Imaging prices at MercyOne New Hampton Medical Center

New Hampton, IA · every code in this section with a posted price and a Medicare benchmark.

122 codes. Prices are the hospital's own posted facility charges.

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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $163.15 $251 2.0×
Abdomen 2 views (74019) $250.90 $386 2.5×
Bone Imaging Whole Body (78306) $1,755 $2,700 4.6×
Chest 1 view (71045) $167.70 $258 2.0×
Chest 2 views (71046) $206.70 $318 2.5×
Clavicle complete (73000)
range across 3 matching MRF lines
$180.70–$271.05 $278–$417 varies
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $1,402.05 $2,157 14.0×
CT abdomen and pelvis without and with contrast (74178) $4,115.15 $6,331 12.3×
CT abdomen and pelvis without contrast (74176) $3,052.40 $4,696 13.3×
CT abdomen w wo contrast (74170) $1,951.30 $3,002 11.6×
CT Angio Abdomen and Pelvis (74174) $4,206.80 $6,472 12.5×
CT Angio Chest (71275) $983.45 $1,513 5.8×
CT Angio Head (70496) $2,528.50 $3,890 15.0×
CT Angio Neck (70498) $2,558.40 $3,936 15.2×
CT cervical spine w/o contrast (72125) $1,506.05 $2,317 15.0×
CT chest w contrast (71260) $1,812.20 $2,788 10.7×
CT chest w/wo contrast (71270) $2,252.90 $3,466 13.4×
CT head/brain without and with contrast (70470) $1,747.20 $2,688 10.4×
CT lower ext w/o (73700)
range across 3 matching MRF lines
$1,413.75–$2,120.95 $2,175–$3,263 varies
CT lower extremity w/contrast material (73701)
range across 3 matching MRF lines
$1,512.55–$2,269.15 $2,327–$3,491 varies
CT lumbar spine w contrast (72132) $1,824.55 $2,807 5.4×
CT lumbar spine w/o contrast (72131) $1,517.10 $2,334 15.1×
CT maxillofacial w contrast (70487) $2,102.10 $3,234 12.5×
CT maxillofacial wo contrast (70486) $1,275.30 $1,962 12.7×
CT pelvis w/o contrast (72192) $1,290.90 $1,986 12.8×
CT soft tissue neck w contrast (70491) $1,603.55 $2,467 9.5×
CT soft tissue neck w/o contrast (70490) $1,277.25 $1,965 12.7×
CT thoracic spine w/o contrast (72128) $1,330.55 $2,047 13.2×
CT thorax w/o contrast (71250) $1,441.70 $2,218 14.3×
CT upper ext wo (73200)
range across 3 matching MRF lines
$1,134.25–$1,701.70 $1,745–$2,618 varies
CT upper extremity with contrast (73201)
range across 3 matching MRF lines
$1,442.35–$2,163.85 $2,219–$3,329 varies
CTA head&neck c+ w/noncontrast img&post-pxessing (70471) $694.85 $1,069 2.1×
Dxa Bone Density Axial (77080) $453.70 $698 4.5×
Dxa bone density study 1/>sites appendiclr skel (77081) $172.25 $265 2.1×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $534.95 $823 5.3×
Fluoroscopy up to 1 hr (76000) $450.45 $693 2.0×
Foot 2 views (73620)
range across 3 matching MRF lines
$180.05–$270.40 $277–$416 varies
Forearm 2 views (73090)
range across 2 matching MRF lines
$805.35–$828.10 — varies
Hepatobil Syst Image W/Drug (78227) $1,440.40 $2,216 2.8×
Infant hip ultrasound with hip movement (dynamic) (76885) $538.85 $829 6.4×
Knee 3 Views (73562)
range across 3 matching MRF lines
$212.55–$319.15 $327–$491 varies
MRA head w/o contrast (70544) $2,500.55 $3,847 10.9×
Mra Neck W/O &W/Contrast Material (70549) $3,547.70 $5,458 10.6×
MRI any jt lower extrem w/o & w/contrast matrl (73723)
range across 3 matching MRF lines
$3,292.25–$4,938.70 $5,065–$7,598 varies
MRI cervical spine w/o cont (72141) $2,547.35 $3,919 11.1×
MRI chest wo w contrast (71552) $2,592.85 $3,989 7.7×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720)
range across 3 matching MRF lines
$3,878.55–$5,818.15 $5,967–$8,951 varies
MRI lower extrem oth/thn jt w/o contr matrl (73718)
range across 3 matching MRF lines
$2,724.80–$4,087.20 $4,192–$6,288 varies
Mri Neck Spine W/O & W/Dye (72156) $3,764.80 $5,792 11.2×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $3,714.10 $5,714 11.1×
MRI pelvis w/o & w contrast (72197) $3,833.70 $5,898 11.4×
MRI pelvis w/o contrast (72195) $2,063.75 $3,175 9.0×
MRI thoracic spine w/o contrast (72146) $2,551.90 $3,926 11.1×
MRI upper extremity oth than jt w/o contr matrl (73218)
range across 3 matching MRF lines
$2,280.85–$3,421.60 $3,509–$5,264 varies
MRI, abdomen, combo (74183) $3,478.15 $5,351 10.4×
MRI, dorsal spine combo (72157) $4,634.50 $7,130 13.8×
MRI, joint upper extrem (73221)
range across 3 matching MRF lines
$2,572.05–$3,858.40 $3,957–$5,936 varies
MRI, joint upper extrem combo (73223)
range across 3 matching MRF lines
$4,106.05–$6,159.40 $6,317–$9,476 varies
MRI, lumbar spine combo (72158) $3,803.15 $5,851 11.3×
Myocardial Spect Multiple Studies (78452)
range across 2 matching MRF lines
$2,913.30 $70–$4,482 2.3×
Neck soft tissue (70360) $189.15 $291 2.3×
Pelvis 1 or 2 views (72170) $226.85 $349 2.3×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $327.60 $504 3.3×
Radex Ankle Complete Minimum 3 Views (73610)
range across 3 matching MRF lines
$271.70–$407.55 $418–$627 varies
Radex Calcaneus Minimum 2 Views (73650)
range across 3 matching MRF lines
$183.30–$274.95 $282–$423 varies
Radex elbow complete minimum 3 views (73080)
range across 3 matching MRF lines
$218.40–$327.60 $336–$504 varies
Radex fingr minimum 2 views (73140) $2,763.80 — 33.0×
Radex foot complete minimum 3 views (73630)
range across 3 matching MRF lines
$226.20–$339.30 $348–$522 varies
Radex Hand Minimum 3 Views (73130)
range across 6 matching MRF lines
$15.60–$305.50 $24–$470 varies
Radex Nasal Bones Complete Minimum 3 Views (70160) $208.65 $321 2.5×
Radex Ribs Unilateral 2 Views (71100) $217.75 $335 2.6×
Radex shoulder complete minimum 2 views (73030)
range across 3 matching MRF lines
$257.40–$386.10 $396–$594 varies
Radex Sternum Minimum 2 Views (71120) $191.10 $294 2.3×
Radex Toe Minimum 2 Views (73660)
range across 3 matching MRF lines
$180.05–$270.40 $277–$416 varies
Radex Wrist Complete Minimum 3 Views (73110)
range across 3 matching MRF lines
$275.60–$413.40 $424–$636 varies
Radiologic exam knee complete 4/more views (73564)
range across 3 matching MRF lines
$322.40–$483.60 $496–$744 varies
Radiologic exam pelvis compl minimum 3 views (72190) $505.05 $777 5.0×
Radiologic exam swallow function contrast study (74230) $454.35 $699 2.7×
Radiologic examination femur minimum 2 views (73552)
range across 3 matching MRF lines
$269.10–$403.65 $414–$621 varies
Radiologic examination knee 1/2 views (73560)
range across 3 matching MRF lines
$177.45–$266.50 $273–$410 varies
Radiologic examination tibia & fibula 2 views (73590)
range across 3 matching MRF lines
$196.95–$295.75 $303–$455 varies
Ribs bilateral 3 views (71110) $261.95 $403 2.6×
Scapula (73010)
range across 3 matching MRF lines
$414.70–$622.05 $638–$957 varies
Screening Digital Breast Tomosynthesis Bi (77063)
range across 3 matching MRF lines
$52–$78 $80–$120 varies
Shoulder 1 view (73020)
range across 3 matching MRF lines
$199.55–$299.65 $307–$461 varies
Skull less than 4 views (70250) $193.05 $297 1.9×
Thoracic spine 2 views (72070) $261.30 $402 2.6×
Thoracic spine 3 views (72072) $333.45 $513 3.3×
Thoracolumbar 2 views (72080) $216.45 $333 2.6×
Ultrasound Breast Limited (76642)
range across 3 matching MRF lines
$486.20–$729.30 $748–$1,122 varies
Ultrasound Exam Aaa Screen (76706) $393.90 $606 3.9×
Ultrasound, abdomen limited (76705) $556.40 $856 5.5×
Us breast unilateral complete (76641)
range across 3 matching MRF lines
$533–$799.50 $820–$1,230 varies
Us chest (76604) $512.20 $788 5.1×
Us complete joint (76881) $642.85 $989 6.4×
Us exam, pelvic, limited (76857) $293.80 $452 2.9×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $514.15 $791 5.1×
Us ob limited 1 or more fetuses (76815) $632.45 $973 6.3×
Us ob transvaginal (76817) $589.55 $907 5.9×
Us pelvic non ob complete (76856) $598 $920 6.0×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $549.90 $846 5.5×
Us preg uterus real time f/u trnsabdl per fetus (76816) $446.55 $687 4.4×
Us retroperitoneal complete (76770) $603.85 $929 6.0×
Us scrotum and contents (76870) $542.75 $835 5.4×
Us thyroid (76536) $553.80 $852 5.5×
Wrist 2 views (73100)
range across 3 matching MRF lines
$247–$370.50 $380–$570 varies
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070)
range across 3 matching MRF lines
$157.95–$237.25 $243–$365 varies
X-Ray Exam Entire Spi 2/3 Vw (72082) $230.10 $354 2.3×
X-Ray Exam Hip Uni 2-3 Views (73502) $222.30 $342 2.7×
X-Ray Exam Hips Bi 2 Views (73521) $312.65 $481 3.1×
X-Ray Exam Hips Bi 3-4 Views (73522) $306.80 $472 3.1×
X-Ray Exam Hips Bi 5/> Views (73523) $430.95 $663 4.3×
X-Ray Exam Neck Spine 2-3 Vw (72040) $251.55 $387 3.0×
X-Ray Exam Neck Spine 6/>Vws (72052) $438.75 $675 4.4×
X-Ray Exam Unilat Ribs/Chest (71101) $494 $760 4.9×
X-ray eye for foreign body (70030)
range across 3 matching MRF lines
$262.60–$393.90 $404–$606 varies
X-ray humerus (73060) $201.50 $310 2.4×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $286 $440 2.8×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $507.65 $781 5.1×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $222.95 $343 2.2×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $221.65 $341 2.6×
Xr c-spine 4 or 5 views (72050) $351 $540 3.5×

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.