Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr at Sanford Tracy Hospital

251 5th St E, Tracy, MN · Sanford Health · · NPI 1003851171

Source: hospital's published price file ↗ · Published Mar 4, 2026 · Ingested Aug 12, 2026

$62.17

Cash price

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Discounted cash price

What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge.

Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.

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What you pay up front if you don't use insurance.

$77.71

Gross charge

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Gross charge (chargemaster price)

The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this.

Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.

Full explanation →

The hospital's undiscounted list price — almost no one pays this.

$18.81 with Blue Cross Blue Shield of Minnesota vs $73.05 with Medica — same scan, same building. Share

Negotiated rates by payer
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Negotiated rate

The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.

Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.

Full explanation →

Payer
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Payer

The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on.

Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509.

Full explanation →
Plan
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Plan

The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates.

Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible.

Full explanation →
Negotiated rate vs. cash
Blue Cross Blue Shield of Minnesota PMAP $18.81 ↓ -70%
Sanford Health Plan Align Medicare Replacement $30.31 ↓ -51%
Ucare Medicare Replacement $32.48 ↓ -48%
Wellmark SD Medicare Replacement $32.48 ↓ -48%
Aetna Medicare Replacement $32.79 ↓ -47%
United Healthcare Medicare Replacement $32.79 ↓ -47%
Health Partners Medicare Replacement $32.79 ↓ -47%
Great Plains Medicare Advantage Medicare Replacement $32.79 ↓ -47%
Primewest Medicare Replacement $33.45 ↓ -46%
Primewest Medicaid Managed Care $37.61 ↓ -40%
Security Health Plan Commercial $42.74 ↓ -31%
Health Partners State Employees $53.54 ↓ -14%
Sanford Health Plan SD Exchange True $61.34 ↓ -1%
Sanford Health Plan Group Health/True $61.34 ↓ -1%
Health Partners Commercial $62.17 ↑ +0%
Blue Cross Blue Shield of Minnesota State Employees $63.57 ↑ +2%
United Healthcare Commercial + Top 20 $64.89 ↑ +4%
Aetna Commercial $67.53 ↑ +9%
Ucare Commercial $68.28 ↑ +10%
Medica Choice $68.31 ↑ +10%
Healthez Commercial $69.94 ↑ +12%
Cigna Commercial $69.94 ↑ +12%
Multiplan Commercial $69.94 ↑ +12%
First Choice Health Network Commercial $69.94 ↑ +12%
Blue Cross Blue Shield of Minnesota Commercial/Federal $71.90 ↑ +16%
Sanford Health Plan SD Exchange Commercial $72.17 ↑ +16%
Sanford Health Plan Commercial/ND Pers $72.17 ↑ +16%
Medica Elect $73.05 ↑ +18%
Ucare Medicaid Managed Care not published by hospital —

Visitor-reported prices

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Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr at other Minnesota hospitals

Hospital City Cash price Negotiated range
Sanford Canby Medical Center Canby $62.48 $18.58 – $69.08
Sanford Bagley Medical Center Bagley $51.17 $15.48 – $57.56
Sanford Wheaton Wheaton $26.80 $8.11 – $30.15
Sanford Luverne Medical Center Luverne $61.83 $18.67 – $69.42
Sanford Bemidji Medical Center Bemidji $50.71 $1.02 – $52.54
Sanford Worthington Medical Center Worthington $62.16 $1.00 – $69.37
Sanford Thief River Falls Medical Center Thief River Falls $37.62 $16.12 – $42.25
Sanford Behavioral Health Thief River Falls Thief River Falls $37.62 $16.12 – $42.25

All Minnesota hospitals for this procedure →