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 |
|---|---|---|---|---|
| Uric acid blood CPT 84550 | $165.00 | $165.00 | $4.38 – $165.00 | 44 |
| Uric acid urine CPT 84560 | $130.00 | $130.00 | $4.93 – $130.00 | 44 |
| Urinalysis microscopic only CPT 81015 | $81.00 | $81.00 | $2.96 – $81.00 | 44 |
| Urinalysis (with microscopy) CPT 81001 | $2,364.00 | $184.00 | $3.07 – $206.55 | 110 |
| Urinalysis (without microscopy) CPT 81003 | $2,139.00 | $120.00 | $2.18 – $206.55 | 110 |
| Urine Culture Test CPT 87086 | $2,971.00 | $214.00 | $7.82 – $217.31 | 110 |
| Urine pregnancy test CPT 81025 | $153.00 | $153.00 | $8.34 – $153.00 | 44 |
| Urography, antegrade CPT 74425 | $1,357.00 | $1,357.00 | $272.76 – $1,357.00 | 110 |
| Ustekinumab 130 mg/26 ml intravenous solution HCPCS J3358 | $6,677.00 | $6,677.00 | $12.24 – $6,677.00 | 110 |
| Ustekinumab 45 mg/0.5 ml subcutaneous solution HCPCS J3357 | $45,913.60 | $45,913.60 | $3,644.10 – $45,913.60 | 102 |
| Vaccine Administration (one shot) CPT 90471 | $223.00 | $223.00 | $3.96 – $139.78 | 110 |
| Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml CPT 91322 | $441.00 | $441.00 | $88.64 – $441.00 | 110 |
| Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml CPT 91321 | $861.00 | $861.00 | $147.06 – $861.00 | 110 |
| Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im CPT 91320 | $159.00 | $159.00 | $31.96 – $226.06 | 110 |
| Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im CPT 91319 | $106.00 | $106.00 | $21.31 – $127.28 | 110 |
| Vaccine covid-19 pfizer tris-sucrose 6mos-4yrs 3mcg/0.3ml im CPT 91318 | $80.00 | $80.00 | $16.08 – $95.05 | 110 |
| Vaccine dtap < 7 years im CPT 90700 | $142.05 | $142.05 | $10.85 – $54.00 | 94 |
| Vaccine dtap-hep b-ipv im CPT 90723 | $513.00 | $513.00 | $30.80 – $165.02 | 102 |
| Vaccine dtap-ipv 4-6 years im CPT 90696 | $88.00 | $88.00 | $17.69 – $221.23 | 94 |
| Vaccine dtap-ipv-hib-hepb im CPT 90697 | $208.00 | $208.00 | $41.60 – $542.58 | 102 |
| Vaccine dtap-ipv/hib im CPT 90698 | $159.00 | $159.00 | $31.96 – $195.74 | 94 |
| Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im CPT 90647 | $60.00 | $60.00 | $12.06 – $60.00 | 94 |
| Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im CPT 90648 | $62.60 | $62.60 | $11.46 – $57.00 | 94 |
| Vaccine hepatitis a (hepa) adult im CPT 90632 | $219.00 | $219.00 | $44.02 – $219.00 | 94 |
| Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im CPT 90636 | $192.00 | $192.00 | $38.59 – $192.00 | 94 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im CPT 90633 | $70.00 | $70.00 | $14.07 – $70.00 | 94 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 3 dose im CPT 90634 | $74.00 | $74.00 | $14.87 – $74.00 | 28 |
| Vaccine hepatitis b (hepb) adolescent 2 dose im CPT 90743 | $88.00 | $88.00 | $17.69 – $108.97 | 110 |
| Vaccine hepatitis b (hepb) adult 3 dose im CPT 90746 | $345.70 | $345.70 | $44.42 – $221.00 | 110 |
| Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im CPT 90739 | $502.00 | $502.00 | $100.90 – $502.00 | 110 |
| Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 | $138.80 | $138.80 | $19.10 – $95.00 | 110 |
| Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im CPT 90651 | $396.00 | $396.00 | $79.20 – $535.02 | 102 |
| Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im CPT 90649 | $348.00 | $348.00 | $69.60 – $348.00 | 36 |
| Vaccine influenza (iiv) preservative free antigen content im CPT 90662 | $230.00 | $230.00 | $46.23 – $230.00 | 110 |
| Vaccine influenza inactivated adjuvant im CPT 90653 | $303.40 | $303.40 | $17.49 – $121.06 | 110 |
| Vaccine influenza nos 0.5ml dose im CPT 90658 | $33.00 | $33.00 | $6.60 – $33.00 | 107 |
| Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im CPT 90656 | $102.45 | $102.45 | $6.43 – $32.41 | 110 |
| Vaccine influenza quadrivalent (iiv4) 0.5ml dose im CPT 90688 | $66.00 | $66.00 | $13.27 – $66.00 | 110 |
| Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im CPT 90694 | $243.00 | $243.00 | $48.84 – $243.00 | 110 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.25ml dose im CPT 90685 | $32.00 | $32.00 | $6.43 – $32.00 | 107 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im CPT 90686 | $70.00 | $70.00 | $14.07 – $70.00 | 110 |
| Vaccine influenza quadrivalent (iiv4) split virus 0.25 ml im CPT 90687 | $34.00 | $34.00 | $6.83 – $34.00 | 107 |
| Vaccine influenza quadrivalent live (laiv4) intranasal CPT 90672 | $87.00 | $87.00 | $17.49 – $87.00 | 107 |
| Vaccine influenza quadrivalent (riv4) rdna antibiotic/preservative free im CPT 90682 | $230.00 | $230.00 | $46.23 – $230.00 | 110 |
| Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im CPT 90661 | $807.00 | $807.00 | $33.39 – $807.00 | 110 |
| Vaccine influenza trivalent (iiv3) 0.25ml dose im CPT 90657 | $50.00 | $50.00 | $10.05 – $50.00 | 107 |
| Vaccine mengingoccocal serogroup b 2 dose im CPT 90620 | $292.00 | $292.00 | $58.40 – $361.27 | 102 |
| Vaccine mengingoccocal serogroup b 2 or 3 dose im CPT 90621 | $260.00 | $260.00 | $52.26 – $330.83 | 94 |
| Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im CPT 90619 | $230.00 | $230.00 | $46.00 – $299.00 | 102 |
| Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im CPT 90734 | $617.00 | $617.00 | $123.40 – $617.00 | 102 |
| Vaccine mmr live subcutaneous CPT 90707 | $466.05 | $466.05 | $25.73 – $162.65 | 94 |
| Vaccine mmrv live subcutaneous CPT 90710 | $652.00 | $652.00 | $130.40 – $652.00 | 102 |
| Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im CPT 90732 | $556.15 | $556.15 | $84.02 – $418.00 | 110 |
| Vaccine pneumococcal conjugate 13 valent (pcv13) im CPT 90670 | $807.00 | $807.00 | $162.21 – $807.00 | 110 |
| Vaccine pneumonococcal conjugate 15 valent (pcv15) im CPT 90671 | $771.00 | $771.00 | $154.97 – $771.00 | 110 |
| Vaccine pneumonococcal conjugate 20 valent (pcv20) im CPT 90677 | $903.00 | $903.00 | $181.50 – $903.00 | 110 |
| Vaccine polio (ipv) subcutaneous/im CPT 90713 | $59.00 | $59.00 | $11.86 – $77.62 | 94 |
| Vaccine rabies im CPT 90675 | $1,998.80 | $1,998.80 | $206.63 – $1,028.00 | 110 |
| Vaccine respiratory syncytial virus bivalent subunit/preservative free im CPT 90678 | $406.00 | $406.00 | $81.20 – $513.30 | 102 |
| Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im CPT 90380 | $2,736.70 | $2,736.70 | $136.20 – $1,808.73 | 102 |
| Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im CPT 90381 | $2,736.70 | $2,736.70 | $136.20 – $904.37 | 102 |
| Vaccine respiratory syncytial virus recombinant subunit adjuvanted/preservative free im CPT 90679 | $386.00 | $386.00 | $77.20 – $511.56 | 102 |
| Vaccine rotavirus attenuated (rv1) live 2 dose oral CPT 90681 | $186.00 | $186.00 | $37.20 – $186.00 | 102 |
| Vaccine rotavirus pentavalent (rv5) live 3 dose oral CPT 90680 | $158.00 | $158.00 | $31.76 – $171.72 | 94 |
| Vaccine tdap >=7 years im CPT 90715 | $231.55 | $231.55 | $16.48 – $82.00 | 94 |
| Vaccine td preservative free >= 7 years im CPT 90714 | $211.80 | $211.80 | $18.49 – $92.00 | 94 |
| Vaccine typhoid vicps im CPT 90691 | $184.00 | $184.00 | $36.98 – $184.00 | 94 |
| Vaccine varicella live subcutaneous CPT 90716 | $960.60 | $960.60 | $48.00 – $318.20 | 102 |
| Vaccine yellow fever live subcutaneous CPT 90717 | $211.00 | $211.00 | $42.41 – $256.04 | 94 |
| Vad univ batt charger hm 1440 HCPCS Q0495 | $9,827.78 | $9,827.78 | $1,975.38 – $9,827.78 | 28 |
| Vag hys/<250g/rmv tube/rpr entero 58263 CPT 58263 | $33,279.68 | not published | $183.41 – $14,396.42 | 83 |
| Vag hyst including t/o CPT 58262 | $31,755.58 | not published | $183.41 – $14,396.42 | 83 |
| Vaginal hysterectomy CPT 58260 | $33,067.29 | not published | $183.41 – $14,396.42 | 83 |
| Valproate in ns IV syringe 10 mg/ml (pediatric) - cnr HCPCS J3379 | $18.05 | $18.05 | $0.72 – $3.60 | 28 |
| Valproic acid total therapeutic drug level CPT 80164 | $336.00 | $336.00 | $13.12 – $143.00 | 44 |
| Valvuloplasty aortic CPT 92986 | $9,287.00 | $9,287.00 | $1,866.69 – $11,049.67 | 108 |
| Vancomycin 1,000 mg intravenous injection HCPCS J3373 | $160.00 | $160.00 | $0.15 – $3.00 | 94 |
| Vancomycin peak therapeutic drug level CPT 80202 | $362.00 | $362.00 | $13.12 – $362.00 | 44 |
| Varicella zoster antibody igg CPT 86787 | $163.00 | $163.00 | $7.84 – $39.00 | 44 |
| Varicella-zoster immue globin im CPT 90396 | $3,095.00 | $3,095.00 | $622.10 – $3,265.81 | 94 |
| Vasopressin 20 unit/ml intravenous solution HCPCS J2598 | $726.75 | $726.75 | $9.92 – $49.35 | 28 |
| Vedolizumab 300 mg intravenous solution HCPCS J3380 | $30,326.10 | $30,326.10 | $20.94 – $30,326.10 | 110 |
| Velaglucerase alfa 400 unit intravenous solution HCPCS J3385 | $7,637.95 | $7,637.95 | $1,520.72 – $7,637.95 | 94 |
| Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture) CPT 36410 | $845.00 | $845.00 | $169.85 – $845.00 | 28 |
| Venogram extremity supervision & interpretation unilateral CPT 75820 | $2,310.00 | $2,310.00 | $464.31 – $3,347.66 | 110 |
| Venous mech thrombectomy CPT 37187 | $25,823.00 | $25,823.00 | $3,460.22 – $22,412.03 | 108 |
| Ventilator each subsequent day CPT 94003 | $5,154.00 | $5,154.00 | $189.00 – $5,154.00 | 110 |
| Ventilator Management (first day) CPT 94002 | $5,054.00 | $5,054.00 | $189.00 – $5,054.00 | 110 |
| Verify external neurostimulato HCPCS A4290 | $1,124.00 | $1,124.00 | $225.92 – $1,124.00 | 28 |
| Version cephalic external CPT 59412 | $1,977.00 | $1,977.00 | $397.38 – $6,284.60 | 108 |
| Vest large holster HCPCS Q0498 | $1,198.75 | $1,198.75 | $240.95 – $1,198.75 | 28 |
| Vest wrp airway ther disp lg slot 1use HCPCS A7025 | $207.59 | $207.59 | $37.39 – $186.02 | 28 |
| Video Swallow Study (Modified Barium Swallow) CPT 74230 | $828.00 | $828.00 | $165.56 – $828.00 | 110 |
| Vinblastine 1 mg/ml intravenous solution HCPCS J9360 | $244.80 | $244.80 | $49.20 – $244.80 | 94 |
| Vincristine 1 mg/ml intravenous solution HCPCS J9370 | $87.15 | $87.15 | $8.60 – $85.75 | 94 |
| Vinorelbine 10 mg/ml intravenous solution (wrapper) HCPCS J9390 | $223.55 | $223.55 | $12.48 – $62.10 | 28 |
| Visit established high 40-54 minutes/level 5 HCPCS G0463 | $2,339.00 | $840.00 | $8.04 – $147.00 | 110 |
| Vitamin b-12 CPT 82607 | $385.00 | $385.00 | $14.62 – $385.00 | 44 |
| Vitamin D Test CPT 82306 | $282.00 | $282.00 | $28.68 – $282.00 | 44 |
| Volume measurement urine timed CPT 81050 | $35.00 | $35.00 | $3.53 – $35.00 | 44 |
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.