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 |
|---|---|---|---|---|
| Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm HCPCS Q4122 | $417.99 | $417.99 | $68.22 – $417.99 | 36 |
| Tissue matrix xcm thk 20x30cm -cost per sq cm HCPCS Q4142 | $75.45 | $75.45 | $12.31 – $75.45 | 36 |
| Tissue surgimend prs meshed 20 cm x 10 cm - cost per 0.5cm HCPCS C9358 | $59.82 | $59.82 | $12.02 – $59.82 | 28 |
| Tissue transglutaminase iga CPT 86364 | $215.00 | $215.00 | $11.17 – $215.00 | 44 |
| Tl-201 thallium diag per mci HCPCS A9505 | $80.10 | $80.10 | $16.10 – $249.52 | 28 |
| Tlh uterus 250 g or less CPT 58570 | $36,544.44 | not published | $183.41 – $20,636.89 | 83 |
| Tlh w/t/o 250 g or less CPT 58571 | $37,910.29 | not published | $183.41 – $20,636.89 | 83 |
| Tlh w/t/o uterus over 250 g CPT 58573 | $41,890.25 | not published | $183.41 – $20,636.89 | 83 |
| Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr HCPCS J3260 | $190.95 | $190.95 | $0.72 – $3.60 | 94 |
| Tobramycin peak therapeutic drug level CPT 80200 | $117.00 | $117.00 | $15.63 – $117.00 | 44 |
| Tocilizumab 162 mg/0.9 ml subcutaneous pen injector HCPCS J3262 | $12,214.20 | $12,214.20 | $5.50 – $2,442.90 | 110 |
| Toe X-ray (both feet) CPT 73660 | $684.00 | $684.00 | $82.14 – $456.00 | 110 |
| Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution HCPCS J9351 | $643.90 | $643.90 | $23.12 – $115.00 | 28 |
| Toripalimab-tpzi 240 mg/6 ml (40 mg/ml) intravenous solution HCPCS J3263 | $48,786.25 | $48,786.25 | $9,480.00 – $48,786.25 | 94 |
| Total Hip Replacement CPT 27130 | $43,323.04 | not published | $0.96 – $24,925.18 | 83 |
| Total hysterectomy CPT 58150 | $27,205.95 | not published | $183.41 – $1,694.07 | 83 |
| Total Knee Replacement CPT 27447 | $40,880.10 | not published | $9.09 – $24,925.18 | 83 |
| Toxoplasma antibody igg CPT 86777 | $111.00 | $111.00 | $13.94 – $111.00 | 44 |
| Toxoplasma antibody igm CPT 86778 | $105.00 | $105.00 | $13.96 – $105.00 | 44 |
| Tprnl plmt biodegrdabl matrl CPT 55874 | $19,895.50 | not published | $9.09 – $10,409.46 | 83 |
| Trabectedin 1 mg intravenous solution HCPCS J9352 | $11,842.80 | $11,842.80 | $332.90 – $11,842.80 | 110 |
| Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution HCPCS J3290 | $41.50 | $41.50 | $1.83 – $9.15 | 99 |
| Transcath mv repair init prosthesis CPT 33418 | $13,018.00 | $13,018.00 | $2,616.62 – $13,018.00 | 26 |
| Transferrin CPT 84466 | $231.00 | $231.00 | $12.36 – $231.00 | 44 |
| Transvaginal Pelvic Ultrasound (not pregnancy) CPT 76830 | $1,190.00 | $1,190.00 | $20.66 – $1,190.00 | 780 |
| Transvaginal Pregnancy Ultrasound CPT 76817 | $609.00 | $609.00 | $22.58 – $609.00 | 780 |
| Trastuzumab 150 mg intravenous solution HCPCS J9355 | $4,708.00 | $4,708.00 | $72.01 – $4,675.30 | 110 |
| Trastuzumab-anns 150 mg intravenous solution HCPCS Q5117 | $10,508.35 | $10,508.35 | $50.41 – $2,766.05 | 110 |
| Trastuzumab-qyyp 150 mg intravenous solution HCPCS Q5116 | $9,357.40 | $9,357.40 | $8.04 – $3,365.30 | 110 |
| Trauma partial team response w/critical care services level 4 HCPCS G0390 | $4,305.00 | $4,305.00 | $692.24 – $3,444.00 | 28 |
| Tray bonemarrw oncontrol 102mm HCPCS C1830 | $1,076.23 | $1,076.23 | $12.26 – $61.00 | 28 |
| Tray trach basic clean/care ster HCPCS A4626 | $0.78 | $0.78 | $0.16 – $0.78 | 28 |
| Treat ankle dislocation CPT 27848 | $104,104.65 | not published | $0.96 – $14,087.30 | 83 |
| Treat ectopic pregnancy CPT 59151 | $27,050.36 | not published | $31.45 – $11,736.86 | 83 |
| Treat lower leg joint CPT 27829 | $30,903.16 | not published | $0.96 – $14,087.30 | 83 |
| Treatment fx radial distal open w/internal fixation 3+ frag left (restricted method ii cah) CPT 25609 | $33,994.07 | not published | $0.96 – $14,087.30 | 83 |
| Treatment fx radial distal open w/internal fixation left (restricted method ii cah) CPT 25607 | $29,136.69 | not published | $0.96 – $14,087.30 | 83 |
| Treatment incomplete abortion completed surgically any trimester CPT 59812 | $16,794.60 | not published | $69.55 – $6,284.60 | 83 |
| Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour CPT 94644 | $340.00 | $340.00 | $68.34 – $340.00 | 110 |
| Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour CPT 94645 | $244.00 | $244.00 | $49.04 – $244.00 | 28 |
| Treatment missed abortion completed surgically 1st trimester CPT 59820 | $17,618.85 | not published | $31.45 – $6,284.60 | 83 |
| Treatment of ankle fracture CPT 27822 | $30,903.16 | not published | $0.96 – $14,087.30 | 83 |
| Treatment radiation delivery level 2 CPT 77407 | $4,367.00 | $4,367.00 | $364.06 – $4,367.00 | 110 |
| Treat metatarsal fracture CPT 28485 | $104,104.65 | not published | $0.96 – $14,087.30 | 83 |
| Treat midfoot fracture each CPT 28465 | $104,104.65 | not published | $0.96 – $14,087.30 | 83 |
| Tremelimumab-actl 20 mg/ml intravenous solution HCPCS J9347 | $127,265.40 | $127,265.40 | $134.29 – $10,605.45 | 110 |
| Treponema pallidum antibody CPT 86780 | $114.00 | $114.00 | $12.83 – $114.00 | 44 |
| Triamcinolone acetonide 40 mg/ml suspension for injection HCPCS J3301 | $37.80 | $37.80 | $0.60 – $3.00 | 94 |
| Triglycerides CPT 84478 | $185.00 | $185.00 | $5.56 – $174.00 | 44 |
| Trilaciclib 300 mg intravenous solution HCPCS J1448 | $8,065.15 | $8,065.15 | $5.24 – $8,065.15 | 110 |
| Trnscath plc stent crv crtd without prtct CPT 37216 | $19,063.00 | $19,063.00 | $2,554.31 – $12,708.00 | 26 |
| Trnscath plc stent crv crtd w/prtct CPT 37215 | $22,167.00 | $22,167.00 | $2,970.38 – $14,778.00 | 26 |
| Trnscath plc stnt ante carotid art CPT 37218 | $26,400.00 | $26,400.00 | $3,537.60 – $17,600.00 | 26 |
| Trnscath tx thromblytc artery non-intracrn ini day CPT 37211 | $1,416.00 | $1,416.00 | $189.74 – $10,802.96 | 108 |
| Trnscath tx thromblytc art/ven sbsq day CPT 37213 | $293.00 | $293.00 | $58.89 – $293.00 | 26 |
| Troponin quantitative CPT 84484 | $13,932.70 | $292.00 | $12.09 – $292.00 | 110 |
| Tte w or without fol w/con,stres HCPCS C8928 | $3,348.00 | $3,348.00 | $530.00 – $3,348.00 | 107 |
| Tte w or without fol w/cont, f/u HCPCS C8922 | $3,219.00 | $3,219.00 | $530.00 – $3,219.00 | 28 |
| Tube drain vert dev st 5-40f HCPCS A5200 | $27.20 | $27.20 | $5.47 – $27.20 | 28 |
| Tube trach disp innr can 5 xlt HCPCS A7521 | $641.52 | $641.52 | $0.68 – $3.39 | 28 |
| Tube trach disp innr can 6 xlt HCPCS A4623 | $4.27 | $4.27 | $0.40 – $1.97 | 28 |
| Tube trach fen sz 6 uncuffed HCPCS A7520 | $197.11 | $197.11 | $0.22 – $1.10 | 28 |
| Ublituximab-xiiy 25 mg/ml intravenous solution HCPCS J2329 | $35,496.45 | $35,496.45 | $67.73 – $35,496.45 | 110 |
| Ultrasound breast unilateral limited (both sides) CPT 76642 | $1,219.00 | $1,219.00 | $75.49 – $813.00 | 110 |
| Ultrasound doppler velocimetry fetal umbilical artery CPT 76820 | $617.00 | $617.00 | $15.34 – $617.00 | 780 |
| Ultrasound elastography parenchyma CPT 76981 | $924.00 | $924.00 | $98.68 – $924.00 | 110 |
| Ultrasound encephalogram CPT 76506 | $1,136.00 | $1,136.00 | $98.68 – $1,136.00 | 110 |
| Ultrasound exam k transpl w/doppler CPT 76776 | $1,492.00 | $1,492.00 | $98.68 – $1,492.00 | 110 |
| Ultrasound fetal biophysical profile without non-stress testing CPT 76819 | $868.00 | $868.00 | $23.43 – $868.00 | 780 |
| Ultrasound Guidance for a Needle Procedure CPT 76942 | $1,189.00 | $1,189.00 | $53.57 – $1,189.00 | 26 |
| Ultrasound guidance for vascular access CPT 76937 | $1,033.00 | $1,033.00 | $1.40 – $1,033.00 | 779 |
| Ultrasound guide intraoperative CPT 76998 | $1,801.00 | $1,801.00 | $15.22 – $1,801.00 | 779 |
| Ultrasound hips infant dynamic CPT 76885 | $511.00 | $511.00 | $82.14 – $511.00 | 110 |
| Ultrasound ob >=14wks ea addl gest CPT 76810 | $316.00 | $316.00 | $30.03 – $162.00 | 768 |
| Ultrasound pregnant uterus detailed fetal exam single/1st gestation CPT 76811 | $1,277.00 | $1,277.00 | $57.72 – $1,277.00 | 780 |
| Ultrasound pregnant uterus follow up per fetus CPT 76816 | $710.00 | $710.00 | $25.99 – $710.00 | 780 |
| Ultrasound prostate/transrectal CPT 76872 | $1,122.00 | $1,122.00 | $98.68 – $1,122.00 | 110 |
| Ultrasound spinal canal and contents CPT 76800 | $643.00 | $643.00 | $98.68 – $643.00 | 110 |
| Umbilicoplasty 15847 CPT 15847 | $37,242.00 | not published | $2,741.72 – $5,639.25 | 82 |
| Unit mobile power mpu HCPCS Q0479 | $18,187.20 | $18,187.20 | $3,655.63 – $18,187.20 | 28 |
| Unlisted laparoscopic liver biopy 47379 CPT 47379 | $33,433.37 | not published | $183.41 – $11,736.86 | 83 |
| Unlisted laps px bladder CPT 51999 | $49,492.83 | not published | $183.41 – $20,636.89 | 83 |
| Unlisted procedure microbiology CPT 87999 | $650.00 | $650.00 | $130.65 – $650.00 | 28 |
| Unlisted px foot/toes CPT 28899 | $25,903.00 | not published | $0.96 – $14,087.30 | 83 |
| Unlstd laps px sprmatic cord CPT 55559 | $27,705.82 | not published | $0.96 – $11,736.86 | 83 |
| Unsched dialysis esrd pt hos HCPCS G0257 | $2,673.00 | $2,673.00 | $320.00 – $2,673.00 | 107 |
| Upper Arm (Humerus) X-ray (left side) CPT 73060 | $582.00 | $582.00 | $82.14 – $582.00 | 110 |
| Upper Back (Thoracic Spine) CT Scan (with contrast) CPT 72129 | $4,165.00 | $4,165.00 | $165.56 – $4,165.00 | 110 |
| Upper Back (Thoracic Spine) CT Scan (without contrast) CPT 72128 | $4,083.00 | $4,083.00 | $98.68 – $4,083.00 | 110 |
| Upper Back (Thoracic Spine) MRI (with and without contrast) CPT 72157 | $8,094.00 | $8,094.00 | $329.29 – $8,094.00 | 110 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | $4,562.00 | $4,562.00 | $225.21 – $4,562.00 | 110 |
| Upper Back (Thoracic Spine) X-ray (2 views) CPT 72070 | $621.00 | $621.00 | $98.68 – $621.00 | 110 |
| Upper Back (Thoracic Spine) X-ray (3 views) CPT 72072 | $681.00 | $681.00 | $98.68 – $681.00 | 110 |
| Upper Endoscopy (EGD, diagnostic) CPT 43235 | $10,416.30 | $446.00 | $0.36 – $1,760.83 | 769 |
| Upper Endoscopy (EGD, with biopsy) CPT 43239 | $10,537.60 | $503.00 | $0.96 – $1,760.83 | 769 |
| Upper GI Barium X-ray (barium and gas) CPT 74246 | $1,145.00 | $1,145.00 | $165.56 – $1,145.00 | 110 |
| Upper GI Barium X-ray (barium only) CPT 74240 | $1,035.00 | $1,035.00 | $165.56 – $1,035.00 | 110 |
| Urea nitrogen CPT 84520 | $113.00 | $113.00 | $3.83 – $113.00 | 44 |
| Urea nitrogen 24 hour urine CPT 84540 | $132.00 | $132.00 | $5.39 – $132.00 | 44 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | $1,110.00 | $1,110.00 | $223.11 – $1,110.00 | 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.