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 |
|---|---|---|---|---|
| Repair tongue lac <2.5cm past 1/3 tongue 41251 CPT 41251 | $623.20 | $779.00 | $188.60 – $701.10 | 15 |
| Reptilase test CPT 85635 | $50.40 | $63.00 | $15.25 – $56.70 | 15 |
| Reslizumab 10 mg/ml intravenous solution HCPCS J2786 | not published | not published | $10.50 – $10.50 | 1 |
| Reticulocyte automated CPT 85045 | $43.20 | $54.00 | $13.07 – $48.60 | 15 |
| Reticulocyte direct measurement automated CPT 85046 | $32.00 | $40.00 | $9.68 – $36.00 | 15 |
| Retifanlimab-dlwr 500 mg/20 ml intravenous solution HCPCS J9345 | not published | not published | $34.97 – $34.97 | 1 |
| Revefenacin inh non-com 1mcg HCPCS J7677 | $30.36 | $37.94 | $9.19 – $34.15 | 15 |
| Rheumatoid factor qualitative CPT 86430 | $32.00 | $40.00 | $9.68 – $36.00 | 15 |
| Rheumatoid factor quantitative CPT 86431 | $38.40 | $48.00 | $10.89 – $40.50 | 15 |
| Rho(d) immune globulin (rhig) human full dose im CPT 90384 | $192.00 | $240.00 | $58.10 – $216.00 | 15 |
| Rib and Chest X-ray (3 views, left side) CPT 71101 | $260.80 | $326.00 | $78.92 – $293.40 | 15 |
| Rib and Chest X-ray (4 or more views, both sides) CPT 71111 | $549.60 | $687.00 | $166.32 – $618.30 | 15 |
| Rib X-ray (3 views, both sides) CPT 71110 | $524.80 | $656.00 | $158.82 – $590.40 | 15 |
| Risankizumab-rzaa 60 mg/ml intravenous solution HCPCS J2327 | $9,116.52 | $11,395.65 | $2,758.89 – $10,256.09 | 15 |
| Rituximab 10 mg/ml concentrate,intravenous HCPCS J9312 | $4,043.40 | $5,054.25 | $419.74 – $1,560.38 | 15 |
| Rituximab-abbs 10 mg/ml intravenous solution HCPCS Q5115 | $877.19 | $1,096.48 | $265.46 – $986.83 | 15 |
| Romiplostim 125 mcg subcutaneous solution HCPCS J2802 | $1,580.10 | $1,975.12 | $478.18 – $1,777.61 | 15 |
| Romosozumab-aqqg 105 mg/1.17 ml subcutaneous syringe (wrapper) HCPCS J3111 | not published | not published | $11.36 – $11.36 | 1 |
| Rozanolixizumab-noli 140 mg/ml subcutaneous solution HCPCS J9333 | not published | not published | $23.21 – $23.21 | 1 |
| Rsv assay w/optic CPT 87807 | $73.60 | $92.00 | $19.37 – $72.00 | 15 |
| Rubella antibody igg CPT 86762 | $72.80 | $91.00 | $10.89 – $40.50 | 15 |
| Rubeola antibody igg CPT 86765 | $83.20 | $104.00 | $25.18 – $93.60 | 15 |
| Russell viper venom diluted CPT 85613 | $56.80 | $71.00 | $7.26 – $27.00 | 15 |
| Rx metab gen seq alys pnl 6 CPT 81418 | $256.00 | $320.00 | $77.47 – $288.00 | 15 |
| Sacroiliac Joint X-ray (3 or more views) CPT 72202 | $363.20 | $454.00 | $109.91 – $408.60 | 15 |
| Sarscov coronavirus ag ia CPT 87426 | $86.40 | $108.00 | $26.15 – $97.20 | 15 |
| Scan duplex extracranial arteries unilateral/limited study CPT 93882 | $647.20 | $809.00 | $195.86 – $728.10 | 15 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $604.00 | $755.00 | $182.79 – $679.50 | 15 |
| Screening Colonoscopy (average risk) HCPCS G0121 | $1,792.00 | $2,240.00 | $1,106.56 – $2,016.00 | 15 |
| Screening Colonoscopy (high risk) HCPCS G0105 | $1,864.80 | $2,331.00 | $1,142.90 – $2,097.90 | 15 |
| Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations HCPCS G0328 | $57.60 | $72.00 | $17.43 – $64.80 | 15 |
| Screening hepatitis c antibody high risk HCPCS G0472 | $122.40 | $153.00 | $37.04 – $137.70 | 15 |
| Screening Mammogram CPT 77067 | $403.20 | $504.00 | $165.00 – $453.60 | 15 |
| Screening prostate cancer PSA HCPCS G0103 | $136.00 | $170.00 | $41.16 – $153.00 | 15 |
| Scrotal (Testicle) Ultrasound CPT 76870 | $554.40 | $693.00 | $167.78 – $623.70 | 15 |
| Sc ther infusion reset pump CPT 96371 | not published | not published | $148.00 – $148.00 | 1 |
| Sedimentation rate erythrocyte automated CPT 85652 | $18.40 | $23.00 | $5.57 – $20.70 | 15 |
| Self-Care and Home Skills Training (each 15 minutes) CPT 97535 | $119.20 | $149.00 | $36.07 – $134.10 | 15 |
| Semen analysis presence/motility CPT 89321 | $60.80 | $76.00 | $18.40 – $68.40 | 15 |
| Semen analysis w/count CPT 89310 | $59.20 | $74.00 | $17.92 – $66.60 | 15 |
| Serial casting application 97139app CPT 97139 | $52.80 | $66.00 | $15.98 – $59.40 | 15 |
| Shot (Injection into Muscle or Under the Skin) CPT 96372 | $136.00 | $170.00 | $6.05 – $22.50 | 15 |
| Shoulder AC Joint X-ray (both sides) CPT 73050 | $330.40 | $413.00 | $99.99 – $371.70 | 15 |
| Shoulder Blade (Scapula) X-ray (both sides) CPT 73010 | $264.80 | $331.00 | $80.14 – $297.90 | 15 |
| Shoulder MRI (with and without contrast) CPT 73223 | $3,566.40 | $4,458.00 | $607.75 – $4,012.20 | 15 |
| Shoulder MRI (with contrast) CPT 73222 | $3,084.00 | $3,855.00 | $611.05 – $3,469.50 | 15 |
| Shoulder MRI (without contrast) CPT 73221 | $2,516.80 | $3,146.00 | $578.05 – $2,831.40 | 15 |
| Shoulder X-ray CPT 73030 | $240.00 | $300.00 | $72.63 – $270.00 | 15 |
| Shoulder X-ray (single view, both shoulders) CPT 73020 | $212.00 | $265.00 | $64.16 – $238.50 | 15 |
| Sickling rbc CPT 85660 | $32.80 | $41.00 | $9.93 – $36.90 | 15 |
| Sigmoidoscopy and biopsy CPT 45331 | $1,578.40 | $1,973.00 | $477.66 – $1,775.70 | 15 |
| Sinus CT scan (with and without contrast) CPT 70488 | $2,582.40 | $3,228.00 | $446.60 – $2,905.20 | 15 |
| Sinus CT scan (with contrast) CPT 70487 | $1,566.40 | $1,958.00 | $446.60 – $1,762.20 | 15 |
| Sinus CT scan (without contrast) CPT 70486 | $1,153.60 | $1,442.00 | $352.55 – $1,297.80 | 15 |
| Sinus X-ray (complete) CPT 70220 | $296.80 | $371.00 | $89.82 – $333.90 | 15 |
| Sinus X-ray (limited) CPT 70210 | $263.20 | $329.00 | $79.65 – $296.10 | 15 |
| Sirolimus, oral HCPCS J7520 | $15.50 | $19.37 | $4.37 – $16.23 | 15 |
| Skull X-ray (1 to 3 views) CPT 70250 | $383.20 | $479.00 | $115.97 – $431.10 | 15 |
| Skull X-ray (complete) CPT 70260 | $545.60 | $682.00 | $165.11 – $613.80 | 15 |
| Sleep Study (Polysomnography) CPT 95810 | $3,964.80 | $4,956.00 | $1,199.85 – $4,460.40 | 15 |
| Sleep study unattended CPT 95806 | $544.80 | $681.00 | $164.87 – $612.90 | 15 |
| Small Bowel Barium X-ray (Follow-Through) CPT 74250 | $752.00 | $940.00 | $227.57 – $846.00 | 15 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $35.20 | $44.00 | $10.65 – $39.60 | 15 |
| Smear gram stain CPT 87205 | $28.80 | $36.00 | $8.72 – $32.40 | 15 |
| Smear nasal eosinophil CPT 89190 | $24.00 | $30.00 | $7.26 – $27.00 | 15 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $45.60 | $57.00 | $13.80 – $51.30 | 15 |
| Smear wet mount CPT 87210 | $27.20 | $34.00 | $8.23 – $30.60 | 15 |
| Sodium 24 hour urine CPT 84300 | $56.00 | $70.00 | $3.87 – $14.40 | 15 |
| Sodium chloride 0.9 % intravenous solution HCPCS J7030 | $60.00 | $75.00 | $18.16 – $67.50 | 15 |
| Sodium chloride 0.9 % IV bolus HCPCS J7040 | $60.00 | $75.00 | $12.11 – $45.00 | 15 |
| Sodium chloride 0.9 % IV bolus HCPCS J7050 | $48.00 | $60.00 | $12.11 – $45.00 | 15 |
| Sodium serum/plasma/whole blood CPT 84295 | $32.80 | $41.00 | $9.93 – $36.90 | 15 |
| Specimen fat stain CPT 89125 | $30.40 | $38.00 | $9.20 – $34.20 | 15 |
| Speech and Language Evaluation (comprehensive) CPT 92523 | $468.00 | $585.00 | $141.63 – $526.50 | 15 |
| Speech Therapy Session (one-on-one) CPT 92507 | $272.00 | $340.00 | $167.75 – $306.00 | 15 |
| Spine X-ray (single view, one level) CPT 72020 | $336.80 | $421.00 | $101.92 – $378.90 | 15 |
| St analysis behavior qualitative voice/resonance CPT 92524 | $279.20 | $349.00 | $84.49 – $314.10 | 15 |
| Staph a dna amp probe CPT 87640 | $136.80 | $171.00 | $41.40 – $153.90 | 15 |
| St cognitve performance testing healthcare professional each hour CPT 96125 | $332.00 | $415.00 | $100.47 – $373.50 | 15 |
| Sterile water/saline, 10 ml HCPCS A4216 | $3.40 | $4.25 | $1.03 – $3.83 | 15 |
| Sterile water/saline, 500 ml HCPCS A4217 | $31.60 | $39.50 | $7.94 – $29.52 | 15 |
| St evaluate speech sound production CPT 92522 | $302.40 | $378.00 | $91.51 – $340.20 | 15 |
| Strapping of ankle and/or ft 29540 CPT 29540 | $222.40 | $278.00 | $67.30 – $250.20 | 15 |
| Strapping of elbow or wrist 29260 CPT 29260 | $200.80 | $251.00 | $60.77 – $225.90 | 15 |
| Strep b dna amp probe CPT 87653 | $195.20 | $244.00 | $56.41 – $209.70 | 15 |
| Stress test pulmonary CPT 94618 | $261.60 | $327.00 | $79.17 – $294.30 | 15 |
| Succinylcholine chloride 20 mg/ml injection solution (wrapper) HCPCS J0330 | $59.44 | $74.30 | $8.88 – $33.01 | 15 |
| Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 | $35.05 | $43.81 | $8.75 – $32.53 | 15 |
| Surgical pathology level 1 gross examination only CPT 88300 | $35.20 | $44.00 | $10.65 – $39.60 | 15 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $68.80 | $86.00 | $20.82 – $77.40 | 15 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $156.00 | $195.00 | $47.21 – $175.50 | 15 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $216.80 | $271.00 | $79.53 – $144.90 | 15 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $494.40 | $618.00 | $149.62 – $556.20 | 15 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $694.40 | $868.00 | $210.14 – $781.20 | 15 |
| Susceptibility agar dilution per agent CPT 87181 | $45.60 | $57.00 | $8.47 – $31.50 | 15 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $29.60 | $37.00 | $8.96 – $33.30 | 15 |
| Susceptibility mic per plate CPT 87186 | $176.00 | $220.00 | $14.04 – $52.20 | 15 |
| Swallowing Evaluation (Bedside) CPT 92610 | $352.80 | $441.00 | $106.77 – $396.90 | 15 |
| Swallowing Therapy Session CPT 92526 | $278.40 | $348.00 | $84.25 – $313.20 | 15 |
| Sweat collection by iontophoresis CPT 89230 | $36.00 | $45.00 | $10.89 – $40.50 | 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.