Gundersen Palmer Lutheran Hospital and Clinics

West Union, IA · Critical Access Hospital

Posts prices for 46 of the 66 common shoppable procedures we track. Price file retrieved 2026-09-08.

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ProcedurePosted cashPosted gross× Medicare
Breast lesion removal (open) (19120) $1,784.38 $3,004 0.5×
Upper GI endoscopy (EGD), diagnostic (43235) $1,849.12 $3,113 2.1×
Upper GI endoscopy (EGD) with biopsy (43239) $1,849.12 $3,113 2.1×
Diagnostic colonoscopy (45378) $1,849.12 $3,113 2.1×
Colonoscopy with biopsy (45380) $1,849.12 $3,113 1.6×
Colonoscopy with lesion removal (45385) $1,849.12 $3,113 1.6×
Epidural injection, lumbar/sacral (with imaging) (62322) $1,053.16 $1,773 1.2×
Transforaminal epidural injection, lumbar/sacral (64483) $1,315.71 $2,215 1.5×
CT head/brain without contrast (70450) $963.47 $1,622 9.6×
MRI brain without contrast (70551) $1,508.17 $2,539 6.6×
MRI brain with contrast (70552) $1,420.25 $2,391 4.2×
MRI brain without and with contrast (70553) $2,645.08 $4,453 7.9×
X-ray lower spine, 4+ views (72110) $281.56 $474 2.8×
MRI lumbar spine without contrast (72148) $1,580.63 $2,661 6.9×
CT pelvis with contrast (72193) $1,213.54 $2,043 7.2×
MRI lower-extremity joint without contrast (73721) $1,436.29 $2,418 6.3×
CT abdomen and pelvis with contrast (74177) $1,912.68 $3,220 5.7×
Ultrasound, abdomen complete (76700) $549.45 $925 5.5×
Ultrasound, pregnant uterus (≥14 weeks) (76805) $324.92 $547 3.2×
Ultrasound, transvaginal (76830) $471.04 $793 4.7×
Mammography, one breast (diagnostic) (77065) $231.07 $389 2.7×
Mammography, both breasts (diagnostic) (77066) $314.82 $530 2.8×
Mammography, screening (bilateral) (77067) $235.82 $397 2.6×
Basic metabolic panel (80048) $57.62 $97 6.8×
Comprehensive metabolic panel (80053) $71.87 $121 6.8×
Obstetric panel (80055) $324.92 $547 6.8×
Lipid panel (80061) $90.88 $153 6.8×
Renal function panel (80069) $58.81 $99 6.8×
Hepatic function panel (80076) $55.84 $94 6.8×
Urinalysis, non-automated, without microscopy (81002) $23.76 $40 6.8×
PSA, total (84153) $125.33 $211 6.8×
Thyroid stimulating hormone (TSH) (84443) $114.05 $192 6.8×
CBC with automated differential (85025) $52.87 $89 6.8×
CBC, automated (85027) $43.96 $74 6.8×
Prothrombin time (PT) (85610) $29.11 $49 6.8×
Partial thromboplastin time (PTT) (85730) $40.99 $69 6.8×
Psychotherapy, 30 minutes (90832) $136.62 $230 0.8×
Psychotherapy, 45 minutes (90834) $196.61 $331 1.2×
Psychotherapy, 60 minutes (90837) $239.38 $403 1.4×
Family psychotherapy, with patient (50 min) (90847) $242.95 $409 1.4×
Group psychotherapy (90853) $126.52 $213 1.3×
Sleep study (attended polysomnography) (95810) $2,444.31 $4,115 3.0×
Physical therapy, therapeutic exercise (per 15 min) (97110) $57.02 $96 2.0×
Office visit, new patient (low complexity, ~30 min) (99203)
range across 2 matching MRF lines		 $131.27–$270.27 $221–$455 varies
Office visit, new patient (moderate complexity, ~45 min) (99204)
range across 2 matching MRF lines		 $131.27–$347.49 $221–$585 varies
Office visit, new patient (high complexity, ~60 min) (99205) $301.75 $508 2.4×

A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.

As a Critical Access Hospital, Medicare pays this facility about 101% of its own costs. The × Medicare column compares the cash price against that cost-based benchmark, not a standard rate.

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