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 |
|---|---|---|---|---|
| Graft nerve adv 3-4x70mm HCPCS C1762 | $6,538.40 | $8,173.00 | $648.18 – $1,698.30 | 15 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $315.20 | $394.00 | $71.45 – $187.20 | 15 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $348.00 | $435.00 | $60.11 – $157.50 | 15 |
| Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm HCPCS Q4130 | $49.60 | $62.00 | $21.30 – $55.80 | 15 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $11,716.00 | $14,645.00 | $23.36 – $61.20 | 15 |
| Granisetron hcl injection HCPCS J1626 | $40.83 | $51.03 | $15.78 – $41.36 | 15 |
| Great toe with reduction 28495 CPT 28495 | not published | not published | $251.87 – $251.87 | 2 |
| Grfg autol fat lipo 25 cc/< CPT 15773 | not published | not published | $1,920.69 – $1,920.69 | 2 |
| Grfg autol fat lipo 50 cc/< CPT 15771 | not published | not published | $3,844.02 – $3,844.02 | 2 |
| Grfg autol soft tiss dir exc CPT 15769 | not published | not published | $3,844.02 – $3,844.02 | 2 |
| Group train without patient HCPCS G0543 | $56.00 | $70.00 | $24.05 – $63.00 | 15 |
| Gstrst open wo constj tube CPT 43830 | not published | not published | $1,991.84 – $1,991.84 | 2 |
| G-tube reposition CPT 43761 | not published | not published | $255.37 – $255.37 | 2 |
| Gu dilat ureter/urethra s&i CPT 74485 | not published | not published | $2,150.94 – $2,150.94 | 2 |
| Guided cath fluid drainage 10030 CPT 10030 | not published | not published | $738.77 – $738.77 | 2 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $718.40 | $898.00 | $2.40 – $6.30 | 15 |
| Gum graft CPT 41870 | not published | not published | $1,555.34 – $1,555.34 | 2 |
| Gw stiffened micro access kit HCPCS C1894 | $157.60 | $197.00 | $22.33 – $58.50 | 15 |
| Gynecomastia (males) 19300 CPT 19300 | not published | not published | $4,020.74 – $4,020.74 | 2 |
| Hair removal by electrolysis 17380 CPT 17380 | not published | not published | $642.74 – $642.74 | 2 |
| Hair trnspl 1-15 punch grfts CPT 15775 | not published | not published | $419.51 – $419.51 | 2 |
| Hair trnspl >15 punch grafts CPT 15776 | not published | not published | $419.51 – $419.51 | 2 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | $82.83 | $103.53 | $17.04 – $44.64 | 15 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $36.10 | $45.12 | $15.03 – $39.39 | 15 |
| Handle/convey/speciman/office-lab 99000 CPT 99000 | $44.80 | $56.00 | $11.34 – $29.70 | 15 |
| Hands-On Manual Therapy (each 15 minutes) CPT 97140 | $123.20 | $154.00 | $58.52 – $138.60 | 15 |
| Hand tendon/muscle transfer CPT 26494 | not published | not published | $3,406.84 – $3,406.84 | 2 |
| Hand tendon reconstruction CPT 26500 | not published | not published | $7,500.92 – $7,500.92 | 2 |
| Hand tendon reconstruction CPT 26502 | not published | not published | $3,406.84 – $3,406.84 | 2 |
| Hand X-ray CPT 73130 | $324.80 | $406.00 | $92.45 – $365.40 | 15 |
| Hand X-ray (2 views, both hands) CPT 73120 | $267.20 | $334.00 | $111.66 – $300.60 | 15 |
| Haptoglobin quantitative CPT 83010 | $108.00 | $135.00 | $46.37 – $121.50 | 15 |
| Harvest auto stem cells CPT 38206 | not published | not published | $1,721.24 – $1,721.24 | 2 |
| Harvest cultured skin graft 15040 CPT 15040 | not published | not published | $1,920.69 – $1,920.69 | 2 |
| Harvest eye tissue alograft CPT 68371 | not published | not published | $2,449.61 – $2,449.61 | 2 |
| Harvest stem cell concentrte CPT 38215 | not published | not published | $459.04 – $459.04 | 2 |
| Hast w/i&r phys/qhp CPT 94452 | not published | not published | $135.35 – $135.35 | 2 |
| Hast w/oxygen titrate CPT 94453 | not published | not published | $135.35 – $135.35 | 2 |
| Hba1/hba2 full gene sequence CPT 81259 | $1,464.00 | $1,830.00 | $628.61 – $1,647.00 | 15 |
| Hba1/hba2 gene dup/del vrnts CPT 81269 | $493.60 | $617.00 | $211.94 – $555.30 | 15 |
| Hbot, full body chamber, 30m HCPCS G0277 | not published | not published | $144.80 – $144.80 | 2 |
| Hc fl sm bowel enteroclss tube w kub double contrast CPT 74251 | not published | not published | $186.92 – $186.92 | 2 |
| Hcg qualitative CPT 84703 | $90.40 | $113.00 | $38.82 – $101.70 | 15 |
| Hcg quantitative CPT 84702 | $98.40 | $123.00 | $19.58 – $51.30 | 15 |
| Hc metata joint dislocation anes CPT 28635 | not published | not published | $1,680.43 – $1,680.43 | 2 |
| Hc mohs micrographic h/n/h/f/g 1st stage 5 blocks CPT 17311 | not published | not published | $642.74 – $642.74 | 2 |
| Hc mohs trunk/arm/leg 1st stage 5 blocks CPT 17313 | not published | not published | $642.74 – $642.74 | 2 |
| Hc nm cardiac blood pool planar 1 stdy wal motn eject fract CPT 78481 | not published | not published | $565.18 – $565.18 | 2 |
| Hc nm fusion spect CT unlisted CPT 78999 | not published | not published | $421.92 – $421.92 | 2 |
| Hc nm kidney imaging with flow CPT 78701 | not published | not published | $421.92 – $421.92 | 2 |
| Hc nm myocard infarct avid plnr tomo spect w/wo quant CPT 78469 | not published | not published | $565.18 – $565.18 | 2 |
| Hc pet myocardial imaging metabolic eval single study CPT 78459 | not published | not published | $1,370.75 – $1,370.75 | 2 |
| Hdr rdncl ntrstl/icav brchtx CPT 77770 | not published | not published | $728.50 – $728.50 | 2 |
| Hdr rdncl ntrstl/icav brchtx CPT 77771 | not published | not published | $728.50 – $728.50 | 2 |
| Hdr rdncl ntrstl/icav brchtx CPT 77772 | not published | not published | $728.50 – $728.50 | 2 |
| Hdr rdncl skn surf brachytx CPT 77767 | not published | not published | $276.13 – $276.13 | 2 |
| Hdr rdncl skn surf brachytx CPT 77768 | not published | not published | $276.13 – $276.13 | 2 |
| Head CT scan (with and without contrast) CPT 70470 | $2,371.20 | $2,964.00 | $186.92 – $2,667.60 | 15 |
| Head CT scan (with contrast) CPT 70460 | $1,966.40 | $2,458.00 | $186.92 – $2,212.20 | 15 |
| Head CT scan (without contrast) CPT 70450 | $1,690.40 | $2,113.00 | $111.66 – $1,901.70 | 15 |
| Heart first pass multiple CPT 78483 | not published | not published | $565.18 – $565.18 | 2 |
| Heart image spect CPT 78494 | not published | not published | $421.92 – $421.92 | 2 |
| Heart infarct image CPT 78466 | not published | not published | $421.92 – $421.92 | 2 |
| Heart infarct image (ef) CPT 78468 | not published | not published | $565.18 – $565.18 | 2 |
| Heel (Calcaneus) X-ray (both feet) CPT 73650 | $220.00 | $275.00 | $92.45 – $247.50 | 15 |
| Helicobacter pylori antibody igm CPT 86677 | $128.00 | $160.00 | $54.96 – $144.00 | 15 |
| Hematocrit CPT 85014 | $35.20 | $44.00 | $15.11 – $39.60 | 15 |
| Hematopoietic nuclear tx CPT 79403 | not published | not published | $235.34 – $235.34 | 2 |
| Hemiepiphyseal arrest CPT 24470 | not published | not published | $3,406.84 – $3,406.84 | 2 |
| Hemodialysis one evaluation CPT 90935 | not published | not published | $734.71 – $734.71 | 2 |
| Hemoglobin CPT 85018 | $36.00 | $45.00 | $15.46 – $40.50 | 15 |
| Hemoglobin methemoglobin quantitative CPT 83050 | $61.60 | $77.00 | $26.45 – $69.30 | 15 |
| Hemoglobin plasma CPT 83051 | $90.40 | $113.00 | $38.82 – $101.70 | 15 |
| Hemophilus influenza antibdy CPT 86684 | $56.80 | $71.00 | $24.39 – $63.90 | 15 |
| Hemorrhoidectomy intern transanal deater 2+ 46948 CPT 46948 | not published | not published | $2,879.51 – $2,879.51 | 2 |
| Hemorrhoidectomy intrnl lig rbbr band ligations CPT 46221 | not published | not published | $957.30 – $957.30 | 2 |
| Hemorrhoidopexy stapling 46947 CPT 46947 | not published | not published | $2,879.51 – $2,879.51 | 2 |
| Heparin assay CPT 85520 | $166.40 | $208.00 | $71.45 – $187.20 | 15 |
| Heparin bolus from bag HCPCS J1644 | $75.96 | $94.95 | $15.10 – $39.56 | 15 |
| Heparin, porcine (pf) 10 unit/ml flush (wrapper) HCPCS J1642 | $34.68 | $43.34 | $0.71 – $1.86 | 15 |
| Hepatitis a antibody igm CPT 86709 | $60.80 | $76.00 | $26.11 – $68.40 | 15 |
| Hepatitis b core antibody igm CPT 86705 | $63.20 | $79.00 | $27.14 – $71.10 | 15 |
| Hepatitis b core antibody total CPT 86704 | $84.80 | $106.00 | $28.51 – $74.70 | 15 |
| Hepatitis b surface antibody CPT 86706 | $88.80 | $111.00 | $38.13 – $99.90 | 15 |
| Hepatitis c antibody CPT 86803 | $80.00 | $100.00 | $28.51 – $74.70 | 15 |
| Hernia Repair (Inguinal) CPT 49505 | not published | not published | $3,705.51 – $3,705.51 | 2 |
| Herpes simplex type 1 antibody igg CPT 86695 | $84.00 | $105.00 | $36.07 – $94.50 | 15 |
| Herpes simplex type 2 antibody igg CPT 86696 | $132.80 | $166.00 | $57.02 – $149.40 | 15 |
| Heterophile antibodies screening CPT 86308 | $51.20 | $64.00 | $21.98 – $57.60 | 15 |
| Hi enrgy eswt plantar fascia CPT 28890 | not published | not published | $1,680.43 – $1,680.43 | 2 |
| Hip and Pelvis X-ray (2 views, both hips) CPT 73521 | $432.00 | $540.00 | $111.66 – $486.00 | 15 |
| Hip and Pelvis X-ray (3 to 4 views, both hips) CPT 73522 | $520.00 | $650.00 | $111.66 – $585.00 | 15 |
| Hip and Pelvis X-ray (single view, left side) CPT 73501 | $255.20 | $319.00 | $92.45 – $287.10 | 15 |
| Hip arthr0 w/debridement CPT 29862 | not published | not published | $7,500.92 – $7,500.92 | 2 |
| Hip arthr0 w/synovectomy CPT 29863 | not published | not published | $3,406.84 – $3,406.84 | 2 |
| Hip arthro acetabuloplasty CPT 29915 | not published | not published | $7,500.92 – $7,500.92 | 2 |
| Hip arthroscopy dx CPT 29860 | not published | not published | $7,500.92 – $7,500.92 | 2 |
| Hip arthro w/fb removal CPT 29861 | not published | not published | $7,500.92 – $7,500.92 | 2 |
| Hip arthro w/femoroplasty CPT 29914 | not published | not published | $7,500.92 – $7,500.92 | 2 |
| Hip arthro w/labral repair CPT 29916 | not published | not published | $7,500.92 – $7,500.92 | 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.