Sanford Medical Center Mayville
42 6th Ave SE, Mayville, ND · Sanford Health · · NPI 1518061803
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 |
|---|---|---|---|---|
| Lidocaine (pf) 10 mg/ml (1 %) injection solution HCPCS J2003 | $31.33 | $39.16 | $0.28 – $1.03 | 15 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | $73.12 | $91.40 | $22.13 – $82.26 | 15 |
| Ligation/biopsy of temporal artery 37609 CPT 37609 | $2,968.00 | $3,710.00 | $898.19 – $3,339.00 | 15 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $128.16 | $160.20 | $28.25 – $105.03 | 15 |
| Lipase CPT 83690 | $53.60 | $67.00 | $16.22 – $60.30 | 15 |
| Lipoprotein direct measurement hdl CPT 83718 | $38.40 | $48.00 | $9.20 – $34.20 | 15 |
| Lipoprotein direct measurement ldl CPT 83721 | $65.60 | $82.00 | $19.85 – $73.80 | 15 |
| Lithium therapeutic drug level CPT 80178 | $39.20 | $49.00 | $11.86 – $44.10 | 15 |
| Liver Function Test CPT 80076 | $112.80 | $141.00 | $34.14 – $126.90 | 15 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $28.00 | $35.00 | $8.47 – $31.50 | 15 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $27.81 | $34.76 | $7.97 – $29.63 | 15 |
| Low-Dose Lung Cancer Screening CT Scan CPT 71271 | $500.00 | $625.00 | $151.31 – $562.50 | 15 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | not published | not published | $446.60 – $446.60 | 1 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | not published | not published | $607.75 – $607.75 | 1 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $1,468.80 | $1,836.00 | $352.55 – $1,652.40 | 15 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $3,924.00 | $4,905.00 | $607.75 – $4,414.50 | 15 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $3,162.40 | $3,953.00 | $607.75 – $3,557.70 | 15 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $2,202.40 | $2,753.00 | $578.05 – $2,477.70 | 15 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $277.60 | $347.00 | $84.01 – $312.30 | 15 |
| Lower Back (Lumbar Spine) X-ray (4 or more views) CPT 72110 | $368.80 | $461.00 | $111.61 – $414.90 | 15 |
| Lower Back (Lumbar Spine) X-ray (with bending views) CPT 72114 | $657.60 | $822.00 | $199.01 – $739.80 | 15 |
| Lower Leg (Shin) X-ray (both sides) CPT 73590 | $193.60 | $242.00 | $58.59 – $217.80 | 15 |
| Lumizyme injection HCPCS J0221 | not published | not published | $205.76 – $205.76 | 1 |
| Lung Function Test Before and After an Inhaler CPT 94060 | $324.80 | $406.00 | $98.29 – $365.40 | 15 |
| Lung function test (mbc/mvv) CPT 94200 | $137.60 | $172.00 | $41.64 – $154.80 | 15 |
| Lung Function Test (Spirometry) CPT 94010 | $270.40 | $338.00 | $81.83 – $304.20 | 15 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | not published | not published | $41.40 – $41.40 | 1 |
| Macroscopic exam arthropod CPT 87168 | $28.80 | $36.00 | $8.72 – $32.40 | 15 |
| Macroscopic exam parasite CPT 87169 | $28.80 | $36.00 | $8.72 – $32.40 | 15 |
| Magnesium CPT 83735 | $40.00 | $50.00 | $5.08 – $18.90 | 15 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $112.68 | $140.85 | $1.95 – $7.25 | 15 |
| Magnetic image bone marrow CPT 77084 | not published | not published | $578.05 – $578.05 | 1 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $74.40 | $93.00 | $22.52 – $83.70 | 15 |
| Mayo aathr protein s free CPT 85306 | $73.60 | $92.00 | $22.27 – $82.80 | 15 |
| Mayo activated protein c resistance assay CPT 85307 | $91.20 | $114.00 | $27.60 – $102.60 | 15 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $172.80 | $216.00 | $52.29 – $194.40 | 15 |
| Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation CPT 80321 | $110.40 | $138.00 | $33.41 – $124.20 | 15 |
| Mayo alcohol definitive assay volatile screen CPT 80320 | $118.40 | $148.00 | $18.40 – $68.40 | 15 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $50.40 | $63.00 | $15.25 – $56.70 | 15 |
| Mayo alkaloids definitive assay nicotine/cotinine CPT 80323 | $88.80 | $111.00 | $26.87 – $99.90 | 15 |
| Mayo alpha 1 antitrypsin CPT 82103 | $97.60 | $122.00 | $22.27 – $82.80 | 15 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $37.60 | $47.00 | $11.38 – $42.30 | 15 |
| Mayo amphu amphetamines definitive assay 3 or 4 urine CPT 80325 | $63.20 | $79.00 | $17.67 – $65.70 | 15 |
| Mayo amphu methylenedioxyamphetamines definitive assay urine CPT 80359 | $73.60 | $92.00 | $21.79 – $81.00 | 15 |
| Mayo analysis gene calr common variants exon 9 CPT 81219 | $556.00 | $695.00 | $168.26 – $625.50 | 15 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $250.40 | $313.00 | $75.78 – $281.70 | 15 |
| Mayo analysis gene smn1 dosage/deletion CPT 81329 | $328.80 | $411.00 | $99.50 – $369.90 | 15 |
| Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 | $3,205.60 | $4,007.00 | $139.21 – $517.50 | 15 |
| Mayo androstenedione CPT 82157 | $68.80 | $86.00 | $20.82 – $77.40 | 15 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | $98.40 | $123.00 | $29.78 – $110.70 | 15 |
| Mayo antithrombin iii antigen CPT 85301 | $71.20 | $89.00 | $21.55 – $80.10 | 15 |
| Mayo aspergillus fumigatus antibody CPT 86606 | $48.00 | $60.00 | $9.20 – $34.20 | 15 |
| Mayo avwpr vw factor activity CPT 85397 | $195.20 | $244.00 | $59.07 – $219.60 | 15 |
| Mayo barbiturates definitive assay confirmation urine CPT 80345 | $81.60 | $102.00 | $15.74 – $58.50 | 15 |
| Mayo bart bartonella henselae antibody igg CPT 86611 | $60.00 | $75.00 | $16.46 – $61.20 | 15 |
| Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative CPT 81207 | $364.00 | $455.00 | $110.16 – $409.50 | 15 |
| Mayo bcrfx analysis translocation bcr/abl1 other breakpoint qualitative/quantitative CPT 81208 | $540.00 | $675.00 | $163.42 – $607.50 | 15 |
| Mayo blastomyces antibody immunodiffusion CPT 86612 | $66.40 | $83.00 | $20.09 – $74.70 | 15 |
| Mayo bordetella pertussis antibody igg CPT 86615 | $72.00 | $90.00 | $21.79 – $81.00 | 15 |
| Mayo c1 esterase inhibitor CPT 83883 | $113.60 | $142.00 | $10.41 – $38.70 | 15 |
| Mayo cannabinoids natural definitive assay thc confirmation urine CPT 80349 | $86.40 | $108.00 | $17.19 – $63.90 | 15 |
| Mayo carnitine total and free quantitative each specimen plasma CPT 82379 | $49.60 | $62.00 | $15.01 – $55.80 | 15 |
| Mayo cdcom hla class ii typing low resolution one locus each CPT 81376 | $348.00 | $435.00 | $90.30 – $335.70 | 15 |
| Mayo ceruloplasmin CPT 82390 | $64.80 | $81.00 | $19.61 – $72.90 | 15 |
| Mayo chemiluminescent parathyroid related peptide CPT 82397 | $131.20 | $164.00 | $10.65 – $39.60 | 15 |
| Mayo chikv chikungunya antibodies igg CPT 86790 | $35.20 | $44.00 | $10.65 – $39.60 | 15 |
| Mayo chlap chlamydia pneumoniae antibody igg CPT 86631 | $56.00 | $70.00 | $16.95 – $63.00 | 15 |
| Mayo chlap chlamydia pneumoniae antibody igm CPT 86632 | $56.00 | $70.00 | $16.95 – $63.00 | 15 |
| Mayo chrcb tissue culture non-neoplastic disorders lymphocyte CPT 88230 | $296.00 | $370.00 | $89.58 – $333.00 | 15 |
| Mayo chromium CPT 82495 | $62.40 | $78.00 | $18.88 – $70.20 | 15 |
| Mayo cocaine definitive assay confirmation urine CPT 80353 | $55.20 | $69.00 | $16.70 – $62.10 | 15 |
| Mayo coccidioides antibody CPT 86635 | $66.40 | $83.00 | $19.13 – $71.10 | 15 |
| Mayo cocou cortisone urine CPT 82542 | $100.00 | $125.00 | $17.43 – $64.80 | 15 |
| Mayo cortisol free CPT 82530 | $108.80 | $136.00 | $15.01 – $55.80 | 15 |
| Mayo csmpu benzodiazepines definitive assay >=13 urine CPT 80347 | $76.00 | $95.00 | $23.00 – $85.50 | 15 |
| Mayo cytopathology in situ hybridization urinary tract 3-5 probes each specimen manual CPT 88120 | $1,207.20 | $1,509.00 | $365.33 – $1,358.10 | 15 |
| Mayo deoxyribonuclease antibody titer CPT 86215 | $56.80 | $71.00 | $17.19 – $63.90 | 15 |
| Mayo dhea (dehydroepiandrosterone) CPT 82626 | $61.60 | $77.00 | $18.64 – $69.30 | 15 |
| Mayo dihydrotestosterone CPT 82642 | $71.20 | $89.00 | $21.55 – $80.10 | 15 |
| Mayo estriol CPT 82677 | $120.80 | $151.00 | $17.67 – $65.70 | 15 |
| Mayo estrone CPT 82679 | $60.00 | $75.00 | $18.16 – $67.50 | 15 |
| Mayo ethosuximide therapeutic drug level CPT 80168 | $40.00 | $50.00 | $12.11 – $45.00 | 15 |
| Mayo factor v CPT 85220 | $88.00 | $110.00 | $26.63 – $99.00 | 15 |
| Mayo factor vii CPT 85230 | $92.80 | $116.00 | $28.08 – $104.40 | 15 |
| Mayo factor viii vw factor antigen CPT 85246 | $184.00 | $230.00 | $55.68 – $207.00 | 15 |
| Mayo factor viii vw factor ristocetin cofactor CPT 85245 | $155.20 | $194.00 | $46.97 – $174.60 | 15 |
| Mayo factor x CPT 85260 | $210.40 | $263.00 | $31.72 – $117.90 | 15 |
| Mayo fat/lipids feces quantitative CPT 82710 | $57.60 | $72.00 | $17.43 – $64.80 | 15 |
| Mayo fbl culture fungi blood CPT 87103 | $55.20 | $69.00 | $16.70 – $62.10 | 15 |
| Mayo ffspg allergen clam igg CPT 86001 | $54.40 | $68.00 | $16.46 – $61.20 | 15 |
| Mayo fibrinogen antigen CPT 85385 | $40.00 | $50.00 | $12.11 – $45.00 | 15 |
| Mayo gabapentin bld/srm/plasma therapeutic drug level CPT 80171 | $71.20 | $89.00 | $21.55 – $80.10 | 15 |
| Mayo hemosiderin qualitative urine CPT 83070 | $24.00 | $30.00 | $7.26 – $27.00 | 15 |
| Mayo hip12 infectious agent nucleic acid amplified probe hiv-1 rna qualitative CPT 87535 | $173.60 | $217.00 | $52.54 – $195.30 | 15 |
| Mayo hip12 infectious agent nucleic acid amplified probe hiv-2 CPT 87538 | $351.20 | $439.00 | $51.57 – $191.70 | 15 |
| Mayo hiser histoplasma antibodies immunodiffusion CPT 86698 | $63.20 | $79.00 | $17.19 – $63.90 | 15 |
| Mayo hla typing a/b/c single antigen CPT 86812 | $148.00 | $185.00 | $41.16 – $153.00 | 15 |
| Mayo hvdip HIV 1 antibody CPT 86701 | $38.40 | $48.00 | $11.62 – $43.20 | 15 |
| Mayo hvdip HIV 2 antibody CPT 86702 | $63.20 | $79.00 | $19.13 – $71.10 | 15 |
| Mayo hydroxyprogesterone 17-d CPT 83498 | $65.60 | $82.00 | $19.85 – $73.80 | 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.