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 |
|---|---|---|---|---|
| Collection blood specimen using established central/peripheral catheter venous nos CPT 36592 | $157.60 | $197.00 | $47.69 – $177.30 | 15 |
| Colonoscopy (diagnostic) CPT 45378 | $1,846.40 | $2,308.00 | $1,140.15 – $2,077.20 | 15 |
| Colonoscopy flex w/rem of tumor(s)/polyp(s)/lesion(s) by hot biopsy(s) forceps (rest meth ii cah) CPT 45384 | $1,846.40 | $2,308.00 | $1,140.15 – $2,077.20 | 15 |
| Colonoscopy stoma w/snare 44394 CPT 44394 | $2,252.00 | $2,815.00 | $681.51 – $2,533.50 | 15 |
| Colonoscopy submucous njx CPT 45381 | $1,846.40 | $2,308.00 | $558.77 – $2,077.20 | 15 |
| Colonoscopy thru stoma spx CPT 44388 | $2,118.40 | $2,648.00 | $641.08 – $2,383.20 | 15 |
| Colonoscopy (with biopsy) CPT 45380 | $1,846.40 | $2,308.00 | $1,140.15 – $2,077.20 | 15 |
| Colonoscopy with biopsy CPT 44389 | $2,194.40 | $2,743.00 | $664.08 – $2,468.70 | 15 |
| Colonoscopy (with polyp removal) CPT 45385 | $1,958.40 | $2,448.00 | $1,191.30 – $2,203.20 | 15 |
| Colonoscopy w/resection CPT 45390 | $1,871.20 | $2,339.00 | $566.27 – $2,105.10 | 15 |
| Compatibility test each unit antiglobulin technique CPT 86922 | $188.80 | $236.00 | $40.67 – $151.20 | 15 |
| Compatibility test each unit immediate spin technique CPT 86920 | $151.20 | $189.00 | $45.76 – $170.10 | 15 |
| Compatibility test incubate CPT 86921 | $140.00 | $175.00 | $42.37 – $157.50 | 15 |
| Complement antigen each component c3 CPT 86160 | $81.60 | $102.00 | $17.19 – $63.90 | 15 |
| Complex repair trunk 1.1-2.5cm 13120 CPT 13120 | $748.80 | $936.00 | $226.61 – $842.40 | 15 |
| Complex repair trunk 2.6-7.5cm 13101 CPT 13101 | $1,585.60 | $1,982.00 | $479.84 – $1,783.80 | 15 |
| Complx repair fccmnaxghf 13132 CPT 13132 | $983.20 | $1,229.00 | $297.54 – $1,106.10 | 15 |
| Concentration infection agents any type CPT 87015 | $38.40 | $48.00 | $9.44 – $35.10 | 15 |
| Condylomata destruction 56420 CPT 56420 | $438.40 | $548.00 | $132.67 – $493.20 | 15 |
| Consultation pathology during surgery cytological exam initial site CPT 88333 | $88.80 | $111.00 | $26.87 – $99.90 | 15 |
| Consultation pathology during surgery frozen section each additional block CPT 88332 | $57.60 | $72.00 | $17.43 – $64.80 | 15 |
| Consultation pathology during surgery frozen section first tissue block CPT 88331 | $93.60 | $117.00 | $28.33 – $105.30 | 15 |
| Contrast baths charges CPT 97034 | $80.00 | $100.00 | $24.21 – $90.00 | 15 |
| Control nosebleed pack+caut 30905 CPT 30905 | $548.80 | $686.00 | $166.08 – $617.40 | 15 |
| Control of nosebleed ant comp 30903 CPT 30903 | $400.80 | $501.00 | $121.29 – $450.90 | 15 |
| Control of nosebleedantersmpl 30901 CPT 30901 | $264.80 | $331.00 | $80.14 – $297.90 | 15 |
| Control oropharyngeal hemorr/simp 42960 CPT 42960 | $632.80 | $791.00 | $191.50 – $711.90 | 15 |
| Coombs direct CPT 86880 | $33.60 | $42.00 | $10.17 – $37.80 | 15 |
| Coombs indirect titer reference CPT 86886 | $37.60 | $47.00 | $11.38 – $42.30 | 15 |
| Cortisol total am CPT 82533 | $83.20 | $104.00 | $13.80 – $51.30 | 15 |
| Counseling smoke cess interm >10mins CPT 99407 | $81.60 | $102.00 | $24.69 – $91.80 | 15 |
| Covid-19 administration immunization im inj 1st/only component CPT 90480 | $71.20 | $89.00 | $21.55 – $80.10 | 15 |
| #covid19rsv-rsv CPT 87634 | $171.20 | $214.00 | $51.81 – $192.60 | 15 |
| CPAP or BiPAP Setup (first day) CPT 94660 | $392.80 | $491.00 | $118.87 – $441.90 | 15 |
| C-peptide CPT 84681 | $117.60 | $147.00 | $35.59 – $132.30 | 15 |
| CPR (Cardiopulmonary Resuscitation) CPT 92950 | $955.20 | $1,194.00 | $289.07 – $1,074.60 | 15 |
| C-reactive protein CPT 86140 | $42.40 | $53.00 | $12.83 – $47.70 | 15 |
| C-reactive protein high sensitivity CPT 86141 | $77.60 | $97.00 | $23.48 – $87.30 | 15 |
| Creatine kinase CPT 82550 | $42.40 | $53.00 | $12.83 – $47.70 | 15 |
| Creatine kinase mb CPT 82553 | $71.20 | $89.00 | $21.55 – $80.10 | 15 |
| Creatinine CPT 82565 | $28.00 | $35.00 | $8.47 – $31.50 | 15 |
| Creatinine 24 hour urine CPT 82570 | $42.40 | $53.00 | $5.08 – $18.90 | 15 |
| Creatinine clearance urine CPT 82575 | $59.20 | $74.00 | $17.92 – $66.60 | 15 |
| #creutz-prot.,western blot CPT 84182 | $120.00 | $150.00 | $36.32 – $135.00 | 15 |
| Critical care each additional 30 minutes CPT 99292 | $813.60 | $1,017.00 | $246.22 – $915.30 | 15 |
| Critical Care (first 30 to 74 minutes) CPT 99291 | $2,549.60 | $3,187.00 | $771.57 – $2,868.30 | 15 |
| Crizanlizumab-tmca 10 mg/ml intravenous solution HCPCS J0791 | not published | not published | $130.95 – $130.95 | 1 |
| Cryofibrinogen qualitative - sendout CPT 82585 | $57.60 | $72.00 | $16.22 – $60.30 | 15 |
| Crystal identification light microscopy CPT 89060 | $45.60 | $57.00 | $13.80 – $51.30 | 15 |
| Cta lower extremity without & w/contrast (both sides) CPT 73706 | not published | not published | $446.60 – $446.60 | 1 |
| CT Angiogram of Abdomen and Pelvis CPT 74174 | $4,526.40 | $5,658.00 | $607.75 – $5,092.20 | 15 |
| CT Angiogram of the Abdomen CPT 74175 | $2,568.80 | $3,211.00 | $446.60 – $2,889.90 | 15 |
| CT Angiogram of the Chest (for blood clot) CPT 71275 | $2,441.60 | $3,052.00 | $446.60 – $2,746.80 | 15 |
| CT Angiogram of the Head CPT 70496 | $2,516.00 | $3,145.00 | $446.60 – $2,830.50 | 15 |
| CT Angiogram of the Neck CPT 70498 | $2,516.00 | $3,145.00 | $446.60 – $2,830.50 | 15 |
| CT angio hrt w/3d image CPT 75574 | not published | not published | $446.60 – $446.60 | 1 |
| CT angio pelvis CPT 72191 | not published | not published | $446.60 – $446.60 | 1 |
| Cta upper extremity w &/or without contrast left CPT 73206 | not published | not published | $446.60 – $446.60 | 1 |
| CT colonography dx CPT 74261 | not published | not published | $352.55 – $352.55 | 1 |
| CT colonography dx w/dye CPT 74262 | not published | not published | $446.60 – $446.60 | 1 |
| CT hrt c+ strux cgen hrt ds CPT 75573 | not published | not published | $446.60 – $446.60 | 1 |
| CT hrt w/3d image CPT 75572 | not published | not published | $446.60 – $446.60 | 1 |
| CT limited or localized follow-up study CPT 76380 | $808.80 | $1,011.00 | $244.76 – $909.90 | 15 |
| CT lwr extremity w/o&w/dye CPT 73702 | not published | not published | $446.60 – $446.60 | 1 |
| Ctrl nosebld postir subsq 30906 CPT 30906 | $496.00 | $620.00 | $150.10 – $558.00 | 15 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $3,004.00 | $3,755.00 | $607.75 – $3,379.50 | 15 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $2,492.80 | $3,116.00 | $607.75 – $2,804.40 | 15 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $2,080.80 | $2,601.00 | $578.05 – $2,340.90 | 15 |
| CT t-spine w /wo contrast CPT 72130 | not published | not published | $446.60 – $446.60 | 1 |
| CT uppr extremity w/o&w/dye CPT 73202 | $2,277.60 | $2,847.00 | $446.60 – $2,562.30 | 15 |
| Culture aerobic additional method definitive id each CPT 87077 | $90.40 | $113.00 | $13.80 – $51.30 | 15 |
| Culture afb any source CPT 87116 | $70.40 | $88.00 | $21.30 – $79.20 | 15 |
| Culture anaerobic additional method definitive id each CPT 87076 | $43.20 | $54.00 | $13.07 – $48.60 | 15 |
| Culture anaerobic except blood CPT 87075 | $55.20 | $69.00 | $16.70 – $62.10 | 15 |
| Culture bact stool aero addl path ea CPT 87046 | $56.00 | $70.00 | $16.95 – $63.00 | 15 |
| Culture body fluid CPT 87070 | $54.40 | $68.00 | $14.28 – $53.10 | 15 |
| Culture fungi definitive id mold CPT 87107 | $62.40 | $78.00 | $18.88 – $70.20 | 15 |
| Culture fungi definitive id yeast CPT 87106 | $66.40 | $83.00 | $18.88 – $70.20 | 15 |
| Culture fungi other (except blood) CPT 87102 | $65.60 | $82.00 | $13.07 – $48.60 | 15 |
| Culture fungi skin/hair/nail CPT 87101 | $49.60 | $62.00 | $15.01 – $55.80 | 15 |
| Culture screening strep group a CPT 87081 | $36.00 | $45.00 | $10.89 – $40.50 | 15 |
| Culture typing immunologic CPT 87147 | $33.60 | $42.00 | $8.72 – $32.40 | 15 |
| Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets CPT 87154 | $576.00 | $720.00 | $174.31 – $648.00 | 15 |
| Culture typing nucleic acid probe amplified per culture/isolate each organism CPT 87150 | $176.00 | $220.00 | $53.26 – $198.00 | 15 |
| Culture urine each isolate CPT 87088 | $44.80 | $56.00 | $13.56 – $50.40 | 15 |
| Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution HCPCS J3420 | $31.00 | $38.75 | $8.06 – $29.97 | 15 |
| Cyclic citrullinated peptide antibody CPT 86200 | $96.80 | $121.00 | $17.19 – $63.90 | 15 |
| Cyclosporine 2 hour CPT 80158 | $112.80 | $141.00 | $34.14 – $126.90 | 15 |
| Cyp2c19 gene com variants CPT 81225 | $256.00 | $320.00 | $77.47 – $288.00 | 15 |
| Cystatin c CPT 82610 | $99.20 | $124.00 | $30.02 – $111.60 | 15 |
| Cystine urine quantitative CPT 82131 | $101.60 | $127.00 | $30.75 – $114.30 | 15 |
| Cystoscopy (Bladder Scope) CPT 52000 | $1,046.40 | $1,308.00 | $316.67 – $1,177.20 | 15 |
| Cystourethroscop/calib/dilat stric 52281 CPT 52281 | $3,036.00 | $3,795.00 | $918.77 – $3,415.50 | 15 |
| Cytogenetics 25-99 CPT 88274 | $103.20 | $129.00 | $31.23 – $116.10 | 15 |
| Cytogenetics 3-5 CPT 88272 | $99.20 | $124.00 | $30.02 – $111.60 | 15 |
| Cytomegalovirus (cmv) antibody igg CPT 86644 | $86.40 | $108.00 | $25.90 – $96.30 | 15 |
| Cytomegalovirus (cmv) antibody igm CPT 86645 | $96.80 | $121.00 | $28.08 – $104.40 | 15 |
| Cytopathology cellular enhancement technique non-gyn CPT 88112 | $100.80 | $126.00 | $30.50 – $113.40 | 15 |
| Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review CPT 88175 | $100.80 | $126.00 | $30.50 – $113.40 | 15 |
| Cytopathology cervical/vaginal thin layer manual screening CPT 88142 | $106.40 | $133.00 | $32.20 – $119.70 | 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.