Sanford Tracy Hospital
251 5th St E, Tracy, MN · Sanford Health · · NPI 1003851171
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 |
|---|---|---|---|---|
| Lipoprotein direct measurement hdl CPT 83718 | $85.60 | $107.00 | $25.90 – $96.30 | 16 |
| Lipoprotein direct measurement ldl CPT 83721 | $112.00 | $140.00 | $33.89 – $126.00 | 16 |
| Lip surgery procedure CPT 40799 | not published | not published | $243.83 – $243.83 | 1 |
| Lithium therapeutic drug level CPT 80178 | $84.80 | $106.00 | $25.66 – $95.40 | 16 |
| Liver elastography 91200 CPT 91200 | not published | not published | $164.28 – $164.28 | 1 |
| Liver Function Test CPT 80076 | $175.20 | $219.00 | $53.02 – $197.10 | 16 |
| Liver imaging CPT 78201 | $1,852.80 | $2,316.00 | $560.70 – $2,084.40 | 16 |
| Liver imag w/vasclr flow CPT 78202 | $1,864.80 | $2,331.00 | $564.34 – $2,097.90 | 16 |
| Liver/spleen imag static only CPT 78215 | $1,676.00 | $2,095.00 | $421.92 – $1,885.50 | 16 |
| Liver/spleen imag w/vasclr flow CPT 78216 | $1,992.80 | $2,491.00 | $421.92 – $2,241.90 | 16 |
| Lmtd oph exam general anes CPT 92019 | not published | not published | $2,449.61 – $2,449.61 | 1 |
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $20.00 | $25.00 | $6.05 – $22.50 | 16 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $60.81 | $76.01 | $18.39 – $68.38 | 16 |
| Loudness balance test CPT 92562 | not published | not published | $326.96 – $326.96 | 1 |
| Low back disk surgery CPT 63030 | not published | not published | $7,500.92 – $7,500.92 | 1 |
| Low-Dose Lung Cancer Screening CT Scan CPT 71271 | not published | not published | $111.66 – $111.66 | 1 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | not published | not published | $186.92 – $446.60 | 2 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $2,769.60 | $3,462.00 | $374.99 – $3,115.80 | 16 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $2,592.00 | $3,240.00 | $111.66 – $2,916.00 | 16 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $4,399.20 | $5,499.00 | $374.99 – $4,949.10 | 16 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $3,508.00 | $4,385.00 | $374.99 – $3,946.50 | 16 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $3,189.60 | $3,987.00 | $253.81 – $3,588.30 | 16 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $501.60 | $627.00 | $111.66 – $564.30 | 16 |
| Lower Back (Lumbar Spine) X-ray (4 or more views) CPT 72110 | $710.40 | $888.00 | $111.66 – $799.20 | 16 |
| Lower Back (Lumbar Spine) X-ray (with bending views) CPT 72114 | $756.00 | $945.00 | $111.66 – $850.50 | 16 |
| Lower jaw bone graft CPT 21215 | not published | not published | $6,211.44 – $6,211.44 | 1 |
| Lower Leg (Shin) X-ray (both sides) CPT 73590 | $456.00 | $570.00 | $92.45 – $513.00 | 16 |
| Lsh uterus 250 g or less CPT 58541 | not published | not published | $10,931.77 – $10,931.77 | 1 |
| Lsh uterus above 250 g CPT 58543 | not published | not published | $10,931.77 – $10,931.77 | 1 |
| Lsh w/t/o ut 250 g or less CPT 58542 | not published | not published | $10,931.77 – $10,931.77 | 1 |
| Lsh w/t/o uterus above 250 g CPT 58544 | not published | not published | $10,931.77 – $10,931.77 | 1 |
| Lumbar diskogram s&i CPT 72295 | not published | not published | $2,050.41 – $2,050.41 | 1 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $19,309.55 – $19,309.55 | 1 |
| Lumizyme injection HCPCS J0221 | not published | not published | $205.76 – $205.76 | 1 |
| Lung Function Test Before and After an Inhaler CPT 94060 | $663.20 | $829.00 | $200.70 – $746.10 | 16 |
| Lung function test (mbc/mvv) CPT 94200 | not published | not published | $62.37 – $62.37 | 1 |
| Lung Function Test (Spirometry) CPT 94010 | $277.60 | $347.00 | $84.01 – $312.30 | 16 |
| Lung perfusion imaging CPT 78580 | $1,500.80 | $1,876.00 | $421.92 – $1,688.40 | 16 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | $18,943.32 | $23,679.15 | $41.40 – $7,148.79 | 16 |
| Lw ntsty Ultrasound stimj bone healg CPT 20979 | not published | not published | $25.71 – $25.71 | 1 |
| Lymphatics/lymph node imaging CPT 78195 | not published | not published | $565.18 – $565.18 | 1 |
| Lymph vessel x-ray arm/leg CPT 75801 | not published | not published | $649.17 – $649.17 | 1 |
| Lymph vessel x-ray arms/legs CPT 75803 | not published | not published | $1,631.11 – $1,631.11 | 1 |
| Lymph vessel x-ray trunk CPT 75805 | not published | not published | $3,304.88 – $3,304.88 | 1 |
| Lymph vessel x-ray trunk CPT 75807 | not published | not published | $3,304.88 – $3,304.88 | 1 |
| Lysis intranasal synechia 30560 CPT 30560 | not published | not published | $534.71 – $534.71 | 1 |
| Lysis of labial adhesions CPT 56441 | not published | not published | $3,338.51 – $3,338.51 | 1 |
| Lysis penil circumic lesion CPT 54162 | not published | not published | $2,150.94 – $2,150.94 | 1 |
| Macroscopic exam arthropod CPT 87168 | $40.00 | $50.00 | $12.11 – $45.00 | 16 |
| Macroscopic exam parasite CPT 87169 | $116.00 | $145.00 | $35.10 – $130.50 | 16 |
| Magnesium CPT 83735 | $88.80 | $111.00 | $9.44 – $35.10 | 16 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $71.07 | $88.83 | $18.29 – $67.98 | 16 |
| Magnetic image bone marrow CPT 77084 | not published | not published | $253.81 – $578.05 | 2 |
| Male sling procedure CPT 53440 | not published | not published | $13,642.04 – $13,642.04 | 1 |
| Manipulate finger w/anesth CPT 26340 | not published | not published | $1,680.43 – $1,680.43 | 1 |
| Manipulate wrist w/anesthes CPT 25259 | not published | not published | $1,680.43 – $1,680.43 | 1 |
| Manipulation of hip joint CPT 27275 | not published | not published | $1,680.43 – $1,680.43 | 1 |
| Manipulation of spine CPT 22505 | not published | not published | $1,680.43 – $1,680.43 | 1 |
| Manipulat palm cord post inj CPT 26341 | not published | not published | $251.87 – $251.87 | 1 |
| Marker biop eviva buckle ss HCPCS A4648 | $339.20 | $424.00 | $100.23 – $372.60 | 16 |
| Mastectomy partial CPT 19301 | not published | not published | $4,020.74 – $4,020.74 | 1 |
| Mast mod rad CPT 19307 | not published | not published | $6,847.53 – $6,847.53 | 1 |
| Mastoidectomy CPT 69501 | not published | not published | $6,211.44 – $6,211.44 | 1 |
| Mastoidectomy complete 69502 CPT 69502 | not published | not published | $6,211.44 – $6,211.44 | 1 |
| Mastoids complete CPT 70130 | $420.00 | $525.00 | $111.66 – $472.50 | 16 |
| Mastoid surgery revision CPT 69603 | not published | not published | $6,211.44 – $6,211.44 | 1 |
| Mastopexy CPT 19316 | not published | not published | $6,847.53 – $6,847.53 | 1 |
| Mast simple complete CPT 19303 | not published | not published | $6,847.53 – $6,847.53 | 1 |
| Maxillofacial fixation CPT 21100 | not published | not published | $6,211.44 – $6,211.44 | 1 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $48.80 | $61.00 | $14.77 – $54.90 | 16 |
| Mayo aathr protein s free CPT 85306 | $501.60 | $627.00 | $151.80 – $564.30 | 16 |
| Mayo activated protein c resistance assay CPT 85307 | $243.20 | $304.00 | $73.60 – $273.60 | 16 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $204.00 | $255.00 | $61.74 – $229.50 | 16 |
| Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation CPT 80321 | $115.20 | $144.00 | $34.86 – $129.60 | 16 |
| Mayo alcohol definitive assay volatile screen CPT 80320 | $155.20 | $194.00 | $21.55 – $80.10 | 16 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $50.40 | $63.00 | $15.25 – $56.70 | 16 |
| Mayo alkaloids definitive assay nicotine/cotinine CPT 80323 | $88.80 | $111.00 | $26.87 – $99.90 | 16 |
| Mayo alpha 1 antitrypsin CPT 82103 | $155.20 | $194.00 | $11.62 – $43.20 | 16 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $40.00 | $50.00 | $12.11 – $45.00 | 16 |
| Mayo amphu methylenedioxyamphetamines definitive assay urine CPT 80359 | $88.00 | $110.00 | $26.63 – $99.00 | 16 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $250.40 | $313.00 | $75.78 – $281.70 | 16 |
| Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 | $2,120.80 | $2,651.00 | $139.21 – $517.50 | 16 |
| Mayo androstenedione CPT 82157 | $51.20 | $64.00 | $15.49 – $57.60 | 16 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | $218.40 | $273.00 | $66.09 – $245.70 | 16 |
| Mayo aspergillus fumigatus antibody CPT 86606 | $111.20 | $139.00 | $9.68 – $36.00 | 16 |
| Mayo avwpr vw factor activity CPT 85397 | $192.80 | $241.00 | $24.69 – $91.80 | 16 |
| Mayo barbiturates definitive assay confirmation urine CPT 80345 | $117.60 | $147.00 | $18.88 – $70.20 | 16 |
| Mayo bart bartonella henselae antibody igg CPT 86611 | $91.20 | $114.00 | $20.58 – $76.50 | 16 |
| Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative CPT 81207 | $353.60 | $442.00 | $107.01 – $397.80 | 16 |
| Mayo bcrfx analysis translocation bcr/abl1 other breakpoint qualitative/quantitative CPT 81208 | $524.00 | $655.00 | $158.58 – $589.50 | 16 |
| Mayo blastomyces antibody immunodiffusion CPT 86612 | $51.20 | $64.00 | $15.49 – $57.60 | 16 |
| Mayo bordetella pertussis antibody igg CPT 86615 | $305.60 | $382.00 | $35.10 – $130.50 | 16 |
| Mayo brcmg brucella antibody igm CPT 86622 | $56.80 | $71.00 | $17.19 – $63.90 | 16 |
| Mayo c1 esterase inhibitor CPT 83883 | $148.80 | $186.00 | $29.29 – $108.90 | 16 |
| Mayo cannabinoids natural definitive assay thc confirmation urine CPT 80349 | $84.00 | $105.00 | $19.61 – $72.90 | 16 |
| Mayo cdcom hla class ii typing low resolution one locus each CPT 81376 | $298.40 | $373.00 | $90.30 – $335.70 | 16 |
| Mayo ceruloplasmin CPT 82390 | $131.20 | $164.00 | $39.70 – $147.60 | 16 |
| Mayo chemiluminescent parathyroid related peptide CPT 82397 | $146.40 | $183.00 | $12.35 – $45.90 | 16 |
| Mayo chikv chikungunya antibodies igg CPT 86790 | $147.20 | $184.00 | $37.77 – $140.40 | 16 |
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.