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 |
|---|---|---|---|---|
| Eye Socket, Pituitary or Ear CT Scan (with contrast) CPT 70481 | $4,049.00 | $4,049.00 | $165.56 – $4,049.00 | 110 |
| Eye Socket, Pituitary or Ear CT Scan (without contrast) CPT 70480 | $3,491.00 | $3,491.00 | $98.68 – $3,491.00 | 110 |
| F-18 fdg pet diag HCPCS A9552 | $1,768.20 | $1,768.20 | $355.41 – $1,768.20 | 28 |
| F-18 florbetapir less than or equal to 10 mci HCPCS A9586 | $15,145.00 | $15,145.00 | $1,789.13 – $15,145.00 | 107 |
| F-18 fluciclovine per mci HCPCS A9588 | $27,455.00 | $27,455.00 | $315.82 – $27,455.00 | 107 |
| F-18 sodium fluoride HCPCS A9580 | $1,391.25 | $1,391.25 | $279.64 – $1,391.25 | 28 |
| Face, Eye Socket and Neck MRI (with and without contrast) CPT 70543 | $8,039.00 | $8,039.00 | $329.29 – $8,039.00 | 110 |
| Face, Eye Socket and Neck MRI (without contrast) CPT 70540 | $4,905.00 | $4,905.00 | $225.21 – $4,905.00 | 110 |
| Facial Bones X-ray (complete) CPT 70150 | $626.00 | $626.00 | $98.68 – $626.00 | 110 |
| Factor ix CPT 85250 | $572.00 | $572.00 | $18.45 – $572.00 | 44 |
| Factor viii CPT 85240 | $657.00 | $657.00 | $17.35 – $350.00 | 44 |
| Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr HCPCS J1308 | $4.10 | $4.10 | $0.60 – $3.00 | 94 |
| Fam-trastuzumab deruxtecan-nxki 100 mg intravenous solution HCPCS J9358 | $9,722.40 | $9,722.40 | $27.37 – $9,722.40 | 110 |
| Fat/lipids feces qualitative CPT 82705 | $65.00 | $65.00 | $4.95 – $65.00 | 44 |
| Fecal microbiota, live-jslm 150 ml rectal suspension enema HCPCS J1440 | $28,233.45 | $28,233.45 | $61.99 – $28,233.45 | 110 |
| #fecal-sodium CPT 84302 | $20.00 | $20.00 | $4.02 – $20.00 | 44 |
| Fem/popl revasc w/stent CPT 37226 | $97,392.00 | $97,392.00 | $10,596.25 – $64,928.00 | 34 |
| Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper) HCPCS J3010 | $78.50 | $78.50 | $0.60 – $3.00 | 28 |
| Fern test HCPCS Q0114 | $315.00 | $315.00 | $9.55 – $315.00 | 41 |
| Ferric carboxymaltose 50 mg iron/ml intravenous solution HCPCS J1439 | $5,262.00 | $5,262.00 | $1.86 – $5,262.00 | 31 |
| Ferritin CPT 82728 | $415.00 | $415.00 | $13.21 – $415.00 | 44 |
| Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution HCPCS Q0138 | $1,333.80 | $1,333.80 | $0.35 – $712.85 | 110 |
| Fetal fibronectin CPT 82731 | $945.00 | $945.00 | $62.41 – $945.00 | 44 |
| Fetal hemoglobin (kleihauer betke) CPT 85460 | $75.00 | $75.00 | $7.49 – $75.00 | 44 |
| Fetal hemoglobin rosette CPT 85461 | $200.00 | $200.00 | $9.07 – $200.00 | 44 |
| Fetal non stress test CPT 59025 | $1,078.25 | $887.00 | $7.90 – $887.00 | 780 |
| Fibrin degradation d dimer quantitative CPT 85379 | $351.00 | $351.00 | $9.86 – $351.00 | 44 |
| Fibrinogen activity CPT 85384 | $259.00 | $259.00 | $9.41 – $253.00 | 44 |
| Fibrinolysins/coagulopathy screen interpretation/report CPT 85390 | $200.00 | $200.00 | $15.00 – $200.00 | 44 |
| Filgrastim-aafi 300 mcg/0.5 ml subcutaneous syringe HCPCS Q5110 | $1,611.50 | $1,611.50 | $0.27 – $1,007.20 | 110 |
| Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr HCPCS J1442 | $1,447.95 | $1,447.95 | $0.98 – $1,447.95 | 110 |
| Filgrastim-sndz 300 mcg/0.5 ml injection syringe HCPCS Q5101 | $2,018.90 | $2,018.90 | $0.34 – $1,261.80 | 110 |
| Filter spider fx 3mmx320cm HCPCS C1884 | $26,937.16 | $26,937.16 | $537.13 – $2,672.31 | 28 |
| Filter vena cava fem denali HCPCS C1880 | $35,888.87 | $35,888.87 | $72.96 – $363.00 | 28 |
| Finger joint sz00 swanson w/grommets HCPCS L8630 | $3,239.60 | $3,239.60 | $177.92 – $885.15 | 28 |
| Finger X-ray (both hands) CPT 73140 | $689.00 | $689.00 | $82.14 – $459.00 | 110 |
| Fixation of knee joint CPT 27570 | $10,412.40 | not published | $9.09 – $3,121.78 | 83 |
| Fl exam g/colon tube w contrast CPT 49465 | $877.00 | $877.00 | $176.28 – $877.00 | 108 |
| Flow cytometry marker each additional CPT 88185 | $298.00 | $298.00 | $8.84 – $44.00 | 28 |
| Flow cytometry one marker technical component CPT 88184 | $1,003.00 | $1,003.00 | $59.09 – $695.89 | 110 |
| Flt3 gene analysis CPT 81246 | $249.00 | $249.00 | $50.05 – $249.00 | 44 |
| Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback HCPCS J1450 | $74.00 | $74.00 | $3.72 – $18.50 | 28 |
| Fludarabine 50 mg intravenous solution HCPCS J9185 | $434.65 | $434.65 | $78.41 – $434.65 | 94 |
| Fluorescent antibody titer dna CPT 86256 | $120.00 | $120.00 | $11.81 – $120.00 | 44 |
| Fluoroguide needle placement CPT 77002 | $1,070.00 | $1,070.00 | $215.07 – $1,070.00 | 26 |
| Fluoroscopy (Live X-ray Guidance, up to 1 hour) CPT 76000 | $31,924.76 | $722.00 | $8.44 – $722.00 | 780 |
| Fluorouracil 50 mg/ml intravenous solution (wrapper) HCPCS J9190 | $147.00 | $147.00 | $1.88 – $48.65 | 94 |
| Fna bx w/mr gdn ea addl CPT 10012 | $557.00 | $557.00 | $65.04 – $557.00 | 26 |
| Folic acid CPT 82746 | $214.00 | $214.00 | $14.25 – $214.00 | 44 |
| Folic acid 5 mg/ml injection solution HCPCS J1808 | $106.00 | $106.00 | $21.31 – $106.00 | 94 |
| Fomepizole 1 gram/ml intravenous solution HCPCS J1451 | $4,534.65 | $4,534.65 | $893.20 – $4,534.65 | 94 |
| Fondaparinux sodium HCPCS J1652 | $43.30 | $43.30 | $3.60 – $43.30 | 94 |
| Foot drp splt w/exp heel lg HCPCS L4398 | $423.24 | $423.24 | $12.61 – $77.24 | 36 |
| Foot X-ray CPT 73630 | $947.00 | $947.00 | $82.14 – $631.00 | 110 |
| Foot X-ray (2 views, both feet) CPT 73620 | $777.00 | $777.00 | $82.14 – $518.00 | 110 |
| Forearm X-ray (both sides) CPT 73090 | $6,145.00 | $840.00 | $82.14 – $560.00 | 110 |
| Fosaprepitant 150 mg intravenous powder for solution HCPCS J1453 | $378.00 | $378.00 | $16.50 – $184.00 | 94 |
| Fosphenytoin 50 mg pe/ml injection (wrapper) HCPCS Q2009 | $106.10 | $106.10 | $1.31 – $121.08 | 107 |
| Fragmenting of kidney stone CPT 50590 | $20,727.07 | not published | $0.96 – $6,843.44 | 83 |
| Freeing of bowel adhesion 44005 CPT 44005 | $3,897.00 | $3,897.00 | $37.48 – $378.88 | 768 |
| Fresh frozen plasma 8-24 hours collection each unit HCPCS P9059 | $288.00 | $288.00 | $57.89 – $546.00 | 110 |
| Fresh frozen plasma frozen within 8 hours of collection each unit HCPCS P9017 | $249.00 | $249.00 | $50.05 – $546.00 | 110 |
| Fresh frozen plasma thawing ea un CPT 86927 | $157.00 | $157.00 | $31.56 – $157.25 | 28 |
| Fructosamine glycated protein CPT 82985 | $76.00 | $76.00 | $15.28 – $76.00 | 44 |
| Full Spine X-ray (Scoliosis Survey) CPT 72082 | $961.00 | $961.00 | $98.68 – $961.00 | 110 |
| Furosemide 10 mg/ml injection solution HCPCS J1938 | $9.20 | $9.20 | $1.85 – $9.20 | 94 |
| Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr HCPCS J1940 | $48.25 | $48.25 | $0.57 – $6.75 | 36 |
| Fusion of ankle joint open CPT 27870 | $59,707.78 | not published | $9.09 – $34,040.37 | 83 |
| Fusion of big toe joint CPT 28755 | $25,903.00 | not published | $0.96 – $14,087.30 | 83 |
| Fusion of foot bones CPT 28730 | $56,940.34 | not published | $9.09 – $24,925.18 | 83 |
| Fusion of foot bones CPT 28740 | $35,705.67 | not published | $0.36 – $14,087.30 | 83 |
| Ga-67 gallium 0.1 mci HCPCS A9556 | $253.10 | $253.10 | $50.87 – $319.00 | 28 |
| Ga-68 gallium 68 dotatate HCPCS A9587 | $15,600.00 | $15,600.00 | $48.64 – $15,600.00 | 107 |
| Gadobutrol 1 mmol/ml intravenous solution (wrapper) HCPCS A9585 | $591.40 | $591.40 | $19.76 – $591.40 | 28 |
| Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper) HCPCS A9579 | $231.00 | $231.00 | $7.35 – $231.00 | 28 |
| Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution HCPCS A9575 | $99.80 | $99.80 | $10.08 – $50.15 | 28 |
| Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution HCPCS A9581 | $674.30 | $674.30 | $135.53 – $674.30 | 28 |
| Gallbladder and Bile Duct Scan (HIDA Scan) CPT 78226 | $2,567.00 | $2,567.00 | $377.34 – $2,567.00 | 110 |
| Gallbladder Function Scan (HIDA with Medication) CPT 78227 | $2,567.00 | $2,567.00 | $512.50 – $2,567.00 | 110 |
| Gallbladder Removal (Laparoscopic) CPT 47562 | $28,549.52 | $2,363.00 | $9.09 – $11,736.86 | 769 |
| Gammaglobulin iga CPT 82784 | $185.00 | $185.00 | $9.02 – $185.00 | 44 |
| Gammaglobulin ige CPT 82785 | $247.00 | $247.00 | $9.85 – $49.00 | 44 |
| Gamma glutamyltransferase CPT 82977 | $162.00 | $162.00 | $6.98 – $162.00 | 44 |
| Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr HCPCS J1570 | $138.00 | $138.00 | $16.64 – $82.80 | 94 |
| Gemcitabine 1 gram intravenous solution HCPCS J9201 | $540.20 | $540.20 | $10.08 – $50.15 | 94 |
| Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln HCPCS J9203 | $31,504.65 | $31,504.65 | $6,332.43 – $31,504.65 | 94 |
| General health panel CPT 80050 | $439.00 | $439.00 | $40.66 – $439.00 | 36 |
| Generator barostim neo2 2014 HCPCS C1767 | $68,971.44 | $68,971.44 | $0.68 – $3.36 | 28 |
| Generator emblem MRI sicd subq HCPCS C1722 | $34,380.00 | $34,380.00 | $151.37 – $753.08 | 28 |
| Generator stim baroreceptor neo legacy implant pulse HCPCS C1825 | $57,801.38 | $57,801.38 | $8,983.49 – $44,694.00 | 28 |
| Gentamicin 10 mg/ml liquid compound - enteral use only HCPCS J1580 | $21.60 | $21.60 | $0.87 – $4.35 | 28 |
| Gentamicin peak therapeutic drug level CPT 80170 | $438.00 | $438.00 | $15.87 – $438.00 | 44 |
| Ghs abscess postoperative iandd complex CPT 10180 | $580.00 | $580.00 | $44.81 – $399.00 | 768 |
| Ghs central line insert < age 5, failed CPT 36555 | $5,746.00 | $5,746.00 | $1,154.95 – $5,746.00 | 26 |
| Ghs fb removal - incisional CPT 10121 | $606.00 | $606.00 | $54.19 – $503.32 | 768 |
| Ghs gastric intub aspiration lavage CPT 43753 | $825.00 | $825.00 | $165.83 – $825.00 | 26 |
| Ghs histoplasma antigen CPT 87385 | $363.00 | $363.00 | $12.84 – $363.00 | 44 |
| Ghs i and d perirectal abscess 46040 CPT 46040 | $1,544.00 | $1,544.00 | $74.29 – $958.00 | 768 |
| Ghs inf midline insertion CPT 36140 | $3,439.00 | $3,439.00 | $691.24 – $3,439.00 | 26 |
| Ghs inj neurolytic other perph nerve CPT 64640 | $3,143.00 | $3,143.00 | $421.10 – $2,095.00 | 108 |
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.