Sanford Canby Medical Center
112 St Olaf Ave S, Canby, MN · Sanford Health · · NPI 1780781054
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 |
|---|---|---|---|---|
| Laser surgery eye strands CPT 67031 | not published | not published | $576.03 – $576.03 | 1 |
| Laser surgery of cervix 57513 CPT 57513 | not published | not published | $3,338.51 – $3,338.51 | 1 |
| Laser surgery of prostate CPT 52647 | not published | not published | $5,337.80 – $5,337.80 | 1 |
| Laser surgery of prostate CPT 52648 | not published | not published | $5,337.80 – $5,337.80 | 1 |
| Laser surg penis lesion(s) CPT 54057 | not published | not published | $1,920.69 – $1,920.69 | 1 |
| Laser treatment of retina CPT 67039 | not published | not published | $4,224.00 – $4,224.00 | 1 |
| Laser treatment of retina CPT 67040 | not published | not published | $4,224.00 – $4,224.00 | 1 |
| Lateral canthopexy CPT 21282 | not published | not published | $3,405.22 – $3,405.22 | 1 |
| 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 |
| Lead capillary CPT 83655 | $122.40 | $153.00 | $9.20 – $34.20 | 15 |
| 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 | $1,441.60 | $1,802.00 | $253.81 – $1,621.80 | 15 |
| Leg CT Scan (with contrast, both legs) CPT 73701 | $1,866.40 | $2,333.00 | $186.92 – $2,099.70 | 15 |
| Leg CT Scan (without contrast, both legs) CPT 73700 | $2,060.80 | $2,576.00 | $111.66 – $2,318.40 | 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 | $1,372.80 | $1,716.00 | $253.81 – $1,544.40 | 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 |
| Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 | $72.24 | $90.29 | $19.87 – $73.85 | 15 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | $4,396.20 | $5,495.25 | $95.29 – $354.22 | 15 |
| Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 | $1,525.68 | $1,907.10 | $461.71 – $1,716.39 | 15 |
| 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 | $10.77 | $13.46 | $1.18 – $4.37 | 15 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $60.98 | $76.22 | $18.45 – $68.60 | 15 |
| Levetiracetam therapeutic drug level CPT 80177 | $73.60 | $92.00 | $22.27 – $82.80 | 15 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $107.54 | $134.42 | $31.77 – $118.10 | 15 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | $191.67 | $239.58 | $58.00 – $215.62 | 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 | $62.29 | $77.86 | $0.01 – $0.04 | 15 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | $106.26 | $132.82 | $32.16 – $119.54 | 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 |
| Lipase CPT 83690 | $107.20 | $134.00 | $32.44 – $120.60 | 15 |
| Lip exc/transverse wedge/w closure 40510 CPT 40510 | not published | not published | $3,405.22 – $3,405.22 | 1 |
| Lipoprotein direct measurement hdl CPT 83718 | $66.40 | $83.00 | $9.44 – $35.10 | 15 |
| Lip surgery procedure CPT 40799 | not published | not published | $243.83 – $243.83 | 1 |
| Lithium therapeutic drug level CPT 80178 | $84.80 | $106.00 | $25.66 – $95.40 | 15 |
| Liver elastography 91200 CPT 91200 | not published | not published | $164.28 – $164.28 | 1 |
| Liver Function Test CPT 80076 | $114.40 | $143.00 | $34.62 – $128.70 | 15 |
| Liver imaging CPT 78201 | $1,680.80 | $2,101.00 | $508.65 – $1,890.90 | 15 |
| Liver imag w/vasclr flow CPT 78202 | not published | not published | $565.18 – $565.18 | 1 |
| Liver/spleen imag static only CPT 78215 | $1,682.40 | $2,103.00 | $421.92 – $1,892.70 | 15 |
| 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 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $20.00 | $25.00 | $6.05 – $22.50 | 15 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $61.42 | $76.77 | $18.29 – $67.98 | 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 | not published | not published | $111.66 – $111.66 | 1 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $2,624.80 | $3,281.00 | $186.92 – $2,952.90 | 15 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $2,637.60 | $3,297.00 | $374.99 – $2,967.30 | 15 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $2,447.20 | $3,059.00 | $111.66 – $2,753.10 | 15 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $4,217.60 | $5,272.00 | $374.99 – $4,744.80 | 15 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $3,407.20 | $4,259.00 | $374.99 – $3,833.10 | 15 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $3,237.60 | $4,047.00 | $253.81 – $3,642.30 | 15 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $425.60 | $532.00 | $111.66 – $478.80 | 15 |
| Lower Back (Lumbar Spine) X-ray (4 or more views) CPT 72110 | $551.20 | $689.00 | $111.66 – $620.10 | 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 | $338.40 | $423.00 | $92.45 – $380.70 | 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 |
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.