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 |
|---|---|---|---|---|
| Cervical or vaginal cancer screening g0101 HCPCS G0101 | $272.00 | $272.00 | $24.30 – $272.00 | 110 |
| Cetuximab 100 mg/50 ml intravenous solution HCPCS J9055 | $4,685.70 | $4,685.70 | $78.74 – $2,342.85 | 110 |
| Change cystostomy tube simple CPT 51705 | $14,514.85 | not published | $0.96 – $485.06 | 83 |
| Change of windpipe airway 31502 CPT 31502 | $3,121.00 | $3,121.00 | $9.69 – $3,121.00 | 780 |
| Chemo ia push tecnique CPT 96420 | $579.00 | $579.00 | $116.38 – $641.26 | 110 |
| Chest CT scan (with and without contrast) CPT 71270 | $5,747.00 | $5,747.00 | $165.56 – $5,747.00 | 110 |
| Chest CT scan (with contrast) CPT 71260 | $4,352.00 | $4,352.00 | $165.56 – $4,352.00 | 110 |
| Chest CT scan (without contrast) CPT 71250 | $3,221.00 | $3,221.00 | $98.68 – $3,221.00 | 110 |
| Chest Physiotherapy (first session) CPT 94667 | $245.00 | $245.00 | $49.25 – $258.30 | 110 |
| Chest Physiotherapy (follow-up session) CPT 94668 | $215.00 | $215.00 | $43.22 – $258.30 | 110 |
| Chest Ultrasound CPT 76604 | $1,078.00 | $1,078.00 | $98.68 – $1,078.00 | 110 |
| Chest X-ray CPT 71046 | $545.00 | $545.00 | $82.14 – $545.00 | 110 |
| Chest X-ray (single view) CPT 71045 | $22,458.89 | $462.00 | $0.96 – $462.00 | 110 |
| Chloride CPT 82435 | $75.00 | $75.00 | $4.46 – $75.00 | 44 |
| Chloride 24 hour urine CPT 82436 | $126.00 | $126.00 | $5.57 – $126.00 | 44 |
| Chloroprocaine hcl injection HCPCS J2401 | $102.90 | $102.90 | $20.68 – $102.90 | 28 |
| Chlorothiazide sodium 500 mg intravenous solution HCPCS J1205 | $735.85 | $735.85 | $40.38 – $735.85 | 94 |
| Chlorpromazine 0.125 mg/ml IV syringe - cnr HCPCS J3230 | $5.10 | $5.10 | $1.03 – $44.20 | 94 |
| Chlorpromazine 100 mg tablet HCPCS Q0161 | $1.25 | $1.25 | $0.20 – $1.75 | 92 |
| Cholangiography and/or pancreatography intraoperative supervision & interpretation CPT 74300 | $1,197.00 | $1,197.00 | $240.60 – $1,197.00 | 26 |
| Cholecystostomy complete w/supervision & interpretation CPT 47490 | $10,685.00 | $10,685.00 | $2,147.69 – $10,685.00 | 108 |
| Cholesterol CPT 82465 | $75.00 | $75.00 | $4.21 – $75.00 | 44 |
| Cholesterol body fluid CPT 84999 | $21.00 | $21.00 | $4.20 – $21.00 | 36 |
| Cholesterol (Lipid) Test CPT 80061 | $286.00 | $286.00 | $12.97 – $286.00 | 44 |
| Cholinesterase CPT 82480 | $160.00 | $160.00 | $7.63 – $160.00 | 44 |
| Chromatography CPT 83021 | $124.00 | $124.00 | $17.50 – $124.00 | 44 |
| Chromosome analysis 15-20 cell count CPT 88262 | $1,191.00 | $1,191.00 | $121.60 – $1,191.00 | 44 |
| Chromosome karyotype study CPT 88280 | $100.00 | $100.00 | $20.10 – $100.00 | 44 |
| Cinacalcet 30 mg tablet HCPCS J0604 | $1.00 | $1.00 | $0.20 – $43.07 | 99 |
| Cine/video x-rays CPT 76120 | $167.00 | $167.00 | $33.57 – $240.48 | 28 |
| Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback HCPCS J0744 | $37.00 | $37.00 | $1.20 – $17.00 | 94 |
| Circumcision (newborn) CPT 54150 | $4,284.00 | $4,284.00 | $733.65 – $4,058.30 | 108 |
| Cisplatin 1 mg/ml desensitization HCPCS J9060 | $379.00 | $379.00 | $10.65 – $93.75 | 94 |
| Cladribine 10 mg/10 ml intravenous solution HCPCS J9065 | $496.70 | $496.70 | $7.27 – $496.70 | 110 |
| Clamp isol transpolr 5mmx6.5cm transpolar HCPCS C1733 | $23,155.00 | $23,155.00 | $6.96 – $34.65 | 28 |
| Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J0736 | $49.00 | $49.00 | $2.38 – $11.85 | 94 |
| Clip ligating vesolock lg HCPCS C1760 | $12,630.00 | $12,630.00 | $0.68 – $3.39 | 28 |
| Clip phn wireless f/baha4 proc HCPCS L9900 | $828.95 | $828.95 | $166.62 – $828.95 | 28 |
| Cllr miami j sm HCPCS L0174 | $934.33 | $934.33 | $9.14 – $55.98 | 36 |
| Clofarabine 1 mg/ml intravenous solution HCPCS J9027 | $17,608.50 | $17,608.50 | $14.08 – $17,608.50 | 110 |
| Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution HCPCS J0735 | $79.35 | $79.35 | $15.95 – $79.35 | 94 |
| Clot factor xii hageman CPT 85280 | $146.00 | $146.00 | $18.75 – $146.00 | 44 |
| Cmbn ant pst colprhy CPT 57260 | $31,106.81 | not published | $9.09 – $14,396.42 | 83 |
| Cmv pcr-sendout CPT 87496 | $487.00 | $487.00 | $34.01 – $487.00 | 44 |
| Co2 monitor per day CPT 94681 | $868.00 | $868.00 | $174.47 – $868.00 | 110 |
| Coagulation factor viia 1,000 mcg/ml inj 1 ml HCPCS J7189 | $17,257.50 | $17,257.50 | $2.57 – $17,257.50 | 110 |
| Coagulation time activated teg CPT 85347 | $131.00 | $131.00 | $4.15 – $131.00 | 44 |
| Cocaine 4 % nasal solution HCPCS C9046 | $3,354.90 | $3,354.90 | $294.40 – $3,354.90 | 92 |
| Coil axium 3d 14mmx40cm qc HCPCS C1770 | $4,536.28 | $4,536.28 | $394.80 – $1,964.19 | 28 |
| Cold agglutinin screen (arc) CPT 86156 | $158.00 | $158.00 | $7.82 – $158.00 | 44 |
| Cold agglutinin titer CPT 86157 | $65.00 | $65.00 | $7.81 – $65.00 | 44 |
| Colectomy/end colost/close dis seg 44143 CPT 44143 | $5,902.00 | $5,902.00 | $37.48 – $570.24 | 768 |
| Collarbone (Clavicle) X-ray (both sides) CPT 73000 | $825.00 | $825.00 | $82.14 – $550.00 | 110 |
| Collar cerv 18.25x3.5in serp firm density sm HCPCS L0120 | $68.41 | $68.41 | $0.39 – $2.36 | 36 |
| Collar cerv adlt perfit ace extric HCPCS L0140 | $77.58 | $77.58 | $0.91 – $4.51 | 28 |
| Collar cerv ascend 172 reg HCPCS L0172 | $1,844.20 | $1,844.20 | $0.43 – $2.62 | 36 |
| Collar cerv patriot adlt HCPCS L0150 | $4.89 | $4.89 | $0.98 – $4.89 | 28 |
| Collar extrication adult univ HCPCS L0200 | $64.50 | $64.50 | $12.96 – $64.50 | 28 |
| Colpopexy extraperitoneal CPT 57282 | $32,651.55 | not published | $9.09 – $14,396.42 | 83 |
| Colporrhapy/vag injury sut/non ob 57200 CPT 57200 | $37,332.58 | not published | $183.41 – $20,636.89 | 83 |
| Compatibility test each unit antiglobulin technique CPT 86922 | $194.00 | $194.00 | $38.99 – $330.76 | 110 |
| Compatibility test each unit electronic CPT 86923 | $272.00 | $272.00 | $54.67 – $330.76 | 110 |
| Compatibility test each unit immediate spin technique CPT 86920 | $130.00 | $130.00 | $26.13 – $330.76 | 110 |
| Compatibility test incubate CPT 86921 | $39.00 | $39.00 | $7.84 – $330.76 | 110 |
| Complement antigen each component c3 CPT 86160 | $316.00 | $316.00 | $11.63 – $316.00 | 44 |
| Complex repair trunk 2.6-7.5cm 13101 CPT 13101 | $18,196.25 | not published | $0.96 – $5,639.25 | 83 |
| Complx repair fccmnaxghf 13131 CPT 13131 | $4,910.00 | $4,910.00 | $383.70 – $4,910.00 | 108 |
| Component ankle afo plastic jt mold to pt mdl foot cup HCPCS L1970 | $2,695.58 | $2,695.58 | $541.81 – $2,695.58 | 28 |
| Computed tomographic angiography head and neck with contrast CPT 70471 | $2,945.00 | $2,945.00 | $330.23 – $2,945.00 | 107 |
| Concentration infection agents any type CPT 87015 | $80.00 | $80.00 | $6.48 – $52.00 | 44 |
| Conduit wrap neuomend 3mmx2.5cm HCPCS C9361 | $5,157.25 | $5,157.25 | $82.33 – $409.61 | 28 |
| Conjugated estrogens 25 mg solution for injection HCPCS J1410 | $1,780.10 | $1,780.10 | $357.80 – $1,780.10 | 110 |
| Connect omega .5mm HCPCS L8613 | $32,593.25 | $32,593.25 | $13.55 – $67.40 | 28 |
| Connector tis 2x10mm HCPCS C9352 | $10,394.49 | $10,394.49 | $254.16 – $1,264.50 | 28 |
| Consultation pathology during surgery CPT 88329 | $147.00 | $147.00 | $29.55 – $147.00 | 107 |
| Consultation pathology during surgery cytological exam initial site CPT 88333 | $240.00 | $240.00 | $48.24 – $1,564.16 | 110 |
| Consultation pathology during surgery frozen section each additional block CPT 88332 | $282.00 | $282.00 | $25.08 – $282.00 | 28 |
| Consultation pathology during surgery frozen section first tissue block CPT 88331 | $333.00 | $333.00 | $35.88 – $333.00 | 110 |
| Consultation/report referred slides prepared elsewhere CPT 88321 | $300.00 | $300.00 | $33.96 – $300.00 | 110 |
| Contrast x-ray of wrist CPT 73115 | $2,558.00 | $2,558.00 | $329.29 – $1,705.00 | 110 |
| Controler lvad heartmate 3 includes ebb HCPCS Q0481 | $15,050.75 | $15,050.75 | $2,327.08 – $11,577.50 | 28 |
| Controller infinity pt dbs HCPCS C1787 | $42,303.21 | $42,303.21 | $10.05 – $50.00 | 28 |
| Control nosebleed pack+caut 30905 CPT 30905 | $378.00 | $378.00 | $27.39 – $362.00 | 768 |
| Coombs direct CPT 86880 | $125.00 | $125.00 | $5.39 – $125.00 | 110 |
| Coombs indirect qualitative each reagent red cell reference CPT 86885 | $142.00 | $142.00 | $5.72 – $330.76 | 110 |
| Coombs indirect titer reference CPT 86886 | $210.00 | $210.00 | $5.18 – $330.76 | 110 |
| Cor hlx vlgs dstl mtar osteo CPT 28296 | $29,528.43 | not published | $0.36 – $6,352.30 | 83 |
| Cornea 1/2moon str split thick HCPCS L8609 | $1,222.35 | $1,222.35 | $245.69 – $1,222.35 | 28 |
| Cornea pre-cut midwest eye cornea pre-cut midwest eye HCPCS V2785 | $8,777.85 | $8,777.85 | $78.39 – $390.00 | 28 |
| Coronary angio/cath placement bypass graft/lv gram/lt heart CPT 93459 | $46,451.00 | $46,451.00 | $3,060.01 – $46,451.00 | 108 |
| Coronary angio/lv gram/lt heart CPT 93458 | $31,599.00 | $31,599.00 | $3,060.01 – $31,599.00 | 108 |
| Coronary angio/lv gram/rt< heart CPT 93460 | $26,228.00 | $26,228.00 | $3,060.01 – $26,228.00 | 108 |
| Coronary art/grft angio s&i CPT 93455 | $12,700.00 | $12,700.00 | $2,552.70 – $12,700.00 | 108 |
| Coronary catheterization w/angiography supervision & interpretation CPT 93454 | $16,118.00 | $16,118.00 | $3,060.01 – $16,118.00 | 108 |
| Cortisol total am CPT 82533 | $264.00 | $264.00 | $15.80 – $264.00 | 44 |
| Cosyntropin 0.25 mg solution for injection HCPCS J0834 | $101.75 | $101.75 | $20.45 – $101.75 | 94 |
| Coveredge 32 lead kit 40cm 48 HCPCS C1897 | $14,208.75 | $14,208.75 | $26.38 – $131.23 | 28 |
| Cover wrist HCPCS L3984 | $0.01 | $0.01 | $0.01 – $0.01 | 12 |
| Covid-19 administration immunization im inj 1st/only component CPT 90480 | $110.00 | $110.00 | $3.96 – $81.00 | 110 |
| Covid-19 IV infusion and post admin monitoring tocilizumab 1st dose HCPCS M0249 | $683.00 | $683.00 | $81.00 – $683.00 | 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.