Sanford Bagley Medical Center
203 4th Street NW, Bagley, MN · Sanford Health · · NPI 1932472255
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 |
|---|---|---|---|---|
| Lat retinacular release open CPT 27425 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Lavage cannulation maxillary sinus CPT 31000 | not published | not published | $243.83 – $243.83 | 1 |
| Lavh >250 gms 58553 CPT 58553 | not published | not published | $10,931.77 – $10,931.77 | 1 |
| Lb with mastopexy 15839 CPT 15839 | not published | not published | $3,005.15 – $3,005.15 | 1 |
| Lefort i-1 piece without graft CPT 21141 | not published | not published | $6,211.44 – $6,211.44 | 1 |
| Lefort i-2 piece without graft CPT 21142 | not published | not published | $6,211.44 – $6,211.44 | 1 |
| Lefort i-3/> piece without graft CPT 21143 | not published | not published | $6,211.44 – $6,211.44 | 1 |
| Lefort ii anterior intrusion CPT 21150 | not published | not published | $6,211.44 – $6,211.44 | 1 |
| Leg Artery Ultrasound (complete, both legs) CPT 93925 | not published | not published | $253.81 – $253.81 | 1 |
| Leg CT Scan (with contrast, both legs) CPT 73701 | $2,099.20 | $2,624.00 | $186.92 – $2,361.60 | 15 |
| Leg CT Scan (without contrast, both legs) CPT 73700 | $1,751.20 | $2,189.00 | $111.66 – $1,970.10 | 15 |
| Leg vein fusion 34530 CPT 34530 | not published | not published | $3,304.88 – $3,304.88 | 1 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $1,243.20 | $1,554.00 | $253.81 – $1,398.60 | 15 |
| Lengthening of hand tendon CPT 26478 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Lengthening of palate CPT 42227 | not published | not published | $6,211.44 – $6,211.44 | 1 |
| Lengthening of palate+pharyngeal flap 42226 CPT 42226 | not published | not published | $6,211.44 – $6,211.44 | 1 |
| Lengthening of thigh tendon CPT 27393 | not published | not published | $7,500.92 – $7,500.92 | 1 |
| Lengthening of thigh tendons CPT 27394 | not published | not published | $7,500.92 – $7,500.92 | 1 |
| Lengthening of thigh tendons CPT 27395 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Lengthen metacarpal/finger CPT 26568 | not published | not published | $7,500.92 – $7,500.92 | 1 |
| Lengthen radius or ulna CPT 25391 | not published | not published | $13,510.16 – $13,510.16 | 1 |
| Lengthen radius & ulna CPT 25393 | not published | not published | $7,500.92 – $7,500.92 | 1 |
| Lev 1 hosp type b ed visit HCPCS G0380 | not published | not published | $88.27 – $88.27 | 1 |
| Lev 2 hosp type b ed visit HCPCS G0381 | not published | not published | $116.19 – $116.19 | 1 |
| Lev 3 hosp type b ed visit HCPCS G0382 | not published | not published | $195.92 – $195.92 | 1 |
| Lev 4 hosp type b ed visit HCPCS G0383 | not published | not published | $299.83 – $299.83 | 1 |
| Lev 5 hosp type b ed visit HCPCS G0384 | not published | not published | $424.08 – $424.08 | 1 |
| Levalbuterol non-comp unit HCPCS J7614 | $12.48 | $15.59 | $3.77 – $14.03 | 15 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $57.60 | $72.00 | $14.91 – $55.42 | 15 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $48.65 | $60.81 | $13.74 – $51.08 | 15 |
| L hrt cath chd nm/abn nt cnj CPT 93595 | not published | not published | $3,377.23 – $3,377.23 | 1 |
| Lidocaine (pf) 10 mg/ml (1 %) injection solution HCPCS J2003 | $51.44 | $64.29 | $13.34 – $49.59 | 15 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | $48.76 | $60.94 | $14.22 – $52.88 | 15 |
| Ligate leg veins open CPT 37761 | not published | not published | $3,304.88 – $3,304.88 | 1 |
| Ligate leg veins radical 37760 CPT 37760 | not published | not published | $3,304.88 – $3,304.88 | 1 |
| Ligate/strip long leg vein CPT 37722 | not published | not published | $3,304.88 – $3,304.88 | 1 |
| Ligate/strip short leg vein CPT 37718 | not published | not published | $3,304.88 – $3,304.88 | 1 |
| Ligate/transect fallopian tubes 58600 CPT 58600 | not published | not published | $3,338.51 – $3,338.51 | 1 |
| Ligation/biopsy of temporal artery 37609 CPT 37609 | not published | not published | $1,701.25 – $1,701.25 | 1 |
| Ligation/divis of long saph vein 37700 CPT 37700 | not published | not published | $3,304.88 – $3,304.88 | 1 |
| Ligation external carotid artery 37600 CPT 37600 | not published | not published | $3,304.88 – $3,304.88 | 1 |
| Ligation internal/common carotid artery 37605 CPT 37605 | not published | not published | $3,304.88 – $3,304.88 | 1 |
| Ligation internal jugular vein 37565 CPT 37565 | not published | not published | $3,304.88 – $3,304.88 | 1 |
| Ligation major artery neck CPT 37615 | not published | not published | $3,304.88 – $3,304.88 | 1 |
| Ligation nasal sinus artery CPT 30915 | not published | not published | $3,304.88 – $3,304.88 | 1 |
| Ligation of femoral vein CPT 37650 | not published | not published | $3,304.88 – $3,304.88 | 1 |
| Ligation of inf vena cava CPT 37619 | not published | not published | $5,675.99 – $5,675.99 | 1 |
| Ligation of neck artery CPT 37606 | not published | not published | $3,304.88 – $3,304.88 | 1 |
| Ligation of salivary duct CPT 42665 | not published | not published | $3,405.22 – $3,405.22 | 1 |
| Ligation upper jaw artery CPT 30920 | not published | not published | $3,304.88 – $3,304.88 | 1 |
| Ligation vericose vein cluster(s) 1 leg CPT 37785 | not published | not published | $3,304.88 – $3,304.88 | 1 |
| Lig/band angioaccess av fistula CPT 37607 | not published | not published | $3,304.88 – $3,304.88 | 1 |
| Lig&div&compl strpg saph vn CPT 37735 | not published | not published | $3,304.88 – $3,304.88 | 1 |
| Limb exercise test CPT 95875 | not published | not published | $164.28 – $164.28 | 1 |
| Limited visual field xm CPT 92081 | not published | not published | $62.37 – $62.37 | 1 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $165.51 | $206.88 | $50.09 – $186.19 | 15 |
| Lip exc/transverse wedge/w closure 40510 CPT 40510 | not published | not published | $3,405.22 – $3,405.22 | 1 |
| Lip surgery procedure CPT 40799 | not published | not published | $243.83 – $243.83 | 1 |
| Liver elastography 91200 CPT 91200 | not published | not published | $164.28 – $164.28 | 1 |
| Liver imaging CPT 78201 | not published | not published | $565.18 – $565.18 | 1 |
| Liver imag w/vasclr flow CPT 78202 | not published | not published | $565.18 – $565.18 | 1 |
| Liver/spleen imag static only CPT 78215 | not published | not published | $421.92 – $421.92 | 1 |
| Liver/spleen imag w/vasclr flow CPT 78216 | not published | not published | $421.92 – $421.92 | 1 |
| Lmtd oph exam general anes CPT 92019 | not published | not published | $2,449.61 – $2,449.61 | 1 |
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $51.04 | $63.80 | $14.67 – $54.52 | 15 |
| Loudness balance test CPT 92562 | not published | not published | $326.96 – $326.96 | 1 |
| Low back disk surgery CPT 63030 | not published | not published | $7,500.92 – $7,500.92 | 1 |
| Low-Dose Lung Cancer Screening CT Scan CPT 71271 | $542.40 | $678.00 | $111.66 – $610.20 | 15 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | not published | not published | $186.92 – $446.60 | 2 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $2,434.40 | $3,043.00 | $374.99 – $2,738.70 | 15 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $1,996.80 | $2,496.00 | $111.66 – $2,246.40 | 15 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $4,034.40 | $5,043.00 | $374.99 – $4,538.70 | 15 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $3,376.80 | $4,221.00 | $374.99 – $3,798.90 | 15 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $2,872.80 | $3,591.00 | $253.81 – $3,231.90 | 15 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $444.00 | $555.00 | $111.66 – $499.50 | 15 |
| Lower Back (Lumbar Spine) X-ray (4 or more views) CPT 72110 | $627.20 | $784.00 | $111.66 – $705.60 | 15 |
| Lower Back (Lumbar Spine) X-ray (with bending views) CPT 72114 | not published | not published | $111.66 – $111.66 | 1 |
| Lower jaw bone graft CPT 21215 | not published | not published | $6,211.44 – $6,211.44 | 1 |
| Lower Leg (Shin) X-ray (both sides) CPT 73590 | $532.80 | $666.00 | $92.45 – $599.40 | 15 |
| Lsh uterus 250 g or less CPT 58541 | not published | not published | $10,931.77 – $10,931.77 | 1 |
| Lsh uterus above 250 g CPT 58543 | not published | not published | $10,931.77 – $10,931.77 | 1 |
| Lsh w/t/o ut 250 g or less CPT 58542 | not published | not published | $10,931.77 – $10,931.77 | 1 |
| Lsh w/t/o uterus above 250 g CPT 58544 | not published | not published | $10,931.77 – $10,931.77 | 1 |
| Lumbar diskogram s&i CPT 72295 | not published | not published | $2,050.41 – $2,050.41 | 1 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $19,309.55 – $19,309.55 | 1 |
| Lumizyme injection HCPCS J0221 | not published | not published | $205.76 – $205.76 | 1 |
| Lung Function Test Before and After an Inhaler CPT 94060 | $630.40 | $788.00 | $190.77 – $709.20 | 15 |
| Lung function test (mbc/mvv) CPT 94200 | not published | not published | $62.37 – $62.37 | 1 |
| Lung Function Test (Spirometry) CPT 94010 | $312.00 | $390.00 | $94.42 – $351.00 | 15 |
| Lung perfusion imaging CPT 78580 | $1,476.00 | $1,845.00 | $421.92 – $1,660.50 | 15 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | not published | not published | $41.40 – $41.40 | 1 |
| Lw ntsty Ultrasound stimj bone healg CPT 20979 | not published | not published | $25.71 – $25.71 | 1 |
| Lymphatics/lymph node imaging CPT 78195 | not published | not published | $565.18 – $565.18 | 1 |
| Lymph vessel x-ray arm/leg CPT 75801 | not published | not published | $649.17 – $649.17 | 1 |
| Lymph vessel x-ray arms/legs CPT 75803 | not published | not published | $1,631.11 – $1,631.11 | 1 |
| Lymph vessel x-ray trunk CPT 75805 | not published | not published | $3,304.88 – $3,304.88 | 1 |
| Lymph vessel x-ray trunk CPT 75807 | not published | not published | $3,304.88 – $3,304.88 | 1 |
| Lysis intranasal synechia 30560 CPT 30560 | not published | not published | $534.71 – $534.71 | 1 |
| Lysis of labial adhesions CPT 56441 | not published | not published | $3,338.51 – $3,338.51 | 1 |
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.