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 |
|---|---|---|---|---|
| Infectious agent nucleic acid joint space pathogens multiplex amplified probe >= 26 targets CPT 87627 | $2,039.00 | $2,039.00 | $409.84 – $2,039.00 | 41 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | $805.00 | $805.00 | $161.81 – $837.73 | 44 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets CPT 87505 | $295.00 | $295.00 | $59.30 – $295.00 | 44 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets CPT 87506 | $559.00 | $559.00 | $112.36 – $559.00 | 44 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | $483.00 | $483.00 | $41.51 – $483.00 | 44 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | $129.00 | $129.00 | $25.93 – $129.00 | 44 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $549.00 | $549.00 | $41.51 – $549.00 | 44 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $685.00 | $685.00 | $82.47 – $685.00 | 44 |
| Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets CPT 87631 | $392.00 | $392.00 | $78.79 – $392.00 | 44 |
| Infliximab 100 mg intravenous solution HCPCS J1745 | $3,222.55 | $3,222.55 | $31.77 – $3,222.55 | 110 |
| Infliximab-axxq 100 mg intravenous solution HCPCS Q5121 | $1,379.70 | $1,379.70 | $23.33 – $1,379.70 | 110 |
| Infliximab-dyyb 100 mg intravenous solution HCPCS Q5103 | $2,739.55 | $2,739.55 | $23.74 – $2,739.55 | 110 |
| Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis CPT 94642 | $497.00 | $497.00 | $99.90 – $497.00 | 110 |
| Inj calcitriol per 0.1 mcg HCPCS J0636 | $45.80 | $45.80 | $9.21 – $45.80 | 94 |
| Inj cntr knee arthro incl ct/mri CPT 27369 | $591.00 | $591.00 | $79.19 – $394.00 | 26 |
| Inj dx for sinogram CPT 20501 | $589.00 | $589.00 | $118.39 – $589.00 | 26 |
| Injection arthrography hip without anesthesia (both sides) CPT 27093 | $1,171.00 | $1,171.00 | $156.78 – $780.00 | 26 |
| Injection epidural blood patch or clot CPT 62273 | $8,073.00 | $8,073.00 | $666.27 – $8,073.00 | 108 |
| Injection for arthrography wrist (both sides) CPT 25246 | $1,098.00 | $1,098.00 | $147.13 – $732.00 | 26 |
| Injection for bladder x-ray CPT 51600 | $2,167.00 | $2,167.00 | $435.57 – $2,167.00 | 26 |
| Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides) CPT 23350 | $1,095.00 | $1,095.00 | $146.73 – $730.00 | 26 |
| Injection for ureter x-ray CPT 50690 | $1,280.00 | $1,280.00 | $257.28 – $1,280.00 | 26 |
| Injection, inclisiran, 1 mg HCPCS J1306 | $18,656.20 | $18,656.20 | $12.12 – $18,656.20 | 110 |
| Injection,onabotulinumtoxina HCPCS J0585 | $3,255.00 | $3,255.00 | $6.28 – $3,255.00 | 31 |
| Injection px peyronie ds CPT 54200 | $678.00 | $678.00 | $136.28 – $678.00 | 108 |
| Injection radioactive tracer sentinel node (both sides) CPT 38792 | $1,691.00 | $1,691.00 | $8.74 – $1,127.00 | 780 |
| Injection(s) anesthetic agent(s) and/or steroid femoral nerve left CPT 64447 | $40,880.10 | not published | $9.09 – $24,925.18 | 83 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 | $37,307.73 | $263.00 | $1.92 – $12,891.30 | 110 |
| Inj for ext venography CPT 36005 | $2,958.00 | $2,958.00 | $396.37 – $1,972.00 | 26 |
| Inj, gadopiclenol, 1 ml HCPCS A9573 | $161.55 | $161.55 | $8.32 – $41.40 | 28 |
| Inj hydroxocobalamin IV 25mg HCPCS J3424 | $4,819.80 | $4,819.80 | $968.78 – $4,819.80 | 94 |
| Inj levocarnitine per 1 gm HCPCS J1955 | $30.55 | $30.55 | $6.14 – $37.06 | 94 |
| Inj mepivacaine hcl/10 ml HCPCS J0670 | $72.00 | $72.00 | $10.31 – $51.30 | 28 |
| Inj., meropenem, vaborbactam HCPCS J2186 | $935.25 | $935.25 | $187.99 – $935.25 | 94 |
| Inj proc elbow arthro CPT 24220 | $771.00 | $771.00 | $103.11 – $513.00 | 26 |
| Inj retro urethrocysto CPT 51610 | $4,577.00 | $4,577.00 | $919.98 – $4,577.00 | 26 |
| Inj testosterone cypionate HCPCS J1071 | $142.75 | $142.75 | $6.00 – $142.75 | 94 |
| Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln HCPCS J9229 | $73,182.85 | $73,182.85 | $2,514.57 – $73,182.85 | 110 |
| Inpt/ed teleconsult30 HCPCS G0425 | $293.00 | $293.00 | $53.68 – $195.00 | 768 |
| Inpt/ed teleconsult50 HCPCS G0426 | $399.00 | $399.00 | $74.76 – $277.00 | 768 |
| Inpt/ed teleconsult70 HCPCS G0427 | $392.00 | $392.00 | $107.35 – $392.00 | 768 |
| Ins cath ren art 1st bi CPT 36252 | $10,070.00 | $10,070.00 | $2,024.07 – $10,070.00 | 108 |
| Ins cath ren art 1st uni CPT 36251 | $15,007.00 | $15,007.00 | $2,980.30 – $15,007.00 | 108 |
| Ins cath ren art 2nd+ uni CPT 36253 | $10,070.00 | $10,070.00 | $2,024.07 – $10,802.96 | 108 |
| Ins cerv dilator (sep proc) CPT 59200 | $883.00 | $883.00 | $177.48 – $883.00 | 108 |
| Insert cath pleura with image CPT 32557 | $7,884.00 | $7,884.00 | $11.93 – $5,256.00 | 780 |
| Insert cath pleura without image CPT 32556 | $795.00 | $795.00 | $13.03 – $262.00 | 768 |
| Insertion catheter bladder non indwelling CPT 51701 | $405.00 | $405.00 | $81.41 – $405.00 | 108 |
| Insertion catheter pleural indwelling tunneled with cuff CPT 32550 | $6,837.00 | $6,837.00 | $1,374.24 – $6,951.03 | 108 |
| Insertion intra aortic balloon assist device percutaneous CPT 33967 | $11,164.00 | $11,164.00 | $2,243.96 – $11,164.00 | 26 |
| Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance CPT 37191 | $12,243.00 | $12,243.00 | $2,460.84 – $12,243.00 | 108 |
| Insertion nontunneled centrally inserted central venous catheter >= 5 years old CPT 36556 | $3,882.00 | $3,882.00 | $7.91 – $6,129.97 | 780 |
| Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular CPT 33208 | $16,985.00 | $16,985.00 | $3,413.99 – $20,291.63 | 108 |
| Insertion of new/replacement ppm w/transvenous electrode(s) ventricular CPT 33207 | $12,819.00 | $12,819.00 | $2,576.62 – $20,291.63 | 108 |
| Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator CPT 33225 | $9,144.00 | $9,144.00 | $1,837.94 – $9,144.00 | 26 |
| Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years CPT 36569 | $4,312.00 | $4,312.00 | $866.71 – $4,312.00 | 108 |
| Insertion picc without port or pump with imaging guidance=>5y CPT 36573 | $5,217.00 | $5,217.00 | $1,048.62 – $5,217.00 | 108 |
| Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber CPT 33249 | $24,681.00 | $24,681.00 | $4,960.88 – $60,938.73 | 108 |
| Insertion/replacement temporary single chamber electrode/pacemaker catheter CPT 33210 | $7,743.00 | $7,743.00 | $1,556.34 – $16,065.94 | 108 |
| Insertion single tranvenous electrode/ppm/implantable defibrillator CPT 33216 | $12,164.00 | $12,164.00 | $2,444.96 – $16,065.94 | 108 |
| Insertion subcutaneous cardiac rhythm monitor CPT 33285 | $18,360.00 | $18,360.00 | $3,690.36 – $18,360.00 | 108 |
| Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides) CPT 36561 | $24,219.00 | $24,219.00 | $0.96 – $16,146.00 | 780 |
| Insert pm/icd lead dual CPT 33217 | $13,382.00 | $13,382.00 | $2,689.78 – $16,065.94 | 108 |
| Insert self-contd prosthesis CPT 54401 | $45,962.19 | not published | $0.96 – $40,237.95 | 80 |
| In situ hybridization per specimen each additional single probe stain CPT 88364 | $190.00 | $190.00 | $38.19 – $190.00 | 28 |
| In situ hybridization per specimen initial single probe stain CPT 88365 | $335.00 | $335.00 | $67.34 – $335.00 | 110 |
| Insole orthotic freedom sz6 6816 HCPCS L3060 | $68.15 | $68.15 | $13.70 – $68.15 | 28 |
| Ins/rpl ldless pm right vent w img & eval CPT 33274 | $28,743.00 | $28,743.00 | $5,777.34 – $37,394.89 | 108 |
| Ins/rpl prph sac/gstr npg/r CPT 64590 | $42,016.18 | not published | $0.96 – $37,663.62 | 83 |
| Inst fibrinolysis agent ini day CPT 32561 | $216.00 | $216.00 | $19.17 – $141.00 | 768 |
| Inst fibrinolysis agent sbsq d CPT 32562 | $193.00 | $193.00 | $2.74 – $20.00 | 768 |
| Ins tun cv cath wo subq prt/pm CPT 36558 | $10,238.00 | $10,238.00 | $1,371.83 – $6,825.00 | 108 |
| Insulin total CPT 83525 | $147.00 | $147.00 | $11.08 – $147.00 | 44 |
| Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm HCPCS Q4114 | $3,590.44 | $3,590.44 | $585.96 – $3,590.44 | 36 |
| Integra os putty 2.5cc - cost per 0.5cc HCPCS C9359 | $225.79 | $225.79 | $45.38 – $225.79 | 28 |
| Interferon beta-1a 30 mcg/0.5 ml im injection (wrapper) HCPCS Q3027 | $10,427.90 | $10,427.90 | $2,096.01 – $10,427.90 | 94 |
| Intrapul surf admin endo tube CPT 94610 | $492.00 | $492.00 | $98.89 – $492.00 | 28 |
| Intrinsic factor antibody CPT 86340 | $142.00 | $142.00 | $14.62 – $85.00 | 44 |
| Intrvasc Ultrasound noncoronary 1st vessel CPT 37252 | $2,435.00 | $2,435.00 | $489.44 – $2,435.00 | 26 |
| Intubation endotracheal emergency procedure CPT 31500 | $21,265.00 | $1,662.00 | $31.45 – $1,662.00 | 780 |
| Iopamidol 250 mg iodine/ml (51 %) intravenous solution HCPCS Q9966 | $192.00 | $192.00 | $38.59 – $192.00 | 28 |
| Iopamidol 300 mg iodine/ml (61 %) intravenous solution HCPCS Q9967 | $117.25 | $117.25 | $2.36 – $11.75 | 28 |
| Ipilimumab 5 mg/ml intravenous solution (wrapper) HCPCS J9228 | $110,829.85 | $110,829.85 | $172.83 – $27,707.50 | 110 |
| Irinotecan 20 mg/ml intravenous solution (wrapper) HCPCS J9206 | $522.90 | $522.90 | $12.85 – $63.95 | 28 |
| Irinotecan liposomal 4.3 mg/ml intravenous HCPCS J9205 | $9,268.95 | $9,268.95 | $64.64 – $9,268.95 | 110 |
| Iron CPT 83540 | $91.00 | $91.00 | $6.27 – $91.00 | 44 |
| Iron binding capacity CPT 83550 | $158.00 | $158.00 | $8.47 – $158.00 | 44 |
| Iron dextran 50 mg/ml injection solution HCPCS J1750 | $185.90 | $185.90 | $17.46 – $185.90 | 31 |
| Iron sucrose 20 mg iron/ml intravenous solution (wrapper) HCPCS J1756 | $158.45 | $158.45 | $22.00 – $158.45 | 94 |
| Irradiation of blood product each unit reference CPT 86945 | $211.00 | $211.00 | $33.96 – $211.00 | 44 |
| Isatuximab-irfc 20 mg/ml intravenous solution HCPCS J9227 | $2,779.35 | $2,779.35 | $77.83 – $2,779.35 | 110 |
| Ivc venogram s&i CPT 75825 | $7,274.00 | $7,274.00 | $1,462.07 – $7,274.00 | 110 |
| IV Fluids (each additional hour) CPT 96361 | $4,437.00 | $306.00 | $9.09 – $427.00 | 110 |
| IV Fluids (first hour) CPT 96360 | $2,919.00 | $966.00 | $9.09 – $966.00 | 110 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $221.00 | $221.00 | $44.42 – $427.00 | 28 |
| IV Medicine Infusion (additional drug) CPT 96367 | $307.00 | $307.00 | $61.71 – $427.00 | 110 |
| IV Medicine Infusion (each additional hour) CPT 96366 | $25,454.49 | $326.00 | $9.09 – $427.00 | 110 |
| IV Medicine Infusion (first hour) CPT 96365 | $25,454.49 | $929.00 | $9.09 – $929.00 | 110 |
| IV Push Injection (each additional drug) CPT 96375 | $8,246.00 | $260.00 | $44.20 – $427.00 | 110 |
| IV Push Injection (first drug) CPT 96374 | $8,246.00 | $458.00 | $88.83 – $458.00 | 110 |
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.