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 |
|---|---|---|---|---|
| Rpr aa hrn rcr < 3 ncr/strn CPT 49614 | $33,462.90 | $2,036.00 | $1.92 – $11,736.86 | 769 |
| Rpr aa hrn rcr < 3 rdc CPT 49613 | $55,739.59 | $1,503.00 | $8.74 – $20,636.89 | 769 |
| Rpr fem hernia init blocked CPT 49553 | $33,885.29 | not published | $0.96 – $6,951.03 | 83 |
| Rubella antibody igg CPT 86762 | $156.00 | $156.00 | $13.94 – $156.00 | 44 |
| Rubeola antibody igg CPT 86765 | $142.00 | $142.00 | $12.48 – $142.00 | 44 |
| Russell viper venom diluted CPT 85613 | $313.00 | $313.00 | $9.28 – $313.00 | 44 |
| Sacituzumab govitecan-hziy 180 mg intravenous solution HCPCS J9317 | $7,844.35 | $7,844.35 | $33.65 – $7,844.35 | 110 |
| Sacroiliac Joint X-ray (3 or more views) CPT 72202 | $600.00 | $600.00 | $98.68 – $600.00 | 110 |
| Scan duplex aorta/ivc/iliac or bypass grafts complete CPT 93978 | $732.00 | $732.00 | $147.13 – $732.00 | 110 |
| Scan duplex extracranial arteries unilateral/limited study CPT 93882 | $1,164.00 | $1,164.00 | $98.68 – $1,164.00 | 110 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $1,571.00 | $1,571.00 | $98.68 – $1,571.00 | 110 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $1,412.00 | $1,412.00 | $14.27 – $1,412.00 | 780 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $1,286.00 | $1,286.00 | $14.48 – $1,286.00 | 780 |
| Scope uretscp lithovue dig disp HCPCS C1747 | $3,868.86 | $3,868.86 | $364.60 – $1,813.91 | 28 |
| Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations HCPCS G0328 | $75.00 | $75.00 | $15.08 – $75.00 | 41 |
| Screening hepatitis b non-obstetric high risk HCPCS G0499 | $138.00 | $138.00 | $27.70 – $138.00 | 41 |
| Screening hepatitis c antibody high risk HCPCS G0472 | $70.00 | $70.00 | $14.07 – $93.16 | 44 |
| Screening HIV antigen/antibody combination assay HCPCS G0475 | $90.00 | $90.00 | $18.09 – $90.00 | 41 |
| Screening prostate cancer PSA HCPCS G0103 | $211.00 | $211.00 | $18.92 – $211.00 | 41 |
| Screw cortex 2.0 x 10mm HCPCS C1713 | $1,194,705.00 | $1,194,705.00 | $0.01 – $0.08 | 28 |
| Scrotal (Testicle) Ultrasound CPT 76870 | $1,318.00 | $1,318.00 | $98.68 – $1,318.00 | 110 |
| Sedation moderate same physician performing a gastrointestinal endoscopic service >= 5 years initial 15 minutes intra-service time HCPCS G0500 | $268.00 | $268.00 | $53.87 – $268.00 | 28 |
| Sedimentation rate erythrocyte automated CPT 85652 | $104.00 | $104.00 | $2.62 – $104.00 | 44 |
| Self-Care and Home Skills Training (each 15 minutes) CPT 97535 | $160.00 | $160.00 | $28.47 – $189.00 | 44 |
| Semen analysis presence/motility CPT 89321 | $138.00 | $138.00 | $11.68 – $138.00 | 44 |
| Sevelamer carbonate 800 mg tablet HCPCS J0601 | $1.50 | $1.50 | $0.30 – $6.38 | 99 |
| Sevelamer carbonate pdr 20mg HCPCS J0602 | $1.75 | $1.75 | $0.35 – $52.20 | 99 |
| Sheath gldlight lasr 12fx50cm HCPCS C2629 | $7,277.64 | $7,277.64 | $146.85 – $730.60 | 28 |
| Sheath laser cavaclear 14f HCPCS C1603 | $8,946.25 | $8,946.25 | $1,336.30 – $6,648.28 | 28 |
| Sho arthrs srg bicp tenodsis CPT 29828 | $26,195.43 | not published | $1.92 – $14,087.30 | 83 |
| Sho arthrs srg capsulorraphy CPT 29806 | $27,228.60 | not published | $1.92 – $14,087.30 | 83 |
| Sho arthrs srg rpr slap les CPT 29807 | $27,834.80 | not published | $9.09 – $14,087.30 | 83 |
| Sho arthrs srg xtnsv dbrdmt CPT 29823 | $24,954.99 | not published | $0.96 – $14,087.30 | 83 |
| Shoe post-op mens m HCPCS L3260 | $65.95 | $65.95 | $0.47 – $2.90 | 36 |
| Shot (Injection into Muscle or Under the Skin) CPT 96372 | $2,482.80 | $215.00 | $43.22 – $427.00 | 110 |
| Shoulder AC Joint X-ray (both sides) CPT 73050 | $542.00 | $542.00 | $82.14 – $542.00 | 110 |
| Shoulder Arthroscopy (Rotator Cuff Repair) CPT 29827 | $27,109.23 | not published | $0.96 – $14,087.30 | 83 |
| Shoulder Blade (Scapula) X-ray (both sides) CPT 73010 | $901.00 | $901.00 | $98.68 – $601.00 | 110 |
| Shoulder MRI (with and without contrast) CPT 73223 | $11,106.00 | $11,106.00 | $329.29 – $7,404.00 | 110 |
| Shoulder MRI (with contrast) CPT 73222 | $9,717.00 | $9,717.00 | $739.93 – $6,477.00 | 110 |
| Shoulder MRI (without contrast) CPT 73221 | $7,839.00 | $7,839.00 | $225.21 – $5,226.00 | 110 |
| Shoulder X-ray CPT 73030 | $46,960.00 | $998.00 | $1.92 – $665.00 | 110 |
| Shoulder X-ray (single view, both shoulders) CPT 73020 | $683.00 | $683.00 | $82.14 – $455.00 | 110 |
| Shrinker prosth above knee HCPCS L8460 | $354.09 | $354.09 | $71.17 – $354.09 | 28 |
| Shrinker prosth below knee HCPCS L8440 | $274.82 | $274.82 | $55.24 – $274.82 | 28 |
| Shunt glaucoma baerveldt 350mm HCPCS C1783 | $4,937.28 | $4,937.28 | $35.90 – $178.61 | 28 |
| Shuntogram nonvascular supervision & interpretation CPT 75809 | $758.00 | $758.00 | $98.68 – $758.00 | 110 |
| Sickling rbc CPT 85660 | $143.00 | $143.00 | $5.33 – $143.00 | 44 |
| Sigmoidoscopy for bleeding CPT 45334 | $428.00 | $428.00 | $16.30 – $374.10 | 768 |
| Sinus CT scan (with and without contrast) CPT 70488 | $5,193.00 | $5,193.00 | $165.56 – $5,193.00 | 110 |
| Sinus CT scan (with contrast) CPT 70487 | $3,821.00 | $3,821.00 | $165.56 – $3,821.00 | 110 |
| Sinus CT scan (without contrast) CPT 70486 | $3,710.00 | $3,710.00 | $98.68 – $3,710.00 | 110 |
| Sinus X-ray (complete) CPT 70220 | $645.00 | $645.00 | $82.14 – $645.00 | 110 |
| Sirolimus, oral HCPCS J7520 | $3.30 | $3.30 | $0.66 – $3.30 | 94 |
| Sirolimus-protein bound 100 mg intravenous suspension HCPCS J9331 | $42,938.50 | $42,938.50 | $8,630.64 – $42,938.50 | 94 |
| Skull X-ray (1 to 3 views) CPT 70250 | $571.00 | $571.00 | $98.68 – $571.00 | 110 |
| Skull X-ray (complete) CPT 70260 | $823.00 | $823.00 | $98.68 – $823.00 | 110 |
| Sleep study unattended CPT 95806 | $765.00 | $765.00 | $153.77 – $2,984.00 | 110 |
| Sleeve fing rolyan med HCPCS L3933 | $57.93 | $57.93 | $11.64 – $57.93 | 28 |
| Sleeve irr assura 1pc disp HCPCS A4397 | $1.00 | $1.00 | $0.20 – $1.00 | 28 |
| Sling arm deluxe w/pad xs HCPCS A4565 | $813.94 | $813.94 | $0.42 – $460.13 | 36 |
| Sling pelv split sam med HCPCS L0621 | $254.70 | $254.70 | $41.57 – $254.70 | 36 |
| Sling suprapubic suburetheral HCPCS C1771 | $14,158.23 | $14,158.23 | $410.39 – $2,041.75 | 28 |
| Sm-153 lexidron ther HCPCS A9604 | $57,456.00 | $57,456.00 | $4,314.91 – $57,456.00 | 94 |
| Small Bowel Barium X-ray (Follow-Through) CPT 74250 | $1,011.00 | $1,011.00 | $165.56 – $1,011.00 | 110 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $239.00 | $239.00 | $5.22 – $103.00 | 44 |
| Smear gram stain CPT 87205 | $154.00 | $154.00 | $4.14 – $154.00 | 44 |
| Smear nasal eosinophil CPT 89190 | $106.00 | $106.00 | $5.61 – $106.00 | 44 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $243.00 | $243.00 | $5.80 – $243.00 | 44 |
| Sock wool above knee HCPCS L8430 | $244.12 | $244.12 | $49.07 – $244.12 | 28 |
| Sodium 24 hour urine CPT 84300 | $113.00 | $113.00 | $4.91 – $113.00 | 44 |
| Sodium chloride 0.9 % intravenous solution HCPCS J7030 | $25.00 | $25.00 | $1.16 – $5.75 | 28 |
| Sodium chloride 0.9 % IV bolus HCPCS J7040 | $20.00 | $20.00 | $3.52 – $17.50 | 28 |
| Sodium chloride 0.9 % IV bolus HCPCS J7050 | $33.00 | $33.00 | $2.76 – $13.75 | 28 |
| Sodium chloride 3 % ivpb HCPCS J7131 | $30.00 | $30.00 | $6.03 – $75.00 | 94 |
| Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous HCPCS J2916 | $40.85 | $40.85 | $8.21 – $40.85 | 94 |
| Sodium serum/plasma/whole blood CPT 84295 | $118.00 | $118.00 | $4.66 – $118.00 | 44 |
| Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution HCPCS J0209 | $495.00 | $495.00 | $0.86 – $495.00 | 107 |
| Specific gravity body fluid CPT 84315 | $62.00 | $62.00 | $3.18 – $62.00 | 44 |
| Speech and Language Evaluation (comprehensive) CPT 92523 | $445.00 | $445.00 | $89.45 – $445.00 | 44 |
| Speech Therapy Session (one-on-one) CPT 92507 | $356.00 | $356.00 | $71.56 – $356.00 | 44 |
| Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance CPT 62328 | $2,045.00 | $2,045.00 | $411.05 – $2,045.00 | 108 |
| Spine X-ray (single view, one level) CPT 72020 | $464.00 | $464.00 | $82.14 – $464.00 | 110 |
| Splint arm vnyl coated padded lft med HCPCS Q4051 | $25.00 | $25.00 | $5.03 – $25.00 | 28 |
| Splint dorsal bloc wh med perf 3.2mm lf polyflex ii HCPCS L3906 | $66.30 | $66.30 | $4.77 – $29.20 | 36 |
| Splint extn xsm w sof-stretch rolyan HCPCS L3925 | $77.51 | $77.51 | $6.45 – $39.50 | 36 |
| Splint finger 4 prong foam sm HCPCS A4570 | $0.85 | $0.85 | $0.13 – $0.67 | 28 |
| Splint finger fold over sm HCPCS L3924 | $0.67 | $0.67 | $0.13 – $0.67 | 28 |
| Splint finger frog med HCPCS L3927 | $0.83 | $0.83 | $0.06 – $0.39 | 36 |
| Splint fing stax assort 1-7in HCPCS Q4049 | $1.60 | $1.60 | $0.32 – $1.60 | 28 |
| Splint func pos polyflex ii med HCPCS L3999 | $51.70 | $51.70 | $8.44 – $51.70 | 36 |
| Splint rstrc wrst/cmc right med HCPCS L3923 | $155.66 | $155.66 | $7.89 – $48.35 | 36 |
| Split blood or products CPT 86985 | $193.00 | $193.00 | $38.79 – $330.76 | 110 |
| Sputum specimen collection CPT 89220 | $160.00 | $160.00 | $32.16 – $330.76 | 107 |
| Sr-89 stront chlor ther / mci HCPCS A9600 | $40,862.00 | $40,862.00 | $4,063.41 – $40,862.00 | 107 |
| St cognitve performance testing healthcare professional each hour CPT 96125 | $553.00 | $553.00 | $75.75 – $553.00 | 44 |
| Stent axios caut enh 15x10mm electrocaut HCPCS C1874 | $49,851.00 | $49,851.00 | $0.01 – $11.31 | 28 |
| Stent bili dbl pgtl 10fx5cm HCPCS C2617 | $9,328.16 | $9,328.16 | $5.98 – $29.75 | 28 |
| Stent bili rx wallflx 10x80 uncvr HCPCS C1876 | $28,791.53 | $28,791.53 | $0.47 – $2.32 | 28 |
| Stent bronch dumon sil 10x40mm HCPCS C1875 | $7,567.48 | $7,567.48 | $169.44 – $843.00 | 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.