MercyOne New Hampton Medical Center
308 North Maple Ave, New Hampton, IA · MercyOne · · NPI 1770651515
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 |
|---|---|---|---|---|
| Radium ra223 dichl ther/uci HCPCS A9606 | $507.10 | $507.10 | $169.08 – $507.10 | 114 |
| Ramucirumab 10 mg/ml intravenous solution HCPCS J9308 | $22,849.50 | $22,849.50 | $1,629.60 – $4,569.90 | 114 |
| Rapid Strep Test CPT 87880 | $94.25 | $145.00 | $12.51 – $145.00 | 780 |
| Rasburicase 1.5 mg intravenous solution HCPCS J2783 | $16,770.95 | $16,770.95 | $1,129.44 – $3,354.20 | 114 |
| Ravulizumab-cwvz 100 mg/ml intravenous solution HCPCS J1303 | $73,649.25 | $73,649.25 | $6,755.70 – $20,086.15 | 114 |
| Rbc count only automated CPT 85041 | $18.20 | $28.00 | $11.09 – $28.00 | 43 |
| Red blood cells leukocytes reduced each unit HCPCS P9016 | $1,673.75 | $654.00 | $2.28 – $654.00 | 114 |
| Red blood cells leukocytes reduced irradiated each unit HCPCS P9040 | $457.60 | $704.00 | $278.71 – $704.00 | 43 |
| Regadenoson 0.4 mg/5 ml intravenous syringe HCPCS J2785 | $92.00 | $92.00 | $11.56 – $92.00 | 114 |
| Remdesivir 100 mg intravenous powder for solution HCPCS J0248 | $3,543.15 | $3,543.15 | $673.00 – $3,543.15 | 114 |
| Removal cerumen impacted (both sides) CPT 69210 | $356.20 | $548.00 | $8.63 – $365.00 | 780 |
| Removal devitalized tissue non-selective debridement without anesthesia per session CPT 97602 | $300.95 | $463.00 | $148.07 – $374.00 | 43 |
| Removal skin tags fibrocutaneous any area <= 15 lesions CPT 11200 | $430.00 | $430.00 | $18.41 – $253.00 | 780 |
| Removal sutr and stapl no anes CPT 15854 | $24.05 | $37.00 | $14.65 – $37.00 | 43 |
| Removal w/reinsrt nonbiogrdble CPT 11983 | $550.00 | $633.00 | $28.33 – $633.00 | 780 |
| Remove wrist/forearm lesion CPT 25116 | $13,087.44 | not published | $0.96 – $4.92 | 72 |
| Renal function panel CPT 80069 | $94.25 | $145.00 | $57.41 – $145.00 | 43 |
| Reptilase test CPT 85635 | $80.60 | $124.00 | $49.09 – $124.00 | 43 |
| Reslizumab 10 mg/ml intravenous solution HCPCS J2786 | $5,680.00 | $5,680.00 | $2,248.71 – $5,680.00 | 43 |
| Reticulated platelet assay CPT 85055 | $52.00 | $80.00 | $31.67 – $80.00 | 43 |
| Reticulocyte automated CPT 85045 | $47.45 | $73.00 | $3.99 – $73.00 | 43 |
| Reticulocyte direct measurement automated CPT 85046 | $44.85 | $69.00 | $27.32 – $69.00 | 43 |
| Retifanlimab-dlwr 500 mg/20 ml intravenous solution HCPCS J9345 | $45,114.00 | $45,114.00 | $16,405.00 – $45,114.00 | 114 |
| Revision of knee joint CPT 27446 | $21,126.16 | not published | $9.09 – $10.20 | 72 |
| Rezafungin 200 mg intravenous solution HCPCS J0349 | $10,657.15 | $10,657.15 | $2,124.00 – $10,657.15 | 114 |
| Rheumatoid factor qualitative CPT 86430 | $54.60 | $84.00 | $33.26 – $84.00 | 43 |
| Rheumatoid factor quantitative CPT 86431 | $70.20 | $108.00 | $42.76 – $108.00 | 43 |
| Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe HCPCS J2791 | $294.95 | $294.95 | $74.55 – $294.95 | 114 |
| Rho(d) immune globulin (rhig) human full dose im CPT 90384 | $151.45 | $233.00 | $82.83 – $233.00 | 114 |
| Rib and Chest X-ray (3 views, left side) CPT 71101 | $494.00 | $760.00 | $300.88 – $760.00 | 43 |
| Rib and Chest X-ray (4 or more views, both sides) CPT 71111 | $507.65 | $781.00 | $309.20 – $781.00 | 43 |
| Rib X-ray (3 views, both sides) CPT 71110 | $261.95 | $403.00 | $159.55 – $403.00 | 43 |
| Rifampin in ns IV syringe 3 mg/ml (neo/ped) - cnr HCPCS J2804 | $82.10 | $82.10 | $9.60 – $82.10 | 114 |
| Ring barrier skin cx 1 9/16 adapt HCPCS A4411 | $2.63 | $4.04 | $1.60 – $4.04 | 43 |
| Ring fx reform 11-13x17mm HCPCS L8610 | $983.30 | $1,512.77 | $45.13 – $114.00 | 43 |
| Ring ostmy barr adapt 48mm HCPCS A4385 | $1.33 | $2.04 | $0.81 – $2.04 | 43 |
| Risankizumab-rzaa 60 mg/ml intravenous solution HCPCS J2327 | $30,071.50 | $30,071.50 | $8,904.00 – $30,071.50 | 114 |
| Rituximab 10 mg/ml concentrate,intravenous HCPCS J9312 | $14,092.80 | $14,092.80 | $4,154.50 – $14,092.80 | 114 |
| Rituximab 1,400 mg/11.7 ml (120 mg/ml)-hyaluronidase subcutaneous soln HCPCS J9311 | $22,548.30 | $22,548.30 | $5,663.00 – $19,729.75 | 114 |
| Rituximab-abbs 10 mg/ml intravenous solution HCPCS Q5115 | $12,035.25 | $12,035.25 | $311.80 – $2,407.05 | 114 |
| Rituximab-arrx 10 mg/ml intravenous solution HCPCS Q5123 | $8,300.55 | $8,300.55 | $657.25 – $1,660.15 | 43 |
| Rituximab-pvvr 10 mg/ml intravenous solution HCPCS Q5119 | $9,889.65 | $9,889.65 | $265.00 – $1,978.00 | 114 |
| Romidepsin 10 mg/2 ml intravenous powder for solution HCPCS J9319 | $8,826.40 | $8,826.40 | $3,401.00 – $8,826.40 | 114 |
| Romiplostim 125 mcg subcutaneous solution HCPCS J2802 | $17,344.00 | $17,344.00 | $1,375.00 – $4,336.10 | 114 |
| Romosozumab-aqqg 105 mg/1.17 ml subcutaneous syringe (wrapper) HCPCS J3111 | $13,801.85 | $13,801.85 | $2,520.00 – $13,801.85 | 114 |
| Ropivacaine 0.2 % epidural pca - 1 hour dose limit HCPCS J2795 | $188.50 | $188.50 | $0.60 – $3.25 | 114 |
| Rozanolixizumab-noli 140 mg/ml subcutaneous solution HCPCS J9333 | $56,796.70 | $56,796.70 | $21,294.00 – $56,796.70 | 114 |
| Rsv assay w/optic CPT 87807 | $74.10 | $114.00 | $9.94 – $114.00 | 780 |
| Rubella antibody igg CPT 86762 | $76.70 | $118.00 | $46.72 – $118.00 | 43 |
| Rubeola antibody igg CPT 86765 | $48.10 | $74.00 | $29.30 – $74.00 | 43 |
| Russell viper venom diluted CPT 85613 | $81.90 | $126.00 | $49.88 – $126.00 | 43 |
| Sacituzumab govitecan-hziy 180 mg intravenous solution HCPCS J9317 | $7,844.35 | $7,844.35 | $2,856.96 – $7,844.35 | 114 |
| Sacroiliac Joint X-ray (3 or more views) CPT 72202 | $222.95 | $343.00 | $135.79 – $343.00 | 43 |
| Sarscov coronavirus ag ia CPT 87426 | $87.10 | $134.00 | $35.33 – $134.00 | 43 |
| Sarscov & inf vir a&b ag ia CPT 87428 | $162.50 | $250.00 | $30.94 – $250.00 | 780 |
| Sbsq nursing facil care/day minor complj 15 min CPT 99308 | $126.75 | $195.00 | $77.20 – $195.00 | 43 |
| Sbsq nursing facil care/day new problem 25 min CPT 99309 | $166.40 | $256.00 | $101.35 – $256.00 | 43 |
| Sbsq nursing facility care/day e/m stable 10 min CPT 99307 | $87.10 | $134.00 | $53.05 – $134.00 | 43 |
| Scan duplex aorta/ivc/iliac or bypass grafts complete CPT 93978 | $824.20 | $1,268.00 | $502.00 – $1,268.00 | 43 |
| Scan duplex extracranial arteries unilateral/limited study CPT 93882 | $479.70 | $738.00 | $292.17 – $738.00 | 43 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $735.80 | $1,132.00 | $448.16 – $1,132.00 | 43 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $686.40 | $1,056.00 | $418.07 – $1,056.00 | 43 |
| Scope uretscp lithovue dig disp HCPCS C1747 | $2,389.32 | $3,675.88 | $638.90 – $1,613.80 | 43 |
| Screening Colonoscopy (average risk) HCPCS G0121 | $3,434.92 | $870.00 | $2.46 – $582.81 | 780 |
| Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations HCPCS G0328 | $61.75 | $95.00 | $18.05 – $95.00 | 43 |
| Screening hepatitis b non-obstetric high risk HCPCS G0499 | $56.55 | $87.00 | $28.27 – $87.00 | 43 |
| Screening hepatitis c antibody high risk HCPCS G0472 | $85.80 | $132.00 | $52.26 – $132.00 | 43 |
| Screening HIV antigen/antibody combination assay HCPCS G0475 | $96.85 | $149.00 | $58.99 – $149.00 | 43 |
| Screening Mammogram CPT 77067 | $461.50 | $710.00 | $81.59 – $473.00 | 43 |
| Screening prostate cancer PSA HCPCS G0103 | $129.35 | $199.00 | $78.78 – $199.00 | 43 |
| Screw cortex 2.0 x 10mm HCPCS C1713 | $3,466,153.38 | $5,332,543.66 | $0.01 – $0.02 | 43 |
| Scrotal (Testicle) Ultrasound CPT 76870 | $542.75 | $835.00 | $330.58 – $835.00 | 43 |
| Sedation moderate same physician performing a gastrointestinal endoscopic service >= 5 years initial 15 minutes intra-service time HCPCS G0500 | $558.35 | $859.00 | $340.08 – $859.00 | 43 |
| Sedimentation rate erythrocyte automated CPT 85652 | $44.20 | $68.00 | $26.92 – $68.00 | 43 |
| Self-Care and Home Skills Training (each 15 minutes) CPT 97535 | $93.60 | $144.00 | $57.01 – $144.00 | 43 |
| Semen analysis presence/motility CPT 89321 | $100.75 | $155.00 | $61.36 – $155.00 | 43 |
| Shave sgl skin lsn f/e/e/n/l/m 0.5cm/< CPT 11310 | $275.72 | $318.00 | $11.61 – $318.00 | 780 |
| Shave sgl skin lsn s/n/h/f/g 0.5cm/< CPT 11305 | $209.61 | $286.00 | $9.28 – $286.00 | 780 |
| Shave sgl skin lsn s/n/h/f/g 0.6-1.0 cm CPT 11306 | $220.35 | $339.00 | $134.21 – $339.00 | 43 |
| Shave sgl skin lsn t/a/l 0.5cm/< CPT 11300 | $219.97 | $336.00 | $6.98 – $288.00 | 780 |
| Shave sgl skin lsn t/a/l 0.6-1.0cm CPT 11301 | $263.25 | $405.00 | $11.53 – $337.00 | 780 |
| Shave sgl skin lsn t/a/l 1.1-2.0cm CPT 11302 | $258.70 | $398.00 | $15.45 – $398.00 | 780 |
| Sheath gldlight lasr 12fx50cm HCPCS C2629 | $4,489.99 | $6,907.68 | $360.27 – $910.00 | 43 |
| Sheath laser cavaclear 14f HCPCS C1603 | $5,525.00 | $8,500.00 | $2,500.77 – $6,316.66 | 43 |
| Shoe post-op mens m HCPCS L3260 | $49.82 | $76.64 | $4.59 – $11.60 | 43 |
| Shot (Injection into Muscle or Under the Skin) CPT 96372 | $538.52 | $159.00 | $3.28 – $159.00 | 779 |
| Shoulder Blade (Scapula) X-ray (both sides) CPT 73010 | $622.05 | $957.00 | $252.58 – $638.00 | 43 |
| Shoulder MRI (with and without contrast) CPT 73223 | $6,159.40 | $9,476.00 | $2,500.90 – $6,317.00 | 43 |
| Shoulder MRI (without contrast) CPT 73221 | $3,858.40 | $5,936.00 | $1,566.58 – $3,957.00 | 43 |
| Shoulder X-ray CPT 73030 | $386.10 | $594.00 | $156.78 – $396.00 | 43 |
| Shoulder X-ray (single view, both shoulders) CPT 73020 | $299.65 | $461.00 | $121.54 – $307.00 | 43 |
| Shrinker prosth above knee HCPCS L8460 | $286.68 | $441.04 | $174.61 – $441.04 | 43 |
| Shrinker prosth below knee HCPCS L8440 | $185.28 | $285.04 | $112.85 – $285.04 | 43 |
| Shunt glaucoma baerveldt 350mm HCPCS C1783 | $3,049.15 | $4,691.00 | $73.44 – $185.50 | 43 |
| Sickling rbc CPT 85660 | $50.70 | $78.00 | $5.51 – $78.00 | 43 |
| Sincalide 5 mcg solution for injection HCPCS J2805 | $651.10 | $651.10 | $135.97 – $651.10 | 114 |
| Sinus CT scan (with contrast) CPT 70487 | $2,102.10 | $3,234.00 | $1,280.34 – $3,234.00 | 43 |
| Sinus CT scan (without contrast) CPT 70486 | $1,275.30 | $1,962.00 | $776.76 – $1,962.00 | 43 |
| Sirolimus-protein bound 100 mg intravenous suspension HCPCS J9331 | $42,938.50 | $42,938.50 | $9,250.00 – $42,938.50 | 114 |
| Skin Biopsy CPT 11102 | $337.00 | $337.00 | $9.59 – $275.00 | 780 |
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.