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 |
|---|---|---|---|---|
| MRI orbit fac&nck w IV cont CPT 70542 | not published | not published | $607.75 – $607.75 | 1 |
| MRI tmj CPT 70336 | $2,450.40 | $3,063.00 | $578.05 – $2,756.70 | 15 |
| MRI upper extremity other than joint without contrast (both sides) CPT 73218 | $2,463.20 | $3,079.00 | $578.05 – $2,771.10 | 15 |
| MRI upper extremity other than joint without & w/contrast (both sides) CPT 73220 | $3,399.20 | $4,249.00 | $607.75 – $3,824.10 | 15 |
| MRI upper extremity w/dye CPT 73219 | not published | not published | $607.75 – $607.75 | 1 |
| MRI without fol w/cont, breast HCPCS C8908 | not published | not published | $607.75 – $607.75 | 1 |
| Mumps antibody igg CPT 86735 | $76.80 | $96.00 | $9.68 – $36.00 | 15 |
| Mycophenolate mofetil 250 mg capsule HCPCS J7517 | $3.40 | $4.25 | $1.03 – $3.83 | 15 |
| Mycophenolic acid HCPCS J7518 | $6.17 | $7.71 | $1.87 – $6.94 | 15 |
| Mycoplasma antibody igm CPT 86738 | $78.40 | $98.00 | $23.73 – $88.20 | 15 |
| Myeloperoxidase ab multi step qualitative/semiquantitative CPT 83516 | $142.40 | $178.00 | $15.98 – $59.40 | 15 |
| Naloxone 0.4 mg/ml injection (wrapper) HCPCS J2312 | $17.83 | $22.28 | $2.18 – $8.10 | 15 |
| Natalizumab 300 mg/15 ml intravenous solution HCPCS J2323 | not published | not published | $24.60 – $24.60 | 1 |
| Natriuretic peptide CPT 83880 | $161.60 | $202.00 | $28.57 – $106.20 | 15 |
| Natural killer cells total count CPT 86357 | $156.00 | $195.00 | $47.21 – $175.50 | 15 |
| Ndl insj without njx 1 or 2 musc CPT 20560 | $36.00 | $45.00 | $10.89 – $40.50 | 15 |
| Ndl insj without njx 3+ musc CPT 20561 | $64.80 | $81.00 | $19.61 – $72.90 | 15 |
| Nebulizer Breathing Treatment CPT 94640 | $199.20 | $249.00 | $38.98 – $144.90 | 15 |
| Neck Airway (Soft Tissue) X-ray CPT 70360 | $317.60 | $397.00 | $96.11 – $357.30 | 15 |
| Neck (Cervical Spine) CT scan (with and without contrast) CPT 72127 | not published | not published | $446.60 – $446.60 | 1 |
| Neck (Cervical Spine) CT scan (with contrast) CPT 72126 | $2,366.40 | $2,958.00 | $607.75 – $2,662.20 | 15 |
| Neck (Cervical Spine) CT scan (without contrast) CPT 72125 | $1,472.00 | $1,840.00 | $352.55 – $1,656.00 | 15 |
| Neck (Cervical Spine) MRI (with and without contrast) CPT 72156 | $3,798.40 | $4,748.00 | $607.75 – $4,273.20 | 15 |
| Neck (Cervical Spine) MRI (with contrast) CPT 72142 | $3,160.80 | $3,951.00 | $607.75 – $3,555.90 | 15 |
| Neck (Cervical Spine) MRI (without contrast) CPT 72141 | $2,066.40 | $2,583.00 | $578.05 – $2,324.70 | 15 |
| Neck (Cervical Spine) X-ray (2 to 3 views) CPT 72040 | $256.00 | $320.00 | $77.47 – $288.00 | 15 |
| Neck (Cervical Spine) X-ray (4 to 5 views) CPT 72050 | $502.40 | $628.00 | $152.04 – $565.20 | 15 |
| Neck (Cervical Spine) X-ray (6 or more views) CPT 72052 | $734.40 | $918.00 | $222.25 – $826.20 | 15 |
| Neck MRA (blood vessel MRI, with and without contrast) CPT 70549 | $3,476.80 | $4,346.00 | $607.75 – $3,911.40 | 15 |
| Neck MRA (blood vessel MRI, with contrast) CPT 70548 | $2,444.80 | $3,056.00 | $607.75 – $2,750.40 | 15 |
| Neck MRA (blood vessel MRI, without contrast) CPT 70547 | $2,468.80 | $3,086.00 | $578.05 – $2,777.40 | 15 |
| Neck Soft Tissue CT Scan (with and without contrast) CPT 70492 | $2,562.40 | $3,203.00 | $446.60 – $2,882.70 | 15 |
| Neck Soft Tissue CT Scan (with contrast) CPT 70491 | $1,790.40 | $2,238.00 | $446.60 – $2,014.20 | 15 |
| Neck Soft Tissue CT Scan (without contrast) CPT 70490 | $1,468.80 | $1,836.00 | $352.55 – $1,652.40 | 15 |
| Neostigmine methylsulfate 1 mg/ml injection (wrapper) HCPCS J2710 | $6.32 | $7.90 | $0.41 – $1.54 | 15 |
| Nicardipine 25 mg/10 ml intravenous solution HCPCS J2404 | $148.08 | $185.10 | $44.81 – $166.59 | 15 |
| Nintedanib 150 mg capsule HCPCS J8999 | $4.06 | $5.07 | $1.03 – $3.83 | 15 |
| Nitroglycerin 50 mg/250 ml (200 mcg/ml) in 5 % dextrose intravenous HCPCS J2305 | $30.64 | $38.29 | $9.27 – $34.46 | 15 |
| Nivolumab 10 mg/ml intravenous solution (wrapper) HCPCS J9299 | not published | not published | $38.06 – $38.06 | 1 |
| Nivolumab 240 mg-relatlimab-rmbw 80 mg/20 ml intravenous solution HCPCS J9298 | not published | not published | $228.20 – $228.20 | 1 |
| No pt prsnt train add 15 HCPCS G0542 | $67.20 | $84.00 | $20.34 – $75.60 | 15 |
| No pt prsnt train initial 30 HCPCS G0541 | $136.00 | $170.00 | $41.16 – $153.00 | 15 |
| Nose (Nasal Bone) X-ray (complete) CPT 70160 | $204.80 | $256.00 | $61.98 – $230.40 | 15 |
| Nuclear Stress Test (Heart) CPT 78452 | not published | not published | $1,556.50 – $1,556.50 | 1 |
| Observation direct referral from physician office for admission HCPCS G0379 | $210.40 | $263.00 | $63.67 – $236.70 | 15 |
| Observation per hour HCPCS G0378 | $47.20 | $59.00 | $14.28 – $53.10 | 15 |
| Obstetrics panel CPT 80055 | $303.20 | $379.00 | $91.76 – $341.10 | 15 |
| Ob Ultrasound nuchal meas 1 gest CPT 76813 | $285.60 | $357.00 | $86.43 – $321.30 | 15 |
| Occupational Therapy Evaluation (high complexity) CPT 97167 | $312.00 | $390.00 | $94.42 – $351.00 | 15 |
| Occupational Therapy Evaluation (low complexity) CPT 97165 | $262.40 | $328.00 | $79.41 – $295.20 | 15 |
| Occupational Therapy Evaluation (moderate complexity) CPT 97166 | $294.40 | $368.00 | $89.09 – $331.20 | 15 |
| Ocrelizumab 30 mg/ml intravenous solution HCPCS J2350 | not published | not published | $60.94 – $74.69 | 2 |
| Octreotide acetate 100 mcg/ml injection (wrapper) HCPCS J2354 | $3.06 | $3.82 | $0.92 – $3.44 | 15 |
| Olanzapine 10 mg intramuscular solution HCPCS J2359 | $72.41 | $90.51 | $10.80 – $40.14 | 15 |
| Omalizumab 150 mg/ml subcutaneous syringe (wrapper) HCPCS J2357 | not published | not published | $39.04 – $39.04 | 1 |
| Oncoprotein dcp CPT 83951 | $156.80 | $196.00 | $47.45 – $176.40 | 15 |
| Ondansetron 4 mg s0119 HCPCS S0119 | $4.04 | $5.04 | $1.03 – $3.83 | 15 |
| Ondansetron hcl (pf) 2 mg/ml injection (wrapper) HCPCS J2405 | $27.39 | $34.23 | $0.81 – $3.02 | 15 |
| Osmolality blood CPT 83930 | $35.20 | $44.00 | $10.65 – $39.60 | 15 |
| Osmolality urine CPT 83935 | $38.40 | $48.00 | $5.08 – $18.90 | 15 |
| Oth resp proc, group HCPCS G0239 | $153.60 | $192.00 | $46.48 – $172.80 | 15 |
| Oth resp proc, indiv HCPCS G0238 | $118.40 | $148.00 | $35.83 – $133.20 | 15 |
| Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes CPT 97763 | $152.80 | $191.00 | $46.24 – $171.90 | 15 |
| Ot re-evaluation patient/family CPT 97168 | $194.40 | $243.00 | $58.83 – $218.70 | 15 |
| Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes CPT 97130 | $96.80 | $121.00 | $29.29 – $108.90 | 15 |
| Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes CPT 97129 | $122.40 | $153.00 | $37.04 – $137.70 | 15 |
| Oxytocin 10 unit/ml injection solution HCPCS J2590 | $26.65 | $33.31 | $8.00 – $29.73 | 15 |
| Paliperidone 117 mg/0.75 ml inj HCPCS J2426 | $3,440.06 | $4,300.07 | $1,041.05 – $3,870.06 | 15 |
| Palonosetron hcl HCPCS J2469 | $33.35 | $41.68 | $8.27 – $30.74 | 15 |
| Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr HCPCS J2470 | $27.71 | $34.63 | $8.17 – $30.38 | 15 |
| Parathormone (pth) intact CPT 83970 | $212.00 | $265.00 | $63.19 – $234.90 | 15 |
| Partial removal of eye fluid CPT 67005 | $2,403.20 | $3,004.00 | $727.27 – $2,703.60 | 15 |
| Pca3/klk3 antigen CPT 81313 | $664.00 | $830.00 | $200.94 – $747.00 | 15 |
| Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector HCPCS J2506 | $4,800.69 | $6,000.86 | $31.73 – $5,400.77 | 15 |
| Pegfilgrastim-apgf 6 mg/0.6 ml subcutaneous syringe HCPCS Q5122 | not published | not published | $98.36 – $98.36 | 1 |
| Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe HCPCS Q5111 | $2,502.00 | $3,127.50 | $146.06 – $2,814.75 | 15 |
| Pegfilgrastim-fpgk 6 mg/0.6 ml subcutaneous syringe HCPCS Q5127 | not published | not published | $311.44 – $311.44 | 1 |
| Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe HCPCS Q5108 | not published | not published | $138.08 – $138.08 | 1 |
| Pegfilgrastim-pbbk 6 mg/0.6 ml subcutaneous syringe HCPCS Q5130 | not published | not published | $189.71 – $189.71 | 1 |
| Pegloticase 8 mg/ml intravenous solution HCPCS J2507 | not published | not published | $3,547.84 – $3,547.84 | 1 |
| Pegunigalsidase alfa-iwxj HCPCS J2508 | not published | not published | $227.78 – $227.78 | 1 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $2,460.00 | $3,075.00 | $446.60 – $2,767.50 | 15 |
| Pelvic CT scan (with contrast) CPT 72193 | $2,152.80 | $2,691.00 | $446.60 – $2,421.90 | 15 |
| Pelvic CT scan (without contrast) CPT 72192 | $1,480.00 | $1,850.00 | $352.55 – $1,665.00 | 15 |
| Pelvic MRI (with and without contrast) CPT 72197 | $3,784.00 | $4,730.00 | $607.75 – $4,257.00 | 15 |
| Pelvic MRI (with contrast) CPT 72196 | not published | not published | $607.75 – $607.75 | 1 |
| Pelvic MRI (without contrast) CPT 72195 | $2,567.20 | $3,209.00 | $578.05 – $2,888.10 | 15 |
| Pelvic Ultrasound (complete) CPT 76856 | $548.80 | $686.00 | $166.08 – $617.40 | 15 |
| Pelvic Ultrasound (limited) CPT 76857 | $512.80 | $641.00 | $155.19 – $576.90 | 15 |
| Pelvis X-ray (1 to 2 views) CPT 72170 | $220.00 | $275.00 | $66.58 – $247.50 | 15 |
| Pelvis X-ray (complete, 4 or more views) CPT 72190 | $400.80 | $501.00 | $121.29 – $450.90 | 15 |
| Pembrolizumab 25 mg/ml intravenous solution HCPCS J9271 | not published | not published | $58.52 – $69.76 | 2 |
| Pemivibart infusion HCPCS M0224 | $783.20 | $979.00 | $237.02 – $881.10 | 15 |
| Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 | $421.72 | $527.15 | $127.62 – $474.44 | 15 |
| Perflutren lipid microspheres 1.1 mg/ml intravenous suspension HCPCS Q9957 | $244.80 | $306.00 | $72.63 – $270.00 | 15 |
| Pertuzumab 30 mg/ml desensitization HCPCS J9306 | not published | not published | $16.20 – $16.20 | 1 |
| Ph body fluid CPT 83986 | $34.40 | $43.00 | $2.91 – $10.80 | 15 |
| Phencyclidine (pcp) CPT 83992 | $96.00 | $120.00 | $29.05 – $108.00 | 15 |
| Phenobarbital therapeutic drug level CPT 80184 | $71.20 | $89.00 | $20.58 – $76.50 | 15 |
| Phenylephrine 10 mg/ml injection solution HCPCS J2371 | $30.04 | $37.55 | $8.83 – $32.82 | 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.