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 |
|---|---|---|---|---|
| Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe HCPCS Q5108 | not published | not published | $138.08 – $138.08 | 1 |
| Pegfilgrastim-pbbk 6 mg/0.6 ml subcutaneous syringe HCPCS Q5130 | not published | not published | $189.71 – $189.71 | 1 |
| Pegloticase 8 mg/ml intravenous solution HCPCS J2507 | not published | not published | $3,547.84 – $3,547.84 | 1 |
| Pegunigalsidase alfa-iwxj HCPCS J2508 | not published | not published | $227.78 – $227.78 | 1 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $2,722.40 | $3,403.00 | $186.92 – $3,062.70 | 15 |
| Pelvic CT scan (with contrast) CPT 72193 | $2,271.20 | $2,839.00 | $186.92 – $2,555.10 | 15 |
| Pelvic CT scan (without contrast) CPT 72192 | $1,952.80 | $2,441.00 | $111.66 – $2,196.90 | 15 |
| Pelvic MRI (with and without contrast) CPT 72197 | $4,303.20 | $5,379.00 | $374.99 – $4,841.10 | 15 |
| Pelvic MRI (with contrast) CPT 72196 | $4,099.20 | $5,124.00 | $374.99 – $4,611.60 | 15 |
| Pelvic MRI (without contrast) CPT 72195 | $3,237.60 | $4,047.00 | $253.81 – $3,642.30 | 15 |
| Pelvic ring fracture uni/bil HCPCS G0413 | not published | not published | $7,500.92 – $7,500.92 | 1 |
| Pelvic Ultrasound (complete) CPT 76856 | $819.20 | $1,024.00 | $111.66 – $921.60 | 15 |
| Pelvic Ultrasound (limited) CPT 76857 | $586.40 | $733.00 | $111.66 – $659.70 | 15 |
| Pelvis X-ray (1 to 2 views) CPT 72170 | $376.80 | $471.00 | $111.66 – $423.90 | 15 |
| Pelvis X-ray (complete, 4 or more views) CPT 72190 | $438.40 | $548.00 | $111.66 – $493.20 | 15 |
| Pembrolizumab 25 mg/ml intravenous solution HCPCS J9271 | $5,240.20 | $6,550.24 | $58.52 – $5,820.18 | 15 |
| Pemetrexed disodium 100 mg intravenous powder for solution HCPCS J9305 | $3,626.43 | $4,533.03 | $1,097.45 – $4,079.73 | 15 |
| Pemivibart infusion HCPCS M0224 | $760.00 | $950.00 | $230.00 – $855.00 | 15 |
| Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 | $471.48 | $589.34 | $142.68 – $530.41 | 15 |
| Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr HCPCS J2540 | $255.81 | $319.76 | $25.39 – $94.37 | 15 |
| Penile injection CPT 54235 | not published | not published | $255.37 – $255.37 | 1 |
| Penile vascular study CPT 93980 | not published | not published | $111.66 – $111.66 | 1 |
| Penile vascular study CPT 93981 | not published | not published | $111.66 – $111.66 | 1 |
| Penile venous occlusion CPT 37790 | not published | not published | $3,621.42 – $3,621.42 | 1 |
| Penis plastic surgery CPT 54360 | not published | not published | $3,621.42 – $3,621.42 | 1 |
| Penis study CPT 54240 | not published | not published | $326.96 – $326.96 | 1 |
| Pentamidine non-comp unit HCPCS J2545 | $130.29 | $162.86 | $39.43 – $146.57 | 15 |
| Perc cryo ablate renal tum CPT 50593 | not published | not published | $10,931.77 – $10,931.77 | 1 |
| Perc d-e cor revasc chro sin HCPCS C9607 | not published | not published | $18,854.56 – $18,854.56 | 1 |
| Perc d-e cor revasc t cabg s HCPCS C9604 | not published | not published | $11,907.60 – $11,907.60 | 1 |
| Perc d-e cor stent ather s HCPCS C9602 | not published | not published | $18,854.56 – $18,854.56 | 1 |
| Perc drug-el cor stent sing HCPCS C9600 | not published | not published | $11,907.60 – $11,907.60 | 1 |
| Perc rf ablate renal tumor CPT 50592 | not published | not published | $6,126.08 – $6,126.08 | 1 |
| Percut ablate liver rf CPT 47382 | not published | not published | $6,126.08 – $6,126.08 | 1 |
| Pericardiocentesis wwo imaging CPT 33016 | not published | not published | $1,631.11 – $1,631.11 | 1 |
| Peri-implt capslc brst compl CPT 19371 | not published | not published | $4,020.74 – $4,020.74 | 1 |
| Perineoplasty rpr per nonob CPT 56810 | not published | not published | $3,338.51 – $3,338.51 | 1 |
| Peripheral vascular rehab CPT 93668 | $142.40 | $178.00 | $43.09 – $160.20 | 15 |
| Peritoneal cath sub q resv per CPT 49419 | not published | not published | $5,675.99 – $5,675.99 | 1 |
| Peritoneogram rs&i CPT 74190 | not published | not published | $575.70 – $575.70 | 1 |
| Perit-vens shunt pat tst CPT 78291 | not published | not published | $421.92 – $421.92 | 1 |
| Perq dev breast 1st mr guide CPT 19287 | not published | not published | $738.77 – $738.77 | 1 |
| Perq dev breast 1st strtctc CPT 19283 | not published | not published | $738.77 – $738.77 | 1 |
| Perq nl/pl lithotrp cplx>2cm CPT 50081 | not published | not published | $9,709.51 – $9,709.51 | 1 |
| Perq nl/pl lithotrp smpl<2cm CPT 50080 | not published | not published | $9,709.51 – $9,709.51 | 1 |
| Perq p-art revsc 1 abnor bi CPT 33903 | not published | not published | $11,907.60 – $11,907.60 | 1 |
| Perq p-art revsc 1 abnor uni CPT 33902 | not published | not published | $18,854.56 – $18,854.56 | 1 |
| Perq p-art revsc 1 nm nt bi CPT 33901 | not published | not published | $11,907.60 – $11,907.60 | 1 |
| Perq plmt bile duct stent CPT 47538 | not published | not published | $6,126.08 – $6,126.08 | 1 |
| Perq plmt bile duct stent CPT 47539 | not published | not published | $6,126.08 – $6,126.08 | 1 |
| Perq plmt bile duct stent CPT 47540 | not published | not published | $6,126.08 – $6,126.08 | 1 |
| Perq rplcmt g-tube req revsn gstrst trk CPT 43763 | not published | not published | $255.37 – $255.37 | 1 |
| Perq skel fix rad/uln dislc CPT 25671 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Perq skel fix ulnar styld fx CPT 25651 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Perq transcath closure pda CPT 93582 | not published | not published | $18,854.56 – $18,854.56 | 1 |
| Perq transcath cls aortic CPT 93591 | not published | not published | $18,854.56 – $18,854.56 | 1 |
| Perq transcath cls mitral CPT 93590 | not published | not published | $18,854.56 – $18,854.56 | 1 |
| Perq tx big toe fracture w/manip 28496 CPT 28496 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Perq tx malar fracture CPT 21355 | not published | not published | $3,405.22 – $3,405.22 | 1 |
| Perq tx mndblr fx xtrnl fixj CPT 21452 | not published | not published | $6,211.44 – $6,211.44 | 1 |
| Perq tx nasoethmoid fx CPT 21340 | not published | not published | $3,405.22 – $3,405.22 | 1 |
| Pertuzumab 30 mg/ml desensitization HCPCS J9306 | not published | not published | $16.20 – $16.20 | 1 |
| Pet CT skull-mid thgh initial CPT 78815 | not published | not published | $1,531.52 – $1,531.52 | 1 |
| Pet CT whole body initial CPT 78816 | not published | not published | $1,531.52 – $1,531.52 | 1 |
| Pet fdg brain metoblic eval sb CPT 78608 | not published | not published | $1,531.52 – $1,531.52 | 1 |
| Pet image full body CPT 78813 | not published | not published | $1,531.52 – $1,531.52 | 1 |
| Pet image ltd area CPT 78811 | not published | not published | $1,370.75 – $1,370.75 | 1 |
| Pet image skull-thigh CPT 78812 | not published | not published | $1,531.52 – $1,531.52 | 1 |
| Pet image w/ct lmtd CPT 78814 | not published | not published | $1,531.52 – $1,531.52 | 1 |
| Pfc sigma fem post aug sz3 8mm HCPCS C1776 | $7,560.00 | $9,450.00 | $296.57 – $1,102.50 | 15 |
| Phalangectomy ea toe 28150 CPT 28150 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Ph body fluid CPT 83986 | $32.80 | $41.00 | $2.91 – $10.80 | 15 |
| Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr HCPCS J2560 | $71.58 | $89.47 | $21.66 – $80.52 | 15 |
| Phenobarbital therapeutic drug level CPT 80184 | $139.20 | $174.00 | $21.55 – $80.10 | 15 |
| Phentolaine mesylate inj HCPCS J2760 | $722.55 | $903.18 | $218.66 – $812.86 | 15 |
| Phenylephrine 10 mg/ml injection solution HCPCS J2371 | $63.60 | $79.50 | $18.44 – $68.55 | 15 |
| Phenytoin total therapeutic drug level CPT 80185 | $153.60 | $192.00 | $42.13 – $156.60 | 15 |
| Phlebotomy therapeutic CPT 99195 | $247.20 | $309.00 | $74.81 – $278.10 | 15 |
| Phleb veins 1 extrm 10-20 stab CPT 37765 | not published | not published | $3,304.88 – $3,304.88 | 1 |
| Phleb veins 1 extrm >20 stab CPT 37766 | not published | not published | $3,304.88 – $3,304.88 | 1 |
| Phosphorus CPT 84100 | $56.80 | $71.00 | $17.19 – $63.90 | 15 |
| Phosphorus 24 hour urine CPT 84105 | $15.20 | $19.00 | $4.60 – $17.10 | 15 |
| Photchmtx tar&uvb/ptrltm&uvb CPT 96910 | not published | not published | $62.37 – $62.37 | 1 |
| Photochemotherapy puva CPT 96912 | not published | not published | $62.37 – $62.37 | 1 |
| Photochemotherapy uv-a or b CPT 96913 | not published | not published | $419.51 – $419.51 | 1 |
| Photo patch test CPT 95052 | not published | not published | $62.37 – $62.37 | 1 |
| Photopheresis CPT 36522 | not published | not published | $4,919.43 – $4,919.43 | 1 |
| Photosensitivity tests CPT 95056 | not published | not published | $135.35 – $135.35 | 1 |
| Physical Therapy Evaluation (high complexity) CPT 97163 | $323.20 | $404.00 | $97.81 – $363.60 | 15 |
| Physical Therapy Evaluation (low complexity) CPT 97161 | $256.80 | $321.00 | $115.50 – $288.90 | 15 |
| Physical Therapy Evaluation (moderate complexity) CPT 97162 | $280.00 | $350.00 | $84.74 – $315.00 | 15 |
| Physical Therapy Re-Evaluation CPT 97164 | $177.60 | $222.00 | $53.75 – $199.80 | 15 |
| Phytonadione (vitamin k1) 10 mg/ml injection solution HCPCS J3430 | $86.50 | $108.12 | $18.83 – $69.99 | 15 |
| Pinch graft 1/mlt c> sm ulcer tip/oth area 2cm 15050 CPT 15050 | not published | not published | $642.74 – $642.74 | 1 |
| Pin finger dislocation CPT 26776 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Pin finger fracture each CPT 26756 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Pin hand dislocation CPT 26676 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Pin knuckle dislocation CPT 26706 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Piperacillin-tazobactam 3.375 gram intravenous solution HCPCS J2543 | $63.60 | $79.50 | $18.64 – $69.29 | 15 |
| Place breast rad tube/caths CPT 19298 | not published | not published | $6,847.53 – $6,847.53 | 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.