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 |
|---|---|---|---|---|
| Aquatic exercise - group charge CPT 97150 | $86.40 | $108.00 | $26.15 – $97.20 | 15 |
| Arm CT Scan (with contrast, both arms) CPT 73201 | $2,022.40 | $2,528.00 | $607.75 – $2,275.20 | 15 |
| Arm CT Scan (without contrast, both arms) CPT 73200 | $1,575.20 | $1,969.00 | $352.55 – $1,772.10 | 15 |
| Arm or Leg Ultrasound (limited, left side) CPT 76882 | $424.00 | $530.00 | $128.31 – $477.00 | 15 |
| Assay myeloperoxidase CPT 83876 | $169.60 | $212.00 | $50.84 – $189.00 | 15 |
| Assay of interleukin-6 (il-6) CPT 83529 | $100.00 | $125.00 | $30.26 – $112.50 | 15 |
| Assay of salicylate CPT 80179 | $175.20 | $219.00 | $53.02 – $197.10 | 15 |
| Assay of tyrosine CPT 84510 | $56.00 | $70.00 | $16.95 – $63.00 | 15 |
| Assay of urine sulfate CPT 84392 | $29.60 | $37.00 | $4.12 – $15.30 | 15 |
| Assess aphasia/interp/rpt/per hr 96105 CPT 96105 | $359.20 | $449.00 | $108.70 – $404.10 | 15 |
| Assessment leukocyte fecal qualitative/semiquantitative CPT 89055 | $27.20 | $34.00 | $8.23 – $30.60 | 15 |
| Ast/sgot CPT 84450 | $36.80 | $46.00 | $11.14 – $41.40 | 15 |
| Atezolizumab 60 mg/ml intravenous solution (wrapper) HCPCS J9022 | not published | not published | $103.32 – $103.32 | 1 |
| Atropine 0.1 mg/ml injection syringe HCPCS J0461 | $15.74 | $19.67 | $0.85 – $3.17 | 15 |
| Automated diff wbc count CPT 85004 | $32.80 | $41.00 | $9.93 – $36.90 | 15 |
| Avelumab 20 mg/ml intravenous solution HCPCS J9023 | not published | not published | $114.04 – $114.04 | 1 |
| Avul nail plate addl CPT 11732 | $232.80 | $291.00 | $70.45 – $261.90 | 15 |
| Avulsion nail plate partial/complete simple single nail plate CPT 11730 | $501.60 | $627.00 | $151.80 – $564.30 | 15 |
| Azithromycin 500 mg intravenous solution HCPCS J0456 | $31.44 | $39.29 | $8.31 – $30.89 | 15 |
| Azithromycin dihydrate, oral HCPCS Q0144 | $43.25 | $54.06 | $5.86 – $21.79 | 15 |
| Baclofen eval charges CPT 97750 | $121.60 | $152.00 | $36.80 – $136.80 | 15 |
| Bacterial meningitis antigen CPT 86403 | $60.80 | $76.00 | $18.40 – $68.40 | 15 |
| Balance and Coordination Retraining (each 15 minutes) CPT 97112 | $111.20 | $139.00 | $63.25 – $125.10 | 15 |
| Barium Enema (Colon X-ray, barium and air) CPT 74280 | $1,140.80 | $1,426.00 | $345.23 – $1,283.40 | 15 |
| Barium Enema (Colon X-ray, barium only) CPT 74270 | $872.80 | $1,091.00 | $264.13 – $981.90 | 15 |
| Barium Swallow (Esophagus X-ray) CPT 74220 | $616.80 | $771.00 | $186.66 – $693.90 | 15 |
| B cells total count CPT 86355 | $156.00 | $195.00 | $47.21 – $175.50 | 15 |
| Belimumab 120 mg intravenous solution HCPCS J0490 | not published | not published | $55.16 – $55.16 | 1 |
| #_benzodiazconfur CPT 80346 | $90.40 | $113.00 | $27.36 – $101.70 | 15 |
| Beta 2 glycoprotein 1 antibody iga CPT 86146 | $140.00 | $175.00 | $18.88 – $70.20 | 15 |
| Beta-2 microglobulin CPT 82232 | $52.80 | $66.00 | $15.25 – $56.70 | 15 |
| Betamethasone acetate and sodium phos 6 mg/ml suspension for injection HCPCS J0702 | $12.68 | $15.84 | $3.83 – $14.26 | 15 |
| Bfb train ea addl 15 min 90913 CPT 90913 | $66.40 | $83.00 | $20.09 – $74.70 | 15 |
| Bilateral n block inj trigeminal 64400 CPT 64400 | $1,064.80 | $1,331.00 | $322.24 – $1,197.90 | 15 |
| Bilicheck CPT 88720 | $20.80 | $26.00 | $6.29 – $23.40 | 15 |
| Bilirubin direct CPT 82248 | $30.40 | $38.00 | $9.20 – $34.20 | 15 |
| Bilirubin total CPT 82247 | $31.20 | $39.00 | $9.44 – $35.10 | 15 |
| Biofeedback, pt CPT 90901 | $124.00 | $155.00 | $37.53 – $139.50 | 15 |
| Biotinidase - quest CPT 82261 | $53.60 | $67.00 | $16.22 – $60.30 | 15 |
| Bladder Catheter Insertion (simple) CPT 51702 | $250.40 | $313.00 | $75.78 – $281.70 | 15 |
| Bladder irrigate/lavage/instill 51700 CPT 51700 | $525.60 | $657.00 | $159.06 – $591.30 | 15 |
| Blepharoplasty upper eyelid 15823 CPT 15823 | $3,424.00 | $4,280.00 | $1,036.19 – $3,852.00 | 15 |
| Blood Clotting (PT/INR) Test CPT 85610 | $35.20 | $44.00 | $3.39 – $12.60 | 15 |
| Blood Clotting (PTT) Test CPT 85730 | $38.40 | $48.00 | $4.60 – $17.10 | 15 |
| Blood Count (CBC) Test CPT 85025 | $76.80 | $96.00 | $41.25 – $86.40 | 15 |
| Blood Count (CBC) Test (without differential) CPT 85027 | $36.80 | $46.00 | $11.14 – $41.40 | 15 |
| Blood Culture Test CPT 87040 | $66.40 | $83.00 | $20.09 – $74.70 | 15 |
| Blood draw capillary 36416 CPT 36416 | $20.00 | $25.00 | $6.05 – $22.50 | 15 |
| Blood Draw (Venipuncture) CPT 36415 | $25.60 | $32.00 | $15.81 – $28.80 | 15 |
| Blood occult fecal hemoglobin immunoassay qualitative 1-3 simultaneous determinations diagnostic CPT 82274 | $57.60 | $72.00 | $17.43 – $64.80 | 15 |
| Blood occult feces 1-3 determinations other than neoplasm screening qualitative CPT 82272 | $20.00 | $25.00 | $6.05 – $22.50 | 15 |
| Blood occult feces colorectal neoplasm screening qualitative CPT 82270 | $20.00 | $25.00 | $6.05 – $22.50 | 15 |
| Blood occult peroxidase activity qualitative gastric CPT 82271 | $22.40 | $28.00 | $6.78 – $25.20 | 15 |
| Blood smear microscopic w manual differential wbc count CPT 85007 | $34.40 | $43.00 | $10.41 – $38.70 | 15 |
| Blood Transfusion CPT 36430 | $844.80 | $1,056.00 | $255.66 – $950.40 | 15 |
| Blood typing abo CPT 86900 | $39.20 | $49.00 | $11.86 – $44.10 | 15 |
| Blood typing ag donor ea ag CPT 86902 | $162.40 | $203.00 | $41.64 – $154.80 | 15 |
| Blood typing patient serum CPT 86904 | $55.20 | $69.00 | $16.70 – $62.10 | 15 |
| Blood typing rbc ag non abo/rh ea CPT 86905 | $23.20 | $29.00 | $7.02 – $26.10 | 15 |
| Blood typing rh (d) CPT 86901 | $39.20 | $49.00 | $11.86 – $44.10 | 15 |
| Blood typing rh phenotype complete reference CPT 86906 | $44.00 | $55.00 | $13.32 – $49.50 | 15 |
| Bone Age X-ray (hand and wrist) CPT 77072 | $315.20 | $394.00 | $95.39 – $354.60 | 15 |
| Bone Density Scan (DEXA) CPT 77080 | $474.40 | $593.00 | $143.57 – $533.70 | 15 |
| Bone imaging multiple areas CPT 78305 | $1,389.60 | $1,737.00 | $420.53 – $1,563.30 | 15 |
| Bone/joint imaging ltd area CPT 78300 | $1,303.20 | $1,629.00 | $394.38 – $1,466.10 | 15 |
| Bone survey-lead poisoning CPT 77074 | $538.40 | $673.00 | $162.93 – $605.70 | 15 |
| Borrelia burgdorferi (lyme disease) antibody nonspecific CPT 86618 | $112.80 | $141.00 | $19.85 – $73.80 | 15 |
| Brace or Splint Fitting and Training (each 15 minutes) CPT 97760 | $122.40 | $153.00 | $37.04 – $137.70 | 15 |
| Brain MRA (blood vessel MRI, with and without contrast) CPT 70546 | $3,603.20 | $4,504.00 | $607.75 – $4,053.60 | 15 |
| Brain MRA (blood vessel MRI, with contrast) CPT 70545 | $2,732.00 | $3,415.00 | $607.75 – $3,073.50 | 15 |
| Brain MRA (blood vessel MRI, without contrast) CPT 70544 | $2,276.80 | $2,846.00 | $578.05 – $2,561.40 | 15 |
| Brain MRI (with and without contrast) CPT 70553 | $3,730.40 | $4,663.00 | $607.75 – $4,196.70 | 15 |
| Brain MRI (with contrast) CPT 70552 | $3,088.80 | $3,861.00 | $607.75 – $3,474.90 | 15 |
| Brain MRI (without contrast) CPT 70551 | $2,140.00 | $2,675.00 | $578.05 – $2,407.50 | 15 |
| Breastbone (Sternum) X-ray CPT 71120 | $363.20 | $454.00 | $109.91 – $408.60 | 15 |
| Budesonide non-comp unit HCPCS J7626 | $11.57 | $14.46 | $2.73 – $10.14 | 15 |
| Bumetanide in d5w IV syringe 0.04 mg/ml (neo/ped) - cnr HCPCS J1939 | $13.63 | $17.03 | $4.12 – $15.32 | 15 |
| Bundled special stain group 1 microorganisms CPT 88312 | $223.20 | $279.00 | $67.55 – $251.10 | 15 |
| Bundled special stain group 2 CPT 88313 | $169.60 | $212.00 | $51.33 – $190.80 | 15 |
| Bupivacaine 0.1 % epidural pca - 1 hour dose limit HCPCS J0665 | $28.76 | $35.94 | $8.08 – $30.05 | 15 |
| C-1 esterase, berinert HCPCS J0597 | not published | not published | $69.64 – $69.64 | 1 |
| C-1 esterase, cinryze HCPCS J0598 | not published | not published | $65.44 – $65.44 | 1 |
| Cadd pump refill CPT 96521 | not published | not published | $300.80 – $300.80 | 1 |
| Calcium 24 hour urine CPT 82340 | $36.00 | $45.00 | $4.60 – $17.10 | 15 |
| Calcium chloride 100 mg/ml (10 %) intravenous syringe HCPCS J0618 | $32.97 | $41.21 | $8.52 – $31.69 | 15 |
| Calcium gluconate 100 mg/ml (10 %) intravenous solution HCPCS J0612 | $32.69 | $40.86 | $9.89 – $36.77 | 15 |
| Calcium ionized CPT 82330 | $76.00 | $95.00 | $23.00 – $85.50 | 15 |
| Calcium total CPT 82310 | $36.00 | $45.00 | $10.89 – $40.50 | 15 |
| Calprotectin fecal CPT 83993 | $117.60 | $147.00 | $35.59 – $132.30 | 15 |
| Canakinumab injection HCPCS J0638 | not published | not published | $130.24 – $130.24 | 1 |
| Carbamazepine free -sendout CPT 80161 | $71.20 | $89.00 | $21.55 – $80.10 | 15 |
| Carbamazepine total therapeutic drug level CPT 80156 | $88.00 | $110.00 | $21.55 – $80.10 | 15 |
| Carbon dioxide CPT 82374 | $27.20 | $34.00 | $8.23 – $30.60 | 15 |
| Carboxyhemoglobin quantitative CPT 82375 | $107.20 | $134.00 | $32.44 – $120.60 | 15 |
| Carcinoembryonic ag (cea) CPT 82378 | $100.00 | $125.00 | $30.26 – $112.50 | 15 |
| Cardiac rehabilitation op phase 2 w/continous ecg monitoring CPT 93798 | $169.60 | $212.00 | $99.79 – $181.80 | 15 |
| Cardiac rehabilitation op phase 2 without continous ecg monitoring CPT 93797 | $208.80 | $261.00 | $63.19 – $234.90 | 15 |
| Cardiolipin antibody iga CPT 86147 | $119.20 | $149.00 | $18.88 – $70.20 | 15 |
| Cardioversion (Scheduled Heart Rhythm Shock) CPT 92960 | $1,602.40 | $2,003.00 | $484.93 – $1,802.70 | 15 |
| Caregiver training strategies&tq 1st 30 minutes CPT 97550 | $136.00 | $170.00 | $41.16 – $153.00 | 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.