Sanford Behavioral Health Thief River Falls
120 Labree Ave S, Thief River Falls, MN · Sanford Health · · NPI 1790842466
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 |
|---|---|---|---|---|
| Low-Dose Lung Cancer Screening CT Scan CPT 71271 | $481.60 | $602.00 | $111.66 – $541.80 | 15 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $2,896.80 | $3,621.00 | $186.92 – $3,258.90 | 15 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $2,419.20 | $3,024.00 | $374.99 – $2,721.60 | 15 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $2,286.40 | $2,858.00 | $111.66 – $2,572.20 | 15 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $4,103.20 | $5,129.00 | $374.99 – $4,616.10 | 15 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $3,382.40 | $4,228.00 | $374.99 – $3,805.20 | 15 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $2,757.60 | $3,447.00 | $253.81 – $3,102.30 | 15 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $412.00 | $515.00 | $111.66 – $463.50 | 15 |
| Lower Back (Lumbar Spine) X-ray (4 or more views) CPT 72110 | $581.60 | $727.00 | $111.66 – $654.30 | 15 |
| Lower Back (Lumbar Spine) X-ray (with bending views) CPT 72114 | $440.00 | $550.00 | $111.66 – $495.00 | 15 |
| Lower jaw bone graft CPT 21215 | not published | not published | $6,211.44 – $6,211.44 | 2 |
| Lower Leg (Shin) X-ray (both sides) CPT 73590 | $273.60 | $342.00 | $92.45 – $307.80 | 15 |
| Lsh uterus 250 g or less CPT 58541 | not published | not published | $10,931.77 – $10,931.77 | 2 |
| Lsh uterus above 250 g CPT 58543 | not published | not published | $10,931.77 – $10,931.77 | 2 |
| Lsh w/t/o ut 250 g or less CPT 58542 | not published | not published | $10,931.77 – $10,931.77 | 2 |
| Lsh w/t/o uterus above 250 g CPT 58544 | not published | not published | $10,931.77 – $10,931.77 | 2 |
| Lumbar diskogram s&i CPT 72295 | not published | not published | $2,050.41 – $2,050.41 | 2 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $19,309.55 – $19,309.55 | 2 |
| Lumizyme injection HCPCS J0221 | not published | not published | $205.76 – $205.76 | 1 |
| Lung Function Test Before and After an Inhaler CPT 94060 | $395.20 | $494.00 | $169.69 – $444.60 | 15 |
| Lung function test (mbc/mvv) CPT 94200 | not published | not published | $62.37 – $62.37 | 2 |
| Lung Function Test (Spirometry) CPT 94010 | $204.80 | $256.00 | $87.94 – $230.40 | 15 |
| Lung perfusion imaging CPT 78580 | $1,460.00 | $1,825.00 | $421.92 – $1,642.50 | 15 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | $8,727.88 | $10,909.84 | $3,747.53 – $9,818.86 | 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 | 2 |
| Lymphatics/lymph node imaging CPT 78195 | $1,548.00 | $1,935.00 | $565.18 – $1,741.50 | 15 |
| Lymphocyte transformation mitogen CPT 86353 | $585.60 | $732.00 | $98.58 – $258.30 | 15 |
| Lymph vessel x-ray arm/leg CPT 75801 | not published | not published | $649.17 – $649.17 | 2 |
| Lymph vessel x-ray arms/legs CPT 75803 | not published | not published | $1,631.11 – $1,631.11 | 2 |
| Lymph vessel x-ray trunk CPT 75805 | not published | not published | $3,304.88 – $3,304.88 | 2 |
| Lymph vessel x-ray trunk CPT 75807 | not published | not published | $3,304.88 – $3,304.88 | 2 |
| Lysis intranasal synechia 30560 CPT 30560 | not published | not published | $534.71 – $534.71 | 2 |
| Lysis of labial adhesions CPT 56441 | not published | not published | $3,338.51 – $3,338.51 | 2 |
| Lysis penil circumic lesion CPT 54162 | not published | not published | $2,150.94 – $2,150.94 | 2 |
| Macroscopic exam arthropod CPT 87168 | $20.80 | $26.00 | $8.93 – $23.40 | 15 |
| Macroscopic exam parasite CPT 87169 | $23.20 | $29.00 | $9.96 – $26.10 | 15 |
| Magnesium CPT 83735 | $76.00 | $95.00 | $7.56 – $19.80 | 15 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $96.12 | $120.15 | $14.88 – $38.98 | 15 |
| Magnetic image bone marrow CPT 77084 | not published | not published | $253.81 – $578.05 | 3 |
| Makena, 10 mg HCPCS J1726 | $1,727.28 | $2,159.10 | $741.65 – $1,943.19 | 15 |
| Male sling procedure CPT 53440 | not published | not published | $13,642.04 – $13,642.04 | 2 |
| Manipulate finger w/anesth CPT 26340 | not published | not published | $1,680.43 – $1,680.43 | 2 |
| Manipulate wrist w/anesthes CPT 25259 | not published | not published | $1,680.43 – $1,680.43 | 2 |
| Manipulation of hip joint CPT 27275 | not published | not published | $1,680.43 – $1,680.43 | 2 |
| Manipulation of spine CPT 22505 | not published | not published | $1,680.43 – $1,680.43 | 2 |
| Manipulat palm cord post inj CPT 26341 | not published | not published | $251.87 – $251.87 | 2 |
| Marker biop eviva buckle ss HCPCS A4648 | $194.40 | $243.00 | $48.43 – $126.90 | 15 |
| Mastectomy partial CPT 19301 | not published | not published | $4,020.74 – $4,020.74 | 2 |
| Mast mod rad CPT 19307 | not published | not published | $6,847.53 – $6,847.53 | 2 |
| Mastoidectomy CPT 69501 | not published | not published | $6,211.44 – $6,211.44 | 2 |
| Mastoidectomy complete 69502 CPT 69502 | not published | not published | $6,211.44 – $6,211.44 | 2 |
| Mastoids complete CPT 70130 | not published | not published | $111.66 – $111.66 | 2 |
| Mastoid surgery revision CPT 69603 | not published | not published | $6,211.44 – $6,211.44 | 2 |
| Mastopexy CPT 19316 | not published | not published | $6,847.53 – $6,847.53 | 2 |
| Mast simple complete CPT 19303 | not published | not published | $6,847.53 – $6,847.53 | 2 |
| Maxillofacial fixation CPT 21100 | not published | not published | $6,211.44 – $6,211.44 | 2 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $208.80 | $261.00 | $89.65 – $234.90 | 15 |
| Mayo aathr protein s free CPT 85306 | $166.40 | $208.00 | $71.45 – $187.20 | 15 |
| Mayo activated protein c resistance assay CPT 85307 | $100.80 | $126.00 | $43.28 – $113.40 | 15 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $238.40 | $298.00 | $102.36 – $268.20 | 15 |
| Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation CPT 80321 | $96.80 | $121.00 | $41.56 – $108.90 | 15 |
| Mayo alcohol definitive assay volatile screen CPT 80320 | $184.00 | $230.00 | $21.30 – $55.80 | 15 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $50.40 | $63.00 | $21.64 – $56.70 | 15 |
| Mayo alkaloids definitive assay nicotine/cotinine CPT 80323 | $88.80 | $111.00 | $38.13 – $99.90 | 15 |
| Mayo alpha 1 antitrypsin CPT 82103 | $143.20 | $179.00 | $15.11 – $39.60 | 15 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $40.00 | $50.00 | $17.18 – $45.00 | 15 |
| Mayo amphu amphetamines definitive assay 3 or 4 urine CPT 80325 | $58.40 | $73.00 | $25.08 – $65.70 | 15 |
| Mayo amphu methylenedioxyamphetamines definitive assay urine CPT 80359 | $73.60 | $92.00 | $31.60 – $82.80 | 15 |
| Mayo analysis gene calr common variants exon 9 CPT 81219 | $512.80 | $641.00 | $188.93 – $495.00 | 15 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $286.40 | $358.00 | $98.93 – $259.20 | 15 |
| Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 | $2,989.60 | $3,737.00 | $197.51 – $517.50 | 15 |
| Mayo androstenedione CPT 82157 | $70.40 | $88.00 | $30.23 – $79.20 | 15 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | $140.80 | $176.00 | $19.92 – $52.20 | 15 |
| Mayo antithrombin iii antigen CPT 85301 | $122.40 | $153.00 | $52.56 – $137.70 | 15 |
| Mayo aspergillus fumigatus antibody CPT 86606 | $84.80 | $106.00 | $13.74 – $36.00 | 15 |
| Mayo avwpr vw factor activity CPT 85397 | $211.20 | $264.00 | $57.02 – $149.40 | 15 |
| Mayo barbiturates definitive assay confirmation urine CPT 80345 | $170.40 | $213.00 | $23.01 – $60.30 | 15 |
| Mayo bart bartonella henselae antibody igg CPT 86611 | $88.00 | $110.00 | $27.82 – $72.90 | 15 |
| Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative CPT 81207 | $353.60 | $442.00 | $145.64 – $381.60 | 15 |
| Mayo bcrfx analysis translocation bcr/abl1 other breakpoint qualitative/quantitative CPT 81208 | $524.00 | $655.00 | $215.72 – $565.20 | 15 |
| Mayo blastomyces antibody immunodiffusion CPT 86612 | $69.60 | $87.00 | $29.88 – $78.30 | 15 |
| Mayo bordetella pertussis antibody igg CPT 86615 | $132.00 | $165.00 | $52.90 – $138.60 | 15 |
| Mayo brcmg brucella antibody igm CPT 86622 | $56.80 | $71.00 | $24.39 – $63.90 | 15 |
| Mayo c1 esterase inhibitor CPT 83883 | $264.00 | $330.00 | $15.46 – $40.50 | 15 |
| Mayo cannabinoids natural definitive assay thc confirmation urine CPT 80349 | $151.20 | $189.00 | $25.08 – $65.70 | 15 |
| Mayo carnitine total and free quantitative each specimen plasma CPT 82379 | $47.20 | $59.00 | $20.27 – $53.10 | 15 |
| Mayo cdcom hla class ii typing low resolution one locus each CPT 81376 | $298.40 | $373.00 | $42.59 – $111.60 | 15 |
| Mayo ceruloplasmin CPT 82390 | $82.40 | $103.00 | $35.38 – $92.70 | 15 |
| Mayo chemiluminescent parathyroid related peptide CPT 82397 | $128.00 | $160.00 | $15.80 – $41.40 | 15 |
| Mayo chikv chikungunya antibodies igg CPT 86790 | $102.40 | $128.00 | $14.43 – $37.80 | 15 |
| Mayo chlap chlamydia pneumoniae antibody igg CPT 86631 | $54.40 | $68.00 | $23.36 – $61.20 | 15 |
| Mayo chlap chlamydia pneumoniae antibody igm CPT 86632 | $54.40 | $68.00 | $23.36 – $61.20 | 15 |
| Mayo chrcb tissue culture non-neoplastic disorders lymphocyte CPT 88230 | $296.00 | $370.00 | $127.10 – $333.00 | 15 |
| Mayo chromium CPT 82495 | $59.20 | $74.00 | $25.42 – $66.60 | 15 |
| Mayo coccidioides antibody CPT 86635 | $95.20 | $119.00 | $23.36 – $61.20 | 15 |
| Mayo cocou cortisone urine CPT 82542 | $230.40 | $288.00 | $24.73 – $64.80 | 15 |
| Mayo cortisol free CPT 82530 | $108.80 | $136.00 | $20.27 – $53.10 | 15 |
| Mayo covid-19 antibody nucleocapsid total CPT 86769 | $71.20 | $89.00 | $30.57 – $80.10 | 15 |
| Mayo coxiella brunetii (q fever) igg antibody CPT 86638 | $62.40 | $78.00 | $13.74 – $36.00 | 15 |
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.