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 |
|---|---|---|---|---|
| Antihemophilic factor-vwf 250 unit-600 unit intravenous solution HCPCS J7187 | $5,144.60 | $5,144.60 | $894.00 – $2,670.45 | 114 |
| Antineutrophil cytoplasmic antibody screen each antibody CPT 86036 | $147.55 | $227.00 | $89.87 – $227.00 | 43 |
| Antinuclear antibodies CPT 86038 | $105.95 | $163.00 | $64.53 – $163.00 | 43 |
| Antinuclear antibodies titer CPT 86039 | $85.80 | $132.00 | $52.26 – $132.00 | 43 |
| Antistreptolysin o screen CPT 86063 | $48.75 | $75.00 | $29.69 – $75.00 | 43 |
| Antithrombin iii activity CPT 85300 | $135.20 | $208.00 | $82.35 – $208.00 | 43 |
| Anti-thymocyte glob (equine)(1:1000) intradermal test dose HCPCS J7504 | $14,664.50 | $14,664.50 | $5,013.11 – $14,664.50 | 114 |
| Aortic Aneurysm Screening Ultrasound CPT 76706 | $393.90 | $606.00 | $239.92 – $606.00 | 43 |
| Application multi layer compression below knee (both sides) CPT 29581 | $612.30 | $942.00 | $248.63 – $628.00 | 43 |
| Applicator tag rfid localizer 12gx7cm HCPCS C1819 | $2,644.20 | $4,068.00 | $4.18 – $10.56 | 43 |
| Appl modality 1/> areas paraffin bath 97018 CPT 97018 | $53.95 | $83.00 | $32.86 – $83.00 | 43 |
| Appl modality 1/> areas vasopneumatic devices 97016 CPT 97016 | $65.00 | $100.00 | $39.59 – $100.00 | 43 |
| Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion HCPCS J0185 | $1,185.25 | $1,185.25 | $235.41 – $1,185.25 | 114 |
| Arm CT Scan (with contrast, both arms) CPT 73201 | $2,163.85 | $3,329.00 | $878.50 – $2,219.00 | 43 |
| Arm CT Scan (without contrast, both arms) CPT 73200 | $1,701.70 | $2,618.00 | $690.85 – $1,745.00 | 43 |
| Arm or Leg Ultrasound (limited, left side) CPT 76882 | $514.15 | $791.00 | $58.20 – $791.00 | 43 |
| Arsenic trioxide 2 mg/ml intravenous solution HCPCS J9017 | $2,478.30 | $2,478.30 | $76.92 – $2,478.30 | 114 |
| Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right CPT 20605 | $974.35 | $1,499.00 | $9.60 – $999.00 | 781 |
| Arthrocentesis/aspiration/injection intermediate joint/bursa w/ultrasound guidance (both sides) CPT 20606 | $206.05 | $317.00 | $83.53 – $211.00 | 43 |
| Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance CPT 20600 | $1,293.63 | $1,199.00 | $3.44 – $475.00 | 780 |
| Arthrocentesis aspir+/injection small jt/bursa with Ultrasound 20604 CPT 20604 | $826.80 | $1,272.00 | $335.72 – $848.00 | 43 |
| Ascenda two piece catheter HCPCS C1772 | $14,560.00 | $22,400.00 | $40.62 – $102.60 | 43 |
| Assay of breath ethanol CPT 82075 | $33.80 | $52.00 | $20.59 – $52.00 | 43 |
| Assay of prostaglandin CPT 84150 | $162.50 | $250.00 | $98.98 – $250.00 | 43 |
| Assessment leukocyte fecal qualitative/semiquantitative CPT 89055 | $43.55 | $67.00 | $4.18 – $67.00 | 43 |
| Ast/sgot CPT 84450 | $59.15 | $91.00 | $36.03 – $91.00 | 43 |
| Atezolizumab 60 mg/ml intravenous solution (wrapper) HCPCS J9022 | $35,811.20 | $35,811.20 | $11,953.20 – $35,811.20 | 114 |
| Atropine 0.1 mg/ml injection syringe HCPCS J0461 | $46.00 | $46.00 | $18.21 – $46.00 | 43 |
| Augment injectable kit 3.0cc HCPCS C1734 | $4,420.00 | $6,800.00 | $206.12 – $520.63 | 43 |
| Avelumab 20 mg/ml intravenous solution HCPCS J9023 | $6,470.55 | $6,470.55 | $2,195.20 – $6,470.55 | 114 |
| Avulsion nail plate partial/complete simple single nail plate CPT 11730 | $225.00 | $306.00 | $15.55 – $306.00 | 780 |
| Azathioprine 50 mg tablet HCPCS J7500 | $3.00 | $3.00 | $0.40 – $2.14 | 114 |
| Azithromycin 500 mg intravenous solution HCPCS J0456 | $9.20 | $9.20 | $2.61 – $8.75 | 114 |
| Baclofen 2,000 mcg/ml intrathecal solution (wrapper) HCPCS J0475 | $3,156.90 | $3,156.90 | $1,249.82 – $3,156.90 | 43 |
| Baclofen 50 mcg/ml intrathecal solution (wrapper) HCPCS J0476 | $164.85 | $164.85 | $65.26 – $164.85 | 43 |
| Bacterial vaginosis pcr CPT 87801 | $429.00 | $660.00 | $70.20 – $660.00 | 29 |
| Bag urine leg fbrc strap 32oz flipflo anti-reflux valve HCPCS A4358 | $75.32 | $115.88 | $32.97 – $83.28 | 43 |
| Balance and Coordination Retraining (each 15 minutes) CPT 97112 | $129.35 | $199.00 | $78.78 – $199.00 | 43 |
| Barrier film 1.0ml wipe HCPCS A5120 | $0.91 | $1.40 | $0.71 – $1.40 | 33 |
| Barrier film 28ml spray no stng cavilon HCPCS A4369 | $15.29 | $23.52 | $9.31 – $23.52 | 43 |
| Barrier skin flat ctf 2.75in HCPCS A4408 | $1.74 | $2.68 | $1.06 – $2.68 | 43 |
| Barrier skin flextend 2.25in floating flang new image HCPCS A4409 | $1.04 | $1.60 | $0.63 – $1.60 | 43 |
| Barrier skin flxtnd ctf 3.5in flt flang 4in w/tape cut to ft HCPCS A4414 | $4.39 | $6.76 | $2.68 – $6.76 | 43 |
| Barrier skn ft cx ff red 2.25 ctf new image w/tape HCPCS A4407 | $56.55 | $87.00 | $1.06 – $2.68 | 43 |
| Bausch health Ultrasound surg HCPCS V2788 | $744.25 | $1,145.00 | $19.80 – $50.00 | 43 |
| B cells total count CPT 86355 | $131.30 | $202.00 | $36.98 – $202.00 | 43 |
| Bcg live 50 mg intravesical suspension HCPCS J9030 | $864.15 | $864.15 | $171.00 – $864.15 | 114 |
| Belatacept 250 mg intravenous solution HCPCS J0485 | $4,849.40 | $4,849.40 | $972.50 – $4,849.40 | 114 |
| Belimumab 120 mg intravenous solution HCPCS J0490 | $11,005.85 | $11,005.85 | $672.12 – $3,302.00 | 114 |
| Belt ostomy lg 34-65in HCPCS A4367 | $1.98 | $3.04 | $1.49 – $2.96 | 33 |
| Bendamustine 100 mg intravenous powder for solution HCPCS J9033 | $14,338.95 | $14,338.95 | $202.00 – $14,338.95 | 114 |
| Bendamustine 25 mg/ml intravenous solution (belrapzo) HCPCS J9036 | $11,945.90 | $11,945.90 | $1,312.00 – $11,945.90 | 114 |
| Bendamustine 25 mg/ml intravenous solution (bendeka) HCPCS J9034 | $8,355.30 | $8,355.30 | $1,436.00 – $8,355.30 | 114 |
| Bendamustine 25 mg/ml intravenous solution (vivimusta) HCPCS J9056 | $19,642.40 | $19,642.40 | $3,070.00 – $19,642.40 | 114 |
| Benign lesion paring 2-4 CPT 11056 | $134.55 | $207.00 | $81.95 – $207.00 | 43 |
| Beta 2 glycoprotein 1 antibody iga CPT 86146 | $108.55 | $167.00 | $66.12 – $167.00 | 43 |
| Beta-2 microglobulin CPT 82232 | $96.20 | $148.00 | $58.59 – $148.00 | 43 |
| Betamethasone acetate and sodium phos 6 mg/ml suspension for injection HCPCS J0702 | $175.75 | $175.75 | $34.45 – $175.75 | 114 |
| Bevacizumab 25 mg/ml intravenous solution HCPCS J9035 | $2,390.85 | $2,390.85 | $799.40 – $2,390.85 | 114 |
| Bevacizumab-awwb 25 mg/ml intravenous solution HCPCS Q5107 | $1,925.35 | $1,925.35 | $288.50 – $1,925.35 | 114 |
| Bevacizumab-bvzr 25 mg/ml intravenous solution HCPCS Q5118 | $6,770.50 | $6,770.50 | $957.20 – $6,770.50 | 114 |
| Bilicheck CPT 88720 | $11.00 | $11.00 | $3.68 – $11.00 | 768 |
| Bilirubin direct CPT 82248 | $42.90 | $66.00 | $26.13 – $66.00 | 43 |
| Bilirubin total CPT 82247 | $83.85 | $99.00 | $9.09 – $84.00 | 43 |
| Biopsy skin incisional single lesion CPT 11106 | $399.00 | $516.00 | $14.74 – $418.00 | 780 |
| Bladder Catheter Insertion (simple) CPT 51702 | $202.80 | $312.00 | $3.77 – $312.00 | 780 |
| Bleomycin 15 unit solution for injection HCPCS J9040 | $488.00 | $488.00 | $22.87 – $263.10 | 114 |
| Blinatumomab 35 mcg intravenous solution HCPCS J9039 | $17,670.55 | $17,670.55 | $6,251.00 – $17,670.55 | 114 |
| Bln 1.2 mono emrg 15x1.2 HCPCS C1725 | $9,340.50 | $14,370.00 | $0.02 – $0.04 | 43 |
| Bln 30frx10mmx12cm renal nephromax HCPCS C1726 | $4,598.68 | $7,074.90 | $12.65 – $31.96 | 43 |
| Bln dil 900ml preperitnl HCPCS C1727 | $1,449.50 | $2,230.00 | $330.63 – $835.14 | 43 |
| Bln inpact admiral 4x150x130cm HCPCS C2623 | $3,438.50 | $5,290.00 | $16.94 – $42.80 | 43 |
| Bln press regulation 71-80cm HCPCS C1815 | $9,605.26 | $14,777.32 | $1,706.33 – $4,310.00 | 43 |
| Bln stent lg 19mm diam 10-12mm palmaz gen trnshpat unmtd HCPCS C1877 | $1,615.25 | $2,485.00 | $618.59 – $1,562.50 | 43 |
| Bln ureth 5ml 28f 2wy ltx st HCPCS A4338 | $7.28 | $11.20 | $5.66 – $11.20 | 33 |
| Blood Clotting (PT/INR) Test CPT 85610 | $42.90 | $66.00 | $3.32 – $66.00 | 780 |
| Blood Clotting (PTT) Test CPT 85730 | $823.55 | $99.00 | $9.09 – $99.00 | 43 |
| Blood Count (CBC) Test CPT 85025 | $607.75 | $112.00 | $7.93 – $112.00 | 43 |
| Blood Count (CBC) Test (without differential) CPT 85027 | $56.55 | $87.00 | $6.47 – $87.00 | 43 |
| Blood Culture Test CPT 87040 | $1,172.60 | $183.00 | $9.09 – $183.00 | 43 |
| Blood Draw (Venipuncture) CPT 36415 | $55.00 | $55.00 | $2.69 – $45.00 | 779 |
| Blood gases o2 saturation direct measurement CPT 82805 | $220.35 | $339.00 | $134.21 – $339.00 | 43 |
| Blood gases ph venous CPT 82800 | $68.25 | $105.00 | $10.78 – $105.00 | 43 |
| Blood occult fecal hemoglobin immunoassay qualitative 1-3 simultaneous determinations diagnostic CPT 82274 | $42.90 | $66.00 | $26.13 – $66.00 | 43 |
| Blood occult feces 1-3 determinations other than neoplasm screening qualitative CPT 82272 | $125.45 | $36.00 | $9.09 – $36.00 | 43 |
| Blood occult feces colorectal neoplasm screening qualitative CPT 82270 | $32.50 | $50.00 | $19.80 – $50.00 | 43 |
| Blood occult peroxidase activity qualitative gastric CPT 82271 | $56.55 | $87.00 | $34.44 – $87.00 | 43 |
| Blood smear microscopic w manual differential wbc count CPT 85007 | $38.35 | $59.00 | $23.36 – $59.00 | 43 |
| Blood Transfusion CPT 36430 | $1,673.75 | $1,197.00 | $2.28 – $1,197.00 | 114 |
| Blood typing abo CPT 86900 | $83.85 | $129.00 | $51.07 – $129.00 | 43 |
| Blood typing ag donor ea ag CPT 86902 | $234.00 | $360.00 | $142.52 – $360.00 | 43 |
| Blood typing rbc ag non abo/rh ea CPT 86905 | $90.35 | $139.00 | $55.03 – $139.00 | 43 |
| Blood typing rh (d) CPT 86901 | $44.85 | $69.00 | $27.32 – $69.00 | 43 |
| Bone acellular derm matrix 2x4cm 0.4-1.0mm allomend-cost per sq cm-8sq cm HCPCS Q4433 | $1,885.00 | $2,900.00 | $37.74 – $95.32 | 43 |
| Bone Density Scan (DEXA) CPT 77080 | $453.70 | $698.00 | $276.34 – $698.00 | 43 |
| Bone filler cerament 10cc HCPCS C1602 | $9,668.16 | $14,874.10 | $286.37 – $723.35 | 43 |
| Bone tendon board add on HCPCS C9356 | $4,608.50 | $7,090.00 | $257.04 – $649.25 | 43 |
| Bone void filler nanoss 10cc HCPCS C9362 | $3,081.00 | $4,740.00 | $79.67 – $201.25 | 43 |
| Boot cast sandal rocker med HCPCS L3265 | $8.76 | $13.48 | $5.34 – $13.48 | 43 |
| Boot heel care softcare one sz HCPCS E0191 | $137.18 | $211.05 | $4.97 – $12.56 | 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.