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 |
|---|---|---|---|---|
| Spine device implant surgery HCPCS C9757 | not published | not published | $13,510.16 – $13,510.16 | 2 |
| Spine X-ray (single view, one level) CPT 72020 | $352.00 | $440.00 | $92.45 – $396.00 | 15 |
| Spirmtry w/brnchdil inf-2 yr CPT 94012 | not published | not published | $326.96 – $326.96 | 2 |
| Spirometry up to 2 yrs old CPT 94011 | not published | not published | $164.28 – $164.28 | 2 |
| Spleen imaging CPT 78185 | not published | not published | $421.92 – $421.92 | 2 |
| Splint rstrc wrst/cmc right med HCPCS L3923 | $52.80 | $66.00 | $22.67 – $59.40 | 15 |
| Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 % CPT 15120 | not published | not published | $3,844.02 – $3,844.02 | 2 |
| Srs linear based CPT 77372 | not published | not published | $8,026.71 – $8,026.71 | 2 |
| Srs multisource CPT 77371 | not published | not published | $8,026.71 – $8,026.71 | 2 |
| Staggered spondaic word test CPT 92572 | not published | not published | $164.28 – $164.28 | 2 |
| St analysis behavior qualitative voice/resonance CPT 92524 | $407.20 | $509.00 | $174.84 – $458.10 | 15 |
| Staph a dna amp probe CPT 87640 | $144.80 | $181.00 | $62.17 – $162.90 | 15 |
| St cognitve performance testing healthcare professional each hour CPT 96125 | $336.80 | $421.00 | $144.61 – $378.90 | 15 |
| Stenger test pure tone CPT 92565 | not published | not published | $62.37 – $62.37 | 2 |
| Stenger test speech CPT 92577 | not published | not published | $557.13 – $557.13 | 2 |
| Stent/athrectomy/fem/pop/unilat 37227 CPT 37227 | not published | not published | $18,854.56 – $18,854.56 | 2 |
| Stent bili rx wallflx 10x80 uncvr HCPCS C1876 | $2,349.60 | $2,937.00 | $1,008.86 – $2,643.30 | 15 |
| Stent iliac/open or perc/uni/init 37221 CPT 37221 | not published | not published | $11,907.60 – $11,907.60 | 2 |
| Stent/tib/peroneal/unilat/initial 37230 CPT 37230 | not published | not published | $18,854.56 – $18,854.56 | 2 |
| St evaluate speech sound production CPT 92522 | $391.20 | $489.00 | $167.97 – $440.10 | 15 |
| St evaluation motion fluoroscopic swallow function cine/video CPT 92611 | $507.20 | $634.00 | $217.78 – $570.60 | 15 |
| Stimulation of spinal cord CPT 63610 | not published | not published | $2,050.41 – $2,050.41 | 2 |
| Stomach Emptying Scan (Nuclear Medicine) CPT 78264 | $1,374.40 | $1,718.00 | $421.92 – $1,546.20 | 15 |
| Strapping of ankle and/or ft 29540 CPT 29540 | not published | not published | $165.68 – $165.68 | 2 |
| Strapping of chest CPT 29200 | not published | not published | $165.68 – $165.68 | 2 |
| Strapping of elbow or wrist 29260 CPT 29260 | not published | not published | $62.37 – $62.37 | 2 |
| Strapping of hand or finger CPT 29280 | not published | not published | $62.37 – $62.37 | 2 |
| Strapping of hip CPT 29520 | not published | not published | $135.35 – $135.35 | 2 |
| Strapping of knee CPT 29530 | not published | not published | $135.35 – $135.35 | 2 |
| Strapping of toes 29550 CPT 29550 | not published | not published | $62.37 – $62.37 | 2 |
| Strep b dna amp probe CPT 87653 | $139.20 | $174.00 | $59.77 – $156.60 | 15 |
| Stress test pulmonary CPT 94618 | $309.60 | $387.00 | $132.93 – $348.30 | 15 |
| Stress tte complete CPT 93351 | $2,420.00 | $3,025.00 | $575.70 – $2,722.50 | 15 |
| Subdural tap fontanelle/sutur infant init 61000 CPT 61000 | not published | not published | $727.15 – $727.15 | 2 |
| Subq njx filling matrl 1cc/< CPT 11950 | not published | not published | $208.64 – $208.64 | 2 |
| Subq njx fil matrl 5.1-10cc CPT 11952 | not published | not published | $642.74 – $642.74 | 2 |
| Subtalar arthro w/deb CPT 29906 | not published | not published | $3,406.84 – $3,406.84 | 2 |
| Subtalar arthro w/exc CPT 29905 | not published | not published | $7,500.92 – $7,500.92 | 2 |
| Subtalar arthro w/fb rmvl CPT 29904 | not published | not published | $3,406.84 – $3,406.84 | 2 |
| Subtalar arthro w/fusion CPT 29907 | not published | not published | $13,510.16 – $13,510.16 | 2 |
| Succinylcholine chloride 20 mg/ml injection solution (wrapper) HCPCS J0330 | $48.72 | $60.90 | $16.23 – $42.53 | 15 |
| Suction lipectomy head&neck CPT 15876 | not published | not published | $3,844.02 – $3,844.02 | 2 |
| Suction lipectomy lwr extrem CPT 15879 | not published | not published | $3,844.02 – $3,844.02 | 2 |
| Suction lipectomy trunk CPT 15877 | not published | not published | $3,844.02 – $3,844.02 | 2 |
| Suction lipectomy upr extrem CPT 15878 | not published | not published | $1,920.69 – $1,920.69 | 2 |
| Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution HCPCS J2865 | $43.35 | $54.18 | $16.08 – $42.14 | 15 |
| Sulfonylurea screen qn-sendout CPT 80377 | $104.00 | $130.00 | $44.66 – $117.00 | 15 |
| Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 | $70.42 | $88.02 | $17.20 – $45.05 | 15 |
| Sup of prep of antigen # of vials 95144 CPT 95144 | not published | not published | $48.45 – $48.45 | 2 |
| Surg dx exam anorectal CPT 45990 | not published | not published | $2,879.51 – $2,879.51 | 2 |
| Surgery for urethra pouch CPT 53240 | not published | not published | $3,621.42 – $3,621.42 | 2 |
| Surgery to stop leg growth CPT 27475 | not published | not published | $7,500.92 – $7,500.92 | 2 |
| Surgery to stop leg growth CPT 27477 | not published | not published | $7,500.92 – $7,500.92 | 2 |
| Surgery to stop leg growth CPT 27479 | not published | not published | $7,500.92 – $7,500.92 | 2 |
| Surgery to stop leg growth CPT 27485 | not published | not published | $7,500.92 – $7,500.92 | 2 |
| Surgical exposure prostate 55860 CPT 55860 | not published | not published | $5,337.80 – $5,337.80 | 2 |
| Surgical opening of stomach CPT 43510 | not published | not published | $984.44 – $984.44 | 2 |
| Surgical opening of throat CPT 42955 | not published | not published | $1,555.34 – $1,555.34 | 2 |
| Surgical pathology level 1 gross examination only CPT 88300 | $59.20 | $74.00 | $25.42 – $66.60 | 15 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $123.20 | $154.00 | $52.90 – $138.60 | 15 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $164.80 | $206.00 | $70.76 – $185.40 | 15 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $148.00 | $185.00 | $42.18 – $99.90 | 15 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $522.40 | $653.00 | $221.90 – $581.40 | 15 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $694.40 | $868.00 | $298.16 – $781.20 | 15 |
| Surg tx anal fistula 2nd stage 46285 CPT 46285 | not published | not published | $2,879.51 – $2,879.51 | 2 |
| Susceptibility agar dilution per agent CPT 87181 | $61.60 | $77.00 | $10.99 – $28.80 | 15 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $32.80 | $41.00 | $14.08 – $36.90 | 15 |
| Susceptibility mic per plate CPT 87186 | $176.00 | $220.00 | $20.27 – $53.10 | 15 |
| Suspension of testis CPT 54620 | not published | not published | $3,621.42 – $3,621.42 | 2 |
| Svc venogram s&i CPT 75827 | not published | not published | $1,631.11 – $1,631.11 | 2 |
| Swallowing Evaluation (Bedside) CPT 92610 | $384.80 | $481.00 | $165.22 – $432.90 | 15 |
| Swallowing Therapy Session CPT 92526 | $280.00 | $350.00 | $120.23 – $315.00 | 15 |
| Sympathectomy cervical CPT 64802 | not published | not published | $2,050.41 – $2,050.41 | 2 |
| Sympathectomy digital artery CPT 64820 | not published | not published | $2,050.41 – $2,050.41 | 2 |
| Sympathectomy supfc palmar CPT 64823 | not published | not published | $3,406.84 – $3,406.84 | 2 |
| Synthetic sentence id test CPT 92576 | not published | not published | $41.21 – $41.21 | 2 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $11.20 | $14.00 | $4.81 – $12.60 | 15 |
| T3 (triiodothyronine) free CPT 84481 | $102.40 | $128.00 | $43.97 – $115.20 | 15 |
| T3 (triiodothyronine) total CPT 84480 | $102.40 | $128.00 | $43.97 – $115.20 | 15 |
| T4 (thyroxine) free CPT 84439 | $89.60 | $112.00 | $38.47 – $100.80 | 15 |
| T4 (thyroxine) total CPT 84436 | $52.80 | $66.00 | $22.67 – $59.40 | 15 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | $5.58 | $6.97 | $2.06 – $5.40 | 15 |
| Tacrolimus therapeutic drug level CPT 80197 | $180.80 | $226.00 | $77.63 – $203.40 | 15 |
| Tailbone (Sacrum and Coccyx) X-ray CPT 72220 | $313.60 | $392.00 | $92.45 – $352.80 | 15 |
| Target gsa panel hmtlmph neop CPT 81450 | $2,392.00 | $2,990.00 | $763.60 – $2,000.70 | 15 |
| Target gsa panel organ/hmtlmph neop CPT 81455 | $7,123.20 | $8,904.00 | $3,058.52 – $8,013.60 | 15 |
| Tattooing/intraderm 6.1-20.0 sq cm 11921 CPT 11921 | not published | not published | $642.74 – $642.74 | 2 |
| Tbs techl calculation only CPT 77091 | not published | not published | $92.45 – $92.45 | 2 |
| Tbs techl prep&transmis data CPT 77090 | not published | not published | $92.45 – $92.45 | 2 |
| Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells CPT 86481 | $304.00 | $380.00 | $130.53 – $342.00 | 15 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $229.60 | $287.00 | $98.58 – $258.30 | 15 |
| Tc-99m labeled rbc HCPCS A9560 | $428.00 | $535.00 | $183.77 – $481.50 | 15 |
| Tc-99m maa HCPCS A9540 | $936.80 | $1,171.00 | $402.24 – $1,053.90 | 15 |
| Tc-99m mebrofenin HCPCS A9537 | $178.40 | $223.00 | $76.60 – $200.70 | 15 |
| Tc-99m medronate HCPCS A9503 | $133.60 | $167.00 | $57.36 – $150.30 | 15 |
| Tc-99m mertiatide HCPCS A9562 | $756.00 | $945.00 | $324.61 – $850.50 | 15 |
| Tc-99m pentetate dtpa HCPCS A9539 | $388.80 | $486.00 | $166.94 – $437.40 | 15 |
| Tc-99m pentetate dtpa aerosol HCPCS A9567 | $388.80 | $486.00 | $166.94 – $437.40 | 15 |
| Tc-99m pertechnetate per mci HCPCS A9512 | $108.00 | $135.00 | $46.37 – $121.50 | 15 |
| Tc-99m pyroph diag per dose up to 25 mci HCPCS A9538 | $186.40 | $233.00 | $80.04 – $209.70 | 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.