Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution 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

$72.35

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.

$90.43

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.

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

$21.89 with Blue Cross Blue Shield of Minnesota vs $85.00 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 $21.89 ↓ -70%
Sanford Health Plan Align Medicare Replacement $35.27 ↓ -51%
Ucare Medicare Replacement $37.80 ↓ -48%
Wellmark SD Medicare Replacement $37.80 ↓ -48%
Aetna Medicare Replacement $38.16 ↓ -47%
United Healthcare Medicare Replacement $38.16 ↓ -47%
Health Partners Medicare Replacement $38.16 ↓ -47%
Great Plains Medicare Advantage Medicare Replacement $38.16 ↓ -47%
Primewest Medicare Replacement $38.93 ↓ -46%
Primewest Medicaid Managed Care $43.77 ↓ -40%
Security Health Plan Commercial $49.74 ↓ -31%
Health Partners State Employees $62.31 ↓ -14%
Sanford Health Plan SD Exchange True $71.39 ↓ -1%
Sanford Health Plan Group Health/True $71.39 ↓ -1%
Health Partners Commercial $72.34 ↓ -0%
Blue Cross Blue Shield of Minnesota State Employees $73.97 ↑ +2%
United Healthcare Commercial + Top 20 $75.51 ↑ +4%
Aetna Commercial $78.58 ↑ +9%
Ucare Commercial $79.45 ↑ +10%
Medica Choice $79.49 ↑ +10%
Healthez Commercial $81.39 ↑ +12%
Cigna Commercial $81.39 ↑ +12%
Multiplan Commercial $81.39 ↑ +12%
First Choice Health Network Commercial $81.39 ↑ +12%
Blue Cross Blue Shield of Minnesota Commercial/Federal $83.67 ↑ +16%
Sanford Health Plan SD Exchange Commercial $83.98 ↑ +16%
Sanford Health Plan Commercial/ND Pers $83.98 ↑ +16%
Medica Elect $85.00 ↑ +17%
Ucare Medicaid Managed Care not published by hospital —

Visitor-reported prices

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Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution at other Minnesota hospitals

Hospital City Cash price Negotiated range
Sanford Canby Medical Center Canby $106.26 $32.16 – $119.54
Sanford Westbrook Hospital Westbrook $108.18 $32.74 – $121.70
Sanford Bagley Medical Center Bagley $48.76 $14.22 – $52.88
Sanford Wheaton Wheaton $50.80 $15.13 – $56.25
Sanford Luverne Medical Center Luverne $154.88 $38.86 – $144.45
Sanford Bemidji Medical Center Bemidji $47.25 $0.01 – $53.15
Sanford Thief River Falls Medical Center Thief River Falls $74.16 $24.01 – $62.91
Sanford Behavioral Health Thief River Falls Thief River Falls $74.16 $24.01 – $62.91

All Minnesota hospitals for this procedure →