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 |
|---|---|---|---|---|
| Eptifibatide 0.75 mg/ml intravenous solution HCPCS J1327 | $690.00 | $690.00 | $178.20 – $690.00 | 114 |
| Eptinezumab-jjmr 100 mg/ml intravenous solution HCPCS J3032 | $10,020.45 | $10,020.45 | $1,985.00 – $10,020.45 | 114 |
| Eribulin 1 mg/2 ml (0.5 mg/ml) intravenous solution HCPCS J9179 | $7,050.00 | $7,050.00 | $1,144.50 – $7,050.00 | 114 |
| Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr HCPCS J1335 | $66.70 | $66.70 | $1.19 – $18.04 | 114 |
| ER Visit (level 1, minor) CPT 99281 | $341.25 | $525.00 | $10.28 – $54.00 | 43 |
| ER Visit (level 2) CPT 99282 | $615.32 | $750.00 | $6.84 – $104.00 | 780 |
| ER Visit (level 3) CPT 99283 | $972.92 | $927.00 | $39.71 – $156.00 | 780 |
| ER Visit (level 4) CPT 99284 | $2,448.55 | $1,280.00 | $1.92 – $284.00 | 780 |
| ER Visit (level 5, high severity) CPT 99285 | $5,452.20 | $1,908.00 | $9.09 – $862.00 | 780 |
| Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1364 | $125.40 | $125.40 | $49.65 – $125.40 | 114 |
| Esmolol 2,500 mg/250 ml (10 mg/ml) in sterile water intravenous soln HCPCS J1806 | $271.25 | $271.25 | $107.39 – $271.25 | 43 |
| Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only HCPCS J1805 | $427.50 | $427.50 | $2.80 – $9.20 | 114 |
| Established Patient Office Visit (level 1) CPT 99211 | $35.10 | $54.00 | $7.37 – $54.00 | 43 |
| Established Patient Office Visit (level 2) CPT 99212 | $304.20 | $114.00 | $8.04 – $114.00 | 781 |
| Established Patient Office Visit (level 3) CPT 99213 | $297.05 | $182.00 | $26.58 – $182.00 | 780 |
| Established Patient Office Visit (level 4) CPT 99214 | $659.10 | $258.00 | $42.60 – $258.00 | 780 |
| Established Patient Office Visit (level 5) CPT 99215 | $1,023.75 | $362.00 | $65.37 – $362.00 | 780 |
| Estradiol total CPT 82670 | $154.70 | $238.00 | $94.22 – $238.00 | 43 |
| Etoposide 20 mg/ml intravenous solution HCPCS J9181 | $174.75 | $174.75 | $69.18 – $174.75 | 114 |
| Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen CPT 84112 | $208.65 | $321.00 | $127.08 – $321.00 | 43 |
| Exam pelvic add-on CPT 99459 | $56.00 | $56.00 | $13.24 – $56.00 | 767 |
| Exc arm/elbo les sc <3cm 24075 CPT 24075 | $1,421.55 | $2,187.00 | $577.22 – $1,458.00 | 43 |
| Exc benign tal 0.5 < cm 11400 CPT 11400 | $275.60 | $424.00 | $70.58 – $334.00 | 43 |
| Exc ben+marg excep skin tag snhfg 0.6-1cm 11421 CPT 11421 | $1,313.65 | $2,021.00 | $91.58 – $531.00 | 43 |
| Exc ben+marg excep skin tag snhfg 2.1-3cm 11423 CPT 11423 | $516.00 | $516.00 | $5.98 – $40.48 | 768 |
| Exc ben+marg excep skin tag tal 0.6-1cm 11401 CPT 11401 | $350.00 | $517.00 | $28.70 – $406.00 | 780 |
| Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm CPT 11422 | $403.00 | $620.00 | $245.46 – $620.00 | 43 |
| Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm CPT 11402 | $457.60 | $704.00 | $30.56 – $569.00 | 780 |
| Exc malig feenl <0.5cm 11640 CPT 11640 | $354.90 | $546.00 | $216.16 – $546.00 | 43 |
| Exc malig tal <0.5cm 11600 CPT 11600 | $350.35 | $539.00 | $213.39 – $539.00 | 43 |
| Exc mal+marg tal 1.1-2 cm 11602 CPT 11602 | $450.45 | $693.00 | $274.36 – $693.00 | 43 |
| Exc mal+marg tal 2.1-3 cm 11603 CPT 11603 | $512.20 | $788.00 | $311.97 – $788.00 | 43 |
| Expander breast 300cc mod hght extra proj smth natrelle HCPCS L8600 | $2,223.00 | $3,420.00 | $0.19 – $0.48 | 43 |
| Expander tiss 133s-mv-12-t 300ml natrelle smth HCPCS C1789 | $2,805.15 | $4,315.62 | $7.92 – $20.00 | 43 |
| Extractable nuclear antigen/antibody any method each antibody centromere CPT 86235 | $133.25 | $205.00 | $17.93 – $205.00 | 43 |
| Eye implant band 40 HCPCS C1784 | $1,015.62 | $1,562.50 | $19.00 – $48.00 | 43 |
| F-18 fdg pet diag HCPCS A9552 | $1,768.20 | $1,768.20 | $700.03 – $1,768.20 | 43 |
| F-18 florbetapir less than or equal to 10 mci HCPCS A9586 | $15,145.00 | $15,145.00 | $5,995.91 – $15,145.00 | 43 |
| F-18 fluciclovine per mci HCPCS A9588 | $27,455.00 | $27,455.00 | $10,869.43 – $27,455.00 | 43 |
| F-18 sodium fluoride HCPCS A9580 | $1,391.25 | $1,391.25 | $550.80 – $1,391.25 | 43 |
| Face, Eye Socket and Neck MRI (with and without contrast) CPT 70543 | $3,714.10 | $5,714.00 | $2,262.17 – $5,714.00 | 43 |
| Factor ix CPT 85250 | $146.25 | $225.00 | $18.66 – $225.00 | 43 |
| Factor viii CPT 85240 | $246.35 | $379.00 | $150.05 – $379.00 | 43 |
| Family therapy with patient 50 min 90847 CPT 90847 | $302.90 | $466.00 | $184.49 – $466.00 | 43 |
| Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr HCPCS J1308 | $4.10 | $4.10 | $0.80 – $3.00 | 114 |
| Fam-trastuzumab deruxtecan-nxki 100 mg intravenous solution HCPCS J9358 | $9,722.40 | $9,722.40 | $3,283.00 – $9,722.40 | 114 |
| Fat/lipids feces qualitative CPT 82705 | $45.50 | $70.00 | $5.00 – $70.00 | 43 |
| Fecal microbiota, live-jslm 150 ml rectal suspension enema HCPCS J1440 | $28,233.45 | $28,233.45 | $9,604.50 – $28,233.45 | 114 |
| Felbamate (felbatol(r)) - sendout CPT 80167 | $65.00 | $100.00 | $39.59 – $100.00 | 43 |
| Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper) HCPCS J3010 | $53.25 | $53.25 | $1.19 – $3.00 | 43 |
| Ferric carboxymaltose 50 mg iron/ml intravenous solution HCPCS J1439 | $5,262.00 | $5,262.00 | $2,083.23 – $5,262.00 | 43 |
| Ferritin CPT 82728 | $107.25 | $165.00 | $65.32 – $165.00 | 43 |
| Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution HCPCS Q0138 | $712.85 | $712.85 | $158.10 – $712.85 | 114 |
| Fetal fibronectin CPT 82731 | $442.00 | $680.00 | $269.21 – $680.00 | 43 |
| Fetal hemoglobin (kleihauer betke) CPT 85460 | $48.75 | $75.00 | $29.69 – $75.00 | 43 |
| Fetal hemoglobin rosette CPT 85461 | $81.90 | $126.00 | $49.88 – $126.00 | 43 |
| Fibrin degradation d dimer quantitative CPT 85379 | $145.60 | $224.00 | $49.49 – $125.00 | 43 |
| Fibrinogen activity CPT 85384 | $67.60 | $104.00 | $10.30 – $104.00 | 43 |
| Fibrinolysins/coagulopathy screen interpretation/report CPT 85390 | $222.30 | $342.00 | $15.17 – $342.00 | 43 |
| Filgrastim-aafi 300 mcg/0.5 ml subcutaneous syringe HCPCS Q5110 | $1,611.50 | $1,611.50 | $87.00 – $1,007.20 | 114 |
| Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr HCPCS J1442 | $1,447.95 | $1,447.95 | $297.00 – $1,447.95 | 114 |
| Filgrastim-sndz 300 mcg/0.5 ml injection syringe HCPCS Q5101 | $2,018.90 | $2,018.90 | $111.00 – $1,261.80 | 114 |
| Filter spider fx 3mmx320cm HCPCS C1884 | $20,371.32 | $31,340.50 | $870.98 – $2,200.00 | 43 |
| Filter vena cava fem denali HCPCS C1880 | $27,141.09 | $41,755.52 | $179.00 – $452.13 | 43 |
| Finger joint sz00 swanson w/grommets HCPCS L8630 | $2,000.70 | $3,078.00 | $436.48 – $1,102.50 | 43 |
| Finger X-ray (both hands) CPT 73140 | $2,763.80 | $435.00 | $114.81 – $290.00 | 43 |
| Flow cytometry one marker technical component CPT 88184 | $248.95 | $383.00 | $151.63 – $383.00 | 43 |
| Fludarabine 50 mg intravenous solution HCPCS J9185 | $434.65 | $434.65 | $78.41 – $434.65 | 114 |
| Fluorescent antibody titer dna CPT 86256 | $79.95 | $123.00 | $48.70 – $123.00 | 43 |
| Fluoroguide needle placement CPT 77002 | $1,372.46 | $766.00 | $3.44 – $766.00 | 114 |
| Fluoroscopy (Live X-ray Guidance, up to 1 hour) CPT 76000 | $450.45 | $693.00 | $274.36 – $693.00 | 43 |
| Fluorouracil 50 mg/ml intravenous solution (wrapper) HCPCS J9190 | $147.00 | $147.00 | $1.88 – $48.65 | 114 |
| Folic acid CPT 82746 | $94.25 | $145.00 | $57.41 – $145.00 | 43 |
| Foot drp splt w/exp heel lg HCPCS L4398 | $342.66 | $527.17 | $36.15 – $91.32 | 43 |
| Foot X-ray CPT 73630 | $339.30 | $522.00 | $137.77 – $348.00 | 43 |
| Foot X-ray (2 views, both feet) CPT 73620 | $270.40 | $416.00 | $109.66 – $277.00 | 43 |
| Forearm X-ray (both sides) CPT 73090 | $828.10 | $537.00 | $60.36 – $358.00 | 43 |
| Fosaprepitant 150 mg intravenous powder for solution HCPCS J1453 | $1,539.00 | $1,539.00 | $609.29 – $1,539.00 | 43 |
| Fosphenytoin 50 mg pe/ml injection (wrapper) HCPCS Q2009 | $150.40 | $150.40 | $5.30 – $25.20 | 114 |
| Fresh frozen plasma 8-24 hours collection each unit HCPCS P9059 | $337.35 | $519.00 | $205.47 – $519.00 | 43 |
| Fructosamine glycated protein CPT 82985 | $69.55 | $107.00 | $42.36 – $107.00 | 43 |
| Full Spine X-ray (Scoliosis Survey) CPT 72082 | $230.10 | $354.00 | $140.15 – $354.00 | 43 |
| Furosemide 10 mg/ml injection solution HCPCS J1938 | $3.00 | $3.00 | $0.80 – $3.00 | 114 |
| Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr HCPCS J1940 | $6.75 | $6.75 | $2.67 – $6.75 | 43 |
| G0180 home health certification HCPCS G0180 | $155.00 | $175.00 | $35.77 – $155.00 | 779 |
| Ga-67 gallium 0.1 mci HCPCS A9556 | $253.10 | $253.10 | $100.20 – $253.10 | 43 |
| Ga-68 gallium 68 dotatate HCPCS A9587 | $15,600.00 | $15,600.00 | $6,176.04 – $15,600.00 | 43 |
| Gadobutrol 1 mmol/ml intravenous solution (wrapper) HCPCS A9585 | $591.40 | $591.40 | $19.76 – $591.40 | 43 |
| Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper) HCPCS A9579 | $231.00 | $231.00 | $7.35 – $231.00 | 43 |
| Gallbladder Function Scan (HIDA with Medication) CPT 78227 | $1,440.40 | $2,216.00 | $877.31 – $2,216.00 | 43 |
| Gammaglobulin iga CPT 82784 | $81.90 | $126.00 | $49.88 – $126.00 | 43 |
| Gammaglobulin ige CPT 82785 | $83.85 | $129.00 | $51.07 – $129.00 | 43 |
| Gamma glutamyltransferase CPT 82977 | $870.35 | $93.00 | $9.09 – $93.00 | 43 |
| Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr HCPCS J1570 | $138.00 | $138.00 | $32.78 – $82.80 | 114 |
| Gemcitabine 1 gram intravenous solution HCPCS J9201 | $540.20 | $540.20 | $16.20 – $50.15 | 114 |
| Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln HCPCS J9203 | $31,504.65 | $31,504.65 | $11,652.30 – $31,504.65 | 114 |
| General health panel CPT 80050 | $263.25 | $405.00 | $160.34 – $405.00 | 43 |
| Generator barostim neo2 2014 HCPCS C1767 | $52,159.90 | $80,246.00 | $5.32 – $13.45 | 43 |
| Generator emblem MRI sicd subq HCPCS C1722 | $26,000.00 | $40,000.00 | $371.35 – $938.00 | 43 |
| Generator stim baroreceptor neo legacy implant pulse HCPCS C1825 | $43,712.50 | $67,250.00 | $20,586.80 – $52,000.00 | 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.