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 |
|---|---|---|---|---|
| Debride skn/sq t/m/f necro infctj abdl wall 11005 CPT 11005 | $2,467.00 | $2,467.00 | $70.68 – $270.88 | 768 |
| Debride/subq tissue/ea add 20sq cm 11045 CPT 11045 | $83.00 | $83.00 | $14.06 – $55.00 | 768 |
| Debr musc/fascia 20sq cm/< 11043 CPT 11043 | $504.00 | $504.00 | $5.64 – $53.92 | 768 |
| Decalcification CPT 88311 | $176.00 | $176.00 | $8.47 – $176.00 | 28 |
| Decitabine 50 mg intravenous solution HCPCS J0894 | $224.90 | $224.90 | $45.20 – $224.90 | 28 |
| Deferoxamine 500 mg solution for injection HCPCS J0895 | $65.35 | $65.35 | $9.02 – $65.35 | 94 |
| Degarelix 120 mg subcutaneous solution HCPCS J9155 | $4,556.35 | $4,556.35 | $4.36 – $1,460.15 | 110 |
| Delayed breast prosthesis 19342 CPT 19342 | $35,865.50 | not published | $0.96 – $15,867.92 | 83 |
| Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device CPT 94664 | $320.00 | $320.00 | $64.32 – $425.12 | 110 |
| Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution HCPCS J0897 | $15,865.45 | $15,865.45 | $27.97 – $11,252.60 | 110 |
| Deodorant ostmy adapt lube 8ml HCPCS A4394 | $0.10 | $0.10 | $0.02 – $0.10 | 28 |
| Desmopressin 4 mcg/ml injection solution HCPCS J2597 | $42.90 | $42.90 | $8.62 – $42.90 | 28 |
| Device ablt adv novasure HCPCS C1886 | $9,596.13 | $9,596.13 | $87.55 – $435.55 | 28 |
| Device hemospray 7frx220cm endo hemostat min access HCPCS C1052 | $3,999.50 | $3,999.50 | $655.81 – $3,262.75 | 28 |
| Device intraute mirena HCPCS J7298 | $3,250.58 | $3,250.58 | $530.49 – $3,250.58 | 36 |
| Device sut capio slim opn HCPCS C2631 | $2,360.40 | $2,360.40 | $212.93 – $1,059.37 | 28 |
| Device tiss remov myosure reach HCPCS C1782 | $6,094.92 | $6,094.92 | $214.06 – $1,064.99 | 28 |
| Dexamethasone 0.4 mg/0.1 ml intraocular injection - cnr HCPCS J1095 | $21.00 | $21.00 | $4.22 – $21.00 | 28 |
| Dexamethasone 4 mg tablet HCPCS J8540 | $28.80 | $28.80 | $0.04 – $1.00 | 94 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $20.20 | $20.20 | $0.60 – $3.00 | 94 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | $884.80 | $884.80 | $32.09 – $344.95 | 110 |
| Dextran 40 infusion HCPCS J7100 | $1,820.00 | $1,820.00 | $66.56 – $1,820.00 | 94 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | $20.00 | $20.00 | $4.02 – $20.00 | 28 |
| Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 | $20.00 | $20.00 | $4.02 – $20.00 | 28 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | $35.00 | $35.00 | $7.04 – $35.00 | 28 |
| Dextrose 5 % IV bolus HCPCS J7070 | $30.00 | $30.00 | $3.52 – $17.50 | 28 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $270.00 | $270.00 | $21.54 – $270.00 | 44 |
| Diabetes (HbA1c) Test CPT 83036 | $245.00 | $245.00 | $9.40 – $130.00 | 44 |
| Diag laparo separate proc 49320 CPT 49320 | $24,453.90 | $1,182.00 | $15.28 – $11,736.86 | 769 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $217.00 | $217.00 | $19.49 – $170.27 | 768 |
| Dialysis one evaluation CPT 90945 | $1,730.00 | $1,730.00 | $347.73 – $1,730.00 | 110 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $250.05 | $250.05 | $34.68 – $172.55 | 28 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $11.50 | $11.50 | $0.63 – $12.79 | 94 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | $13,725.30 | $13,725.30 | $2,758.79 – $13,725.30 | 94 |
| Digoxin total therapeutic drug level CPT 80162 | $316.00 | $316.00 | $12.87 – $316.00 | 44 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | $358.75 | $358.75 | $18.49 – $92.00 | 28 |
| Dilator fascial 10fx20cm HCPCS C2627 | $423.05 | $423.05 | $9.30 – $46.25 | 28 |
| Diltiazem 5 mg/ml intravenous solution HCPCS J1163 | $8.85 | $8.85 | $0.20 – $3.00 | 94 |
| Diphenhydramine 12.5 mg/5 ml oral elixir HCPCS Q0163 | $3.40 | $3.40 | $0.02 – $3.40 | 94 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $3.70 | $3.70 | $0.74 – $3.70 | 94 |
| Dna antibody native/double stranded CPT 86225 | $154.00 | $154.00 | $13.31 – $154.00 | 44 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $183.75 | $183.75 | $5.99 – $29.80 | 94 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | $115.00 | $115.00 | $8.20 – $115.00 | 94 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $91.25 | $91.25 | $2.43 – $12.10 | 94 |
| Doppler echo complete CPT 93320 | $1,045.00 | $1,045.00 | $11.08 – $1,045.00 | 779 |
| Doppler intravascular pressure flow initial vessel CPT 93571 | $2,214.00 | $2,214.00 | $445.01 – $2,214.00 | 26 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $867.00 | $867.00 | $13.63 – $867.00 | 780 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $804.00 | $804.00 | $7.46 – $804.00 | 780 |
| Dornhoffer fixed part w/window HCPCS L8614 | $74,450.39 | $31,736.18 | $0.96 – $64,012.49 | 110 |
| Dostarlimab-gxly 50 mg/ml intravenous solution HCPCS J9272 | $36,812.65 | $36,812.65 | $229.63 – $36,812.65 | 110 |
| Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 | $1,578.20 | $1,578.20 | $5.96 – $93.40 | 94 |
| Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension HCPCS Q2050 | $7,093.75 | $7,093.75 | $342.45 – $1,920.95 | 31 |
| Doxycycline hyclate 100 mg intravenous powder for solution HCPCS J1271 | $28.30 | $28.30 | $5.69 – $28.30 | 94 |
| Drain cath image guided visceral pq CPT 49405 | $572.00 | $572.00 | $114.97 – $3,206.43 | 108 |
| Drain chst dry seal exp thorastat HCPCS A7041 | $212.98 | $212.98 | $42.81 – $212.98 | 28 |
| Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm HCPCS Q4108 | $1,504.70 | $1,504.70 | $15.11 – $92.61 | 36 |
| Droperidol 2.5 mg/ml injection solution HCPCS J1790 | $44.55 | $44.55 | $5.36 – $44.55 | 94 |
| Drsg interceed 3x4in adh wnd barr absorb HCPCS C1765 | $5,886.99 | $5,886.99 | $138.77 – $690.42 | 28 |
| Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm HCPCS Q4103 | $241.26 | $241.26 | $39.37 – $241.26 | 36 |
| Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm HCPCS Q4102 | $53.60 | $53.60 | $7.12 – $43.65 | 36 |
| Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm HCPCS Q4124 | $64.30 | $64.30 | $9.88 – $60.55 | 36 |
| Drsg sht 5.625x4.625in std HCPCS A6025 | $123.24 | $123.24 | $21.41 – $106.53 | 28 |
| Drsg surg adh 11x11 3/4 occl drap wnd 28x30 HCPCS A6259 | $0.73 | $0.73 | $0.15 – $0.73 | 28 |
| Drsg wnd 8.2x9cm sq bilayer theragenesis ster-74sq cm-cost per sq cm HCPCS A2008 | $146.06 | $146.06 | $22.54 – $112.15 | 28 |
| Drsg wnd hyalomatrix 10x10cm -cost per sq cm HCPCS Q4117 | $72.19 | $72.19 | $9.37 – $46.60 | 28 |
| Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm HCPCS Q4104 | $9,582.38 | $9,582.38 | $14.94 – $74.31 | 36 |
| Drsg wound/burn 18x10cm suprathel resorb cost per sq cm HCPCS A2012 | $25.75 | $25.75 | $0.79 – $3.91 | 28 |
| Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm HCPCS A2007 | $381.35 | $381.35 | $40.11 – $199.54 | 28 |
| Drug assay posaconazole CPT 80187 | $495.00 | $495.00 | $26.27 – $495.00 | 44 |
| Drug assay vedolizumab CPT 80280 | $192.00 | $192.00 | $37.37 – $192.00 | 44 |
| Drug assay voriconazole CPT 80285 | $239.00 | $239.00 | $26.27 – $239.00 | 44 |
| Drug test(s) presumptive any class instrument chemistry analyzers CPT 80307 | $21,627.71 | $331.00 | $9.09 – $6,614.04 | 110 |
| Duplex scan bilateral study 93985 CPT 93985 | $337.00 | $337.00 | $67.74 – $463.22 | 110 |
| Duplex scan unilateral study 93986 CPT 93986 | $337.00 | $337.00 | $67.74 – $337.00 | 110 |
| Dup scan/hemodialysis access 93990 CPT 93990 | $1,344.00 | $1,344.00 | $14.11 – $1,344.00 | 780 |
| Dup scan/ue art/graft/bilat/comp 93930 CPT 93930 | $1,889.00 | $1,889.00 | $225.21 – $1,889.00 | 110 |
| Duragen 1x1 5ea/bx HCPCS C9354 | $2,313.19 | $2,313.19 | $122.42 – $609.04 | 28 |
| Dura-guard dura repair patch 10x16cm -q4432-cost per sq cm-160sq cm HCPCS Q4432 | $264.34 | $264.34 | $5.48 – $27.25 | 28 |
| Durvalumab 50 mg/ml intravenous solution HCPCS J9173 | $13,206.10 | $13,206.10 | $81.58 – $3,169.50 | 110 |
| Dx bronchoscope/lavage 31624 CPT 31624 | $4,149.00 | $4,149.00 | $38.56 – $4,149.00 | 780 |
| Dx bronchoscope/wash 31622 CPT 31622 | $4,511.00 | $4,511.00 | $906.71 – $4,511.00 | 26 |
| Ecg external < 48 hours recording CPT 93225 | $731.00 | $731.00 | $125.59 – $731.00 | 110 |
| Ecg external < 48 hours scanning analysis w/report CPT 93226 | $1,058.00 | $1,058.00 | $55.68 – $1,058.00 | 110 |
| Ecg external > 48 hours up to 7 days recording CPT 93242 | $92.00 | $92.00 | $18.49 – $530.00 | 110 |
| Ecg external >7 days up to 15 days recording CPT 93246 | $152.00 | $152.00 | $30.55 – $530.00 | 110 |
| Echocardiogram (Heart Ultrasound) CPT 93306 | $2,452.00 | $2,452.00 | $43.03 – $2,452.00 | 780 |
| Echocardiogram (Limited Follow-Up Heart Ultrasound) CPT 93308 | $1,386.00 | $1,386.00 | $15.76 – $1,386.00 | 780 |
| Echocardiography doppler color flow mapping CPT 93325 | $1,045.00 | $1,045.00 | $2.13 – $1,045.00 | 779 |
| Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler HCPCS C8929 | $3,587.00 | $3,587.00 | $530.00 – $3,587.00 | 110 |
| Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast HCPCS C8924 | $1,524.00 | $1,524.00 | $306.32 – $1,524.00 | 107 |
| Echocardiograpy doppler follow up/limited study CPT 93321 | $647.00 | $647.00 | $4.69 – $647.00 | 779 |
| Echo tee cngntl wo ctrst probe plcmnt CPT 93316 | $1,940.00 | $1,940.00 | $389.94 – $1,940.00 | 28 |
| Echo tee guidance CPT 93355 | $2,776.00 | $2,776.00 | $530.00 – $2,776.00 | 28 |
| Echo tee probe placement image acquisition interpretation & report CPT 93312 | $3,157.00 | $3,157.00 | $67.10 – $3,157.00 | 780 |
| Echo transesophageal CPT 93314 | $1,605.00 | $1,605.00 | $322.61 – $1,605.00 | 28 |
| Echo transesophageal intraop CPT 93318 | $325.00 | $325.00 | $64.97 – $325.00 | 768 |
| Echo transthoracic CPT 93303 | $1,973.00 | $1,973.00 | $396.57 – $1,973.00 | 110 |
| Echo transthoracic CPT 93304 | $1,347.00 | $1,347.00 | $270.75 – $1,347.00 | 110 |
| Echo tte 2d comp wo ctrst wo clr/dplr CPT 93307 | $3,553.00 | $3,553.00 | $225.21 – $3,553.00 | 110 |
| Eculizumab 300 mg/30 ml intravenous solution HCPCS J1299 | $18,199.20 | $18,199.20 | $44.13 – $18,199.20 | 107 |
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.