Mercyone Genesis Dewitt Medical Center

1118 11Th Street, Dewitt, IA 52742 · (563) 659-4200

Critical Access HospitalsVoluntary non-profit - PrivateClinton, IA metro Part of Trinity Health · 52 hospitals

Price file

Prices published

File dated 2026-03-31

2,512 price rows for 58 procedures

Published prices

cash · negotiated range · list

Basic metabolic panel (blood test)

CPT 80048 · lowest of 8 lines · metro median $29

$29

cash

$16 to $67

20 negotiated rates

$48

list

CT scan of the abdomen and pelvis, with contrast

CPT 74177 · lowest of 4 lines · metro median $2,676

$2,676

cash

$1,516 to $3,256

10 negotiated rates

$4,460

list

CT scan of the head, no contrast

CPT 70450 · lowest of 6 lines · metro median $1,199

$1,199

cash

$679 to $1,459

15 negotiated rates

$1,998

list

CT scan of the pelvis, with contrast

CPT 72193 · lowest of 2 lines · metro median $1,434

$1,434

cash

$813 to $1,745

5 negotiated rates

$2,390

list

Cesarean delivery with prenatal and postpartum care

CPT 59510 · metro median $4,721

$4,721

cash

$928 to $5,744

4 negotiated rates

$7,869

list

Chlamydia test (DNA)

CPT 87491 · lowest of 31 lines · metro median $86

$86

cash

$49 to $184

73 negotiated rates

$143

list

Colonoscopy (diagnostic)

CPT 45378 · metro median $516

$516

cash

$628 to $2,679

4 negotiated rates

$860

list

Colonoscopy with biopsy

CPT 45380 · metro median $338

$338

cash

$411 to $2,679

4 negotiated rates

$563

list

Colonoscopy with polyp removal

CPT 45385 · metro median $377

$377

cash

$459 to $2,679

4 negotiated rates

$629

list

Complete blood count (CBC) with differential

CPT 85025 · lowest of 6 lines · metro median $35

$35

cash

$20 to $65

15 negotiated rates

$58

list

Comprehensive metabolic panel (blood test)

CPT 80053 · lowest of 8 lines · metro median $85

$102

cash

$58 to $134

20 negotiated rates

$170

list

Diagnostic mammogram (both breasts)

CPT 77066 · lowest of 15 lines · metro median $85

$85

cash

$48 to $360

36 negotiated rates

$142

list

Electrocardiogram (ECG) with interpretation

CPT 93000 · lowest of 2 lines · metro median $95

$95

cash

$115 to $2,679

8 negotiated rates

$158

list

Established patient office visit (about 40 minutes)

CPT 99215 · lowest of 3 lines · metro median $181

$181

cash

$103 to $2,679

9 negotiated rates

$302

list

Family psychotherapy with the patient

CPT 90847 · metro median $174

$174

cash

$212 to $2,679

4 negotiated rates

$290

list

Family psychotherapy without the patient

CPT 90846 · metro median $114

$114

cash

$139 to $2,679

4 negotiated rates

$190

list

Gallbladder removal (laparoscopic)

CPT 47562 · metro median $1,408

$1,408

cash

$928 to $2,679

4 negotiated rates

$2,346

list

Gonorrhea test (DNA)

CPT 87591 · lowest of 26 lines · metro median $58

$58

cash

$33 to $162

59 negotiated rates

$97

list

Group psychotherapy

CPT 90853 · metro median $37

$37

cash

$45 to $2,679

4 negotiated rates

$61

list

Inguinal hernia repair (age 5 and up)

CPT 49505 · metro median $977

$977

cash

$928 to $2,679

4 negotiated rates

$1,629

list

Knee arthroscopy with meniscus repair

CPT 29881 · metro median $755

$755

cash

$919 to $2,679

4 negotiated rates

$1,259

list

Laser treatment after cataract surgery (YAG)

CPT 66821 · lowest of 3 lines · metro median $678

$678

cash

$486 to $729

3 negotiated rates

$1,130

list

Lipid panel (cholesterol test)

CPT 80061 · lowest of 14 lines · metro median $40

$40

cash

$22 to $65

35 negotiated rates

$66

list

Liver function panel

CPT 80076 · lowest of 4 lines · metro median $58

$58

cash

$33 to $72

10 negotiated rates

$97

list

MRI of the brain, with and without contrast

CPT 70553 · lowest of 18 lines · metro median $2,998

$2,998

cash

$1,699 to $3,647

45 negotiated rates

$4,996

list

MRI of the knee or other lower joint, no contrast

CPT 73721 · lowest of 15 lines · metro median $1,491

$1,751

cash

$992 to $2,131

27 negotiated rates

$2,919

list

MRI of the lower back (lumbar spine), no contrast

CPT 72148 · lowest of 7 lines · metro median $1,179

$1,179

cash

$668 to $2,130

13 negotiated rates

$1,965

list

MRI of the neck (cervical spine), no contrast

CPT 72141 · lowest of 4 lines · metro median $1,742

$1,742

cash

$987 to $2,119

7 negotiated rates

$2,903

list

Nerve block injection, lower back, with imaging guidance

CPT 64483 · lowest of 4 lines · metro median $463

$463

cash

$563 to $2,679

10 negotiated rates

$771

list

New patient office visit (about 30 minutes)

CPT 99203 · lowest of 3 lines · metro median $103

$103

cash

$58 to $2,679

9 negotiated rates

$171

list

New patient office visit (about 45 minutes)

CPT 99204 · lowest of 3 lines · metro median $169

$169

cash

$96 to $2,679

9 negotiated rates

$281

list

New patient office visit (about 60 minutes)

CPT 99205 · lowest of 3 lines · metro median $170

$170

cash

$97 to $2,679

9 negotiated rates

$284

list

PSA test (prostate)

CPT 84153 · lowest of 21 lines · metro median $64

$64

cash

$36 to $100

52 negotiated rates

$107

list

Partial thromboplastin time (blood clotting test)

CPT 85730 · lowest of 19 lines · metro median $16

$16

cash

$12 to $120

46 negotiated rates

$27

list

Physical therapy, therapeutic exercise (15 minutes)

CPT 97110 · lowest of 14 lines · metro median $52

$52

cash

$39 to $2,679

27 negotiated rates

$87

list

Pregnancy ultrasound (after first trimester)

CPT 76805 · lowest of 11 lines · metro median $299

$299

cash

$256 to $2,679

29 negotiated rates

$499

list

Preventive visit, new patient age 18 to 39

CPT 99385 · metro median $175

$175

cash

$212 to $2,679

4 negotiated rates

$291

list

Preventive visit, new patient age 40 to 64

CPT 99386 · metro median $229

$229

cash

$279 to $2,679

4 negotiated rates

$382

list

Prostate biopsy

CPT 55700 · lowest of 2 lines · metro median $466

$1,000

cash

$567 to $1,217

5 negotiated rates

$1,667

list

Prothrombin time (blood clotting test)

CPT 85610 · lowest of 9 lines · metro median $9

$11

cash

$8 to $58

23 negotiated rates

$19

list

Psychotherapy, 30 minutes

CPT 90832 · metro median $59

$59

cash

$72 to $2,679

4 negotiated rates

$98

list

Psychotherapy, 45 minutes

CPT 90834 · metro median $114

$114

cash

$139 to $2,679

4 negotiated rates

$190

list

Psychotherapy, 60 minutes

CPT 90837 · metro median $146

$146

cash

$178 to $2,679

4 negotiated rates

$244

list

Removal of a breast lump (biopsy by excision)

CPT 19120 · metro median $914

$914

cash

$928 to $2,679

4 negotiated rates

$1,523

list

Screening mammogram (both breasts)

CPT 77067 · lowest of 34 lines · metro median $68

$68

cash

$38 to $337

64 negotiated rates

$113

list

Sleep study (overnight, attended)

CPT 95810 · lowest of 8 lines · metro median $1,785

$3,031

cash

$1,717 to $3,687

20 negotiated rates

$5,051

list

Spinal injection, lower back, no imaging guidance

CPT 62322 · metro median $164

$164

cash

$200 to $2,679

4 negotiated rates

$274

list

Spinal injection, lower back, with imaging guidance

CPT 62323 · lowest of 15 lines · metro median $188

$188

cash

$229 to $2,679

39 negotiated rates

$314

list

TSH test (thyroid)

CPT 84443 · lowest of 21 lines · metro median $53

$53

cash

$32 to $100

61 negotiated rates

$88

list

Tonsils and adenoids removal (under age 12)

CPT 42820 · metro median $577

$577

cash

$702 to $2,679

4 negotiated rates

$961

list

Transvaginal ultrasound

CPT 76830 · lowest of 7 lines · metro median $266

$266

cash

$191 to $2,679

19 negotiated rates

$443

list

Ultrasound of the abdomen (complete)

CPT 76700 · lowest of 4 lines · metro median $709

$709

cash

$402 to $862

10 negotiated rates

$1,181

list

Upper endoscopy (EGD)

CPT 43235 · metro median $181

$181

cash

$220 to $2,679

4 negotiated rates

$302

list

Upper endoscopy with biopsy

CPT 43239 · metro median $205

$205

cash

$249 to $2,679

4 negotiated rates

$341

list

Urinalysis with microscope

CPT 81001 · lowest of 11 lines · metro median $20

$20

cash

$12 to $2,679

29 negotiated rates

$34

list

Vaginal delivery after a previous cesarean

CPT 59610 · metro median $4,471

$4,471

cash

$928 to $5,439

4 negotiated rates

$7,451

list

Vaginal delivery with prenatal and postpartum care

CPT 59400 · metro median $4,264

$4,264

cash

$928 to $5,187

4 negotiated rates

$7,106

list

X-ray of the lower spine (4 or more views)

CPT 72110 · metro median $355

$355

cash

$255 to $255

1 negotiated rates

$592

list

Source files

The machine-readable files this hospital lists in its cms-hpt.txt. Every price above comes from one of them.

https://trinityhealth.pt.panaceainc.com/MRFDownload/trinityhealth/genesishealth-cah
MercyOne Genesis DeWitt Medical Center · parsed · tall v3.0.0 · file dated 2026-03-31 · 2.3 MB · 2512 price rows read · read Nov 2026