Supplies, drugs & other prices at MercyOne Genesis Dewitt Medical Center
Dewitt, IA · every code in this section with a posted price and a Medicare benchmark.
44 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Adm of soc dtr assess 5-15 m (G0136) | $16.80 | $28 | 0.5× |
| Admin hepatitis b vaccine (G0010) | $33 | $55 | 0.7× |
| Admin influenza virus vac (G0008) | $33 | $55 | 0.7× |
| Admin pneumococcal vaccine (G0009) | $33 | $55 | 0.7× |
| Annual alcohol screen 15 min (G0442) | $23.40 | $39 | 0.6× |
| Behavior counsel obesity 15m (G0447) | $34.80 | $58 | 0.4× |
| Ca screen;flexi sigmoidscope (G0104) | $228.60 | $381 | 0.3× |
| Ca screen;pelvic/breast exam (G0101) | $62.40 | $104 | 0.6× |
| Colon ca scrn not hi rsk ind (G0121) | $643.20 | $1,072 | 0.7× |
| Colorectal scrn; hi risk ind (G0105) | $643.20 | $1,072 | 0.7× |
| Depression screen annual (G0444) | $23.40 | $39 | 0.6× |
| Dermal filler injection(s) (G0429) | $57 | $95 | 0.0× |
| Diab manage trn per indiv (G0108) | $82.80 | $138 | 1.5× |
| Diab manage trn ind/group (G0109) | $37.80 | $63 | 2.4× |
| Direct refer hospital observ (G0379) | $137.40 | $229 | 0.2× |
| Ekg tracing for initial prev (G0404) | $17.40 | $29 | 0.6× |
| Elec stim other than wound (G0283) | $79.20 | $132 | 6.2× |
| Fecal blood scrn immunoassay (G0328) | $48 | $80 | 2.7× |
| Fern test (Q0114) | $26.40 | $44 | 2.7× |
| Group mnt 2 or more 30 mins (G0271) | $39.60 | $66 | 2.3× |
| Initial preventive exam (G0402) | $259.20 | $432 | 2.0× |
| Inj for sacroiliac jt anesth (G0260) | $778.20 | $1,297 | 1.1× |
| Intens behave ther cardio dx (G0446) | $34.80 | $58 | 1.0× |
| Intens cardiac rehab no exer (G0423) range across 2 matching MRF lines |
$148.20–$186 | $247–$310 | varies |
| Intens cardiac rehab w/exerc (G0422) range across 2 matching MRF lines |
$148.20–$186 | $247–$310 | varies |
| Mnt subs tx for change dx (G0270) | $88.20 | $147 | 2.8× |
| Njx platelet plasma (0232T) | $390 | $650 | 0.9× |
| Obtaining screen pap smear (Q0091) | $87 | $145 | 3.1× |
| Onc thyr 10 microrna seq +/- rslt mod hi rsk mal (0018U) | $8,019 | $13,365 | 2.7× |
| Oth resp proc, group (G0239) | $108.60 | $181 | 3.0× |
| Oth resp proc, indiv (G0238) range across 5 matching MRF lines |
$37.20–$58.80 | $62–$98 | varies |
| Potassium hydroxide preps (Q0112) | $12.60 | $21 | 2.2× |
| Ppps, initial visit (G0438) | $284.40 | $474 | 1.6× |
| Ppps, subseq visit (G0439) | $190.20 | $317 | 1.4× |
| Psa screening (G0103) range across 4 matching MRF lines |
$64.20–$67.20 | $107–$112 | varies |
| Therapeutic procd strg endur (G0237) range across 6 matching MRF lines |
$43.80–$69 | $73–$115 | varies |
| Trauma respons w/hosp criti (G0390) range across 2 matching MRF lines |
$3,296.40–$4,063.80 | $5,494–$6,773 | varies |
| Trim nail(s) (G0127) | $37.20 | $62 | 0.7× |
| Trluml Perip Athrc Iliac Art (0238T) | $20,630.40 | $34,384 | 1.2× |
| Tte w or wo fol wcon,doppler (C8929) | $1,683.60 | $2,806 | 2.2× |
| Visit esketamine 56m or less (G2082) | $1,735.80 | $2,893 | 1.8× |
| Visit esketamine, > 56m (G2083) | $2,189.40 | $3,649 | 1.4× |
| Visit to determ ldct elig (G0296) | $26.40 | $44 | 0.3× |
| Wet mounts/ w preparations (Q0111) | $21.60 | $36 | 1.2× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.