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 |
|---|---|---|---|---|
| Positioner proc acufex leg acs HCPCS E0190 | $303.30 | $303.30 | $49.50 – $303.30 | 36 |
| Potassium 24 hour urine CPT 84133 | $171.00 | $171.00 | $4.58 – $171.00 | 44 |
| Potassium chloride 10 meq/100ml in sterile water intravenous piggyback HCPCS J3480 | $35.00 | $35.00 | $0.15 – $3.00 | 94 |
| Potassium serum/plasma/whole blood CPT 84132 | $28,672.17 | $117.00 | $4.61 – $6,176.47 | 110 |
| Pouch high output 2pc 50mm red HCPCS A4413 | $434.29 | $434.29 | $87.29 – $434.29 | 28 |
| Pouch ostmy flat lk n 2.5in roll premier 1pc trnsp HCPCS A4388 | $0.43 | $0.43 | $0.09 – $0.43 | 28 |
| Pouch ostmy nb pouchkin ctf HCPCS A5062 | $0.59 | $0.59 | $0.09 – $0.47 | 28 |
| Pouch uros new (both sides) 2.75in clr HCPCS A4432 | $104.37 | $104.37 | $0.10 – $0.48 | 28 |
| Powder prem protct 1oz HCPCS A4371 | $0.70 | $0.70 | $0.14 – $0.70 | 28 |
| Pq thr inj ext pse CPT 36002 | $1,662.00 | $1,662.00 | $222.71 – $1,217.85 | 108 |
| Pr biopsy skin punch single lesion CPT 11104 | $329.00 | $329.00 | $12.14 – $103.00 | 768 |
| Pr correction hallux valgus (bunionectomy) with sesamoidectomy when performed with first metatarsal and cuneiform joint arthrodesis any method CPT 28297 | $34,444.04 | not published | $1.92 – $24,925.18 | 83 |
| Pr correction hammertoe CPT 28285 | $25,903.00 | not published | $0.96 – $14,087.30 | 83 |
| Pr cystourethroscopy with insertion indwelling ureteral stent CPT 52332 | $20,051.97 | not published | $0.96 – $6,843.44 | 83 |
| Pr discharge day management hospital ip/obs <=30 min on ecounter date CPT 99238 | $174.00 | $174.00 | $47.71 – $173.00 | 768 |
| Pr discharge day management hospital ip/obs > 30 min on encounter date CPT 99239 | $256.00 | $256.00 | $67.95 – $245.00 | 768 |
| Prealbumin CPT 84134 | $254.00 | $254.00 | $14.14 – $254.00 | 44 |
| Pr ecg 12 lead report only CPT 93010 | $26.00 | $26.00 | $5.33 – $17.00 | 768 |
| Prednisone 1 mg tablet HCPCS J7512 | $1.00 | $1.00 | $0.01 – $1.00 | 28 |
| Pregnancy Ultrasound (complete, after first trimester) CPT 76805 | $981.00 | $981.00 | $30.03 – $981.00 | 780 |
| Pregnancy Ultrasound (first trimester) CPT 76801 | $1,244.00 | $1,244.00 | $29.61 – $1,244.00 | 780 |
| Pregnancy Ultrasound (limited) CPT 76815 | $634.00 | $634.00 | $9.80 – $634.00 | 780 |
| Prep skin to 100cm2 other CPT 15004 | $22,636.85 | not published | $0.96 – $789.21 | 83 |
| Pretreatment serum by diff red cell adsorption patient rbc/known phenotype each adsorption ref CPT 86977 | $919.00 | $919.00 | $157.25 – $919.00 | 110 |
| Pretreat rbc absorption reference CPT 86978 | $267.00 | $267.00 | $33.96 – $267.00 | 110 |
| Pretreat rbc density gradient separation reference CPT 86972 | $348.00 | $348.00 | $69.95 – $348.00 | 110 |
| Pretreat rbc w chem/drugs reference CPT 86970 | $348.00 | $348.00 | $33.96 – $348.00 | 110 |
| Pretreat rbc w enzyme reference CPT 86971 | $228.00 | $228.00 | $45.83 – $330.76 | 110 |
| Pr evaluation psychiatric diagnostic w/medical services CPT 90792 | $421.00 | $421.00 | $81.35 – $421.00 | 768 |
| Pr excision benign lesion trunk/arms/legs 3.1 - 4.0 cm CPT 11404 | $540.00 | $540.00 | $47.05 – $372.00 | 768 |
| Pr gastrorrhaphy suture perforated duodenal or gastric ulcer/wound/ injury CPT 43840 | $4,853.00 | $4,853.00 | $35.19 – $473.12 | 768 |
| Pr hospital ip/obs care initial high level per day CPT 99223 | $483.00 | $483.00 | $99.68 – $368.00 | 768 |
| Pr hospital ip/obs care initial moderate level per day CPT 99222 | $328.00 | $328.00 | $74.55 – $276.00 | 768 |
| Pr hospital ip/obs care initial straightforward or low level per day CPT 99221 | $241.00 | $241.00 | $47.50 – $175.00 | 768 |
| Pr hospital ip/obs care subsequent high level per day CPT 99233 | $255.00 | $255.00 | $68.16 – $250.00 | 768 |
| Pr hospital ip/obs care subsequent moderate level per day CPT 99232 | $173.00 | $173.00 | $44.94 – $168.00 | 768 |
| Pr hospital ip/obs care subsequent straightforward or low level per day CPT 99231 | $106.00 | $106.00 | $28.12 – $104.00 | 768 |
| Prim art mech thrmbc non-intracranial CPT 37184 | $19,338.00 | $19,338.00 | $2,591.29 – $35,589.27 | 108 |
| Prim art mech thrmbc non-intracranial add-on CPT 37185 | $19,338.00 | $19,338.00 | $3,886.94 – $19,338.00 | 26 |
| Pr incision & drainage abscess complicated/multiple CPT 10061 | $607.00 | $607.00 | $5.92 – $65.12 | 768 |
| Pr incision & drainage abscess simple/single CPT 10060 | $11,096.85 | $1,777.00 | $0.96 – $1,777.00 | 780 |
| Pr incision & drainage abscess vulva/perineal CPT 56405 | $283.00 | $283.00 | $37.28 – $283.00 | 768 |
| Pr moderate sedation same physician >= 5 years initial 15 minutes CPT 99152 | $37.00 | $37.00 | $5.94 – $26.00 | 768 |
| Pr neuroplasty and/or transposition ulnar nerve at elbow CPT 64718 | $19,998.17 | not published | $9.09 – $6,632.15 | 83 |
| Probe cryo 1150mm endo flex ster disp HCPCS C2618 | $7,267.51 | $7,267.51 | $84.72 – $421.50 | 28 |
| Procainamide 100 mg/ml injection (wrapper) HCPCS J2690 | $2,889.60 | $2,889.60 | $8.51 – $692.51 | 110 |
| Procalcitonin CPT 84145 | $389.00 | $389.00 | $26.38 – $389.00 | 44 |
| Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution HCPCS J0780 | $21.20 | $21.20 | $2.52 – $21.20 | 94 |
| Prochlorperazine maleate 5 mg tablet HCPCS Q0164 | $1.00 | $1.00 | $0.20 – $1.15 | 94 |
| Progesterone CPT 84144 | $332.00 | $332.00 | $20.22 – $332.00 | 44 |
| Prolactin CPT 84146 | $416.00 | $416.00 | $11.66 – $58.00 | 44 |
| Promethazine 25 mg tablet HCPCS Q0169 | $1.00 | $1.00 | $0.06 – $1.00 | 94 |
| Propofol infusion 10 mg/ml HCPCS J2704 | $46.50 | $46.50 | $1.87 – $9.30 | 28 |
| Propranolol in ns IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J1800 | $45.50 | $45.50 | $1.85 – $14.65 | 94 |
| Prostatectomy (turp) CPT 52601 | $23,014.60 | not published | $31.45 – $10,409.46 | 83 |
| Prosthesis voc advantage 20f 14mm HCPCS L8509 | $3,638.95 | $3,638.95 | $0.15 – $0.89 | 36 |
| Prosthesis voc lopres 20f 22mm HCPCS L8507 | $711.83 | $711.83 | $12.21 – $60.73 | 28 |
| Protamine 10 mg/ml intravenous solution HCPCS J2720 | $50.15 | $50.15 | $8.20 – $50.15 | 94 |
| Protector nerve neurawrap 4cm HCPCS C9353 | $5,508.79 | $5,508.79 | $1,097.26 – $5,459.00 | 28 |
| Protein c activity CPT 85303 | $218.00 | $218.00 | $13.41 – $218.00 | 44 |
| Protein electrophoretic fractionation & quantitation serum CPT 84165 | $496.00 | $496.00 | $10.40 – $496.00 | 44 |
| Protein s total CPT 85305 | $242.00 | $242.00 | $11.25 – $93.00 | 44 |
| Protein total 24 hour urine CPT 84156 | $2,591.00 | $154.00 | $3.56 – $206.55 | 110 |
| Protein total body fluid CPT 84157 | $155.00 | $155.00 | $3.88 – $155.00 | 44 |
| Protein total serum plasma whole blood CPT 84155 | $140.00 | $140.00 | $3.56 – $140.00 | 44 |
| Prothrombin time substitution plasma fractions each CPT 85611 | $100.00 | $100.00 | $3.81 – $100.00 | 44 |
| Provox xtraflange 17fr HCPCS L8499 | $129.58 | $129.58 | $20.85 – $103.73 | 28 |
| Prp i/hern init block >5 yr CPT 49507 | $39,313.67 | $2,594.00 | $0.96 – $6,951.03 | 769 |
| Pr planning advance care 1st 30 minutes CPT 99497 | $190.00 | $190.00 | $39.02 – $159.00 | 768 |
| Prq tcat plmt ntrac st 1 les CPT 92928 | $28,608.00 | $28,608.00 | $5,750.21 – $28,608.00 | 108 |
| Prq tcat plmt ntrac st 2+les CPT 92930 | $14,047.00 | $14,047.00 | $2,823.45 – $35,589.27 | 105 |
| Prq trluml c angiop 1art&/br CPT 92920 | $10,933.00 | $10,933.00 | $2,197.53 – $11,049.67 | 108 |
| Pr removal drug delivery implant CPT 11982 | $12,431.20 | $297.00 | $0.96 – $867.28 | 769 |
| Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm CPT 12001 | $13,952.85 | not published | $0.96 – $1,434.84 | 83 |
| Pr robotic surgical system HCPCS S2900 | $32,183.43 | not published | $0.36 – $11,736.86 | 83 |
| Pr split-thickness autograft trunk/arm/leg 1st 100 sq cm/<tbsa infant/child CPT 15100 | $18,762.70 | not published | $0.96 – $4,005.68 | 83 |
| Pr tube thoracostomy w/connection to drainage open CPT 32551 | $2,813.00 | $2,813.00 | $7.11 – $3,056.08 | 780 |
| PSA (Prostate) Test CPT 84153 | $244.00 | $244.00 | $17.82 – $230.00 | 44 |
| Pt wheelchair management each 15 minutes CPT 97542 | $69.00 | $69.00 | $13.87 – $189.00 | 44 |
| Pulse ox continuous overnight monitoring CPT 94762 | $39,520.98 | $1,203.00 | $9.09 – $1,203.00 | 110 |
| Pulse ox multiple CPT 94761 | $228.00 | $228.00 | $45.83 – $228.00 | 28 |
| Pulse ox single CPT 94760 | $96.00 | $96.00 | $19.30 – $189.00 | 28 |
| Pump on-q 100mlx2ml/hr 2 day delivery HCPCS C9804 | $564.81 | $564.81 | $38.61 – $192.09 | 28 |
| Puncture arterial withdrawal blood for diagnosis CPT 36600 | $231.00 | $231.00 | $46.43 – $258.30 | 110 |
| Puncture aspiration abscess/hematoma/bulla/cyst CPT 10160 | $2,038.00 | $2,038.00 | $383.70 – $2,038.00 | 108 |
| Puncture spinal lumbar diagnostic CPT 62270 | $1,780.00 | $1,780.00 | $18.75 – $1,780.00 | 780 |
| Pyridoxine hcl 100 mg HCPCS J3415 | $19.55 | $19.55 | $3.93 – $22.88 | 94 |
| Rabies immune globulin (pf) 300 unit/ml intramuscular solution CPT 90375 | $9,641.40 | $9,641.40 | $274.35 – $3,213.80 | 110 |
| Radium ra223 dichl ther/uci HCPCS A9606 | $507.10 | $507.10 | $101.93 – $507.10 | 110 |
| Radphm lcl tumor plr sgl day CPT 78800 | $1,457.00 | $1,457.00 | $292.86 – $1,457.00 | 110 |
| Ramucirumab 10 mg/ml intravenous solution HCPCS J9308 | $22,849.50 | $22,849.50 | $71.62 – $4,569.90 | 110 |
| Rasburicase 1.5 mg intravenous solution HCPCS J2783 | $16,770.95 | $16,770.95 | $375.70 – $3,354.20 | 107 |
| Ravulizumab-cwvz 100 mg/ml intravenous solution HCPCS J1303 | $73,649.25 | $73,649.25 | $220.31 – $20,086.15 | 110 |
| Rbc count only automated CPT 85041 | $50.00 | $50.00 | $2.93 – $50.00 | 44 |
| Rbc deglycerolized each unit HCPCS P9039 | $1,180.00 | $1,180.00 | $237.18 – $1,180.00 | 28 |
| Rebuild outer ear canal CPT 69310 | $32,745.88 | not published | $0.36 – $11,492.83 | 83 |
| Reconstruction knee CPT 27427 | $33,184.87 | not published | $1.92 – $14,087.30 | 83 |
| Reconstruct shoulder joint CPT 23470 | $39,463.85 | not published | $9.09 – $24,925.18 | 83 |
| Reconstruct shoulder joint CPT 23472 | $46,379.67 | not published | $9.09 – $34,040.37 | 83 |
| Red blood cells frozen/deglycerolized/washed leukocytes reduced irradiated each unit HCPCS P9057 | $1,211.00 | $1,211.00 | $243.41 – $1,211.00 | 28 |
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.