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 |
|---|---|---|---|---|
| Phenylep ketorolac opth soln HCPCS J1097 | $592.00 | $740.00 | $177.94 – $661.50 | 15 |
| Phenytoin total therapeutic drug level CPT 80185 | $82.40 | $103.00 | $22.52 – $83.70 | 15 |
| Phosphorus CPT 84100 | $32.80 | $41.00 | $9.93 – $36.90 | 15 |
| Phosphorus 24 hour urine CPT 84105 | $33.60 | $42.00 | $4.36 – $16.20 | 15 |
| Physical Therapy Evaluation (high complexity) CPT 97163 | $312.00 | $390.00 | $94.42 – $351.00 | 15 |
| Physical Therapy Evaluation (low complexity) CPT 97161 | $262.40 | $328.00 | $115.50 – $295.20 | 15 |
| Physical Therapy Evaluation (moderate complexity) CPT 97162 | $294.40 | $368.00 | $89.09 – $331.20 | 15 |
| Physical Therapy Re-Evaluation CPT 97164 | $181.60 | $227.00 | $54.96 – $204.30 | 15 |
| Phytonadione (vitamin k1) 10 mg/ml injection solution HCPCS J3430 | $94.70 | $118.37 | $10.09 – $37.50 | 15 |
| Pinworm exam CPT 87172 | $29.60 | $37.00 | $8.96 – $33.30 | 15 |
| Piperacillin-tazobactam 3.375 gram intravenous solution HCPCS J2543 | $32.95 | $41.18 | $8.32 – $30.92 | 15 |
| Place gastrostomy tube perc CPT 49440 | $2,286.40 | $2,858.00 | $691.92 – $2,572.20 | 15 |
| Platelet aggregation each agent teg CPT 85576 | $111.20 | $139.00 | $33.65 – $125.10 | 15 |
| Platelet automated CPT 85049 | $31.20 | $39.00 | $9.44 – $35.10 | 15 |
| Platelets pheresis leukocytes reduced each unit HCPCS P9035 | $1,408.00 | $1,760.00 | $426.10 – $1,584.00 | 15 |
| Platelets pheresis leukocytes reduced irradiated each unit HCPCS P9037 | $1,316.00 | $1,645.00 | $398.25 – $1,480.50 | 15 |
| Plethysmography lung volumes/airway resistance CPT 94726 | $445.60 | $557.00 | $134.85 – $501.30 | 15 |
| Poct blood gases ph pco2 po2 arterial calculated o2 CPT 82803 | $105.60 | $132.00 | $31.96 – $118.80 | 15 |
| Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap CPT 95811 | $4,293.60 | $5,367.00 | $1,299.35 – $4,830.30 | 15 |
| Potassium 24 hour urine CPT 84133 | $27.20 | $34.00 | $3.63 – $13.50 | 15 |
| Potassium chloride 10 meq/100ml in sterile water intravenous piggyback HCPCS J3480 | $92.00 | $115.00 | $7.92 – $29.43 | 15 |
| Potassium serum/plasma/whole blood CPT 84132 | $36.80 | $46.00 | $11.14 – $41.40 | 15 |
| Pr application of long arm splint CPT 29105 | $320.00 | $400.00 | $96.84 – $360.00 | 15 |
| Pr application splint static short arm CPT 29125 | $285.60 | $357.00 | $86.43 – $321.30 | 15 |
| Pr counseling smoke/tobacco intermediate greater 3 - 10 minutes CPT 99406 | $54.40 | $68.00 | $16.46 – $61.20 | 15 |
| Prealbumin CPT 84134 | $59.20 | $74.00 | $17.92 – $66.60 | 15 |
| Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution HCPCS J7510 | $12.04 | $15.05 | $1.03 – $3.83 | 15 |
| Pregnancy Ultrasound (complete, after first trimester) CPT 76805 | $554.40 | $693.00 | $167.78 – $623.70 | 15 |
| Pregnancy Ultrasound (first trimester) CPT 76801 | $482.40 | $603.00 | $145.99 – $542.70 | 15 |
| Pregnancy Ultrasound (limited) CPT 76815 | $505.60 | $632.00 | $153.01 – $568.80 | 15 |
| Pressure max expiratory/inspiratory CPT 94799 | $150.40 | $188.00 | $45.51 – $169.20 | 15 |
| Pretreat rbc w chem/drugs reference CPT 86970 | $51.20 | $64.00 | $15.49 – $57.60 | 15 |
| Pr incision & drainage abscess simple/single CPT 10060 | $522.40 | $653.00 | $158.09 – $587.70 | 15 |
| Pr incision & drainage abscess vulva/perineal CPT 56405 | $690.40 | $863.00 | $208.93 – $776.70 | 15 |
| Pr incision & removal foreign body subcutaneous tissues simple CPT 10120 | $751.20 | $939.00 | $227.33 – $845.10 | 15 |
| Procainamide 100 mg/ml injection (wrapper) HCPCS J2690 | $3.36 | $4.20 | $1.02 – $3.78 | 15 |
| Procalcitonin CPT 84145 | $96.00 | $120.00 | $29.05 – $108.00 | 15 |
| Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution HCPCS J0780 | $34.89 | $43.61 | $8.22 – $30.57 | 15 |
| Progesterone CPT 84144 | $120.00 | $150.00 | $36.32 – $135.00 | 15 |
| Prolactin CPT 84146 | $123.20 | $154.00 | $14.77 – $54.90 | 15 |
| Propofol infusion 10 mg/ml HCPCS J2704 | $34.56 | $43.20 | $10.46 – $38.88 | 15 |
| Propranolol in ns IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J1800 | $27.52 | $34.39 | $8.33 – $30.95 | 15 |
| Protamine 10 mg/ml intravenous solution HCPCS J2720 | $7.38 | $9.22 | $2.18 – $8.09 | 15 |
| Protein c activity CPT 85303 | $83.20 | $104.00 | $25.18 – $93.60 | 15 |
| Protein electrophoretic fractionation & quantitation serum CPT 84165 | $73.60 | $92.00 | $18.88 – $70.20 | 15 |
| Protein s total CPT 85305 | $77.60 | $97.00 | $23.48 – $87.30 | 15 |
| Protein total 24 hour urine CPT 84156 | $23.20 | $29.00 | $6.78 – $25.20 | 15 |
| Protein total body fluid CPT 84157 | $52.00 | $65.00 | $15.74 – $58.50 | 15 |
| Protein total serum plasma whole blood CPT 84155 | $33.60 | $42.00 | $10.17 – $37.80 | 15 |
| Prothrombin complex kcentra HCPCS J7168 | $1,136.40 | $1,420.50 | $343.90 – $1,278.45 | 15 |
| Pr removal foreign body external auditory canal without anesthesia CPT 69200 | $230.40 | $288.00 | $69.72 – $259.20 | 15 |
| Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm CPT 12032 | $828.00 | $1,035.00 | $250.57 – $931.50 | 15 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm CPT 12011 | $355.20 | $444.00 | $107.49 – $399.60 | 15 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm CPT 12013 | $321.60 | $402.00 | $97.32 – $361.80 | 15 |
| Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm CPT 12001 | $355.20 | $444.00 | $107.49 – $399.60 | 15 |
| Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm CPT 12002 | $355.20 | $444.00 | $107.49 – $399.60 | 15 |
| Pr tube thoracostomy w/connection to drainage open CPT 32551 | $1,588.00 | $1,985.00 | $480.57 – $1,786.50 | 15 |
| PSA (Prostate) Test CPT 84153 | $121.60 | $152.00 | $27.12 – $100.80 | 15 |
| Psychoeducation 45 min + HCPCS G0177 | $520.00 | $650.00 | $157.37 – $585.00 | 15 |
| Psychotherapy group therapy CPT 90853 | $588.00 | $735.00 | $177.94 – $661.50 | 15 |
| Psychotherapy patient individual therapy 30 minutes CPT 90832 | $488.00 | $610.00 | $147.68 – $549.00 | 15 |
| Psychotherapy patient individual therapy 45 minutes CPT 90834 | $604.00 | $755.00 | $182.79 – $679.50 | 15 |
| Psychotherapy patient individual therapy 60 minutes CPT 90837 | $616.00 | $770.00 | $186.42 – $693.00 | 15 |
| Psychthrp grp 45-50min mcr HCPCS G0410 | $588.00 | $735.00 | $177.94 – $661.50 | 15 |
| Pt application of modality >=1 area hot/cold packs CPT 97010 | $20.00 | $25.00 | $6.05 – $22.50 | 15 |
| Pt application of modality >=1 area iontophoresis each 15 minutes CPT 97033 | $108.80 | $136.00 | $32.93 – $122.40 | 15 |
| Pt application of modality >=1 area ultrasound each 15 minutes CPT 97035 | $73.60 | $92.00 | $22.27 – $82.80 | 15 |
| Pt application of modality traction mechanical CPT 97012 | $61.60 | $77.00 | $18.64 – $69.30 | 15 |
| Pt repositioning canalith procedure(s) per day CPT 95992 | $164.00 | $205.00 | $49.63 – $184.50 | 15 |
| Pt therapeutic procedure >=1 area massage each 15 minutes CPT 97124 | $76.80 | $96.00 | $23.24 – $86.40 | 15 |
| Pt wheelchair management each 15 minutes CPT 97542 | $101.60 | $127.00 | $30.75 – $114.30 | 15 |
| Pulse ox multiple CPT 94761 | $203.20 | $254.00 | $61.49 – $228.60 | 15 |
| Puncture arterial withdrawal blood for diagnosis CPT 36600 | $186.40 | $233.00 | $56.41 – $209.70 | 15 |
| Puncture aspiration abscess/hematoma/bulla/cyst CPT 10160 | $460.00 | $575.00 | $139.21 – $517.50 | 15 |
| Puncture spinal lumbar diagnostic CPT 62270 | $1,208.80 | $1,511.00 | $365.81 – $1,359.90 | 15 |
| Pyruvate CPT 84210 | $57.60 | $72.00 | $17.43 – $64.80 | 15 |
| Quest t3 uptake CPT 84479 | $48.80 | $61.00 | $14.77 – $54.90 | 15 |
| Racepinephrine hcl soln nebu 2.25% (base equivalent) HCPCS J7699 | $4.11 | $5.13 | $1.16 – $4.31 | 15 |
| Rapid Strep Test CPT 87880 | $56.80 | $71.00 | $17.19 – $63.90 | 15 |
| Ravulizumab-cwvz 100 mg/ml intravenous solution HCPCS J1303 | not published | not published | $221.77 – $224.93 | 2 |
| Rbc count only automated CPT 85041 | $14.40 | $18.00 | $4.36 – $16.20 | 15 |
| Red blood cells leukocytes reduced each unit HCPCS P9016 | $459.20 | $574.00 | $138.97 – $516.60 | 15 |
| Red blood cells leukocytes reduced irradiated each unit HCPCS P9040 | $641.60 | $802.00 | $194.16 – $721.80 | 15 |
| Refill/maint pump/resvr syst CPT 96522 | not published | not published | $284.80 – $284.80 | 1 |
| Rem/biv cast full arm/leg CPT 29705 | $370.40 | $463.00 | $112.09 – $416.70 | 15 |
| Remdesivir 100 mg intravenous powder for solution HCPCS J0248 | $880.00 | $1,100.00 | $266.31 – $990.00 | 15 |
| Removal central venous catheter tunneled without port/pump CPT 36589 | $1,632.00 | $2,040.00 | $493.88 – $1,836.00 | 15 |
| Removal cerumen impacted (both sides) CPT 69210 | $177.60 | $222.00 | $53.75 – $199.80 | 15 |
| Removal embedded foreign body vestibule mouth smpl CPT 40804 | $751.20 | $939.00 | $227.33 – $845.10 | 15 |
| Removal foreign body foot subcutaneous right CPT 28190 | $1,408.00 | $1,760.00 | $426.10 – $1,584.00 | 15 |
| Removal skin tags fibrocutaneous any area <= 15 lesions CPT 11200 | $230.40 | $288.00 | $69.72 – $259.20 | 15 |
| Remove foreign body from eye CPT 65235 | $3,682.40 | $4,603.00 | $1,114.39 – $4,142.70 | 15 |
| Renal function panel CPT 80069 | $65.60 | $82.00 | $19.85 – $73.80 | 15 |
| Repair complex wound scalp/arms/legs 2.6 - 7.5 cm CPT 13121 | $830.40 | $1,038.00 | $251.30 – $934.20 | 15 |
| Repair eyelid defect CPT 67904 | $3,581.60 | $4,477.00 | $1,083.88 – $4,029.30 | 15 |
| Repair eyelid defect CPT 67917 | $2,924.80 | $3,656.00 | $885.12 – $3,290.40 | 15 |
| Repair eyelid defect CPT 67924 | $2,856.80 | $3,571.00 | $864.54 – $3,213.90 | 15 |
| Repair lip full thkns >one-half vert height/cmplx CPT 40654 | $1,571.20 | $1,964.00 | $475.48 – $1,767.60 | 15 |
| Repair rpr lac tongue floor mouth > 2.6 cm/cmplx CPT 41252 | $1,026.40 | $1,283.00 | $310.61 – $1,154.70 | 15 |
| Repair rpr lip full thickness vermilion only CPT 40650 | $1,496.80 | $1,871.00 | $452.97 – $1,683.90 | 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.