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 |
|---|---|---|---|---|
| Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 | $114.88 | $143.60 | $19.83 – $73.70 | 15 |
| Sup of prep of antigen # of vials 95144 CPT 95144 | not published | not published | $48.45 – $48.45 | 1 |
| Support clav 29.6-40.5in med HCPCS L3650 | $28.80 | $36.00 | $7.51 – $27.90 | 15 |
| Surg dx exam anorectal CPT 45990 | not published | not published | $2,879.51 – $2,879.51 | 1 |
| Surgery for urethra pouch CPT 53240 | not published | not published | $3,621.42 – $3,621.42 | 1 |
| Surgery to stop leg growth CPT 27475 | not published | not published | $7,500.92 – $7,500.92 | 1 |
| Surgery to stop leg growth CPT 27477 | not published | not published | $7,500.92 – $7,500.92 | 1 |
| Surgery to stop leg growth CPT 27479 | not published | not published | $7,500.92 – $7,500.92 | 1 |
| Surgery to stop leg growth CPT 27485 | not published | not published | $7,500.92 – $7,500.92 | 1 |
| Surgical exposure prostate 55860 CPT 55860 | not published | not published | $5,337.80 – $5,337.80 | 1 |
| Surgical opening of stomach CPT 43510 | not published | not published | $984.44 – $984.44 | 1 |
| Surgical opening of throat CPT 42955 | not published | not published | $1,555.34 – $1,555.34 | 1 |
| Surgical pathology level 1 gross examination only CPT 88300 | $34.40 | $43.00 | $10.41 – $38.70 | 15 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $80.80 | $101.00 | $24.45 – $90.90 | 15 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $99.20 | $124.00 | $30.02 – $111.60 | 15 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $115.20 | $144.00 | $65.66 – $129.60 | 15 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $528.00 | $660.00 | $159.79 – $594.00 | 15 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $745.60 | $932.00 | $225.64 – $838.80 | 15 |
| Surg tx anal fistula 2nd stage 46285 CPT 46285 | not published | not published | $2,879.51 – $2,879.51 | 1 |
| Susceptibility agar dilution per agent CPT 87181 | $56.80 | $71.00 | $4.84 – $18.00 | 15 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $37.60 | $47.00 | $11.38 – $42.30 | 15 |
| Susceptibility mic per plate CPT 87186 | $239.20 | $299.00 | $15.74 – $58.50 | 15 |
| Suspension of testis CPT 54620 | not published | not published | $3,621.42 – $3,621.42 | 1 |
| Svc venogram s&i CPT 75827 | not published | not published | $1,631.11 – $1,631.11 | 1 |
| Swallowing Evaluation (Bedside) CPT 92610 | $371.20 | $464.00 | $112.33 – $417.60 | 15 |
| Swallowing Therapy Session CPT 92526 | $300.00 | $375.00 | $90.79 – $337.50 | 15 |
| Sympathectomy cervical CPT 64802 | not published | not published | $2,050.41 – $2,050.41 | 1 |
| Sympathectomy digital artery CPT 64820 | not published | not published | $2,050.41 – $2,050.41 | 1 |
| Sympathectomy supfc palmar CPT 64823 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Synthetic sentence id test CPT 92576 | not published | not published | $41.21 – $41.21 | 1 |
| Synvisc or synvisc-one HCPCS J7325 | $395.25 | $494.06 | $92.17 – $342.62 | 15 |
| System pacing micra av HCPCS C1786 | $4,507.20 | $5,634.00 | $1,363.99 – $5,070.60 | 15 |
| System pcmkr dual chamber leadless micra av2 intrdcr cath HCPCS C1785 | $7,077.60 | $8,847.00 | $1,511.67 – $5,619.60 | 15 |
| T3 (triiodothyronine) free CPT 84481 | $358.40 | $448.00 | $108.46 – $403.20 | 15 |
| T3 (triiodothyronine) total CPT 84480 | $156.80 | $196.00 | $47.45 – $176.40 | 15 |
| T4 (thyroxine) free CPT 84439 | $87.20 | $109.00 | $26.39 – $98.10 | 15 |
| T4 (thyroxine) total CPT 84436 | $68.80 | $86.00 | $20.82 – $77.40 | 15 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | $6.60 | $8.24 | $1.45 – $5.38 | 15 |
| Tacrolimus therapeutic drug level CPT 80197 | $240.00 | $300.00 | $72.63 – $270.00 | 15 |
| Tailbone (Sacrum and Coccyx) X-ray CPT 72220 | $359.20 | $449.00 | $92.45 – $404.10 | 15 |
| Tattooing/intraderm 6.1-20.0 sq cm 11921 CPT 11921 | not published | not published | $642.74 – $642.74 | 1 |
| Tbs techl calculation only CPT 77091 | not published | not published | $92.45 – $92.45 | 1 |
| Tbs techl prep&transmis data CPT 77090 | not published | not published | $92.45 – $92.45 | 1 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $186.40 | $233.00 | $16.70 – $62.10 | 15 |
| Tc-99m labeled rbc HCPCS A9560 | $428.00 | $535.00 | $129.52 – $481.50 | 15 |
| Tc-99m maa HCPCS A9540 | $936.80 | $1,171.00 | $283.50 – $1,053.90 | 15 |
| Tc-99m mebrofenin HCPCS A9537 | $178.40 | $223.00 | $53.99 – $200.70 | 15 |
| Tc-99m medronate HCPCS A9503 | $133.60 | $167.00 | $40.43 – $150.30 | 15 |
| Tc-99m mertiatide HCPCS A9562 | $756.00 | $945.00 | $228.78 – $850.50 | 15 |
| Tc-99m pentetate dtpa HCPCS A9539 | $388.80 | $486.00 | $117.66 – $437.40 | 15 |
| Tc-99m pertechnetate per mci HCPCS A9512 | $108.00 | $135.00 | $32.68 – $121.50 | 15 |
| Tc-99m sestamibi p study dose HCPCS A9500 | $352.00 | $440.00 | $106.52 – $396.00 | 15 |
| Tc-99m sulfur colloid HCPCS A9541 | $308.00 | $385.00 | $93.21 – $346.50 | 15 |
| Tcd emboli detect w/inj CPT 93893 | not published | not published | $111.66 – $111.66 | 1 |
| Tcd emboli detect without inj CPT 93892 | not published | not published | $111.66 – $111.66 | 1 |
| T-cell depletion of harvest CPT 38210 | not published | not published | $459.04 – $459.04 | 1 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $228.80 | $286.00 | $46.24 – $171.90 | 15 |
| T cells absolute cd 4 count CPT 86361 | $103.20 | $129.00 | $31.23 – $116.10 | 15 |
| T cells total count CPT 86359 | $183.20 | $229.00 | $46.24 – $171.90 | 15 |
| Tcranial magn stim tx deli CPT 90868 | not published | not published | $326.96 – $326.96 | 1 |
| Tcranial magn stim tx plan CPT 90867 | not published | not published | $326.96 – $326.96 | 1 |
| Tcran magn stim redetemine CPT 90869 | not published | not published | $326.96 – $326.96 | 1 |
| Tee w or without fol w/cont,cong HCPCS C8926 | not published | not published | $829.56 – $829.56 | 1 |
| Tee w or without fol w/cont, mon HCPCS C8927 | not published | not published | $829.56 – $829.56 | 1 |
| Telehealth original site facility fee HCPCS Q3014 | $67.20 | $84.00 | $20.34 – $75.60 | 15 |
| Telethx isodose plan cplx CPT 77307 | not published | not published | $384.37 – $384.37 | 1 |
| Telethx isodose plan simple CPT 77306 | not published | not published | $384.37 – $384.37 | 1 |
| Temperature gradient studies CPT 93740 | not published | not published | $164.28 – $164.28 | 1 |
| Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln HCPCS J9330 | $2,061.22 | $2,576.52 | $623.78 – $2,318.87 | 15 |
| Tendon lengthening CPT 26476 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Tendon lngth upr a/e ea tdn CPT 24305 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Tendon shortening CPT 26477 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Tendon transfer with graft CPT 26492 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) HCPCS J3101 | $9,301.73 | $11,627.16 | $2,748.09 – $10,215.95 | 15 |
| Tenodesis biceps tdn at elbw CPT 24340 | not published | not published | $7,500.92 – $7,500.92 | 1 |
| Tenolysis extensor tendon hand/finger each CPT 26445 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Tenolysis triceps CPT 24332 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Tenoplasty elbow to sho 1 CPT 24320 | not published | not published | $7,500.92 – $7,500.92 | 1 |
| Tenosynovectomy radic 26145 CPT 26145 | not published | not published | $1,680.43 – $1,680.43 | 1 |
| Tenotomy length/rls abductor hallucis musc 28240 CPT 28240 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Tenotomy open tndn flxr toe sgl tndn spx CPT 28232 | not published | not published | $1,680.43 – $1,680.43 | 1 |
| Terbutaline 1 mg/ml subcutaneous solution HCPCS J3105 | $63.16 | $78.95 | $19.11 – $71.06 | 15 |
| Testicular imaging w/vasc flow CPT 78761 | $1,339.20 | $1,674.00 | $405.28 – $1,506.60 | 15 |
| Test stress cardiovascular tracing only CPT 93017 | $900.80 | $1,126.00 | $272.60 – $1,013.40 | 15 |
| Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe HCPCS J2356 | not published | not published | $18.45 – $18.45 | 1 |
| Thaw preserved stem cells CPT 38208 | not published | not published | $459.04 – $459.04 | 1 |
| Theophylline therapeutic drug level CPT 80198 | $121.60 | $152.00 | $36.80 – $136.80 | 15 |
| Therapeutic procd strg endur HCPCS G0237 | $129.60 | $162.00 | $25.71 – $145.80 | 15 |
| Therapy Activity Training (each 15 minutes) CPT 97530 | $125.60 | $157.00 | $60.50 – $141.30 | 15 |
| Therapy Exercise Session (each 15 minutes) CPT 97110 | $126.40 | $158.00 | $63.25 – $142.20 | 15 |
| Therapy nutrition individual initial f2f w/patient each 15 minutes CPT 97802 | $41.60 | $52.00 | $12.59 – $46.80 | 15 |
| Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes CPT 97803 | $41.60 | $52.00 | $12.59 – $46.80 | 15 |
| Therapy photodnmc lght dstr lsn skn by staff rx per day CPT 96567 | not published | not published | $208.64 – $208.64 | 1 |
| Ther fx nasal inf turbinate CPT 30930 | not published | not published | $3,405.22 – $3,405.22 | 1 |
| Ther nma rdctj intus/obstrcj CPT 74283 | not published | not published | $186.92 – $186.92 | 1 |
| Ther/proph/diag inj ia CPT 96373 | $172.00 | $215.00 | $44.80 – $193.50 | 15 |
| Thiamine hcl (vitamin b1) 100 mg/ml injection solution HCPCS J3411 | $64.16 | $80.20 | $18.59 – $69.10 | 15 |
| Thigh Bone (Femur) X-ray (both sides) CPT 73552 | $329.60 | $412.00 | $92.45 – $370.80 | 15 |
| Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides) CPT 32555 | $1,907.20 | $2,384.00 | $577.17 – $2,145.60 | 15 |
| Thoracoscopy diagnostic 32601 CPT 32601 | not published | not published | $6,126.08 – $6,126.08 | 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.