Sanford Clear Lake Medical Center
701 3rd Ave S, Clear Lake, SD · Sanford Health · · NPI 1851305296
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 |
|---|---|---|---|---|
| Pulse ox multiple CPT 94761 | $233.60 | $292.00 | $149.80 – $262.80 | 17 |
| Puncture arterial withdrawal blood for diagnosis CPT 36600 | $105.60 | $132.00 | $67.72 – $118.80 | 17 |
| Puncture aspiration abscess/hematoma/bulla/cyst CPT 10160 | $654.40 | $818.00 | $419.63 – $736.20 | 17 |
| Rabies immune globulin (pf) 300 unit/ml intramuscular solution CPT 90375 | $817.68 | $1,022.10 | $524.34 – $919.89 | 17 |
| Racepinephrine hcl soln nebu 2.25% (base equivalent) HCPCS J7699 | $5.44 | $6.80 | $3.49 – $6.12 | 17 |
| Rapid Strep Test CPT 87880 | $44.00 | $55.00 | $28.22 – $49.50 | 17 |
| Ravulizumab-cwvz 100 mg/ml intravenous solution HCPCS J1303 | not published | not published | $224.93 – $443.54 | 2 |
| Rbc count only automated CPT 85041 | $31.20 | $39.00 | $20.01 – $35.10 | 17 |
| Red blood cells each unit HCPCS P9021 | $473.60 | $592.00 | $303.70 – $532.80 | 17 |
| Red blood cells leukocytes reduced each unit HCPCS P9016 | $516.00 | $645.00 | $330.89 – $580.50 | 17 |
| Refill/maint pump/resvr syst CPT 96522 | not published | not published | $284.80 – $284.80 | 1 |
| Regadenoson 0.4 mg/5 ml intravenous syringe HCPCS J2785 | $357.91 | $447.38 | $42.41 – $74.41 | 17 |
| Remdesivir 100 mg intravenous powder for solution HCPCS J0248 | $880.00 | $1,100.00 | $564.30 – $990.00 | 17 |
| Removal cerumen impacted (both sides) CPT 69210 | $264.80 | $331.00 | $169.80 – $297.90 | 17 |
| Removal devitalized tissue non-selective debridement without anesthesia per session CPT 97602 | $257.60 | $322.00 | $165.19 – $289.80 | 17 |
| Removal skin tags fibrocutaneous any area <= 15 lesions CPT 11200 | $404.80 | $506.00 | $259.58 – $455.40 | 17 |
| Renal function panel CPT 80069 | $125.60 | $157.00 | $80.54 – $141.30 | 17 |
| Repair complex wound scalp/arms/legs 2.6 - 7.5 cm CPT 13121 | $1,846.40 | $2,308.00 | $1,184.00 – $2,077.20 | 17 |
| Repair lip full thkns =<one-half vert height CPT 40652 | $1,467.20 | $1,834.00 | $940.84 – $1,650.60 | 17 |
| Reslizumab 10 mg/ml intravenous solution HCPCS J2786 | not published | not published | $10.50 – $10.50 | 1 |
| #resp virpnl dfa-adenovirus CPT 87260 | $90.40 | $113.00 | $57.97 – $101.70 | 17 |
| #resp virpnl dfa-parainfluenza CPT 87279 | $66.40 | $83.00 | $42.58 – $74.70 | 17 |
| Reticulocyte automated CPT 85045 | $57.60 | $72.00 | $36.94 – $64.80 | 17 |
| Reticulocyte direct measurement automated CPT 85046 | $34.40 | $43.00 | $22.06 – $38.70 | 17 |
| 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 | $32.28 | $40.35 | $20.70 – $36.32 | 17 |
| Rheumatoid factor qualitative CPT 86430 | $67.20 | $84.00 | $43.09 – $75.60 | 17 |
| Rheumatoid factor quantitative CPT 86431 | $52.80 | $66.00 | $33.86 – $59.40 | 17 |
| Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe HCPCS J2791 | $143.24 | $179.04 | $91.85 – $161.14 | 17 |
| Rib and Chest X-ray (3 views, left side) CPT 71101 | $509.60 | $637.00 | $326.78 – $573.30 | 17 |
| Rib and Chest X-ray (4 or more views, both sides) CPT 71111 | $672.00 | $840.00 | $430.92 – $756.00 | 17 |
| Rib X-ray (3 views, both sides) CPT 71110 | $627.20 | $784.00 | $402.19 – $705.60 | 17 |
| Rituximab-abbs 10 mg/ml intravenous solution HCPCS Q5115 | $3,267.60 | $4,084.49 | $604.37 – $1,060.29 | 17 |
| Rituximab-arrx 10 mg/ml intravenous solution HCPCS Q5123 | $5,579.36 | $6,974.20 | $3,577.76 – $6,276.78 | 17 |
| Romiplostim 125 mcg subcutaneous solution HCPCS J2802 | $2,052.58 | $2,565.72 | $1,316.21 – $2,309.15 | 17 |
| 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 | $99.20 | $124.00 | $63.61 – $111.60 | 17 |
| Rubella antibody igg CPT 86762 | $82.40 | $103.00 | $24.11 – $42.30 | 17 |
| Rubeola antibody igg CPT 86765 | $136.00 | $170.00 | $34.88 – $61.20 | 17 |
| Russell viper venom diluted CPT 85613 | $112.00 | $140.00 | $71.82 – $126.00 | 17 |
| Rx metab gen seq alys pnl 6 CPT 81418 | $256.00 | $320.00 | $164.16 – $288.00 | 17 |
| Sacroiliac Joint X-ray (3 or more views) CPT 72202 | $430.40 | $538.00 | $275.99 – $484.20 | 17 |
| Sarscov coronavirus ag ia CPT 87426 | $86.40 | $108.00 | $55.40 – $97.20 | 17 |
| Scan duplex aorta/ivc/iliac or bypass grafts complete CPT 93978 | $1,125.60 | $1,407.00 | $721.79 – $1,266.30 | 17 |
| Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 | $863.20 | $1,079.00 | $553.53 – $971.10 | 17 |
| Scan duplex extracranial arteries unilateral/limited study CPT 93882 | $902.40 | $1,128.00 | $578.66 – $1,015.20 | 17 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $897.60 | $1,122.00 | $575.59 – $1,009.80 | 17 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $958.40 | $1,198.00 | $614.57 – $1,078.20 | 17 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $955.20 | $1,194.00 | $612.52 – $1,074.60 | 17 |
| Screening Colonoscopy (average risk) HCPCS G0121 | not published | not published | $2,285.80 – $2,285.80 | 1 |
| Screening Colonoscopy (high risk) HCPCS G0105 | not published | not published | $2,285.80 – $2,285.80 | 1 |
| Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations HCPCS G0328 | $57.60 | $72.00 | $36.94 – $64.80 | 17 |
| Screening hepatitis c antibody high risk HCPCS G0472 | $122.40 | $153.00 | $78.49 – $137.70 | 17 |
| Screening Mammogram CPT 77067 | $487.20 | $609.00 | $312.42 – $548.10 | 17 |
| Screening prostate cancer PSA HCPCS G0103 | $146.40 | $183.00 | $93.88 – $164.70 | 17 |
| Screw cortex 2.0 x 10mm HCPCS C1713 | $32,832.00 | $41,040.00 | $850.55 – $1,492.20 | 17 |
| Scrotal (Testicle) Ultrasound CPT 76870 | $824.80 | $1,031.00 | $528.90 – $927.90 | 17 |
| Sc ther infusion reset pump CPT 96371 | not published | not published | $148.00 – $148.00 | 1 |
| Sedimentation rate erythrocyte automated CPT 85652 | $48.00 | $60.00 | $30.78 – $54.00 | 17 |
| Self-Care and Home Skills Training (each 15 minutes) CPT 97535 | $121.60 | $152.00 | $77.98 – $136.80 | 17 |
| Shave sgl skin lsn s/n/h/f/g 0.5cm/< CPT 11305 | $258.40 | $323.00 | $165.70 – $290.70 | 17 |
| Shave sgl skin lsn s/n/h/f/g 0.6-1.0 cm CPT 11306 | $280.80 | $351.00 | $180.06 – $315.90 | 17 |
| Shot (Injection into Muscle or Under the Skin) CPT 96372 | $172.00 | $215.00 | $12.83 – $22.50 | 17 |
| Shoulder AC Joint X-ray (both sides) CPT 73050 | $356.00 | $445.00 | $228.29 – $400.50 | 17 |
| Shoulder Blade (Scapula) X-ray (both sides) CPT 73010 | $408.80 | $511.00 | $262.14 – $459.90 | 17 |
| Shoulder MRI (with and without contrast) CPT 73223 | $4,104.00 | $5,130.00 | $1,215.50 – $4,617.00 | 17 |
| Shoulder MRI (with contrast) CPT 73222 | $3,597.60 | $4,497.00 | $1,222.10 – $4,047.30 | 17 |
| Shoulder MRI (without contrast) CPT 73221 | $2,979.20 | $3,724.00 | $1,156.10 – $3,351.60 | 17 |
| Shoulder X-ray CPT 73030 | $365.60 | $457.00 | $234.44 – $411.30 | 17 |
| Shoulder X-ray (single view, both shoulders) CPT 73020 | $296.80 | $371.00 | $190.32 – $333.90 | 17 |
| Sickling rbc CPT 85660 | $32.80 | $41.00 | $21.03 – $36.90 | 17 |
| Sincalide 5 mcg solution for injection HCPCS J2805 | $424.00 | $530.00 | $232.90 – $408.60 | 17 |
| Sinus CT scan (with and without contrast) CPT 70488 | $2,929.60 | $3,662.00 | $893.20 – $3,295.80 | 17 |
| Sinus CT scan (with contrast) CPT 70487 | $2,228.00 | $2,785.00 | $893.20 – $2,506.50 | 17 |
| Sinus CT scan (without contrast) CPT 70486 | $2,128.00 | $2,660.00 | $705.10 – $2,394.00 | 17 |
| Sinus X-ray (complete) CPT 70220 | $536.00 | $670.00 | $343.71 – $603.00 | 17 |
| Sinus X-ray (limited) CPT 70210 | $324.00 | $405.00 | $207.77 – $364.50 | 17 |
| Skull X-ray (1 to 3 views) CPT 70250 | $427.20 | $534.00 | $273.94 – $480.60 | 17 |
| Skull X-ray (complete) CPT 70260 | $621.60 | $777.00 | $398.60 – $699.30 | 17 |
| Sleep Study (Polysomnography) CPT 95810 | $4,360.80 | $5,451.00 | $2,796.36 – $4,905.90 | 17 |
| Slp eval non-spch gen comm dev CPT 92605 | $376.80 | $471.00 | $241.62 – $423.90 | 17 |
| Slp ther svc non-spch gen CPT 92606 | $296.00 | $370.00 | $189.81 – $333.00 | 17 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $73.60 | $92.00 | $47.20 – $82.80 | 17 |
| Smear gram stain CPT 87205 | $56.00 | $70.00 | $35.91 – $63.00 | 17 |
| Smear nasal eosinophil CPT 89190 | $44.00 | $55.00 | $28.22 – $49.50 | 17 |
| Smear wet mount CPT 87210 | $38.40 | $48.00 | $24.62 – $43.20 | 17 |
| Sodium 24 hour urine CPT 84300 | $32.80 | $41.00 | $21.03 – $36.90 | 17 |
| Sodium chloride 0.9 % intravenous solution HCPCS J7030 | $86.40 | $108.00 | $55.40 – $97.20 | 17 |
| Sodium chloride 0.9 % IV bolus HCPCS J7040 | $86.40 | $108.00 | $41.55 – $72.90 | 17 |
| Sodium chloride 0.9 % IV bolus HCPCS J7050 | $64.80 | $81.00 | $41.55 – $72.90 | 17 |
| Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous HCPCS J2916 | $67.06 | $83.82 | $43.00 – $75.44 | 17 |
| Sodium serum/plasma/whole blood CPT 84295 | $40.00 | $50.00 | $25.65 – $45.00 | 17 |
| Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution HCPCS J0209 | $99.92 | $124.90 | $64.07 – $112.41 | 17 |
| Specimen fat stain CPT 89125 | $52.00 | $65.00 | $33.35 – $58.50 | 17 |
| Speech and Language Evaluation (comprehensive) CPT 92523 | $446.40 | $558.00 | $286.25 – $502.20 | 17 |
| Speech Therapy Session (one-on-one) CPT 92507 | $315.20 | $394.00 | $202.12 – $354.60 | 17 |
| Spine X-ray (single view, one level) CPT 72020 | $248.80 | $311.00 | $159.54 – $279.90 | 17 |
| St analysis behavior qualitative voice/resonance CPT 92524 | $248.00 | $310.00 | $159.03 – $279.00 | 17 |
| St cognitve performance testing healthcare professional each hour CPT 96125 | $313.60 | $392.00 | $201.10 – $352.80 | 17 |
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.