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 |
|---|---|---|---|---|
| Uric acid blood CPT 84550 | $57.85 | $89.00 | $35.24 – $89.00 | 43 |
| Uric acid urine CPT 84560 | $66.30 | $102.00 | $4.98 – $102.00 | 43 |
| Urinalysis microscopic only CPT 81015 | $31.85 | $49.00 | $4.48 – $49.00 | 43 |
| Urinalysis (with microscopy) CPT 81001 | $341.25 | $68.00 | $26.92 – $68.00 | 43 |
| Urinalysis (without microscopy) CPT 81003 | $39.65 | $61.00 | $24.15 – $61.00 | 43 |
| Urine Culture Test CPT 87086 | $58.50 | $90.00 | $35.63 – $90.00 | 43 |
| Urine pregnancy test CPT 81025 | $42.25 | $65.00 | $6.03 – $65.00 | 780 |
| Ustekinumab 130 mg/26 ml intravenous solution HCPCS J3358 | $6,677.00 | $6,677.00 | $1,727.70 – $6,677.00 | 114 |
| Ustekinumab 45 mg/0.5 ml subcutaneous solution HCPCS J3357 | $45,913.60 | $45,913.60 | $3,644.10 – $45,913.60 | 114 |
| Vaccine Administration (one shot) CPT 90471 | $95.55 | $147.00 | $4.32 – $39.00 | 779 |
| Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml CPT 91322 | $273.00 | $420.00 | $161.65 – $420.00 | 114 |
| Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml CPT 91321 | $533.00 | $820.00 | $147.06 – $820.00 | 114 |
| Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im CPT 91320 | $341.00 | $341.00 | $59.78 – $341.00 | 780 |
| Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im CPT 91319 | $65.65 | $101.00 | $39.99 – $101.00 | 114 |
| Vaccine covid-19 pfizer tris-sucrose 6mos-4yrs 3mcg/0.3ml im CPT 91318 | $49.40 | $76.00 | $30.09 – $76.00 | 114 |
| Vaccine dtap < 7 years im CPT 90700 | $67.00 | $67.00 | $16.88 – $67.00 | 553 |
| Vaccine dtap-hep b-ipv im CPT 90723 | $228.00 | $228.00 | $58.20 – $228.00 | 553 |
| Vaccine dtap-ipv 4-6 years im CPT 90696 | $142.00 | $142.00 | $33.26 – $142.00 | 552 |
| Vaccine dtap-ipv-hib-hepb im CPT 90697 | $128.70 | $198.00 | $78.39 – $198.00 | 114 |
| Vaccine dtap-ipv/hib im CPT 90698 | $98.15 | $151.00 | $59.78 – $151.00 | 114 |
| Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im CPT 90647 | $37.05 | $57.00 | $22.57 – $57.00 | 114 |
| Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im CPT 90648 | $35.10 | $54.00 | $9.33 – $54.00 | 553 |
| Vaccine hepatitis a (hepa) adult im CPT 90632 | $157.00 | $209.00 | $58.92 – $209.00 | 779 |
| Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im CPT 90636 | $281.00 | $281.00 | $72.45 – $193.17 | 555 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im CPT 90633 | $87.00 | $87.00 | $24.14 – $87.00 | 553 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 3 dose im CPT 90634 | $45.50 | $70.00 | $27.71 – $70.00 | 43 |
| Vaccine hepatitis b (hepb) adolescent 2 dose im CPT 90743 | $54.60 | $84.00 | $33.26 – $84.00 | 114 |
| Vaccine hepatitis b (hepb) adult 3 dose im CPT 90746 | $345.70 | $345.70 | $59.20 – $210.00 | 779 |
| Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im CPT 90739 | $310.70 | $478.00 | $177.56 – $478.00 | 114 |
| Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 | $138.80 | $138.80 | $31.67 – $90.00 | 114 |
| Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im CPT 90651 | $686.00 | $686.00 | $149.25 – $686.00 | 555 |
| Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im CPT 90649 | $215.15 | $331.00 | $131.04 – $331.00 | 43 |
| Vaccine influenza (iiv) preservative free antigen content im CPT 90662 | $142.35 | $219.00 | $86.70 – $219.00 | 114 |
| Vaccine influenza inactivated adjuvant im CPT 90653 | $303.40 | $303.40 | $32.86 – $183.00 | 779 |
| Vaccine influenza nos 0.5ml dose im CPT 90658 | $20.15 | $31.00 | $12.27 – $31.00 | 114 |
| Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im CPT 90656 | $1,149.20 | $102.45 | $11.88 – $49.00 | 779 |
| Vaccine influenza quadrivalent (iiv4) 0.5ml dose im CPT 90688 | $40.95 | $63.00 | $18.44 – $63.00 | 114 |
| Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im CPT 90694 | $150.15 | $231.00 | $67.98 – $231.00 | 114 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.25ml dose im CPT 90685 | $19.50 | $30.00 | $11.88 – $30.00 | 114 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im CPT 90686 | $43.55 | $67.00 | $19.73 – $67.00 | 114 |
| Vaccine influenza quadrivalent (iiv4) split virus 0.25 ml im CPT 90687 | $20.80 | $32.00 | $9.22 – $32.00 | 114 |
| Vaccine influenza quadrivalent live (laiv4) intranasal CPT 90672 | $53.95 | $83.00 | $24.50 – $83.00 | 114 |
| Vaccine influenza quadrivalent (riv4) rdna antibiotic/preservative free im CPT 90682 | $142.35 | $219.00 | $64.51 – $219.00 | 114 |
| Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im CPT 90661 | $499.85 | $769.00 | $49.50 – $769.00 | 114 |
| Vaccine influenza trivalent (iiv3) 0.25ml dose im CPT 90657 | $31.20 | $48.00 | $11.03 – $48.00 | 114 |
| Vaccine mengingoccocal serogroup b 2 dose im CPT 90620 | $499.00 | $499.00 | $110.06 – $499.00 | 555 |
| Vaccine mengingoccocal serogroup b 2 or 3 dose im CPT 90621 | $161.20 | $248.00 | $98.18 – $248.00 | 114 |
| Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im CPT 90619 | $142.35 | $219.00 | $86.70 – $219.00 | 114 |
| Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im CPT 90734 | $382.20 | $588.00 | $73.60 – $588.00 | 555 |
| Vaccine mmr live subcutaneous CPT 90707 | $213.00 | $213.00 | $48.30 – $156.00 | 555 |
| Vaccine mmrv live subcutaneous CPT 90710 | $621.00 | $621.00 | $95.64 – $621.00 | 553 |
| Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im CPT 90732 | $556.15 | $556.15 | $133.47 – $398.00 | 114 |
| Vaccine pneumococcal conjugate 13 valent (pcv13) im CPT 90670 | $499.85 | $769.00 | $257.99 – $769.00 | 114 |
| Vaccine pneumonococcal conjugate 15 valent (pcv15) im CPT 90671 | $477.10 | $734.00 | $261.15 – $734.00 | 114 |
| Vaccine pneumonococcal conjugate 20 valent (pcv20) im CPT 90677 | $652.00 | $860.00 | $257.09 – $860.00 | 779 |
| Vaccine polio (ipv) subcutaneous/im CPT 90713 | $100.00 | $100.00 | $22.17 – $75.24 | 555 |
| Vaccine rabies im CPT 90675 | $1,083.55 | $1,667.00 | $279.65 – $1,667.00 | 779 |
| Vaccine respiratory syncytial virus bivalent subunit/preservative free im CPT 90678 | $658.00 | $658.00 | $153.21 – $451.83 | 554 |
| Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im CPT 90380 | $1,159.00 | $1,159.00 | $256.94 – $812.09 | 552 |
| Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im CPT 90381 | $1,159.00 | $1,159.00 | $256.94 – $811.14 | 553 |
| Vaccine respiratory syncytial virus recombinant subunit adjuvanted/preservative free im CPT 90679 | $239.20 | $368.00 | $145.69 – $368.00 | 114 |
| Vaccine rotavirus attenuated (rv1) live 2 dose oral CPT 90681 | $309.00 | $309.00 | $70.07 – $309.00 | 552 |
| Vaccine rotavirus pentavalent (rv5) live 3 dose oral CPT 90680 | $97.50 | $150.00 | $59.39 – $150.00 | 114 |
| Vaccine tdap >=7 years im CPT 90715 | $231.55 | $231.55 | $33.38 – $178.00 | 779 |
| Vaccine td preservative free >= 7 years im CPT 90714 | $211.80 | $211.80 | $21.34 – $88.00 | 779 |
| Vaccine typhoid vicps im CPT 90691 | $113.75 | $175.00 | $69.28 – $175.00 | 114 |
| Vaccine varicella live subcutaneous CPT 90716 | $408.00 | $408.00 | $74.24 – $242.00 | 555 |
| Vaccine yellow fever live subcutaneous CPT 90717 | $130.65 | $201.00 | $79.58 – $201.00 | 114 |
| Vad univ batt charger hm 1440 HCPCS Q0495 | $6,069.41 | $9,337.56 | $3,696.74 – $9,337.56 | 43 |
| Valproate in ns IV syringe 10 mg/ml (pediatric) - cnr HCPCS J3379 | $32.20 | $32.20 | $1.43 – $3.60 | 43 |
| Valproic acid total therapeutic drug level CPT 80164 | $131.95 | $203.00 | $80.37 – $203.00 | 43 |
| Vancomycin 1,000 mg intravenous injection HCPCS J3373 | $25.80 | $25.80 | $0.75 – $7.30 | 114 |
| Vancomycin peak therapeutic drug level CPT 80202 | $159.90 | $246.00 | $97.39 – $246.00 | 43 |
| Varicella zoster antibody igg CPT 86787 | $90.35 | $139.00 | $55.03 – $139.00 | 43 |
| Varicella-zoster immue globin im CPT 90396 | $1,916.20 | $2,948.00 | $1,167.11 – $2,948.00 | 114 |
| Vedolizumab 300 mg intravenous solution HCPCS J3380 | $30,326.10 | $30,326.10 | $6,618.00 – $30,326.10 | 114 |
| Velaglucerase alfa 400 unit intravenous solution HCPCS J3385 | $7,637.95 | $7,637.95 | $1,520.72 – $7,637.95 | 114 |
| Ventilator Management (first day) CPT 94002 | $2,653.95 | $4,083.00 | $1,616.46 – $4,083.00 | 43 |
| Verify external neurostimulato HCPCS A4290 | $910.00 | $1,400.00 | $554.26 – $1,400.00 | 43 |
| Vest large holster HCPCS Q0498 | $970.51 | $1,493.10 | $591.12 – $1,493.10 | 43 |
| Vest wrp airway ther disp lg slot 1use HCPCS A7025 | $140.14 | $215.60 | $76.49 – $193.20 | 43 |
| Video Swallow Study (Modified Barium Swallow) CPT 74230 | $454.35 | $699.00 | $276.73 – $699.00 | 43 |
| Vinblastine 1 mg/ml intravenous solution HCPCS J9360 | $244.80 | $244.80 | $57.90 – $244.80 | 114 |
| Vincristine 1 mg/ml intravenous solution HCPCS J9370 | $87.15 | $87.15 | $8.60 – $85.75 | 114 |
| Vinorelbine 10 mg/ml intravenous solution (wrapper) HCPCS J9390 | $223.55 | $223.55 | $24.59 – $62.10 | 43 |
| Visit established high 40-54 minutes/level 5 HCPCS G0463 | $619.45 | $511.00 | $8.04 – $130.00 | 43 |
| Vitamin b-12 CPT 82607 | $94.90 | $146.00 | $57.80 – $146.00 | 43 |
| Vitamin D Test CPT 82306 | $174.85 | $269.00 | $106.50 – $269.00 | 43 |
| Volume measurement urine timed CPT 81050 | $21.45 | $33.00 | $3.57 – $33.00 | 43 |
| Voriconazole in ns IV syringe 5 mg/ml (pediatric) - cnr HCPCS J3465 | $561.40 | $561.40 | $15.60 – $561.40 | 114 |
| Vutrisiran 25 mg/0.5 ml subcutaneous syringe HCPCS J0225 | $272,036.50 | $272,036.50 | $107,699.25 – $272,036.50 | 114 |
| Walking (Gait) Training (each 15 minutes) CPT 97116 | $92.30 | $142.00 | $56.22 – $142.00 | 43 |
| Warde 1003990 aldosterone CPT 82088 | $287.30 | $442.00 | $108.87 – $275.00 | 43 |
| Warde 1005055 5-hiaa 24 hour urine CPT 83497 | $80.60 | $124.00 | $49.09 – $124.00 | 43 |
| Warde 1006955 catecholamines fractionated 24 hour urine CPT 82384 | $128.05 | $197.00 | $77.99 – $197.00 | 43 |
| Warde 1015200 kappa light chain free CPT 83521 | $126.10 | $194.00 | $76.80 – $194.00 | 43 |
| Warde 3004000 immunoglobulin subclass 1 CPT 82787 | $64.35 | $99.00 | $39.19 – $99.00 | 43 |
| Warde 3008005 oligoclonal bands CPT 83916 | $120.90 | $186.00 | $26.84 – $88.00 | 43 |
| Warde 3016000 west nile virus antibody CPT 86788 | $79.30 | $122.00 | $16.51 – $122.00 | 43 |
| Warde 3016000 west nile virus antibody igg CPT 86789 | $87.75 | $135.00 | $14.10 – $135.00 | 43 |
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.