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 |
|---|---|---|---|---|
| Wrist arthroscopy/surgery CPT 29847 | not published | not published | $7,500.92 – $7,500.92 | 2 |
| Wrist endoscopy/surgery CPT 29848 | not published | not published | $1,680.43 – $1,680.43 | 2 |
| Wrist X-ray CPT 73110 | $313.60 | $392.00 | $92.45 – $352.80 | 15 |
| Wrist X-ray (2 views, both wrists) CPT 73100 | $262.40 | $328.00 | $92.45 – $295.20 | 15 |
| Xcapsl ctrc rmvl cplx w/ecp CPT 66987 | not published | not published | $4,224.00 – $4,224.00 | 2 |
| Xcapsl ctrc rmvl cplx wo ecp CPT 66982 | not published | not published | $2,394.77 – $2,394.77 | 2 |
| Xcapsl ctrc rmvl insj 1+ CPT 66991 | not published | not published | $5,417.70 – $5,417.70 | 2 |
| Xcapsl ctrc rmvl w/ecp CPT 66988 | not published | not published | $4,224.00 – $4,224.00 | 2 |
| Xcpsl ctrc rmvl cplx insj 1+ CPT 66989 | not published | not published | $5,417.70 – $5,417.70 | 2 |
| Xfer tis f/c/c/m/n/a/g/h/f 10sq cm/< CPT 14040 | not published | not published | $1,920.69 – $1,920.69 | 2 |
| Xfer tis s/a/l 10 sq cm/< CPT 14020 | not published | not published | $1,920.69 – $1,920.69 | 2 |
| X-ray abdomen >=3 views CPT 74021 | $377.60 | $472.00 | $111.66 – $424.80 | 15 |
| X-ray arthrogram shoulder supervision & interpretation (both sides) CPT 73040 | $1,044.80 | $1,306.00 | $374.99 – $1,175.40 | 15 |
| X-ray bone length studies CPT 77073 | $368.80 | $461.00 | $111.66 – $414.90 | 15 |
| X-ray bone survey infant CPT 77076 | $484.80 | $606.00 | $111.66 – $545.40 | 15 |
| X-ray exam entire spi 4/5 vw CPT 72083 | not published | not published | $111.66 – $111.66 | 2 |
| X-ray exam entire spi 6/> vw CPT 72084 | $619.20 | $774.00 | $111.66 – $696.60 | 15 |
| X-ray exam of arm infant CPT 73092 | $164.80 | $206.00 | $70.76 – $185.40 | 15 |
| X-ray exam of femur 1 CPT 73551 | $212.80 | $266.00 | $91.37 – $239.40 | 15 |
| X-ray exam of jaw joint CPT 70328 | $372.00 | $465.00 | $92.45 – $418.50 | 15 |
| X-ray exam of jaw joint CPT 70332 | not published | not published | $253.81 – $253.81 | 2 |
| X-ray exam of mastoids CPT 70120 | $283.20 | $354.00 | $111.66 – $318.60 | 15 |
| X-ray exam of middle ear CPT 70134 | not published | not published | $575.70 – $575.70 | 2 |
| X-ray exam of penis CPT 74445 | not published | not published | $111.66 – $111.66 | 2 |
| X-ray exam of perineum CPT 74775 | not published | not published | $253.81 – $253.81 | 2 |
| X-ray exam of salivary gland CPT 70380 | not published | not published | $92.45 – $92.45 | 2 |
| X-ray exam of tear duct CPT 70170 | not published | not published | $253.81 – $253.81 | 2 |
| X-ray exam of teeth CPT 70300 | not published | not published | $92.45 – $92.45 | 2 |
| X-ray exam of teeth CPT 70310 | $60.80 | $76.00 | $26.11 – $68.40 | 15 |
| X-ray exam si joints CPT 72200 | $94.40 | $118.00 | $40.53 – $106.20 | 15 |
| X-ray exam thorac spine4/>vw CPT 72074 | $516.80 | $646.00 | $111.66 – $581.40 | 15 |
| X-ray eye detection foreign body (both sides) CPT 70030 | $262.40 | $328.00 | $92.45 – $295.20 | 15 |
| X-ray head for orthodontia CPT 70350 | $90.40 | $113.00 | $38.82 – $101.70 | 15 |
| X-ray hip uni w/wo pelvis min 4 views CPT 73503 | $473.60 | $592.00 | $111.66 – $532.80 | 15 |
| X-ray hip with pelvis when performed bilateral >= 5 views CPT 73523 | $663.20 | $829.00 | $111.66 – $746.10 | 15 |
| X-ray joint survey 1 view CPT 77077 | $220.80 | $276.00 | $94.81 – $248.40 | 15 |
| X-ray lower extremities infant > 2 views (both sides) CPT 73592 | $184.80 | $231.00 | $79.35 – $207.90 | 15 |
| X-ray l/s-spine bend vw only 2-3 vw CPT 72120 | $407.20 | $509.00 | $111.66 – $458.10 | 15 |
| X-ray male genital tract CPT 74440 | not published | not published | $253.81 – $253.81 | 2 |
| X-ray mandible ltd <4 views CPT 70100 | $334.40 | $418.00 | $92.45 – $376.20 | 15 |
| X-ray nose to rectum for foreign body child CPT 76010 | $276.00 | $345.00 | $92.45 – $310.50 | 15 |
| X-ray of mammary ducts CPT 77054 | not published | not published | $253.81 – $253.81 | 2 |
| X-ray optic foramina CPT 70190 | not published | not published | $92.45 – $92.45 | 2 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | not published | not published | $374.99 – $374.99 | 2 |
| X-ray ribs 2 views left CPT 71100 | $313.60 | $392.00 | $92.45 – $352.80 | 15 |
| X-ray sella turcica CPT 70240 | not published | not published | $92.45 – $92.45 | 2 |
| X-ray sinus tract/fistula/abscess CPT 76080 | $764.00 | $955.00 | $328.04 – $859.50 | 15 |
| X-ray slg plne bdy sect without urogr CPT 76100 | not published | not published | $111.66 – $111.66 | 2 |
| X-ray small intestine follow-through study CPT 74248 | $763.20 | $954.00 | $327.70 – $858.60 | 15 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | $340.80 | $426.00 | $92.45 – $383.40 | 15 |
| X-ray surgical specimen CPT 76098 | $464.80 | $581.00 | $199.57 – $522.90 | 15 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | $281.60 | $352.00 | $92.45 – $316.80 | 15 |
| X-ray xm phrnx&/crv esoph c+ CPT 74210 | not published | not published | $186.92 – $186.92 | 2 |
| Ziprasidone 20 mg/ml (final concentration) intramuscular solution HCPCS J3486 | $103.08 | $128.85 | $18.84 – $49.37 | 15 |
| Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 | $2,457.77 | $3,072.21 | $18.10 – $47.43 | 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.