Sanford Bemidji Medical Center
1300 Anne Street NW, Bemidji, MN · Sanford Health · · NPI 1801870191
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 |
|---|---|---|---|---|
| Above knee cushion socket HCPCS L5648 | not published | not published | $831.69 – $1,106.29 | 8 |
| Above knee flex cover system HCPCS L5964 | not published | not published | $1,278.07 – $1,573.68 | 8 |
| Above knee hydracadence HCPCS L5610 | not published | not published | $2,867.49 – $3,478.95 | 8 |
| Above knee leather socket HCPCS L5642 | not published | not published | $774.36 – $1,041.09 | 8 |
| Above knee manual lock HCPCS L5925 | not published | not published | $380.88 – $564.61 | 8 |
| Above knee wood socket HCPCS L5644 | not published | not published | $669.53 – $992.48 | 8 |
| Abrasion lesions add-on CPT 15787 | not published | not published | $1.02 – $30.31 | 8 |
| Abrasion lesion single CPT 15786 | not published | not published | $144.42 – $204.75 | 8 |
| Abscess drain retroperitoneal surg code CPT 49406 | $3,945.60 | $4,932.00 | $1,169.64 – $4,438.80 | 15 |
| Abscess imaging ltd area CPT 78805 | not published | not published | $297.55 – $297.55 | 1 |
| Abscess imaging whole body CPT 78806 | not published | not published | $297.55 – $297.55 | 1 |
| Absorpt drg >16<=48 in w/bdr HCPCS A6255 | not published | not published | $1.02 – $4.46 | 8 |
| Absorpt drg >16 <=48 without bdr HCPCS A6252 | not published | not published | $1.02 – $4.78 | 8 |
| Absorpt drg <=16 sq in w/bdr HCPCS A6254 | not published | not published | $1.02 – $1.75 | 8 |
| Absorpt drg <=16 sq in without b HCPCS A6251 | not published | not published | $1.02 – $2.92 | 8 |
| Absorpt drg > 48 sq in without b HCPCS A6253 | not published | not published | $1.02 – $9.29 | 8 |
| Access & clsr pq fem art endogft dlvry w/img uni CPT 34713 | $3,893.60 | $4,867.00 | $1.02 – $4,380.30 | 15 |
| Access thoracic lymph duct CPT 38794 | not published | not published | $1.02 – $278.98 | 8 |
| Acetaminophen 10 mg/ml soln 100 ml glass cont HCPCS J0131 | $50.51 | $63.13 | $1.02 – $56.82 | 12 |
| Acetaminophen level CPT 80143 | not published | not published | $17.71 – $19.57 | 8 |
| Acetazolamide 500 mg solution for injection HCPCS J1120 | $81.15 | $101.43 | $1.02 – $71.33 | 12 |
| Acetone qualitative CPT 82009 | not published | not published | $4.29 – $4.75 | 8 |
| Acetylcholine receptor modulating antibody CPT 86043 | not published | not published | $11.45 – $12.65 | 8 |
| Acetylcholinesterase assay CPT 82013 | not published | not published | $11.68 – $12.90 | 8 |
| Acetylcysteine 200 mg/ml (20 %) intravenous solution HCPCS J0132 | $83.09 | $103.86 | $1.02 – $73.49 | 12 |
| Acetylcysteine non-comp unit HCPCS J7608 | $59.76 | $74.69 | $6.95 – $59.53 | 12 |
| Acid perfusion of esophagus CPT 91030 | not published | not published | $386.67 – $546.77 | 8 |
| Acne surgery 10040 CPT 10040 | not published | not published | $144.42 – $204.75 | 8 |
| Aco annual medicare visit (awv), initial g0438aco HCPCS G0438 | not published | not published | $150.67 – $166.52 | 8 |
| Aco annual medicare visit (awv), subsq g0439aco HCPCS G0439 | not published | not published | $118.78 – $131.29 | 8 |
| Aco ccm; at least 20 min 99490aco CPT 99490 | not published | not published | $64.30 – $95.32 | 8 |
| Aco ccm; ea addl 20 min 99439aco CPT 99439 | not published | not published | $1.02 – $47.86 | 8 |
| Aco cmplx chron care addl 20 min 99489aco CPT 99489 | not published | not published | $1.02 – $73.57 | 8 |
| Aco cmplx chron care without pt visit, 60 min 99487aco CPT 99487 | not published | not published | $115.02 – $165.57 | 8 |
| Aco cont gluc mnt phys/qhp eqp 95250aco CPT 95250 | $487.20 | $609.00 | $95.37 – $548.10 | 15 |
| Aco depression screen annual medicare g0444aco HCPCS G0444 | not published | not published | $20.71 – $30.70 | 8 |
| Aco med nutria tx/group, ea 30 min 97804aco CPT 97804 | $68.00 | $85.00 | $15.65 – $76.50 | 15 |
| Acoustic immitance testing CPT 92570 | not published | not published | $112.68 – $161.23 | 8 |
| Acoustic refl threshold tst CPT 92568 | not published | not published | $28.94 – $40.45 | 8 |
| Acromp/acromionectomy prtl CPT 23130 | not published | not published | $2,335.16 – $3,343.47 | 8 |
| Acth stimulation panel CPT 80402 | not published | not published | $82.61 – $91.31 | 8 |
| Acth stimulation panel CPT 80406 | not published | not published | $74.35 – $82.17 | 8 |
| Actigraphy testing CPT 95803 | $135.20 | $169.00 | $44.13 – $152.10 | 15 |
| Actinotherapy uv light CPT 96900 | not published | not published | $28.94 – $40.45 | 8 |
| Acup 1/> w/estim 1st 15 min CPT 97813 | not published | not published | $21.49 – $25.24 | 8 |
| Acup 1/> w/estim ea addl 15 CPT 97814 | not published | not published | $27.00 – $29.85 | 8 |
| Acup 1/> without estim ea add 15 CPT 97811 | not published | not published | $23.86 – $26.37 | 8 |
| Acup 1/> wo estim 1st 15 min CPT 97810 | not published | not published | $21.49 – $25.24 | 8 |
| Acute hepatitis panel CPT 80074 | not published | not published | $45.25 – $50.01 | 8 |
| Acute venous thrombus image CPT 78456 | not published | not published | $1,024.41 – $1,345.26 | 8 |
| Acyclovir 400 mg tablet HCPCS J8499 | $742.65 | $928.31 | $2.89 – $5.78 | 12 |
| Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr HCPCS J0133 | $50.71 | $63.38 | $1.02 – $52.54 | 12 |
| #acylcarnitineprfl CPT 82017 | not published | not published | $16.03 – $17.71 | 8 |
| Acylcarnitines qual CPT 82016 | not published | not published | $15.67 – $17.31 | 8 |
| Adalimumab injection HCPCS J0135 | not published | not published | $1,867.51 – $1,867.51 | 1 |
| Adapt behavior tx phys/qhp CPT 97155 | not published | not published | $115.02 – $165.57 | 8 |
| Adapter b 8 channel 10cm HCPCS C1883 | $3,816.00 | $4,770.00 | $1.02 – $202.50 | 12 |
| Adaptive behavior tx by tech CPT 97153 | not published | not published | $64.30 – $95.32 | 8 |
| Adding walker to prev cast CPT 29440 | not published | not published | $113.68 – $162.60 | 8 |
| Additional switch, ext power HCPCS L6611 | not published | not published | $469.41 – $621.63 | 8 |
| Add le poly knee custom kafo HCPCS L2387 | not published | not published | $217.22 – $261.02 | 8 |
| Add ue prost a/e acrylic HCPCS L7404 | not published | not published | $633.74 – $839.18 | 8 |
| Add ue prost a/e ultlite mat HCPCS L7401 | not published | not published | $391.16 – $518.05 | 8 |
| Add ue prost b/e acrylic HCPCS L7403 | not published | not published | $419.88 – $556.01 | 8 |
| Add ue prost be/wd, ultlite HCPCS L7400 | not published | not published | $349.43 – $462.75 | 8 |
| Add ue prost s/d acrylic HCPCS L7405 | not published | not published | $828.76 – $1,097.51 | 8 |
| Add ue prost s/d ultlite mat HCPCS L7402 | not published | not published | $422.47 – $559.44 | 8 |
| Add up-ex prosthes lock mech HCPCS L6698 | not published | not published | $563.85 – $835.83 | 8 |
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | $77.96 | $97.45 | $1.02 – $52.25 | 12 |
| Adenovirus ag ia CPT 87301 | not published | not published | $11.38 – $12.58 | 8 |
| Adenovirus antibody,serum - quest CPT 86603 | not published | not published | $12.23 – $13.51 | 8 |
| Adenovirus assay w/optic CPT 87809 | not published | not published | $20.67 – $22.85 | 8 |
| Adenovirus vaccine type 4 CPT 90476 | not published | not published | $270.78 – $270.78 | 1 |
| Adhesiolysis tube ovary 58740 CPT 58740 | not published | not published | $786.50 – $869.29 | 8 |
| Adhesive, liquid or equal HCPCS A4364 | not published | not published | $1.02 – $4.32 | 8 |
| Adh-sendout CPT 84588 | not published | not published | $32.24 – $35.64 | 8 |
| Adj gastric band via subq port CPT 43999 | not published | not published | $653.96 – $966.13 | 8 |
| Adjmt/revj ext fixj sys anes CPT 20693 | not published | not published | $5,161.17 – $7,361.40 | 8 |
| Adj tis trans/see area/10.1-30sqcm 14041 CPT 14041 | not published | not published | $1,315.61 – $1,884.97 | 8 |
| Adjustment gastric band HCPCS S2083 | $1,698.40 | $2,123.00 | $141.62 – $1,910.70 | 12 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $87.89 | $109.86 | $1.02 – $13.50 | 12 |
| Admin ecg contrast agent CPT 93352 | $162.40 | $203.00 | $32.48 – $182.70 | 15 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $95.20 | $119.00 | $50.82 – $107.10 | 15 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | $218.40 | $273.00 | $50.82 – $245.70 | 15 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $443.20 | $554.00 | $244.33 – $498.60 | 15 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | $251.20 | $314.00 | $143.09 – $341.80 | 15 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | $225.60 | $282.00 | $50.82 – $136.80 | 15 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $182.40 | $228.00 | $50.82 – $205.20 | 15 |
| Administration immunization each additional component CPT 90461 | not published | not published | $7.83 – $8.65 | 8 |
| Administration immunization each additional vaccine CPT 90472 | $64.80 | $81.00 | $1.02 – $72.90 | 15 |
| Administration immunization first component each vaccine CPT 90460 | not published | not published | $21.10 – $23.32 | 8 |
| Administration immunization intranasal/oral route 1 vaccine CPT 90473 | $67.20 | $84.00 | $38.28 – $75.60 | 15 |
| Administration immunization intranasal/oral route each additional vaccine CPT 90474 | $61.60 | $77.00 | $1.02 – $69.30 | 15 |
| Administration rsv monoclonal ab seasonal dose im w/counseling CPT 96380 | not published | not published | $21.33 – $23.57 | 8 |
| Administration vaccine hepatitis b HCPCS G0010 | not published | not published | $34.27 – $47.55 | 8 |
| Administration vaccine influenza virus HCPCS G0008 | $40.80 | $51.00 | $23.24 – $47.55 | 15 |
| Administration vaccine pneumococcal HCPCS G0009 | not published | not published | $34.27 – $47.55 | 8 |
| Administration vaccine rsv monoclonal ab seasonal dose im CPT 96381 | not published | not published | $18.23 – $20.15 | 8 |
| Ado-trastuzumab emtansine 100 mg intravenous solution HCPCS J9354 | not published | not published | $39.03 – $44.27 | 8 |
| Adrenal cortex & medulla img CPT 78075 | not published | not published | $1,024.41 – $1,345.26 | 8 |
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.