32.72 – $162.77 | 28 |
| Icd crtp serena MRI HCPCS C2621 | $14,208.75 | $14,208.75 | $599.21 – $2,981.16 | 28 |
| Icd reliance df4 ib 64cm HCPCS C1895 | $7,110.69 | $7,110.69 | $18.29 – $90.99 | 28 |
| Ifosfamide 1 gram intravenous solution HCPCS J9208 | $494.70 | $494.70 | $25.71 – $169.00 | 94 |
| Ihc/icc per specimen each additional single antibody stain CPT 88341 | $41,637.31 | $400.00 | $59.30 – $9,711.82 | 110 |
| Ihc/icc per specimen each multiplex antibody stain CPT 88344 | $444.00 | $444.00 | $89.24 – $695.89 | 110 |
| Ihc/icc per specimen initial single antibody stain CPT 88342 | $41,637.31 | $434.00 | $69.55 – $434.00 | 110 |
| Imetelstat 188 mg intravenous solution HCPCS J0870 | $31,931.40 | $31,931.40 | $57.14 – $7,982.85 | 107 |
| Immob elbow child sm HCPCS L3762 | $44.65 | $44.65 | $0.61 – $3.75 | 36 |
| Immobilizer lwr extrem nylon 20in reinforc 21-35in HCPCS L2999 | $807.71 | $807.71 | $17.21 – $85.60 | 28 |
| Immobilizer shldr cntor adlt HCPCS L3670 | $263.74 | $263.74 | $0.40 – $2.44 | 36 |
| Immobilizer shldr dlx str 24-36in med HCPCS L1830 | $209.88 | $209.88 | $0.70 – $4.02 | 36 |
| Immobilizer shldr sling med HCPCS L3660 | $52.36 | $52.36 | $10.52 – $52.36 | 28 |
| Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution HCPCS J1569 | $10,106.10 | $10,106.10 | $46.34 – $1,684.35 | 110 |
| Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution HCPCS J1566 | $4,576.15 | $4,576.15 | $77.31 – $4,576.15 | 110 |
| Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution HCPCS J1568 | $6,381.00 | $6,381.00 | $46.44 – $1,063.50 | 110 |
| Immunoassay tumor antigen quantitative ca 125 CPT 86304 | $418.00 | $418.00 | $20.17 – $418.00 | 44 |
| Immunoassay tumor antigen quantitative ca 19-9 CPT 86301 | $301.00 | $301.00 | $20.17 – $301.00 | 44 |
| Immunodiff gel qual ea antigen/ab CPT 86331 | $36.00 | $36.00 | $7.24 – $36.00 | 44 |
| Immunofixation electrophoresis serum CPT 86334 | $385.00 | $385.00 | $21.64 – $385.00 | 44 |
| Immunofluorescence per specimen each additional single antibody stain CPT 88350 | $377.00 | $377.00 | $7.84 – $89.12 | 28 |
| Immunofluorescence per specimen initial single antibody stain CPT 88346 | $357.00 | $357.00 | $71.76 – $357.00 | 110 |
| Immunoglobulin assay CPT 86023 | $284.00 | $284.00 | $12.08 – $284.00 | 44 |
| Impl ahmed 6x25x9.6mm glaucoma vlv w/sil ped ster HCPCS L8612 | $8,420.00 | $8,420.00 | $452.98 – $2,253.62 | 28 |
| Implant 11 volt lithium-ion backup battery for controller pocket HCPCS Q0506 | $1,405.00 | $1,405.00 | $282.41 – $1,405.00 | 28 |
| Implant cartilage 10mm synthetic HCPCS L8699 | $6,525.50 | $6,525.50 | $10.89 – $54.20 | 28 |
| Implant cochlear device CPT 69930 | $78,755.54 | not published | $0.96 – $64,012.49 | 83 |
| Implant cochlear osia osi300 HCPCS L8690 | $48,020.46 | $9,768.72 | $0.96 – $24,925.18 | 110 |
| Implant power module patient cable cable 14 volt HCPCS Q0477 | $3,512.50 | $3,512.50 | $706.01 – $3,512.50 | 28 |
| Implant pulse generator remede el HCPCS C1823 | $18,945.00 | $18,945.00 | $1,970.96 – $9,805.78 | 28 |
| Implant ureth bulk agent HCPCS L8606 | $3,231.50 | $3,231.50 | $299.63 – $1,490.71 | 28 |
| Impl ear abutment ba300 9mm HCPCS L8693 | $5,699.03 | $5,699.03 | $593.41 – $3,200.13 | 36 |
| Impl eye bio-eye 16mm HCPCS L8042 | $2,550.08 | $2,550.08 | $105.16 – $523.17 | 28 |
| Implnt bio implnt for soft tiss reinforcement 15777 CPT 15777 | $73,098.62 | $924.00 | $62.90 – $15,867.92 | 769 |
| Impl oi implt sk tc esp<100 CPT 69716 | $47,069.05 | not published | $0.36 – $64,012.49 | 83 |
| Impl oi implt skull perq esp CPT 69714 | $52,423.57 | not published | $1.92 – $24,925.18 | 83 |
| In-111 autologous plt stdy dx HCPCS A9571 | $1,494.95 | $1,494.95 | $300.48 – $6,195.34 | 28 |
| In-111 autol wbc diag per dose HCPCS A9570 | $10,776.60 | $10,776.60 | $1,081.13 – $10,776.60 | 107 |
| In-111 capromab pendet HCPCS A9507 | $7,024.00 | $7,024.00 | $1,411.82 – $7,024.00 | 28 |
| In-111 ibritumomab tiux dx HCPCS A9542 | $7,246.75 | $7,246.75 | $1,157.13 – $7,246.75 | 28 |
| In-111 oxyquinolin per 0.5 mci HCPCS A9547 | $10,776.60 | $10,776.60 | $814.83 – $10,776.60 | 107 |
| In-111 pentetate dtpa / 0.5 mci HCPCS A9548 | $11,163.95 | $11,163.95 | $730.71 – $11,163.95 | 107 |
| In-111 pentetreotide HCPCS A9572 | $15,327.00 | $15,327.00 | $1,960.92 – $15,327.00 | 107 |
| In-111 satumomab pend HCPCS A4642 | $3,524.25 | $3,524.25 | $708.37 – $3,524.25 | 28 |
| Incision & drainage hematoma/seroma/fluid collection CPT 10140 | $14,575.00 | $14,575.00 | $0.96 – $14,575.00 | 108 |
| Incision of breast lesion CPT 19020 | $23,042.80 | not published | $279.68 – $3,206.43 | 83 |
| Incision of midfoot bones CPT 28304 | $104,104.65 | not published | $0.96 – $14,087.30 | 83 |
| Incision of tibia CPT 27705 | $112,432.88 | not published | $12,118.25 – $24,925.18 | 82 |
| Incision tendon sheath CPT 26055 | $12,020.25 | not published | $9.09 – $3,121.78 | 83 |
| Inf agt nucleic acid human papillomavirus separately reported high-risk types pooled result(s) CPT 87626 | $211.00 | $211.00 | $42.41 – $211.00 | 41 |
| Infect ag drug suscept pheno predict CPT 87900 | $737.00 | $737.00 | $126.31 – $737.00 | 44 |
| Infect ag genotype na dna hepatitis b CPT 87912 | $772.00 | $772.00 | $155.17 – $772.00 | 44 |
| Infect ag genotype na hiv-1 other region CPT 87906 | $608.00 | $608.00 | $122.21 – $608.00 | 44 |
| Infect ag genotype na hiv-1 revr trn/prt CPT 87901 | $525.00 | $525.00 | $105.53 – $525.00 | 44 |
| Infectious agent antigen immunoassay direct optical observation sars-cov-2 CPT 87811 | $84.00 | $84.00 | $16.88 – $84.00 | 44 |
| Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin CPT 87324 | $86.00 | $86.00 | $11.61 – $86.00 | 44 |
| Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans CPT 87327 | $333.00 | $333.00 | $13.01 – $333.00 | 44 |
| Infectious agent antigen immunoassay ql/sq multi step cryptosporidium CPT 87328 | $286.00 | $286.00 | $13.39 – $286.00 | 44 |
| Infectious agent antigen immunoassay ql/sq multi step giardia CPT 87329 | $285.00 | $285.00 | $11.61 – $285.00 | 44 |
| Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool CPT 87338 | $211.00 | $211.00 | $13.93 – $211.00 | 44 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn CPT 87340 | $250.00 | $250.00 | $10.01 – $250.00 | 44 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization CPT 87341 | $273.00 | $273.00 | $10.01 – $273.00 | 44 |
| Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies CPT 87389 | $293.00 | $293.00 | $23.34 – $293.00 | 44 |
| Infectious agent antigen immunoassay ql/sq multi step legionella urine CPT 87449 | $416.00 | $416.00 | $11.61 – $168.00 | 44 |
| Infectious agent antigen immunoassay ql/sq multi step rotavirus CPT 87425 | $291.00 | $291.00 | $11.61 – $291.00 | 44 |
| Infectious agent nucleic acid amplified probe CPT 87798 | $145.00 | $145.00 | $29.15 – $145.00 | 44 |
| Infectious agent nucleic acid amplified probe chlamydia trachomatis CPT 87491 | $511.00 | $511.00 | $34.01 – $342.00 | 44 |
| Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s) CPT 87493 | $372.00 | $372.00 | $36.12 – $372.00 | 44 |
| Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets CPT 87483 | $1,205.00 | $1,205.00 | $242.21 – $1,205.00 | 44 |
| Infectious agent nucleic acid amplified probe hsv-1 CPT 87529 | $415.00 | $415.00 | $34.01 – $415.00 | 44 |
| Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus CPT 87641 | $374.00 | $374.00 | $34.01 – $374.00 | 44 |
| Infectious agent nucleic acid amplified probe mycobacteria tuberculosis CPT 87556 | $279.00 | $279.00 | $40.39 – $279.00 | 44 |
| Infectious agent nucleic acid amplified probe neisseria gonorrhoeae CPT 87591 | $342.00 | $342.00 | $34.01 – $342.00 | 44 |
| Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 CPT 87635 | $200.00 | $200.00 | $40.20 – $200.00 | 44 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b CPT 87636 | $556.00 | $556.00 | $111.76 – $556.00 | 44 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv CPT 87637 | $2,551.00 | $556.00 | $9.09 – $556.00 | 110 |
| Infectious agent nucleic acid amplified probe streptococcus group a CPT 87651 | $184.00 | $184.00 | $34.01 – $184.00 | 44 |
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | $53.00 | $53.00 | $10.65 – $70.53 | 44 |
| Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae CPT 87494 | $211.00 | $211.00 | $42.41 – $211.00 | 41 |
| Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance CPT 87564 | $323.00 | $323.00 | $64.92 – $323.00 | 41 |
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.