Sanford Thief River Falls Medical Center
3001 Sanford Pkwy, Thief River Falls, MN · Sanford Health · · NPI 1043218753
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 |
|---|---|---|---|---|
| Destruction ciliary body CPT 66700 | not published | not published | $2,394.77 – $2,394.77 | 2 |
| Destruction ciliary body CPT 66720 | not published | not published | $2,449.61 – $2,449.61 | 2 |
| Destruction ciliary body CPT 66740 | not published | not published | $2,449.61 – $2,449.61 | 2 |
| Destruction cryosurgery anal lesion(s) simpl 46916 CPT 46916 | not published | not published | $208.64 – $208.64 | 2 |
| Destruction laser surgery anal lesions 46917 CPT 46917 | not published | not published | $2,879.51 – $2,879.51 | 2 |
| Destruction les conjunctiva CPT 68135 | not published | not published | $2,449.61 – $2,449.61 | 2 |
| Destruction mal lsn s/n/h/f/g 2.1-3cm CPT 17273 | not published | not published | $419.51 – $419.51 | 2 |
| Destruction mal lsn s/n/h/f/g 3.1-4cm CPT 17274 | not published | not published | $419.51 – $419.51 | 2 |
| Destruction mal lsn t/a/l 3.1-4cm CPT 17264 | not published | not published | $419.51 – $419.51 | 2 |
| Destruction mal lsn t/a/l >4cm CPT 17266 | not published | not published | $419.51 – $419.51 | 2 |
| Destruction penis lesion(s) chem 54050 CPT 54050 | not published | not published | $419.51 – $419.51 | 2 |
| Destruction penis lesion(s) exten 54065 CPT 54065 | not published | not published | $1,920.69 – $1,920.69 | 2 |
| Destruction premal lesions 15/> 17004 CPT 17004 | not published | not published | $419.51 – $419.51 | 2 |
| Destruction rectal tumor 45190 CPT 45190 | not published | not published | $2,879.51 – $2,879.51 | 2 |
| Destruction vag lesions complex 57065 CPT 57065 | not published | not published | $3,338.51 – $3,338.51 | 2 |
| Destruction vag lesions simple 57061 CPT 57061 | not published | not published | $3,338.51 – $3,338.51 | 2 |
| Destruct penis les/smp/electrodesi 54055 CPT 54055 | not published | not published | $1,920.69 – $1,920.69 | 2 |
| Devel tst phys/qhp 1st hr CPT 96112 | not published | not published | $164.28 – $164.28 | 2 |
| Device intraute mirena HCPCS J7298 | $752.95 | $941.18 | $183.09 – $479.70 | 15 |
| Devlopment test interpt&rep HCPCS G0451 | not published | not published | $97.13 – $97.13 | 2 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | $117.60 | $147.00 | $50.49 – $132.30 | 15 |
| Dexamethasone 4 mg tablet HCPCS J8540 | $5.48 | $6.84 | $2.06 – $5.40 | 15 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $39.39 | $49.23 | $2.33 – $6.10 | 15 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | $401.58 | $501.97 | $160.67 – $420.96 | 15 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $143.20 | $179.00 | $61.49 – $161.10 | 15 |
| Diabetes (HbA1c) Test CPT 83036 | $67.20 | $84.00 | $14.82 – $35.10 | 15 |
| Diabetes training group per 30 min g0109 HCPCS G0136 | not published | not published | $31.28 – $31.28 | 2 |
| Diab manage trn ind/group HCPCS G0109 | $60.80 | $76.00 | $26.11 – $68.40 | 15 |
| Diag bronchoscope/catheter CPT 31643 | not published | not published | $1,810.69 – $1,810.69 | 2 |
| Diag laparo separate proc 49320 CPT 49320 | not published | not published | $6,126.08 – $6,126.08 | 2 |
| Diagnostic anoscopy CPT 46601 | not published | not published | $418.99 – $418.99 | 2 |
| Diagnostic anoscopy & biopsy CPT 46607 | not published | not published | $1,238.03 – $1,238.03 | 2 |
| Diagnostic anoscopy spx 46600 CPT 46600 | $282.40 | $353.00 | $121.26 – $317.70 | 15 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | $436.80 | $546.00 | $187.55 – $491.40 | 15 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | $356.00 | $445.00 | $152.86 – $400.50 | 15 |
| Diagnostic laryngoscopy 31505 CPT 31505 | not published | not published | $203.85 – $203.85 | 2 |
| Diagnostic laryngoscopy 31575 CPT 31575 | not published | not published | $203.85 – $203.85 | 2 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $494.40 | $618.00 | $212.28 – $556.20 | 15 |
| Diagnostic Mammogram (one breast) CPT 77065 | $386.40 | $483.00 | $165.91 – $434.70 | 15 |
| Diagnostic radio unlisted proc CPT 76499 | $223.20 | $279.00 | $87.25 – $228.60 | 15 |
| Dialysis one evaluation CPT 90945 | not published | not published | $447.11 – $447.11 | 2 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $42.59 | $53.23 | $17.35 – $45.47 | 15 |
| Dicyclomine injection HCPCS J0500 | $49.60 | $62.00 | $21.30 – $55.80 | 15 |
| Diffusing capacity CPT 94729 | $305.60 | $382.00 | $131.22 – $343.80 | 15 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $35.64 | $44.55 | $15.06 – $39.47 | 15 |
| Digoxin total therapeutic drug level CPT 80162 | $134.40 | $168.00 | $57.71 – $151.20 | 15 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | $149.44 | $186.80 | $45.40 – $118.96 | 15 |
| Dilate esophagus CPT 43453 | not published | not published | $1,991.84 – $1,991.84 | 2 |
| Dilate esophagus 1/mult pass CPT 43450 | not published | not published | $984.44 – $984.44 | 2 |
| Dilate tear duct opening CPT 68801 | not published | not published | $418.99 – $418.99 | 2 |
| Dilate urethra stricture CPT 53600 | not published | not published | $255.37 – $255.37 | 2 |
| Dilate urethra stricture CPT 53601 | not published | not published | $135.35 – $135.35 | 2 |
| Dilate urethra stricture CPT 53605 | not published | not published | $3,621.42 – $3,621.42 | 2 |
| Dilate urethra stricture CPT 53621 | not published | not published | $255.37 – $255.37 | 2 |
| Dilation/female urethra/initial 53660 CPT 53660 | not published | not published | $164.28 – $164.28 | 2 |
| Dilation of anal sphincter CPT 45905 | not published | not published | $1,238.03 – $1,238.03 | 2 |
| Dilation of cervical canal 57800 CPT 57800 | not published | not published | $3,338.51 – $3,338.51 | 2 |
| Dilation of rectal stricture 45910 CPT 45910 | not published | not published | $1,238.03 – $1,238.03 | 2 |
| Dilation of salivary duct CPT 42660 | not published | not published | $534.71 – $534.71 | 2 |
| Dilation of urethra CPT 53661 | not published | not published | $135.35 – $135.35 | 2 |
| Dilation of urethra CPT 53665 | not published | not published | $2,150.94 – $2,150.94 | 2 |
| Dilation of vagina CPT 57400 | not published | not published | $3,338.51 – $3,338.51 | 2 |
| Dilation salivary duct 42650 CPT 42650 | not published | not published | $1,555.34 – $1,555.34 | 2 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | not published | not published | $700.84 – $700.84 | 2 |
| Dilat xst trc ndurlgc px CPT 50436 | not published | not published | $3,621.42 – $3,621.42 | 2 |
| Dilat xst trc new access rcs CPT 50437 | not published | not published | $3,621.42 – $3,621.42 | 2 |
| Diltiazem 5 mg/ml intravenous solution HCPCS J1163 | $35.73 | $44.66 | $15.03 – $39.38 | 15 |
| Diphenhydramine 12.5 mg/5 ml oral elixir HCPCS Q0163 | $4.80 | $6.00 | $2.06 – $5.40 | 15 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $35.20 | $44.00 | $15.05 – $39.42 | 15 |
| Dir nsl mucous membrane test CPT 95065 | not published | not published | $41.21 – $41.21 | 2 |
| Disability dlco CPT 94727 | not published | not published | $164.28 – $164.28 | 2 |
| Disaccharidases CPT 82657 | $230.40 | $288.00 | $98.93 – $259.20 | 15 |
| Disarticulation sho sec clsr CPT 23921 | not published | not published | $1,920.69 – $1,920.69 | 2 |
| Discography cerv/thor spine CPT 72285 | not published | not published | $2,050.41 – $2,050.41 | 2 |
| Dise eval slp do brth flx dx CPT 42975 | not published | not published | $1,810.69 – $1,810.69 | 2 |
| Dist revas ligation hemo CPT 36838 | not published | not published | $5,675.99 – $5,675.99 | 2 |
| Diverticulectomy/hypophar/esoph 43130 CPT 43130 | not published | not published | $6,211.44 – $6,211.44 | 2 |
| Dna antibody native/double stranded CPT 86225 | $103.20 | $129.00 | $23.36 – $61.20 | 15 |
| Dna gardnerella CPT 87510 | $101.60 | $127.00 | $43.62 – $114.30 | 15 |
| Dna trichomonas CPT 87660 | $101.60 | $127.00 | $43.62 – $114.30 | 15 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $77.56 | $96.95 | $32.62 – $85.46 | 15 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | $1,205.48 | $1,506.84 | $132.89 – $348.19 | 15 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $139.40 | $174.25 | $32.19 – $84.33 | 15 |
| Doppler echo complete CPT 93320 | $791.20 | $989.00 | $339.72 – $890.10 | 15 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $660.80 | $826.00 | $164.28 – $743.40 | 15 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $432.80 | $541.00 | $135.35 – $486.90 | 15 |
| Dostarlimab-gxly 50 mg/ml intravenous solution HCPCS J9272 | $15,594.79 | $19,493.48 | $283.24 – $17,544.13 | 15 |
| Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 | $325.49 | $406.86 | $17.75 – $46.51 | 15 |
| Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension HCPCS Q2050 | $2,925.79 | $3,657.23 | $114.74 – $521.91 | 15 |
| Doxycycline hyclate 100 mg intravenous powder for solution HCPCS J1271 | $48.40 | $60.50 | $19.01 – $49.82 | 15 |
| Drainage absc/cyst/hmtma/vestibule mouth smpl CPT 40800 | not published | not published | $738.77 – $738.77 | 2 |
| Drainage ext aud canal abscess 69020 CPT 69020 | not published | not published | $738.77 – $738.77 | 2 |
| Drainage external ear complex 69005 CPT 69005 | not published | not published | $1,701.25 – $1,701.25 | 2 |
| Drainage external ear simple 69000 CPT 69000 | $771.20 | $964.00 | $331.13 – $867.60 | 15 |
| Drainage lymph node lesion 38300 CPT 38300 | not published | not published | $3,005.15 – $3,005.15 | 2 |
| Drainage lymph node lesion 38305 CPT 38305 | not published | not published | $3,005.15 – $3,005.15 | 2 |
| Drainage mouth roof lesion CPT 42000 | not published | not published | $243.83 – $243.83 | 2 |
| Drainage of arm bursa 23931 CPT 23931 | not published | not published | $1,701.25 – $1,701.25 | 2 |
| Drainage of bladder abscess CPT 51080 | not published | not published | $3,005.15 – $3,005.15 | 2 |
| Drainage of eye CPT 65800 | not published | not published | $2,394.77 – $2,394.77 | 2 |
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.