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 |
|---|---|---|---|---|
| Cytopathology concentration technique smears & interpretation CPT 88108 | $147.20 | $184.00 | $44.55 – $165.60 | 15 |
| Cytopathology fluids/washings/brushings smears with interpretation CPT 88104 | $108.00 | $135.00 | $32.68 – $121.50 | 15 |
| Cytopathology fna adequacy evaluation first episode each site CPT 88172 | $52.00 | $65.00 | $15.74 – $58.50 | 15 |
| Cytopathology fna adequacy evaluation first episode each site interp/rpt CPT 88173 | $216.80 | $271.00 | $65.61 – $243.90 | 15 |
| Cytopath smear other source CPT 88160 | $110.40 | $138.00 | $33.41 – $124.20 | 15 |
| Cytopath smear oth prep screen & interp CPT 88161 | $109.60 | $137.00 | $33.17 – $123.30 | 15 |
| Daptomycin 500 mg/10 ml intravenous solution HCPCS J0878 | $549.34 | $686.67 | $11.43 – $42.51 | 15 |
| Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln HCPCS J9144 | not published | not published | $61.60 – $61.60 | 1 |
| Darbepoetin alfa, esrd use HCPCS J0882 | $917.20 | $1,146.50 | $171.46 – $637.38 | 15 |
| Dch glucoscan CPT 82948 | $16.00 | $20.00 | $4.84 – $18.00 | 15 |
| Dch validity tests CPT 81002 | $16.00 | $20.00 | $4.84 – $18.00 | 15 |
| Deamidated gliadin antibody iga CPT 86258 | $54.40 | $68.00 | $12.83 – $47.70 | 15 |
| Debridement (>20 cm) charge pt CPT 97598 | $359.20 | $449.00 | $108.70 – $404.10 | 15 |
| Debrid/rmv fgn bdy/open fx/skin/sq 11010 CPT 11010 | $1,776.00 | $2,220.00 | $537.46 – $1,998.00 | 15 |
| Decalcification CPT 88311 | $51.20 | $64.00 | $15.49 – $57.60 | 15 |
| Delivery of placenta 59414 CPT 59414 | $1,064.80 | $1,331.00 | $322.24 – $1,197.90 | 15 |
| Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device CPT 94664 | $208.80 | $261.00 | $39.22 – $145.80 | 15 |
| Dentoalveolar/drain abs/cyst/hema 41800 CPT 41800 | $401.60 | $502.00 | $121.53 – $451.80 | 15 |
| Desmopressin 4 mcg/ml injection solution HCPCS J2597 | $27.37 | $34.21 | $8.28 – $30.79 | 15 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | $291.20 | $364.00 | $88.12 – $327.60 | 15 |
| Dexamethasone 4 mg tablet HCPCS J8540 | $24.00 | $30.00 | $1.03 – $3.83 | 15 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $37.11 | $46.38 | $1.59 – $5.91 | 15 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | $60.00 | $75.00 | $18.16 – $67.50 | 15 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | $60.00 | $75.00 | $12.11 – $45.00 | 15 |
| Dextrose 5 % IV bolus HCPCS J7070 | $60.00 | $75.00 | $18.16 – $67.50 | 15 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $128.00 | $160.00 | $38.74 – $144.00 | 15 |
| Diabetes (HbA1c) Test CPT 83036 | $55.20 | $69.00 | $34.09 – $62.10 | 15 |
| Diab manage trn ind/group HCPCS G0109 | $64.00 | $80.00 | $19.37 – $72.00 | 15 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $494.40 | $618.00 | $149.62 – $556.20 | 15 |
| Diagnostic Mammogram (one breast) CPT 77065 | $389.60 | $487.00 | $117.90 – $438.30 | 15 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $29.63 | $37.03 | $0.90 – $3.36 | 15 |
| Diffusing capacity CPT 94729 | $360.80 | $451.00 | $109.19 – $405.90 | 15 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $28.68 | $35.85 | $8.00 – $29.75 | 15 |
| Digoxin total therapeutic drug level CPT 80162 | $73.60 | $92.00 | $22.27 – $82.80 | 15 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | $97.56 | $121.95 | $29.52 – $109.76 | 15 |
| Diltiazem 5 mg/ml intravenous solution HCPCS J1163 | $10.84 | $13.54 | $1.40 – $5.19 | 15 |
| Diphenhydramine 12.5 mg/5 ml oral elixir HCPCS Q0163 | $3.40 | $4.25 | $1.03 – $3.83 | 15 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $27.96 | $34.94 | $7.99 – $29.72 | 15 |
| Diphtheria-tetanus toxoids 0.5 ml (peds) CPT 90702 | $133.60 | $167.00 | $40.43 – $150.30 | 15 |
| Dna antibody native/double stranded CPT 86225 | $80.00 | $100.00 | $24.21 – $90.00 | 15 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $142.68 | $178.35 | $43.18 – $160.52 | 15 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $111.88 | $139.85 | $27.60 – $102.60 | 15 |
| Doppler echo complete CPT 93320 | $548.00 | $685.00 | $165.84 – $616.50 | 15 |
| Dostarlimab-gxly 50 mg/ml intravenous solution HCPCS J9272 | not published | not published | $283.24 – $283.24 | 1 |
| Doxycycline hyclate 100 mg intravenous powder for solution HCPCS J1271 | $39.76 | $49.70 | $10.78 – $40.09 | 15 |
| Drainage external ear simple 69000 CPT 69000 | $616.00 | $770.00 | $186.42 – $693.00 | 15 |
| Drainage of arm bursa 23931 CPT 23931 | $2,491.20 | $3,114.00 | $753.90 – $2,802.60 | 15 |
| Drain blood from under nail 11740 CPT 11740 | $232.00 | $290.00 | $70.21 – $261.00 | 15 |
| Drain finger abscess;simple 26010 CPT 26010 | $472.80 | $591.00 | $143.08 – $531.90 | 15 |
| Drain lower leg lesion 27603 CPT 27603 | $2,920.00 | $3,650.00 | $883.67 – $3,285.00 | 15 |
| Dress/debride pt-tck burn/5-10% bs 16025 CPT 16025 | $492.00 | $615.00 | $148.89 – $553.50 | 15 |
| Dress/debride pt-thick burn/<5% bs 16020 CPT 16020 | $353.60 | $442.00 | $107.01 – $397.80 | 15 |
| Drug assay vedolizumab CPT 80280 | $193.60 | $242.00 | $58.59 – $217.80 | 15 |
| Drug of abuse screen urine CPT 80305 | $61.60 | $77.00 | $18.64 – $69.30 | 15 |
| Drug test(s) presumptive any class instrument chemistry analyzers CPT 80307 | $316.80 | $396.00 | $45.51 – $169.20 | 15 |
| Drvvt confirm - quest CPT 85597 | $167.20 | $209.00 | $50.60 – $188.10 | 15 |
| Dry needling (97799) CPT 97799 | $108.00 | $135.00 | $32.68 – $121.50 | 15 |
| Durvalumab 50 mg/ml intravenous solution HCPCS J9173 | not published | not published | $98.03 – $98.03 | 1 |
| Ear irrigation 69209 CPT 69209 | $102.40 | $128.00 | $30.99 – $115.20 | 15 |
| Ecallantide injection HCPCS J1290 | not published | not published | $576.49 – $576.49 | 1 |
| Ecg external < 48 hours recording CPT 93225 | $256.00 | $320.00 | $77.47 – $288.00 | 15 |
| Ecg external > 48 hours up to 7 days recording CPT 93242 | $364.80 | $456.00 | $110.40 – $410.40 | 15 |
| Ecg external >7 days up to 15 days recording CPT 93246 | $218.40 | $273.00 | $66.09 – $245.70 | 15 |
| Echocardiogram (Heart Ultrasound) CPT 93306 | $1,661.60 | $2,077.00 | $849.75 – $1,869.30 | 15 |
| Echocardiogram (Limited Follow-Up Heart Ultrasound) CPT 93308 | $632.00 | $790.00 | $191.26 – $711.00 | 15 |
| Echocardiography doppler color flow mapping CPT 93325 | $450.40 | $563.00 | $136.30 – $506.70 | 15 |
| Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler HCPCS C8929 | $2,002.40 | $2,503.00 | $605.98 – $2,252.70 | 15 |
| Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast HCPCS C8924 | $1,195.20 | $1,494.00 | $361.70 – $1,344.60 | 15 |
| Echocardiograpy doppler follow up/limited study CPT 93321 | $348.80 | $436.00 | $105.56 – $392.40 | 15 |
| Echo stress CPT 93350 | $1,854.40 | $2,318.00 | $561.19 – $2,086.20 | 15 |
| Echo tee probe placement image acquisition interpretation & report CPT 93312 | $2,469.60 | $3,087.00 | $747.36 – $2,778.30 | 15 |
| Echo transthoracic CPT 93303 | $1,204.80 | $1,506.00 | $364.60 – $1,355.40 | 15 |
| Echo tte 2d comp wo ctrst wo clr/dplr CPT 93307 | $1,440.00 | $1,800.00 | $435.78 – $1,620.00 | 15 |
| Eculizumab injection HCPCS J1300 | not published | not published | $228.86 – $228.86 | 1 |
| Edu/train/pt/nonmd/in person/30 min98960 CPT 98960 | $108.00 | $135.00 | $32.68 – $121.50 | 15 |
| Efgartigimod alfa-fcab 20 mg/ml intravenous solution HCPCS J9332 | not published | not published | $33.19 – $33.19 | 1 |
| Egd dilate stricture CPT 43245 | $2,283.20 | $2,854.00 | $690.95 – $2,568.60 | 15 |
| Egd endo mucosal resection CPT 43254 | $2,396.80 | $2,996.00 | $725.33 – $2,696.40 | 15 |
| Egd remove lesion snare CPT 43251 | $2,397.60 | $2,997.00 | $725.57 – $2,697.30 | 15 |
| EKG (Electrocardiogram) CPT 93000 | $103.20 | $129.00 | $31.23 – $116.10 | 15 |
| EKG tracing for initial prev HCPCS G0404 | $60.00 | $75.00 | $18.16 – $67.50 | 15 |
| EKG (Tracing Only) CPT 93005 | $177.60 | $222.00 | $79.75 – $199.80 | 15 |
| Elbow X-ray (2 views, both sides) CPT 73070 | $177.60 | $222.00 | $53.75 – $199.80 | 15 |
| Elbow X-ray (3 or more views, both sides) CPT 73080 | $241.60 | $302.00 | $73.11 – $271.80 | 15 |
| Electrical Stimulation Therapy (each 15 minutes) CPT 97032 | $67.20 | $84.00 | $20.34 – $75.60 | 15 |
| Electrical stimulation/unattended 97014 CPT 97014 | $54.40 | $68.00 | $16.46 – $61.20 | 15 |
| Electrolyte panel CPT 80051 | $45.60 | $57.00 | $13.80 – $51.30 | 15 |
| Elosulfase alfa, injection HCPCS J1322 | not published | not published | $299.48 – $299.48 | 1 |
| Endoscopy swallow (fees) vid CPT 92612 | $572.80 | $716.00 | $173.34 – $644.40 | 15 |
| Enoxaparin 30 mg/0.3 ml subcutaneous syringe HCPCS J1650 | $71.21 | $89.01 | $8.44 – $31.39 | 15 |
| Epinephrine 0.1 mg/ml injection syringe HCPCS J0168 | $33.67 | $42.08 | $8.64 – $32.10 | 15 |
| Epinephrine 1 mg/ml im kit - adult HCPCS J0169 | $7.43 | $9.28 | $2.25 – $8.35 | 15 |
| Episiotomy/vag rpr oth/thn attending phys 59300 CPT 59300 | $1,607.20 | $2,009.00 | $486.38 – $1,808.10 | 15 |
| Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr HCPCS J0885 | $176.79 | $220.98 | $30.38 – $112.94 | 15 |
| Epstein barr nuclear antigen antibody CPT 86664 | $88.80 | $111.00 | $24.94 – $92.70 | 15 |
| Epstein barr viral capsid antigen antibody igm CPT 86665 | $96.00 | $120.00 | $25.90 – $96.30 | 15 |
| Eptinezumab-jjmr 100 mg/ml intravenous solution HCPCS J3032 | not published | not published | $19.05 – $19.05 | 1 |
| Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr HCPCS J1335 | $125.84 | $157.29 | $12.32 – $45.81 | 15 |
| ER Visit (level 1, minor) CPT 99281 | $238.40 | $298.00 | $72.15 – $268.20 | 15 |
| ER Visit (level 2) CPT 99282 | $395.20 | $494.00 | $119.60 – $444.60 | 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.