Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
Laps Gstr Rstcv Px W/Byp Roux-en-Y Limb <150 Cm
The hospitals that file a Wellmark rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.
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67 hospital rates
| # | Plans | |||
|---|---|---|---|---|
| 1 | Allen Memorial Hospital Corporation Waterloo, IA fee schedule · both | 4 | $3,055 | $1,549 – $3,952 |
| 2 | Catholic Health Initiatives-Iowa Corp West Des Moines, IA facility · fee schedule · outpatient | 3 | $455.78 | $135.93 – $1,415 |
| 3 | Catholic Health Initiatives-Iowa Corp West Des Moines, IA professional · fee schedule · both | 3 | $241.73 | $113.20 – $316.19 |
| 4 | Catholic Health Initiatives-Iowa Corp West Des Moines, IA professional · fee schedule · inpatient | 3 | $1,511 | $707.53 – $1,976 |
| 5 | Catholic Health Initiatives-Iowa Corp West Des Moines, IA professional · fee schedule · outpatient | 3 | $1,511 | $707.53 – $1,976 |
| 6 | Central Iowa Hospital Corporation Des Moines, IA fee schedule · both | 4 | $3,055 | $1,549 – $3,952 |
| 7 | Central Iowa Hospital Corporation West Des Moines, IA fee schedule · both | 4 | $3,055 | $1,549 – $3,952 |
| 8 | Grinnell Regional Medical Center Grinnell, IA fee schedule · both | 4 | $3,055 | $1,549 – $3,952 |
| 9 | Gundersen Palmer Lutheran Hospital and Clinic Inc West Union, IA facility · case rate · outpatient | 2 | $12,610 | $12,021 – $13,200 |
| 10 | Holy Cross Hospital-Silver Spring Silver Spring, MD professional · percent of total billed charges · bothfrom % of charges | 1 | $2,186 | $603.04 – $3,769 |
| 11 | Mercy Fitzgerald Hospital Darby, PA professional · fee schedule · both | 2 | $409.33 | $133.36 – $978.71 |
| 12 | Mercy Fitzgerald Hospital Darby, PA professional · fee schedule · inpatient | 2 | $930.31 | $833.51 – $978.71 |
| 13 | Mercy Fitzgerald Hospital Darby, PA professional · fee schedule · outpatient | 2 | $930.31 | $833.51 – $978.71 |
| 14 | MercyOne Genesis Aledo Medical Center Aledo, IL facility · case rate · inpatient | 1 | $13,923 | $13,923 – $13,923 |
| 15 | MercyOne Genesis Aledo Medical Center Aledo, IL facility · per diem · inpatient | 1 | $2,970 | $2,970 – $2,970 |
| 16 | MercyOne Genesis DeWitt Medical Center DeWitt, IA facility · per diem · inpatient | 2 | $1,804 | $928.00 – $2,679 |
| 17 | MercyOne Genesis Silvis Medical Center Silvis, IL facility · case rate · inpatient | 1 | $5,141 | $5,141 – $5,141 |
| 18 | Meriter Hospital, Inc Madison, WI case rate · both | 1 | $5,046 | $5,046 – $5,046 |
| 19 | Meriter Hospital, Inc Madison, WI per diem · outpatient | 1 | $17,482 | $17,482 – $17,482 |
| 20 | Mount Carmel East Reynoldsburg, OH professional · percent of total billed charges · inpatientfrom % of charges | 1 | $2,240 | $603.04 – $3,986 |
| 21 | Mount Carmel East Reynoldsburg, OH professional · percent of total billed charges · outpatientfrom % of charges | 1 | $3,349 | $560.32 – $7,450 |
| 22 | Mount Carmel Grove City Grove City, OH facility · fee schedule · outpatient | 1 | $21,745 | $21,745 – $21,745 |
| 23 | Northwest Iowa Hospital Corporation Sioux City, IA fee schedule · both | 4 | $3,055 | $1,549 – $3,952 |
| 24 | Saint Alphonsus Regional Medical Center - Boise Boise, ID professional · fee schedule · both | 2 | $789.13 | $113.76 – $1,685 |
| 25 | Saint Alphonsus Regional Medical Center - Boise Boise, ID professional · fee schedule · inpatient | 2 | $741.15 | $82.19 – $1,685 |
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