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 |
|---|---|---|---|---|
| Ixabepilone 15 mg intravenous solution HCPCS J9207 | $18,131.05 | $18,131.05 | $127.12 – $6,043.70 | 110 |
| Jaw (Mandible) X-ray (complete) CPT 70110 | $583.00 | $583.00 | $98.68 – $583.00 | 110 |
| Jkt lso inter HCPCS L0560 | $63.49 | $63.49 | $12.76 – $63.49 | 28 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $162.00 | $162.00 | $7.92 – $162.00 | 44 |
| Ketorolac (Toradol) Pain Shot, 15 mg HCPCS J1885 | $30.05 | $30.05 | $1.53 – $17.20 | 31 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $1,539.00 | $1,539.00 | $98.68 – $1,539.00 | 110 |
| Kidney (Retroperitoneal) Ultrasound (limited) CPT 76775 | $600.00 | $600.00 | $98.68 – $600.00 | 110 |
| Kit case 4.2mm spinejack HCPCS C1062 | $9,130.54 | $9,130.54 | $589.37 – $2,932.18 | 28 |
| Kit cast tcc 3in w/2reg boots total contact cast HCPCS Q4038 | $395.71 | $395.71 | $68.48 – $340.71 | 28 |
| Kit cath f 8f w/glv + wipe ster HCPCS A4353 | $2.02 | $2.02 | $0.27 – $1.33 | 28 |
| Kit cath ivl 2.5x40mm 135cm shockwave s4 HCPCS C1761 | $9,893.50 | $9,893.50 | $1,163.54 – $5,788.75 | 28 |
| Kit hfx iq ipg bundle HCPCS C1822 | $40,833.13 | $40,833.13 | $7,872.65 – $39,167.42 | 28 |
| Kit ipg optimizer smart HCPCS C1824 | $44,694.00 | $44,694.00 | $7,946.94 – $39,537.00 | 28 |
| Kit irrigator stoma cone 7721 HCPCS A4398 | $3.16 | $3.16 | $0.64 – $3.16 | 28 |
| Kit lead specify 5-6-5 HCPCS C1778 | $20,699.16 | $20,699.16 | $28.81 – $143.33 | 28 |
| Kit monitr cath camino icp w/integratd licox bolt fitting HCPCS A9279 | $2,021.18 | $2,021.18 | $406.26 – $2,021.18 | 28 |
| Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set HCPCS C1878 | $2,141.22 | $2,141.22 | $410.62 – $2,042.87 | 28 |
| Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm HCPCS Q4105 | $360.12 | $360.12 | $34.41 – $210.83 | 36 |
| Kit sound processor cochlear osia 2 HCPCS L8691 | $9,517.95 | $9,517.95 | $1,038.85 – $6,365.52 | 36 |
| Kit trach suct cls 30.5cm HCPCS A4605 | $4,830.98 | $4,830.98 | $8.41 – $41.85 | 28 |
| Knee Arthroscopy (Meniscus Trimming) CPT 29881 | $18,070.14 | not published | $0.96 – $6,352.30 | 83 |
| Knee arthroscopy/surgery CPT 29874 | $36,887.37 | not published | $0.96 – $14,087.30 | 83 |
| Knee arthroscopy/surgery CPT 29880 | $20,337.35 | not published | $9.09 – $6,352.30 | 83 |
| Knee arthroscopy/surgery CPT 29888 | $33,184.87 | not published | $1.92 – $14,087.30 | 83 |
| Knee MRI (with and without contrast) CPT 73723 | $6,996.00 | $6,996.00 | $255.10 – $4,664.00 | 110 |
| Knee MRI (with contrast) CPT 73722 | $7,995.00 | $7,995.00 | $311.07 – $5,330.00 | 110 |
| Knee MRI (without contrast) CPT 73721 | $7,689.00 | $7,689.00 | $225.21 – $5,126.00 | 110 |
| Knee X-ray (1 to 2 views, both knees) CPT 73560 | $822.00 | $822.00 | $82.14 – $548.00 | 110 |
| Knee X-ray (3 views, both knees) CPT 73562 | $1,027.00 | $1,027.00 | $82.14 – $685.00 | 110 |
| Labetalol 5 mg/ml IV (wrapper) HCPCS J1920 | $13.80 | $13.80 | $2.77 – $13.80 | 28 |
| Lacosamide 200 mg/20 ml intravenous solution HCPCS C9254 | $53.80 | $53.80 | $10.81 – $53.80 | 28 |
| Lactate dehydrogenase (ldh) CPT 83615 | $214.00 | $214.00 | $5.85 – $105.00 | 44 |
| Lactated ringers intravenous solution HCPCS J7120 | $20.00 | $20.00 | $4.02 – $20.00 | 28 |
| Lactic acid CPT 83605 | $142.00 | $142.00 | $11.21 – $142.00 | 44 |
| Lactoferrin fecal qualitative CPT 83630 | $160.00 | $160.00 | $19.09 – $160.00 | 44 |
| Lanreotide 120 mg/0.5 ml subcutaneous syringe HCPCS J1930 | $29,832.00 | $29,832.00 | $93.06 – $29,832.00 | 31 |
| Lanthanum carbonate oral 5mg HCPCS J0607 | $5.15 | $5.15 | $1.03 – $13.05 | 99 |
| Laparo-asst vag hysterectomy CPT 58550 | $35,872.63 | not published | $183.41 – $11,736.86 | 83 |
| Laparo cholecystectomy/graph CPT 47563 | $29,361.77 | $2,574.00 | $1.92 – $11,736.86 | 769 |
| Laparo partial nephrectomy CPT 50543 | $41,708.29 | not published | $183.41 – $20,636.89 | 83 |
| Laparo proc abdm/per/oment 49329 CPT 49329 | $37,244.40 | not published | $183.41 – $20,636.89 | 83 |
| Laparoscopy aspiration CPT 49322 | $31,180.07 | $1,350.00 | $15.06 – $11,736.86 | 769 |
| Laparoscopy biopsy CPT 49321 | $30,852.75 | $1,241.00 | $16.16 – $11,736.86 | 769 |
| Laparoscopye procstom 43659 CPT 43659 | $43,284.27 | not published | $183.41 – $20,636.89 | 83 |
| Laparoscopy excise lesions CPT 58662 | $37,983.73 | not published | $251.60 – $11,736.86 | 83 |
| Laparoscopy gastrostomy CPT 43653 | $2,076.00 | $2,076.00 | $24.28 – $204.80 | 768 |
| Laparoscopy lymphadenectomy CPT 38571 | $45,439.49 | not published | $366.82 – $20,636.89 | 83 |
| Laparoscopy remove adnexa CPT 58661 | $31,180.07 | $2,826.00 | $29.91 – $11,736.86 | 769 |
| Laparoscopy surg colpopexy CPT 57425 | $62,828.90 | not published | $9.09 – $20,636.89 | 83 |
| Laparo urethral suspension CPT 51990 | $50,747.88 | not published | $94.35 – $20,636.89 | 83 |
| Lap enterectomy 44202 CPT 44202 | $4,954.00 | $4,954.00 | $37.48 – $480.64 | 768 |
| Lap enterolysis CPT 44180 | $23,988.95 | $3,286.00 | $9.09 – $11,736.86 | 769 |
| Lap gastric bypass/roux-en-y CPT 43644 | $41,926.77 | $6,181.00 | $9.09 – $2,874.16 | 769 |
| Lap ing hernia repair init CPT 49650 | $34,029.37 | $3,112.00 | $0.96 – $11,736.86 | 769 |
| Lap ing hernia repair recur CPT 49651 | $38,505.92 | $2,506.00 | $0.96 – $11,736.86 | 769 |
| Lap paraesophag hern repair CPT 43281 | $43,284.27 | $5,464.00 | $37.48 – $20,636.89 | 769 |
| Lap rmvl gastr adj all parts CPT 43774 | $25,905.64 | $3,431.00 | $9.09 – $7,485.06 | 769 |
| Lap sleeve gastrectomy CPT 43775 | $34,626.30 | $3,927.00 | $9.09 – $1,769.66 | 769 |
| Laps surg prst8ect rpbic rad CPT 55866 | $45,439.49 | not published | $366.82 – $20,636.89 | 83 |
| Large Joint Injection or Fluid Draw (both sides) CPT 20610 | $1,949.00 | $1,949.00 | $261.10 – $1,299.00 | 108 |
| Laser surgery of prostate CPT 52648 | $20,546.40 | not published | $0.96 – $10,409.46 | 83 |
| Lead acuity x4 spiral l 86cm HCPCS C1900 | $4,420.50 | $4,420.50 | $20.32 – $101.07 | 28 |
| Lead capillary CPT 83655 | $120.00 | $120.00 | $11.73 – $120.00 | 44 |
| Lead ingevity 45cm pfret MRI HCPCS C1898 | $6,399.62 | $6,399.62 | $0.05 – $0.26 | 28 |
| Lead tachy durata sj4 58cm HCPCS C1777 | $12,619.48 | $12,619.48 | $18.78 – $93.42 | 28 |
| Leg Artery Ultrasound (complete, both legs) CPT 93925 | $1,977.00 | $1,977.00 | $225.21 – $1,977.00 | 110 |
| Leg CT Scan (with contrast, both legs) CPT 73701 | $5,144.00 | $5,144.00 | $165.56 – $3,429.00 | 110 |
| Leg CT Scan (without contrast, both legs) CPT 73700 | $4,853.00 | $4,853.00 | $98.68 – $3,235.00 | 110 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $2,230.00 | $2,230.00 | $20.45 – $2,230.00 | 780 |
| Lens iol 23.0 d 1.5 cyl eyhance toric HCPCS V2787 | $645.00 | $645.00 | $10.05 – $50.00 | 28 |
| Lens iol ant bicnvx 24.0 multi HCPCS V2632 | $1,065.00 | $1,065.00 | $10.05 – $50.00 | 28 |
| Lens iol ant chamb 10.5 HCPCS V2630 | $545.00 | $545.00 | $10.05 – $50.00 | 28 |
| Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 | $396.40 | $396.40 | $2.76 – $13.75 | 94 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | $37,312.35 | $37,312.35 | $70.48 – $473.02 | 110 |
| Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 | $5,218.50 | $5,218.50 | $1,048.92 – $5,218.50 | 110 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $17.90 | $17.90 | $1.60 – $7.95 | 94 |
| Levetiracetam therapeutic drug level CPT 80177 | $245.00 | $245.00 | $12.84 – $245.00 | 44 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $61.50 | $61.50 | $1.96 – $19.25 | 94 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | $434.65 | $434.65 | $77.00 – $434.65 | 94 |
| Liberta rc ipg HCPCS C1820 | $45,975.98 | $45,975.98 | $13.81 – $68.71 | 28 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | $37.50 | $37.50 | $7.54 – $37.50 | 28 |
| Lidocaine therapeutic drug level CPT 80176 | $399.00 | $399.00 | $14.69 – $399.00 | 28 |
| Lift heel adj small gl60404sm HCPCS L3332 | $58.98 | $58.98 | $11.85 – $58.98 | 28 |
| Lift heel adjustable med HCPCS L3334 | $4.66 | $4.66 | $0.94 – $4.66 | 28 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $36.00 | $36.00 | $7.24 – $36.00 | 94 |
| Lipase CPT 83690 | $2,269.00 | $292.00 | $6.68 – $206.55 | 110 |
| Lipoprotein direct measurement hdl CPT 83718 | $106.00 | $106.00 | $7.94 – $106.00 | 44 |
| Lipoprotein direct measurement ldl CPT 83721 | $88.00 | $88.00 | $10.18 – $88.00 | 44 |
| Lithium therapeutic drug level CPT 80178 | $228.00 | $228.00 | $6.41 – $228.00 | 44 |
| Lithotripsy transluminal coronary percutaneous CPT 92972 | $2,733.00 | $2,733.00 | $530.00 – $2,733.00 | 28 |
| Liver elastography 91200 CPT 91200 | $510.00 | $510.00 | $102.51 – $510.00 | 108 |
| Liver Function Test CPT 80076 | $464.00 | $464.00 | $7.92 – $464.00 | 44 |
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | $104,104.65 | not published | $0.96 – $14,087.30 | 83 |
| Loncastuximab tesirine-lpyl 10 mg intravenous solution HCPCS J9359 | $87,089.35 | $87,089.35 | $197.84 – $87,089.35 | 110 |
| Loop ostmy bridg ster HCPCS A4421 | $69.90 | $69.90 | $0.11 – $0.56 | 28 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $60.90 | $60.90 | $2.29 – $11.40 | 94 |
| Low-Dose Lung Cancer Screening CT Scan CPT 71271 | $3,482.00 | $3,482.00 | $98.68 – $3,482.00 | 110 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $4,165.00 | $4,165.00 | $329.29 – $4,165.00 | 110 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $4,083.00 | $4,083.00 | $98.68 – $4,083.00 | 110 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $7,543.00 | $7,543.00 | $329.29 – $7,543.00 | 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.