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 |
|---|---|---|---|---|
| Control of nosebleed ant comp 30903 CPT 30903 | $769.60 | $1,184.00 | $63.29 – $789.00 | 43 |
| Coombs direct CPT 86880 | $74.75 | $115.00 | $45.53 – $115.00 | 43 |
| Coombs indirect titer reference CPT 86886 | $136.50 | $210.00 | $68.49 – $173.00 | 43 |
| Cornea 1/2moon str split thick HCPCS L8609 | $989.62 | $1,522.50 | $602.76 – $1,522.50 | 43 |
| Cornea pre-cut midwest eye cornea pre-cut midwest eye HCPCS V2785 | $5,421.00 | $8,340.00 | $153.41 – $387.50 | 43 |
| Cortisol total am CPT 82533 | $122.20 | $188.00 | $74.43 – $188.00 | 43 |
| Cosyntropin 0.25 mg solution for injection HCPCS J0834 | $101.75 | $101.75 | $28.02 – $101.75 | 114 |
| Counseling smoke cess interm >10mins CPT 99407 | $76.05 | $117.00 | $12.95 – $117.00 | 780 |
| Coveredge 32 lead kit 40cm 48 HCPCS C1897 | $8,775.00 | $13,500.00 | $61.67 – $155.76 | 43 |
| Cover wrist HCPCS L3984 | $0.03 | $0.04 | $0.02 – $0.04 | 43 |
| Covid-19 administration immunization im inj 1st/only component CPT 90480 | $88.00 | $110.00 | $5.09 – $88.00 | 780 |
| Covid-19 IV infusion and post admin monitoring tocilizumab 1st dose HCPCS M0249 | $443.95 | $683.00 | $270.40 – $683.00 | 43 |
| Covid-19 IV infusion and post admin monitoring tocilizumab 2nd dose HCPCS M0250 | $443.95 | $683.00 | $270.40 – $683.00 | 43 |
| #covid19rsv-rsv CPT 87634 | $140.40 | $216.00 | $68.80 – $216.00 | 43 |
| CPAP or BiPAP Setup (first day) CPT 94660 | $641.55 | $987.00 | $390.75 – $987.00 | 43 |
| C-peptide CPT 84681 | $163.80 | $252.00 | $99.77 – $252.00 | 43 |
| CPR (Cardiopulmonary Resuscitation) CPT 92950 | $1,591.20 | $2,448.00 | $108.63 – $973.00 | 780 |
| Cr-51 sodium chromate HCPCS A9553 | $7,028.75 | $7,028.75 | $2,782.68 – $7,028.75 | 43 |
| C-reactive protein CPT 86140 | $70.85 | $109.00 | $43.15 – $109.00 | 43 |
| C-reactive protein high sensitivity CPT 86141 | $129.35 | $199.00 | $78.78 – $199.00 | 43 |
| Creatine kinase CPT 82550 | $66.30 | $102.00 | $40.38 – $102.00 | 43 |
| Creatine kinase mb CPT 82553 | $109.20 | $168.00 | $66.51 – $168.00 | 43 |
| Creatinine CPT 82565 | $42.25 | $65.00 | $25.73 – $65.00 | 43 |
| Creatinine 24 hour urine CPT 82570 | $63.05 | $97.00 | $38.40 – $97.00 | 43 |
| Creatinine clearance urine CPT 82575 | $69.55 | $107.00 | $42.36 – $107.00 | 43 |
| Critical care each additional 30 minutes CPT 99292 | $325.00 | $500.00 | $63.90 – $293.00 | 780 |
| Critical Care (first 30 to 74 minutes) CPT 99291 | $1,240.20 | $1,908.00 | $126.95 – $659.00 | 780 |
| Crizanlizumab-tmca 10 mg/ml intravenous solution HCPCS J0791 | $7,358.85 | $7,358.85 | $2,591.60 – $7,358.85 | 114 |
| Cryofibrinogen qualitative - sendout CPT 82585 | $30.55 | $47.00 | $13.86 – $47.00 | 43 |
| Cryoprecipitate each unit HCPCS P9012 | $123.50 | $190.00 | $75.22 – $190.00 | 43 |
| Crystal identification light microscopy CPT 89060 | $83.20 | $128.00 | $50.68 – $128.00 | 43 |
| CT Angiogram of Abdomen and Pelvis CPT 74174 | $4,206.80 | $6,472.00 | $2,562.26 – $6,472.00 | 43 |
| CT Angiogram of the Chest (for blood clot) CPT 71275 | $983.45 | $1,513.00 | $599.00 – $1,513.00 | 43 |
| CT Angiogram of the Head CPT 70496 | $2,528.50 | $3,890.00 | $1,540.05 – $3,890.00 | 43 |
| CT Angiogram of the Neck CPT 70498 | $2,558.40 | $3,936.00 | $1,558.26 – $3,936.00 | 43 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $4,115.15 | $6,331.00 | $2,506.44 – $6,331.00 | 43 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $4,174.95 | $5,637.00 | $9.09 – $5,637.00 | 43 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $3,052.40 | $4,696.00 | $1,859.15 – $4,696.00 | 43 |
| Culture aerobic additional method definitive id each CPT 87077 | $62.40 | $96.00 | $38.01 – $96.00 | 43 |
| Culture afb any source CPT 87116 | $76.05 | $117.00 | $10.69 – $117.00 | 43 |
| Culture anaerobic additional method definitive id each CPT 87076 | $53.30 | $82.00 | $32.46 – $82.00 | 43 |
| Culture anaerobic except blood CPT 87075 | $82.55 | $127.00 | $50.28 – $127.00 | 43 |
| Culture body fluid CPT 87070 | $94.90 | $146.00 | $57.80 – $146.00 | 43 |
| Culture fungi definitive id mold CPT 87107 | $364.00 | $560.00 | $221.70 – $560.00 | 43 |
| Culture fungi definitive id yeast CPT 87106 | $111.80 | $172.00 | $10.21 – $172.00 | 43 |
| Culture fungi other (except blood) CPT 87102 | $92.95 | $143.00 | $8.41 – $143.00 | 43 |
| Culture fungi skin/hair/nail CPT 87101 | $55.25 | $85.00 | $7.71 – $85.00 | 43 |
| Culture quantitative aerobic other source CPT 87071 | $85.80 | $132.00 | $52.26 – $132.00 | 43 |
| Culture screening strep group a CPT 87081 | $65.65 | $101.00 | $6.63 – $78.00 | 43 |
| Culture typing immunologic CPT 87147 | $29.90 | $46.00 | $18.21 – $46.00 | 43 |
| Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets CPT 87154 | $1,172.60 | $500.00 | $9.09 – $500.00 | 43 |
| Culture typing nucleic acid probe amplified per culture/isolate each organism CPT 87150 | $157.30 | $242.00 | $34.73 – $242.00 | 43 |
| Culture urine each isolate CPT 87088 | $55.25 | $85.00 | $8.01 – $85.00 | 43 |
| Cutter lead HCPCS C1773 | $3,162.98 | $4,866.12 | $147.16 – $371.70 | 43 |
| Cv stress test i&r only 93018 CPT 93018 | $76.70 | $118.00 | $13.18 – $47.00 | 43 |
| Cv stress test/supervision only 93016 CPT 93016 | $80.60 | $124.00 | $13.21 – $70.00 | 780 |
| Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution HCPCS J3420 | $7.85 | $7.85 | $0.56 – $7.20 | 779 |
| Cyclic citrullinated peptide antibody CPT 86200 | $97.50 | $150.00 | $59.39 – $150.00 | 43 |
| Cyclophosphamide 1 gram intravenous powder for solution HCPCS J9075 | $5,154.25 | $5,154.25 | $510.16 – $1,288.60 | 43 |
| Cyclophosphamide 25 mg capsule HCPCS J8530 | $17.10 | $17.10 | $2.17 – $17.10 | 114 |
| Cyclosporine 250 mg/5 ml intravenous solution HCPCS J7516 | $137.50 | $137.50 | $54.44 – $137.50 | 43 |
| Cyclosporine 2 hour CPT 80158 | $126.10 | $194.00 | $76.80 – $194.00 | 43 |
| Cylinder pump set 20cm titan zero angl HCPCS C1813 | $16,206.14 | $24,932.52 | $15.84 – $40.00 | 43 |
| Cystatin c CPT 82610 | $72.80 | $112.00 | $44.34 – $112.00 | 43 |
| Cystoscopy (Bladder Scope) CPT 52000 | $1,909.70 | $2,938.00 | $1,163.15 – $2,938.00 | 43 |
| Cytarabine 20 mg/ml injection solution HCPCS J9100 | $135.00 | $135.00 | $4.40 – $48.40 | 114 |
| Cytomegalovirus (cmv) antibody igg CPT 86644 | $94.90 | $146.00 | $57.80 – $146.00 | 43 |
| Cytomegalovirus (cmv) antibody igm CPT 86645 | $109.85 | $169.00 | $66.91 – $169.00 | 43 |
| Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review CPT 88175 | $79.95 | $123.00 | $26.61 – $123.00 | 43 |
| Cytopathology cervical/vaginal thin layer manual screening CPT 88142 | $70.85 | $109.00 | $20.26 – $109.00 | 43 |
| Cytopathology concentration technique smears & interpretation CPT 88108 | $124.80 | $192.00 | $76.01 – $192.00 | 43 |
| Dacarbazine 100 mg intravenous solution HCPCS J9130 | $56.45 | $56.45 | $4.18 – $55.20 | 114 |
| Dactinomycin 0.5 mg intravenous solution HCPCS J9120 | $13,542.70 | $13,542.70 | $331.50 – $13,542.70 | 114 |
| Dalbavancin 500 mg intravenous solution HCPCS J0875 | $7,773.10 | $7,773.10 | $1,555.00 – $7,773.10 | 114 |
| Daptomycin 500 mg/10 ml intravenous solution HCPCS J0878 | $96.00 | $96.00 | $31.41 – $79.35 | 43 |
| Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln HCPCS J9144 | $33,713.70 | $33,713.70 | $13,347.25 – $33,713.70 | 43 |
| Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe HCPCS J0881 | $18,648.65 | $18,648.65 | $75.00 – $932.45 | 114 |
| Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution HCPCS J9153 | $34,410.00 | $34,410.00 | $12,283.04 – $34,410.00 | 114 |
| Daunorubicin 5 mg/ml intravenous solution HCPCS J9150 | $308.50 | $308.50 | $122.14 – $308.50 | 43 |
| Deamidated gliadin antibody iga CPT 86258 | $63.70 | $98.00 | $12.05 – $98.00 | 43 |
| Debridement (>20 cm) charge pt CPT 97598 | $191.10 | $294.00 | $116.39 – $294.00 | 43 |
| Debridement subcutaneous tissue <= 20 sq cm CPT 11042 | $276.90 | $426.00 | $51.57 – $426.00 | 43 |
| Decalcification CPT 88311 | $72.15 | $111.00 | $43.94 – $111.00 | 43 |
| Decitabine 50 mg intravenous solution HCPCS J0894 | $224.90 | $224.90 | $89.04 – $224.90 | 43 |
| Deferoxamine 500 mg solution for injection HCPCS J0895 | $159.70 | $159.70 | $9.02 – $159.70 | 114 |
| Degarelix 120 mg subcutaneous solution HCPCS J9155 | $4,556.35 | $4,556.35 | $381.60 – $1,460.15 | 114 |
| Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution HCPCS J0897 | $15,865.45 | $15,865.45 | $13.96 – $11,252.60 | 779 |
| Dentoalveolar/drain abs/cyst/hema 41800 CPT 41800 | $562.00 | $562.00 | $21.53 – $390.57 | 768 |
| Deodorant ostmy adapt lube 8ml HCPCS A4394 | $0.26 | $0.40 | $0.16 – $0.40 | 43 |
| Desmopressin 4 mcg/ml injection solution HCPCS J2597 | $428.60 | $428.60 | $169.68 – $428.60 | 43 |
| Dest mal lesion feenlm <0.5cm 17280 CPT 17280 | $252.85 | $389.00 | $154.01 – $389.00 | 43 |
| Dest mal lesion feenlm 0.6-1cm 17281 CPT 17281 | $319.80 | $492.00 | $194.78 – $492.00 | 43 |
| Dest mal lesion tal <0.5 17260 CPT 17260 | $277.17 | $333.00 | $18.85 – $262.00 | 780 |
| Dest mal lesion tal 0.6-1.0cm 17261 CPT 17261 | $262.60 | $404.00 | $159.94 – $404.00 | 43 |
| Destroy cervthor facet jnt 64633 CPT 64633 | $4,394.65 | $6,761.00 | $55.06 – $703.33 | 780 |
| Destroy cth facet jnt addl 64634 CPT 64634 | $7,416.45 | $1,538.00 | $0.96 – $576.00 | 780 |
| Destroy premlg lesns;1st lesn 17000 CPT 17000 | $1,208.00 | $1,208.00 | $15.23 – $223.00 | 780 |
| Destruction 2-14 lesions 17003 CPT 17003 | $82.55 | $127.00 | $1.07 – $24.00 | 780 |
| Destruction benign lesions < 14 lesions CPT 17110 | $3,684.85 | $376.00 | $12.62 – $313.00 | 780 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides) CPT 64636 | $12,575.06 | $4,013.00 | $0.96 – $340.00 | 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.