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 |
|---|---|---|---|---|
| St evaluate speech sound production CPT 92522 | $445.00 | $445.00 | $86.24 – $445.00 | 44 |
| St evaluation motion fluoroscopic swallow function cine/video CPT 92611 | $504.00 | $504.00 | $84.86 – $504.00 | 44 |
| Strap chin dlx f/cpap HCPCS A7036 | $53.70 | $53.70 | $10.79 – $53.70 | 28 |
| Strap montgmry ns 8 hl sht 7.25 x 11.25in HCPCS A4461 | $0.39 | $0.39 | $0.08 – $0.39 | 28 |
| Succinylcholine chloride 20 mg/ml injection solution (wrapper) HCPCS J0330 | $82.50 | $82.50 | $15.52 – $77.20 | 28 |
| Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution HCPCS J2865 | $23.00 | $23.00 | $4.62 – $23.00 | 28 |
| Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 | $17.70 | $17.70 | $3.54 – $234.80 | 102 |
| Support clav 29.6-40.5in med HCPCS L3650 | $144.91 | $144.91 | $0.53 – $3.26 | 36 |
| Surgical pathology level 1 gross examination only CPT 88300 | $149.00 | $149.00 | $24.96 – $149.00 | 110 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $271.00 | $271.00 | $24.96 – $271.00 | 110 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $424.00 | $424.00 | $49.19 – $424.00 | 110 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $562.00 | $562.00 | $31.45 – $562.00 | 110 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $716.00 | $716.00 | $143.92 – $716.00 | 110 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $944.00 | $944.00 | $189.74 – $1,564.16 | 110 |
| Susceptibility agar dilution per agent CPT 87181 | $80.00 | $80.00 | $4.60 – $80.00 | 44 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $44.00 | $44.00 | $4.60 – $44.00 | 44 |
| Susceptibility mic per plate CPT 87186 | $313.00 | $313.00 | $5.23 – $26.00 | 44 |
| Swallowing Evaluation (Bedside) CPT 92610 | $524.00 | $524.00 | $55.26 – $524.00 | 44 |
| Swallowing Therapy Session CPT 92526 | $217.00 | $217.00 | $43.62 – $217.00 | 44 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $69.00 | $69.00 | $4.26 – $69.00 | 44 |
| System cardiomems hosp electronics HCPCS C2624 | $36,958.50 | $36,958.50 | $3,179.13 – $15,816.55 | 28 |
| System pacing micra av HCPCS C1786 | $25,785.00 | $25,785.00 | $15.58 – $77.51 | 28 |
| System pcmkr dual chamber leadless micra av2 intrdcr cath HCPCS C1785 | $41,690.91 | $41,690.91 | $22.10 – $109.96 | 28 |
| System recell skin grafting/harvesting HCPCS C1832 | $13,777.23 | $13,777.23 | $2,769.22 – $13,777.23 | 28 |
| System sealant biosentry tract HCPCS C2613 | $1,003.62 | $1,003.62 | $201.73 – $1,003.62 | 28 |
| T3 (triiodothyronine) free CPT 84481 | $240.00 | $240.00 | $16.41 – $240.00 | 44 |
| T3 (triiodothyronine) total CPT 84480 | $267.00 | $267.00 | $13.74 – $267.00 | 44 |
| T4 (thyroxine) free CPT 84439 | $111.00 | $111.00 | $8.74 – $111.00 | 44 |
| T4 (thyroxine) total CPT 84436 | $303.00 | $303.00 | $6.66 – $303.00 | 44 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | $170.70 | $170.70 | $0.15 – $1.00 | 94 |
| Tacrolimus 5 mg/ml intravenous solution HCPCS J7525 | $1,208.10 | $1,208.10 | $242.83 – $1,208.10 | 94 |
| Tacrolimus therapeutic drug level CPT 80197 | $345.00 | $345.00 | $13.30 – $345.00 | 44 |
| Tafasitamab-cxix 200 mg intravenous solution HCPCS J9349 | $4,272.00 | $4,272.00 | $13.52 – $4,272.00 | 110 |
| Tailbone (Sacrum and Coccyx) X-ray CPT 72220 | $625.00 | $625.00 | $82.14 – $625.00 | 110 |
| Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection HCPCS J9325 | $88,021.00 | $88,021.00 | $65.46 – $880.35 | 110 |
| Talquetamab-tgvs 2 mg/ml subcutaneous solution HCPCS J3055 | $35,941.50 | $35,941.50 | $73.42 – $4,492.75 | 107 |
| Tape plstc 1inx5yd hosp tb pk HCPCS A4452 | $4.67 | $4.67 | $0.94 – $4.67 | 28 |
| Target gsa panel hmtlmph neop CPT 81450 | $1,437.00 | $1,437.00 | $288.84 – $1,526.66 | 44 |
| Tarlatamab-dlle 10 mg intravenous solution HCPCS J9026 | $46,350.00 | $46,350.00 | $931.64 – $4,635.00 | 107 |
| Tavr perq femoral CPT 33361 | $11,468.00 | $11,468.00 | $2,305.07 – $11,468.00 | 26 |
| Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe HCPCS J1447 | $463.10 | $463.10 | $0.24 – $289.40 | 110 |
| Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells CPT 86481 | $250.00 | $250.00 | $50.25 – $250.00 | 44 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $593.00 | $593.00 | $60.06 – $593.00 | 44 |
| Tc-99m apcitide diag HCPCS A9504 | $1,765.30 | $1,765.30 | $354.83 – $1,765.30 | 28 |
| Tc-99m arcitumomab HCPCS A9568 | $4,224.15 | $4,224.15 | $689.38 – $4,224.15 | 36 |
| Tc-99m bicisate HCPCS A9557 | $7,128.20 | $7,128.20 | $760.01 – $7,128.20 | 107 |
| Tc-99m depreotide HCPCS A9536 | $1,937.35 | $1,937.35 | $389.41 – $1,937.35 | 28 |
| Tc-99m diag per dose HCPCS A4641 | $575.50 | $575.50 | $115.68 – $575.50 | 26 |
| Tc-99m disofenin HCPCS A9510 | $339.80 | $339.80 | $68.30 – $339.80 | 28 |
| Tc-99m exame autol wbc diag per dose HCPCS A9569 | $8,194.15 | $8,194.15 | $915.45 – $8,194.15 | 107 |
| Tc-99m exametazime diag HCPCS A9521 | $7,382.05 | $7,382.05 | $909.16 – $7,382.05 | 107 |
| Tc-99m fanolesomab diag HCPCS A9566 | $17,688.75 | $17,688.75 | $3,555.44 – $17,688.75 | 26 |
| Tc-99m gluceptate HCPCS A9550 | $1,105.40 | $1,105.40 | $222.19 – $1,105.40 | 26 |
| Tc-99m labeled rbc HCPCS A9560 | $857.40 | $857.40 | $152.90 – $857.40 | 28 |
| Tc-99m maa HCPCS A9540 | $760.95 | $760.95 | $42.69 – $760.95 | 28 |
| Tc-99m mebrofenin HCPCS A9537 | $308.25 | $308.25 | $61.96 – $308.25 | 28 |
| Tc-99m medronate HCPCS A9503 | $210.35 | $210.35 | $42.28 – $210.35 | 28 |
| Tc-99m mertiatide HCPCS A9562 | $1,340.90 | $1,340.90 | $269.52 – $2,227.87 | 28 |
| Tc-99m non-heu per study dose HCPCS Q9969 | $1.00 | $1.00 | $0.16 – $14.50 | 36 |
| Tc-99m oxidronate HCPCS A9561 | $199.60 | $199.60 | $40.12 – $199.60 | 28 |
| Tc-99m pentetate dtpa HCPCS A9539 | $627.25 | $627.25 | $36.58 – $627.25 | 28 |
| Tc-99m pentetate dtpa aerosol HCPCS A9567 | $627.25 | $627.25 | $29.55 – $627.25 | 28 |
| Tc-99m pertechnetate per mci HCPCS A9512 | $99.30 | $99.30 | $19.96 – $534.62 | 28 |
| Tc-99m pyroph diag per dose up to 25 mci HCPCS A9538 | $335.80 | $335.80 | $55.81 – $335.80 | 28 |
| Tc-99m sestamibi p study dose HCPCS A9500 | $221.60 | $221.60 | $44.54 – $653.34 | 28 |
| Tc-99m succimer (dmsa) HCPCS A9551 | $2,988.10 | $2,988.10 | $600.61 – $2,988.10 | 107 |
| Tc-99m sulfur colloid HCPCS A9541 | $855.40 | $855.40 | $171.94 – $1,089.53 | 28 |
| Tc-99m tetrofosmin p study dose HCPCS A9502 | $198.05 | $198.05 | $39.81 – $228.88 | 28 |
| Tc-99m tilmanocept diag HCPCS A9520 | $2,740.00 | $2,740.00 | $550.74 – $2,740.00 | 26 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $153.00 | $153.00 | $30.75 – $153.00 | 44 |
| T cells total count CPT 86359 | $113.00 | $113.00 | $22.71 – $113.00 | 44 |
| Tebentafusp-tebn 100 mcg/0.5 ml intravenous solution HCPCS J9274 | $107,550.00 | $107,550.00 | $203.61 – $107,550.00 | 110 |
| Temozolomide 100 mg intravenous solution HCPCS J9328 | $5,015.55 | $5,015.55 | $1,008.13 – $5,015.55 | 94 |
| Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln HCPCS J9330 | $10,501.70 | $10,501.70 | $53.30 – $10,501.70 | 31 |
| Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) HCPCS J3101 | $23,582.35 | $23,582.35 | $4,298.50 – $23,273.85 | 94 |
| Terbutaline 1 mg/ml subcutaneous solution HCPCS J3105 | $6.90 | $6.90 | $1.39 – $6.90 | 28 |
| Test pathogen(s) for platelets reference HCPCS P9100 | $160.00 | $160.00 | $32.16 – $160.00 | 110 |
| Test stress cardiovascular tracing only CPT 93017 | $1,365.00 | $1,365.00 | $203.81 – $1,365.00 | 110 |
| Tetanus immune globulin inj HCPCS J1670 | $2,622.15 | $2,622.15 | $527.05 – $2,622.15 | 110 |
| Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe HCPCS J2356 | $22,937.05 | $22,937.05 | $18.16 – $22,937.05 | 31 |
| Theophylline therapeutic drug level CPT 80198 | $267.00 | $267.00 | $13.70 – $267.00 | 44 |
| Therapy Activity Training (each 15 minutes) CPT 97530 | $165.00 | $165.00 | $31.45 – $189.00 | 44 |
| Therapy Exercise Session (each 15 minutes) CPT 97110 | $151.00 | $151.00 | $25.38 – $189.00 | 44 |
| Ther/proph/diag inj ia CPT 96373 | $279.00 | $279.00 | $56.08 – $427.00 | 110 |
| Thiamine hcl (vitamin b1) 100 mg/ml injection solution HCPCS J3411 | $5.80 | $5.80 | $1.17 – $5.80 | 94 |
| Thigh Bone (Femur) X-ray (both sides) CPT 73552 | $1,310.00 | $983.00 | $82.14 – $655.00 | 110 |
| Thiotepa 15 mg solution for injection HCPCS J9341 | $1,090.00 | $1,090.00 | $219.09 – $1,090.00 | 28 |
| Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides) CPT 32555 | $5,530.00 | $5,530.00 | $8.69 – $3,687.00 | 780 |
| Thrombectmy crnry perq mechanical CPT 92973 | $24,855.00 | $24,855.00 | $4,995.86 – $24,855.00 | 26 |
| Thrombin time CPT 85670 | $112.00 | $112.00 | $5.59 – $112.00 | 44 |
| Thromboplastin time partial (ptt) substitution fractions each CPT 85732 | $179.00 | $179.00 | $6.27 – $179.00 | 44 |
| Thyroglobulin antibody CPT 86800 | $155.00 | $155.00 | $15.41 – $155.00 | 44 |
| Thyroid (TSH) Test CPT 84443 | $28,727.38 | $323.00 | $16.28 – $5,110.80 | 110 |
| Thyroid Ultrasound CPT 76536 | $1,209.00 | $1,209.00 | $98.68 – $1,209.00 | 110 |
| Thyrotropin alfa 0.9 mg intramuscular solution HCPCS J3240 | $10,828.50 | $10,828.50 | $1,992.78 – $10,828.50 | 110 |
| Tib/per revasc w/ather add-on 37233 CPT 37233 | $52,944.00 | $52,944.00 | $5,760.31 – $35,296.00 | 34 |
| Tirofiban 12.5 mg/50 ml HCPCS J3246 | $359.50 | $359.50 | $51.45 – $256.30 | 94 |
| Tisotumab vedotin-tftv 40 mg intravenous solution HCPCS J9273 | $22,202.40 | $22,202.40 | $170.43 – $22,202.40 | 110 |
| Tissue amnio epifix inj 100mg HCPCS Q4145 | $3,932.14 | $3,932.14 | $415.14 – $2,065.35 | 28 |
| Tissue dermagraft 2x3in 37.5sqcm-cost per sq cm HCPCS Q4431 | $104.20 | $104.20 | $20.94 – $104.20 | 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.