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 |
|---|---|---|---|---|
| Mosunetuzumab-axgb 1 mg/ml intravenous solution HCPCS J9350 | $58,093.20 | $58,093.20 | $389.23 – $1,936.45 | 110 |
| M/phmtrc alys ishquant/semiq CPT 88377 | $256.00 | $256.00 | $51.46 – $346.81 | 110 |
| MRA chest wwo IV cont HCPCS C8911 | $4,137.00 | $4,137.00 | $305.55 – $4,137.00 | 44 |
| MRA without fol w/cont, abd HCPCS C8902 | $5,086.00 | $5,086.00 | $307.19 – $5,086.00 | 44 |
| MRI cardiac morph & func wo IV cont CPT 75557 | $4,436.00 | $4,436.00 | $225.21 – $4,436.00 | 110 |
| MRI cardiac morph & func wwo IV cont CPT 75561 | $5,996.00 | $5,996.00 | $329.29 – $5,996.00 | 110 |
| MRI cardiac morph & func wwo IV cont w/stress img CPT 75563 | $5,098.00 | $5,098.00 | $739.93 – $5,098.00 | 110 |
| MRI chest without contrast CPT 71550 | $4,402.00 | $4,402.00 | $225.21 – $4,402.00 | 110 |
| MRI chest without & w/contrast CPT 71552 | $4,347.00 | $4,347.00 | $329.29 – $4,347.00 | 110 |
| MRI lower extremity other than joint without contrast (both sides) CPT 73718 | $9,257.00 | $9,257.00 | $149.28 – $6,171.00 | 110 |
| MRI lower extremity other than joint without & w/contrast (both sides) CPT 73720 | $10,285.00 | $10,285.00 | $329.29 – $6,857.00 | 110 |
| MRI orbit fac&nck w IV cont CPT 70542 | $1,011.00 | $1,011.00 | $203.21 – $1,011.00 | 110 |
| MRI upper extremity other than joint without contrast (both sides) CPT 73218 | $8,573.00 | $8,573.00 | $225.85 – $5,715.00 | 110 |
| MRI upper extremity other than joint without & w/contrast (both sides) CPT 73220 | $11,134.00 | $11,134.00 | $329.29 – $7,422.00 | 110 |
| Mr safety determination physician/other qhp CPT 76016 | $185.00 | $185.00 | $37.19 – $198.11 | 28 |
| Mr safety implant elec prepj CPT 76018 | $193.00 | $193.00 | $38.79 – $206.53 | 28 |
| Mr safety implant&/fb assmt clin staff ea add 30 CPT 76015 | $103.00 | $103.00 | $20.70 – $103.00 | 26 |
| Mr safety implt pos&/immoblj CPT 76019 | $125.00 | $125.00 | $25.13 – $133.65 | 28 |
| Mr sfty implt&/fb asmt stf 1 CPT 76014 | $51.00 | $51.00 | $10.25 – $55.10 | 28 |
| Mr sfty med physics xm cstmz CPT 76017 | $507.00 | $507.00 | $101.91 – $543.87 | 28 |
| Mumps antibody igg CPT 86735 | $140.00 | $140.00 | $12.65 – $140.00 | 44 |
| Muscle-skin graft trunk CPT 15734 | $4,864.00 | $4,864.00 | $37.48 – $525.92 | 768 |
| Mycobacteria dna amp probe CPT 87551 | $381.00 | $381.00 | $46.75 – $381.00 | 44 |
| Mycophenolate mofetil 250 mg capsule HCPCS J7517 | $2.80 | $2.80 | $0.56 – $3.48 | 94 |
| Mycophenolic acid HCPCS J7518 | $1.00 | $1.00 | $0.20 – $1.00 | 94 |
| Mycoplasma antibody igm CPT 86738 | $300.00 | $300.00 | $12.83 – $78.00 | 44 |
| Myeloperoxidase ab multi step qualitative/semiquantitative CPT 83516 | $360.00 | $360.00 | $11.17 – $360.00 | 44 |
| Nafcillin 2 gram solution for injection HCPCS J2290 | $27.30 | $27.30 | $5.49 – $40.60 | 94 |
| Nalbuphine 10 mg/ml injection solution HCPCS J2300 | $28.50 | $28.50 | $3.51 – $28.50 | 94 |
| Naloxone 0.4 mg/ml injection (wrapper) HCPCS J2312 | $546.10 | $546.10 | $3.42 – $17.00 | 94 |
| Natalizumab 300 mg/15 ml intravenous solution HCPCS J2323 | $26,637.70 | $26,637.70 | $24.02 – $26,637.70 | 110 |
| Natriuretic peptide CPT 83880 | $383.00 | $383.00 | $38.05 – $383.00 | 44 |
| Natural killer cells total count CPT 86357 | $187.00 | $187.00 | $36.56 – $187.00 | 44 |
| Navigational bronchoscopy 31627 CPT 31627 | $2,216.00 | $2,216.00 | $445.42 – $2,216.00 | 26 |
| Ndl round specialty proguide HCPCS C1715 | $1,879.19 | $1,879.19 | $7.13 – $35.45 | 28 |
| Nebulizer Breathing Treatment CPT 94640 | $400.00 | $400.00 | $80.40 – $425.12 | 110 |
| Neck Airway (Soft Tissue) X-ray CPT 70360 | $416.00 | $416.00 | $82.14 – $416.00 | 110 |
| Neck (Cervical Spine) CT scan (with contrast) CPT 72126 | $2,305.00 | $2,305.00 | $329.29 – $2,305.00 | 110 |
| Neck (Cervical Spine) CT scan (without contrast) CPT 72125 | $4,083.00 | $4,083.00 | $98.68 – $4,083.00 | 110 |
| Neck (Cervical Spine) MRI (with and without contrast) CPT 72156 | $8,073.00 | $8,073.00 | $329.29 – $8,073.00 | 110 |
| Neck (Cervical Spine) MRI (without contrast) CPT 72141 | $5,492.00 | $5,492.00 | $225.21 – $5,492.00 | 110 |
| Neck (Cervical Spine) X-ray (2 to 3 views) CPT 72040 | $658.00 | $658.00 | $82.14 – $658.00 | 110 |
| Neck (Cervical Spine) X-ray (4 to 5 views) CPT 72050 | $857.00 | $857.00 | $98.68 – $857.00 | 110 |
| Neck (Cervical Spine) X-ray (6 or more views) CPT 72052 | $919.00 | $919.00 | $98.68 – $919.00 | 110 |
| Neck MRA (blood vessel MRI, with and without contrast) CPT 70549 | $5,535.00 | $5,535.00 | $329.29 – $5,535.00 | 110 |
| Neck MRA (blood vessel MRI, with contrast) CPT 70548 | $3,542.00 | $3,542.00 | $329.29 – $3,542.00 | 110 |
| Neck MRA (blood vessel MRI, without contrast) CPT 70547 | $2,658.00 | $2,658.00 | $225.21 – $2,658.00 | 110 |
| Neck Soft Tissue CT Scan (with and without contrast) CPT 70492 | $4,942.00 | $4,942.00 | $165.56 – $4,942.00 | 110 |
| Neck Soft Tissue CT Scan (with contrast) CPT 70491 | $4,224.00 | $4,224.00 | $165.56 – $4,224.00 | 110 |
| Neck Soft Tissue CT Scan (without contrast) CPT 70490 | $3,295.00 | $3,295.00 | $98.68 – $3,295.00 | 110 |
| Nerve conduction 7-8 studies CPT 95910 | $1,441.00 | $1,441.00 | $289.64 – $1,441.00 | 110 |
| Neurorraphy w/vein autograft CPT 64911 | $31,325.07 | not published | $0.96 – $17,037.54 | 83 |
| New Patient Office Visit (level 4) CPT 99204 | $307.00 | $307.00 | $74.55 – $285.00 | 768 |
| New Patient Office Visit (level 5) CPT 99205 | $402.00 | $402.00 | $102.24 – $388.00 | 768 |
| Nicardipine 25 mg/10 ml intravenous solution HCPCS J2404 | $27.30 | $27.30 | $5.49 – $29.00 | 94 |
| Nitroglycerin 50 mg/250 ml (200 mcg/ml) in 5 % dextrose intravenous HCPCS J2305 | $112.50 | $112.50 | $13.87 – $69.00 | 94 |
| Nivolumab 10 mg/ml intravenous solution (wrapper) HCPCS J9299 | $24,305.85 | $24,305.85 | $31.59 – $4,051.00 | 110 |
| Nivolumab 240 mg-relatlimab-rmbw 80 mg/20 ml intravenous solution HCPCS J9298 | $94,382.55 | $94,382.55 | $183.98 – $94,382.55 | 110 |
| Nm imaging gastrointestinal acute blood loss CPT 78278 | $1,406.00 | $1,406.00 | $282.61 – $1,406.00 | 110 |
| Nm imaging kidney morphology vascular flow/function single study w/pharmacological intervention CPT 78708 | $2,534.00 | $2,534.00 | $509.33 – $2,534.00 | 110 |
| Nm imaging pulmonary ventilation/perfusion CPT 78582 | $2,162.00 | $2,162.00 | $434.56 – $2,162.00 | 110 |
| Nose (Nasal Bone) X-ray (complete) CPT 70160 | $539.00 | $539.00 | $82.14 – $539.00 | 110 |
| Nuclear rx intra-arterial CPT 79445 | $1,172.00 | $1,172.00 | $220.24 – $1,172.00 | 110 |
| Nuclear Stress Test (Heart) CPT 78452 | $6,381.00 | $6,381.00 | $1,222.00 – $6,381.00 | 110 |
| Nusinersen (pf) 12 mg/5 ml intrathecal solution HCPCS J2326 | $455,355.55 | $455,355.55 | $1,187.16 – $455,355.55 | 110 |
| Obinutuzumab 1,000 mg/40 ml intravenous solution HCPCS J9301 | $28,351.00 | $28,351.00 | $79.99 – $28,351.00 | 110 |
| Observation direct referral from physician office for admission HCPCS G0379 | $195.00 | $195.00 | $39.20 – $4,658.00 | 110 |
| Observation/inpatient hospital care hi severity 99236 CPT 99236 | $519.00 | $519.00 | $120.98 – $438.00 | 768 |
| Observation/inpatient hospital care low severity 99234 CPT 99234 | $318.00 | $318.00 | $56.23 – $206.00 | 768 |
| Observation/inpatient hospital care mod severity 99235 CPT 99235 | $404.00 | $404.00 | $91.16 – $335.00 | 768 |
| Observation per hour HCPCS G0378 | $25,454.49 | $243.00 | $9.09 – $11,736.86 | 110 |
| Ob Ultrasound nuchal meas 1 gest CPT 76813 | $592.00 | $592.00 | $36.00 – $592.00 | 780 |
| Ob Ultrasound nuchal meas add-on CPT 76814 | $918.00 | $918.00 | $184.52 – $918.00 | 26 |
| Occupational Therapy Evaluation (high complexity) CPT 97167 | $407.00 | $407.00 | $72.58 – $407.00 | 44 |
| Occupational Therapy Evaluation (low complexity) CPT 97165 | $407.00 | $407.00 | $72.58 – $388.00 | 44 |
| Occupational Therapy Evaluation (moderate complexity) CPT 97166 | $407.00 | $407.00 | $72.58 – $407.00 | 44 |
| Ocrelizumab 30 mg/ml intravenous solution HCPCS J2350 | $65,142.90 | $65,142.90 | $62.03 – $65,142.90 | 31 |
| Octreotide acetate 100 mcg/ml injection (wrapper) HCPCS J2354 | $32.20 | $32.20 | $0.38 – $2.35 | 94 |
| Octreotide,microspheres ER 20 mg intramuscular susp, extended release HCPCS J2353 | $19,011.30 | $19,011.30 | $195.19 – $12,696.00 | 110 |
| Ofatumumab 20 mg/ml intravenous solution (wrapper) HCPCS J9302 | $1,810.15 | $1,810.15 | $363.84 – $1,810.15 | 94 |
| Oil silicone ophth 8.5ml silikon 1000 HCPCS C1814 | $1,115.54 | $1,115.54 | $224.22 – $1,115.54 | 28 |
| Olanzapine 10 mg intramuscular solution HCPCS J2359 | $51.25 | $51.25 | $10.30 – $51.25 | 28 |
| Omalizumab 150 mg/ml subcutaneous syringe (wrapper) HCPCS J2357 | $7,768.80 | $7,768.80 | $44.59 – $7,768.80 | 110 |
| Omental flap intra-abdom 49905 CPT 49905 | $1,254.00 | $1,254.00 | $32.14 – $120.00 | 768 |
| Ondansetron 8 mg disintegrating tablet HCPCS Q0162 | $19.50 | $19.50 | $0.04 – $1.00 | 94 |
| Ondansetron hcl (pf) 2 mg/ml injection (wrapper) HCPCS J2405 | $4.10 | $4.10 | $0.36 – $4.10 | 94 |
| Open periprosthetic breast capsule 19370 CPT 19370 | $35,865.50 | not published | $0.96 – $15,867.92 | 83 |
| Opn exc/dstr ntra-abd 5.1-10 CPT 49187 | $5,817.00 | $5,817.00 | $13.60 – $581.28 | 768 |
| Opn exc/dstr ntra-abd 5 cm/< CPT 49186 | $4,577.00 | $4,577.00 | $16.40 – $455.52 | 768 |
| Optx clavicular fx w/int fix CPT 23515 | $36,226.68 | not published | $9.09 – $14,087.30 | 83 |
| Oritavancin 1,200 mg intravenous solution HCPCS J2406 | $28,018.60 | $28,018.60 | $42.20 – $28,018.60 | 110 |
| Oritavancin 400 mg intravenous solution HCPCS J2407 | $5,978.20 | $5,978.20 | $29.11 – $5,978.20 | 31 |
| Orphenadrine citrate 30 mg/ml injection solution HCPCS J2360 | $55.20 | $55.20 | $9.45 – $55.20 | 94 |
| Orthopantogram CPT 70355 | $558.00 | $558.00 | $82.14 – $558.00 | 110 |
| Orthosis lso rigd frm hyperex HCPCS L0472 | $1,383.14 | $1,383.14 | $278.01 – $1,383.14 | 28 |
| Oscillation chest wall mechanical per session CPT 94669 | $349.00 | $349.00 | $70.15 – $425.12 | 110 |
| Osmolality blood CPT 83930 | $200.00 | $200.00 | $6.41 – $200.00 | 44 |
| Osmolality urine CPT 83935 | $198.00 | $198.00 | $6.61 – $198.00 | 44 |
| Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes CPT 97763 | $143.00 | $143.00 | $28.74 – $189.00 | 44 |
| Otoplasty 69300 CPT 69300 | $38,163.63 | not published | $0.96 – $15,867.92 | 83 |
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.