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 |
|---|---|---|---|---|
| Ot re-evaluation patient/family CPT 97168 | $179.00 | $179.00 | $35.98 – $189.00 | 44 |
| Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes CPT 97130 | $272.00 | $272.00 | $17.81 – $189.00 | 44 |
| Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes CPT 97129 | $272.00 | $272.00 | $18.89 – $272.00 | 44 |
| Ovarian cystectomy 58925 CPT 58925 | $28,595.75 | not published | $62.90 – $9,711.82 | 83 |
| Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr HCPCS J2700 | $14.50 | $14.50 | $2.91 – $14.50 | 94 |
| Oxaliplatin 5 mg/ml desensitization HCPCS J9263 | $1,200.00 | $1,200.00 | $23.12 – $115.00 | 28 |
| Oxytocin 10 unit/ml injection solution HCPCS J2590 | $6.85 | $6.85 | $0.87 – $6.85 | 94 |
| P-32 chromic phos ther per mci HCPCS A9564 | $1,730.00 | $1,730.00 | $347.73 – $3,292.52 | 28 |
| P-32 sod phosphate ther per mci HCPCS A9563 | $1,383.10 | $1,383.10 | $179.12 – $1,383.10 | 94 |
| Pacemaker leadless 19.5f 32.2mm ra HCPCS C1605 | $22,352.16 | $22,352.16 | $4,492.78 – $22,352.16 | 28 |
| Paclitaxel 6 mg/ml concentrate,intravenous HCPCS J9267 | $328.00 | $328.00 | $3.60 – $36.70 | 94 |
| Paclitaxel protein-bound 100 mg intravenous suspension HCPCS J9264 | $4,766.15 | $4,766.15 | $8.02 – $4,766.15 | 110 |
| Pad repl cerv collr univ adult HCPCS L0999 | $93.32 | $93.32 | $10.96 – $54.55 | 28 |
| Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution HCPCS J2430 | $136.60 | $136.60 | $8.60 – $42.80 | 94 |
| Panitumumab 20 mg/ml intravenous solution (wrapper) HCPCS J9303 | $20,996.10 | $20,996.10 | $162.13 – $5,249.05 | 110 |
| Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr HCPCS J2470 | $10.25 | $10.25 | $0.91 – $14.18 | 94 |
| Papaverin hcl injection HCPCS J2440 | $29.90 | $29.90 | $5.98 – $39.27 | 32 |
| Parathormone (pth) intact CPT 83970 | $620.00 | $620.00 | $40.00 – $620.00 | 44 |
| Particle matristem matrix 1000mg micron-q4118-cost per mg HCPCS Q4118 | $340.09 | $340.09 | $0.40 – $2.43 | 36 |
| Passy muir valve metal trach HCPCS L8501 | $373.03 | $373.03 | $15.81 – $78.66 | 28 |
| Paste skin barrier .5oz adapt HCPCS A4406 | $0.65 | $0.65 | $0.13 – $0.65 | 28 |
| Pd hl 3.5in 4d med rbr mld 6432 HCPCS L3350 | $144.91 | $144.91 | $29.13 – $144.91 | 28 |
| Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector HCPCS J2506 | $17,709.85 | $17,709.85 | $120.38 – $17,709.85 | 110 |
| Pegfilgrastim-apgf 6 mg/0.6 ml subcutaneous syringe HCPCS Q5122 | $10,830.70 | $10,830.70 | $130.39 – $10,830.70 | 110 |
| Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe HCPCS Q5111 | $20,144.40 | $20,144.40 | $158.75 – $20,144.40 | 110 |
| Pegfilgrastim-fpgk 6 mg/0.6 ml subcutaneous syringe HCPCS Q5127 | $11,866.15 | $11,866.15 | $2,385.10 – $11,866.15 | 94 |
| Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe HCPCS Q5108 | $5,037.30 | $5,037.30 | $96.89 – $5,037.30 | 110 |
| Pegfilgrastim-pbbk 6 mg/0.6 ml subcutaneous syringe HCPCS Q5130 | $11,497.50 | $11,497.50 | $124.68 – $11,497.50 | 110 |
| Pegloticase 8 mg/ml intravenous solution HCPCS J2507 | $95,364.75 | $95,364.75 | $3,610.60 – $95,364.75 | 110 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $3,063.00 | $3,063.00 | $165.56 – $3,063.00 | 110 |
| Pelvic CT scan (with contrast) CPT 72193 | $3,436.00 | $3,436.00 | $165.56 – $3,436.00 | 110 |
| Pelvic CT scan (without contrast) CPT 72192 | $3,263.00 | $3,263.00 | $98.68 – $3,263.00 | 110 |
| Pelvic MRI (with and without contrast) CPT 72197 | $7,541.00 | $7,541.00 | $329.29 – $7,541.00 | 110 |
| Pelvic MRI (without contrast) CPT 72195 | $2,865.00 | $2,865.00 | $145.16 – $2,865.00 | 110 |
| Pelvic Ultrasound (complete) CPT 76856 | $981.00 | $981.00 | $98.68 – $981.00 | 110 |
| Pelvic Ultrasound (limited) CPT 76857 | $1,049.00 | $1,049.00 | $98.68 – $1,049.00 | 110 |
| Pelvis X-ray (1 to 2 views) CPT 72170 | $47,217.57 | $562.00 | $9.09 – $562.00 | 110 |
| Pembrolizumab 25 mg/ml intravenous solution HCPCS J9271 | $18,047.05 | $18,047.05 | $57.42 – $18,047.05 | 110 |
| Pemetrexed disodium 100 mg intravenous powder for solution HCPCS J9305 | $5,906.25 | $5,906.25 | $3.52 – $1,181.25 | 110 |
| Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 | $1,928.25 | $1,928.25 | $21.71 – $1,928.25 | 110 |
| Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr HCPCS J2540 | $234.00 | $234.00 | $0.65 – $3.25 | 94 |
| Penile rear tip xtnd 0.5cm HCPCS C2622 | $20,815.21 | $20,815.21 | $10.05 – $50.00 | 28 |
| Pentamidine 300 mg solution for injection HCPCS J2516 | $792.75 | $792.75 | $159.34 – $792.75 | 28 |
| Pentostatin 10 mg intravenous solution HCPCS J9268 | $14,509.25 | $14,509.25 | $2,486.35 – $14,509.25 | 110 |
| Perc drug-el cor stent sing HCPCS C9600 | $35,266.00 | $35,266.00 | $7,088.47 – $35,266.00 | 108 |
| Perflutren lipid microspheres 1.1 mg/ml intravenous suspension HCPCS Q9957 | $393.60 | $393.60 | $79.11 – $393.60 | 28 |
| Pertuzumab 30 mg/ml desensitization HCPCS J9306 | $20,666.10 | $20,666.10 | $15.59 – $20,666.10 | 110 |
| Pessary 3.5 in 7 vag sil rng fold HCPCS A4562 | $148.28 | $148.28 | $22.35 – $111.21 | 28 |
| Pet CT skull-mid thgh initial CPT 78815 | $9,778.20 | $8,010.00 | $1,349.71 – $8,010.00 | 110 |
| Pet CT whole body initial CPT 78816 | $11,540.00 | $11,540.00 | $1,349.71 – $11,540.00 | 110 |
| Pet fdg brain metoblic eval sb CPT 78608 | $4,186.00 | $4,186.00 | $841.39 – $4,186.00 | 110 |
| Pet image w/ct lmtd CPT 78814 | $7,347.00 | $7,347.00 | $1,349.71 – $7,347.00 | 110 |
| Pfc sigma fem post aug sz3 8mm HCPCS C1776 | $84,222.41 | $84,222.41 | $0.01 – $0.01 | 28 |
| Ph body fluid CPT 83986 | $43.00 | $43.00 | $3.47 – $43.00 | 44 |
| Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr HCPCS J2560 | $201.80 | $201.80 | $13.16 – $65.45 | 94 |
| Phenobarbital therapeutic drug level CPT 80184 | $237.00 | $237.00 | $14.83 – $237.00 | 44 |
| Phentolaine mesylate inj HCPCS J2760 | $1,621.15 | $1,621.15 | $325.85 – $1,621.15 | 110 |
| Phenylephrine 10 mg/ml injection solution HCPCS J2371 | $11.90 | $11.90 | $0.60 – $3.00 | 28 |
| Phenytoin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1165 | $3.00 | $3.00 | $0.60 – $3.00 | 94 |
| Phenytoin total therapeutic drug level CPT 80185 | $274.00 | $274.00 | $12.84 – $274.00 | 44 |
| Phosphorus CPT 84100 | $42,502.97 | $124.00 | $4.59 – $13,116.76 | 110 |
| Phosphorus 24 hour urine CPT 84105 | $107.00 | $107.00 | $5.60 – $107.00 | 44 |
| Physical Therapy Evaluation (high complexity) CPT 97163 | $419.00 | $419.00 | $74.80 – $419.00 | 44 |
| Physical Therapy Evaluation (low complexity) CPT 97161 | $407.00 | $407.00 | $74.80 – $407.00 | 44 |
| Physical Therapy Evaluation (moderate complexity) CPT 97162 | $407.00 | $407.00 | $74.80 – $407.00 | 44 |
| Physical Therapy Re-Evaluation CPT 97164 | $179.00 | $179.00 | $35.98 – $189.00 | 44 |
| Phytonadione (vitamin k1) 10 mg/ml injection solution HCPCS J3430 | $22.60 | $22.60 | $2.84 – $19.80 | 94 |
| Pillow shldr abduc inflat univ HCPCS L3960 | $1,202.93 | $1,202.93 | $30.41 – $186.36 | 36 |
| Pin caspar distraction 12mm HCPCS C1821 | $37,392.12 | $37,392.12 | $0.01 – $0.40 | 28 |
| Pinworm exam CPT 87172 | $70.00 | $70.00 | $4.14 – $70.00 | 44 |
| Piperacillin-tazobactam 3.375 gram intravenous solution HCPCS J2543 | $89.80 | $89.80 | $2.22 – $15.80 | 94 |
| Place cath intracranial art CPT 36228 | $853.00 | $853.00 | $114.17 – $568.00 | 26 |
| Place cath xtrnl carotid CPT 36227 | $290.00 | $290.00 | $38.79 – $193.00 | 26 |
| Place duod/jej tube perc CPT 49441 | $868.00 | $868.00 | $30.80 – $666.50 | 768 |
| Place gastrostomy tube perc CPT 49440 | $1,993.00 | $1,993.00 | $400.59 – $3,725.39 | 108 |
| Placement localization device(s) breast percutaneous mammographic guide ea addl lesion left CPT 19282 | $2,381.00 | $2,381.00 | $44.46 – $2,381.00 | 26 |
| Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides) CPT 19285 | $14,439.00 | $14,439.00 | $75.66 – $9,625.00 | 108 |
| Placement occlusive device venous/arterial access site post procedure HCPCS G0269 | $263.00 | $263.00 | $52.86 – $263.00 | 26 |
| Placement stent(s) intravascular transcatheter artery initial CPT 37236 | $26,977.00 | $26,977.00 | $3,614.78 – $22,412.03 | 108 |
| Place non-slctv cath thoracic arta CPT 36221 | $11,500.00 | $11,500.00 | $2,311.50 – $11,500.00 | 108 |
| Place right device/marker pros CPT 55876 | $19,895.50 | not published | $9.09 – $10,409.46 | 83 |
| Plasma cryoprecipitate reduced each unit HCPCS P9044 | $381.00 | $381.00 | $76.58 – $546.00 | 28 |
| Platelet aggregation each agent teg CPT 85576 | $310.00 | $310.00 | $24.13 – $310.00 | 44 |
| Platelet automated CPT 85049 | $139.00 | $139.00 | $4.35 – $139.00 | 44 |
| Platelets hla matched leukocytes reduced apheresis/pheresis each unit HCPCS P9052 | $3,071.00 | $3,071.00 | $546.00 – $3,071.00 | 110 |
| Platelets leukocytes reduced each unit HCPCS P9031 | $377.00 | $377.00 | $75.78 – $546.00 | 110 |
| Platelets leukocytes reduced irradiated each unit HCPCS P9033 | $616.00 | $616.00 | $123.82 – $616.00 | 110 |
| Platelets leukoreduced cmv negative apheresis/phresis each unit HCPCS P9055 | $2,750.00 | $2,750.00 | $546.00 – $2,750.00 | 28 |
| Platelets pheresis leukocytes reduced cmv negative irradiated each unit HCPCS P9053 | $1,764.00 | $1,764.00 | $354.56 – $1,764.00 | 110 |
| Platelets pheresis leukocytes reduced each unit HCPCS P9035 | $1,426.00 | $1,426.00 | $286.63 – $1,426.00 | 110 |
| Platelets pheresis leukocytes reduced irradiated each unit HCPCS P9037 | $1,546.00 | $1,546.00 | $310.75 – $1,546.00 | 110 |
| Platelets pheresis pathogen-reduced each unit HCPCS P9073 | $1,115.00 | $1,115.00 | $224.12 – $1,220.93 | 110 |
| Plcmnt ureteral stent pq w/img exstng trct CPT 50693 | $2,054.00 | $2,054.00 | $275.17 – $6,843.44 | 108 |
| Plcmt sft tiss loc pq w/img 1st lsn CPT 10035 | $4,177.00 | $4,177.00 | $75.66 – $2,785.00 | 108 |
| Plmt access bil tree sm bwl CPT 47541 | $9,290.00 | $9,290.00 | $1,867.29 – $9,290.00 | 26 |
| Plmt biliary drainage cath CPT 47534 | $1,420.00 | $1,420.00 | $285.42 – $6,951.03 | 108 |
| Plug insert indwelling 16f HCPCS L8511 | $235.90 | $235.90 | $47.42 – $235.90 | 28 |
| Pm device progr eval dual CPT 93280 | $112.00 | $112.00 | $22.51 – $112.00 | 108 |
| Poct blood gases ph pco2 po2 arterial calculated o2 CPT 82803 | $504.00 | $504.00 | $25.27 – $504.00 | 44 |
| Polatuzumab vedotin-piiq 140 mg intravenous solution HCPCS J9309 | $59,184.30 | $59,184.30 | $122.12 – $12,682.40 | 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.