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 |
|---|---|---|---|---|
| Elbow X-ray (2 views, both sides) CPT 73070 | $289.60 | $362.00 | $185.71 – $325.80 | 17 |
| Elbow X-ray (3 or more views, both sides) CPT 73080 | $368.00 | $460.00 | $235.98 – $414.00 | 17 |
| Electrical Stimulation Therapy (each 15 minutes) CPT 97032 | $105.60 | $132.00 | $67.72 – $118.80 | 17 |
| Electrical stimulation/unattended 97014 CPT 97014 | $100.80 | $126.00 | $64.64 – $113.40 | 17 |
| Electrolyte panel CPT 80051 | $100.00 | $125.00 | $64.13 – $112.50 | 17 |
| Elosulfase alfa, injection HCPCS J1322 | not published | not published | $299.48 – $299.48 | 1 |
| Enoxaparin 30 mg/0.3 ml subcutaneous syringe HCPCS J1650 | $123.59 | $154.48 | $39.63 – $69.53 | 17 |
| Epinephrine 0.1 mg/ml injection syringe HCPCS J0168 | $68.51 | $85.63 | $43.93 – $77.07 | 17 |
| Epinephrine 1 mg/ml im kit - adult HCPCS J0169 | $70.60 | $88.25 | $39.83 – $69.89 | 17 |
| Epinephrine 1 mg/ml im kit - pediatric HCPCS J0165 | $312.29 | $390.36 | $200.25 – $351.32 | 17 |
| Epinephrine hcl (pf) 1 mg/ml (1 ml) injection solution HCPCS J0166 | $97.08 | $121.35 | $62.25 – $109.22 | 17 |
| Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr HCPCS J0885 | $588.00 | $735.00 | $377.06 – $661.50 | 17 |
| Epstein barr nuclear antigen antibody CPT 86664 | $96.00 | $120.00 | $61.56 – $108.00 | 17 |
| Epstein barr viral capsid antigen antibody igm CPT 86665 | $136.00 | $170.00 | $87.21 – $153.00 | 17 |
| Eptinezumab-jjmr 100 mg/ml intravenous solution HCPCS J3032 | $2,452.00 | $3,065.00 | $19.05 – $2,758.50 | 17 |
| Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr HCPCS J1335 | $194.63 | $243.28 | $77.86 – $136.59 | 17 |
| ER Visit (level 1, minor) CPT 99281 | $302.40 | $378.00 | $193.91 – $340.20 | 17 |
| ER Visit (level 2) CPT 99282 | $483.20 | $604.00 | $309.85 – $543.60 | 17 |
| ER Visit (level 3) CPT 99283 | $827.20 | $1,034.00 | $530.44 – $930.60 | 17 |
| ER Visit (level 4) CPT 99284 | $1,103.20 | $1,379.00 | $707.43 – $1,241.10 | 17 |
| ER Visit (level 5, high severity) CPT 99285 | $1,428.00 | $1,785.00 | $915.71 – $1,606.50 | 17 |
| Esoph egd dilation <30 mm CPT 43249 | not published | not published | $1,916.20 – $1,916.20 | 1 |
| Established Patient Office Visit (level 1) CPT 99211 | $188.00 | $235.00 | $51.30 – $90.00 | 17 |
| Established Patient Office Visit (level 2) CPT 99212 | $126.40 | $158.00 | $81.05 – $142.20 | 17 |
| Established Patient Office Visit (level 3) CPT 99213 | $213.60 | $267.00 | $93.37 – $163.80 | 17 |
| Established Patient Office Visit (level 4) CPT 99214 | $271.20 | $339.00 | $117.48 – $206.10 | 17 |
| Established Patient Office Visit (level 5) CPT 99215 | $327.20 | $409.00 | $146.72 – $257.40 | 17 |
| Estradiol total CPT 82670 | $200.00 | $250.00 | $128.25 – $225.00 | 17 |
| Estrogens total-sendout CPT 82672 | $52.80 | $66.00 | $33.86 – $59.40 | 17 |
| Ethylene glycol -sendout CPT 82693 | $200.00 | $250.00 | $128.25 – $225.00 | 17 |
| Eval/fit voice prosthesis iii, st CPT 92607 | $516.00 | $645.00 | $330.89 – $580.50 | 17 |
| Exc ben+marg excep skin tag feenlm <0.5cm 11440 CPT 11440 | $1,568.80 | $1,961.00 | $1,005.99 – $1,764.90 | 17 |
| Exc ben+marg excep skin tag feenlm 2.1-3cm 11443 CPT 11443 | $2,384.00 | $2,980.00 | $1,528.74 – $2,682.00 | 17 |
| Exc ben+marg excep skin tag snhfg 0.6-1cm 11421 CPT 11421 | $2,014.40 | $2,518.00 | $1,291.73 – $2,266.20 | 17 |
| Exc ben+marg excep skin tag snhfg 2.1-3cm 11423 CPT 11423 | $2,560.00 | $3,200.00 | $1,641.60 – $2,880.00 | 17 |
| Exc ben+marg excep skin tag tal 0.6-1cm 11401 CPT 11401 | $1,168.00 | $1,460.00 | $748.98 – $1,314.00 | 17 |
| Exc ben+marg excep skin tag tal 2.1-3/>cm 11403 CPT 11403 | $2,323.20 | $2,904.00 | $1,489.75 – $2,613.60 | 17 |
| Exc feenl mal+mrg 0.6-1 11641 CPT 11641 | $1,841.60 | $2,302.00 | $1,180.93 – $2,071.80 | 17 |
| Excision benign lesion face/ears/eyelids/nose/lips/muc memb 0.6 - 1.0 cm CPT 11441 | $1,600.00 | $2,000.00 | $1,026.00 – $1,800.00 | 17 |
| Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm CPT 11422 | $2,464.00 | $3,080.00 | $1,580.04 – $2,772.00 | 17 |
| Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm CPT 11402 | $1,944.00 | $2,430.00 | $1,246.59 – $2,187.00 | 17 |
| Exc malig feenl 1.1-2 11642 CPT 11642 | $2,080.00 | $2,600.00 | $1,333.80 – $2,340.00 | 17 |
| Exc mal+marg tal 1.1-2 cm 11602 CPT 11602 | $1,604.00 | $2,005.00 | $1,028.57 – $1,804.50 | 17 |
| Exc tr-ext mal+marg tal >4 cm 11606 CPT 11606 | $4,169.60 | $5,212.00 | $2,673.76 – $4,690.80 | 17 |
| Exercise tst brncspsm w/ecg CPT 94617 | $365.60 | $457.00 | $234.44 – $411.30 | 17 |
| Ext ecg>48hr<7d scan a/r CPT 93243 | $396.80 | $496.00 | $254.45 – $446.40 | 17 |
| Ext ecg>7d<15d scan a/r CPT 93247 | $380.00 | $475.00 | $243.68 – $427.50 | 17 |
| External tissue culture neoplastic disorders bone marrow/blood cells CPT 88237 | $520.80 | $651.00 | $318.06 – $558.00 | 17 |
| Extractable nuclear antigen/antibody any method each antibody centromere CPT 86235 | $165.60 | $207.00 | $36.42 – $63.90 | 17 |
| Eye Socket (Orbit) X-ray CPT 70200 | $415.20 | $519.00 | $266.25 – $467.10 | 17 |
| Eye Socket, Pituitary or Ear CT Scan (with and without contrast) CPT 70482 | $2,815.20 | $3,519.00 | $893.20 – $3,167.10 | 17 |
| Eye Socket, Pituitary or Ear CT Scan (with contrast) CPT 70481 | $2,409.60 | $3,012.00 | $893.20 – $2,710.80 | 17 |
| Eye Socket, Pituitary or Ear CT Scan (without contrast) CPT 70480 | $2,154.40 | $2,693.00 | $705.10 – $2,423.70 | 17 |
| Face, Eye Socket and Neck MRI (with and without contrast) CPT 70543 | $4,656.80 | $5,821.00 | $1,215.50 – $5,238.90 | 17 |
| Face, Eye Socket and Neck MRI (without contrast) CPT 70540 | $3,123.20 | $3,904.00 | $1,156.10 – $3,513.60 | 17 |
| Facial Bones X-ray (1 to 2 views) CPT 70140 | $357.60 | $447.00 | $229.31 – $402.30 | 17 |
| Facial Bones X-ray (complete) CPT 70150 | $581.60 | $727.00 | $372.95 – $654.30 | 17 |
| Factor ix CPT 85250 | $234.40 | $293.00 | $150.31 – $263.70 | 17 |
| Factor viii CPT 85240 | $250.40 | $313.00 | $160.57 – $281.70 | 17 |
| Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr HCPCS J1308 | $60.52 | $75.65 | $38.73 – $67.94 | 17 |
| Fat/lipids feces qualitative CPT 82705 | $74.40 | $93.00 | $47.71 – $83.70 | 17 |
| Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper) HCPCS J3010 | $60.48 | $75.60 | $38.78 – $68.04 | 17 |
| Ferric carboxymaltose 50 mg iron/ml intravenous solution HCPCS J1439 | $1,291.32 | $1,614.15 | $828.06 – $1,452.74 | 17 |
| Ferritin CPT 82728 | $120.00 | $150.00 | $76.95 – $135.00 | 17 |
| Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution HCPCS Q0138 | $703.01 | $878.76 | $450.80 – $790.88 | 17 |
| Fetal biophys profile w/nst 76818 CPT 76818 | $732.80 | $916.00 | $469.91 – $824.40 | 17 |
| Fibrin degradation d dimer quantitative CPT 85379 | $132.00 | $165.00 | $84.65 – $148.50 | 17 |
| Fibrin degrade semiquant CPT 85378 | $137.60 | $172.00 | $88.24 – $154.80 | 17 |
| Fibrinogen activity CPT 85384 | $48.00 | $60.00 | $30.78 – $54.00 | 17 |
| Filgrastim-sndz 300 mcg/0.5 ml injection syringe HCPCS Q5101 | $453.99 | $567.48 | $134.51 – $235.98 | 17 |
| Finger X-ray (both hands) CPT 73140 | $240.80 | $301.00 | $154.41 – $270.90 | 17 |
| Flebogamma injection HCPCS J1572 | not published | not published | $52.94 – $52.94 | 1 |
| Flow cytometry marker each additional CPT 88185 | $157.60 | $197.00 | $77.98 – $136.80 | 17 |
| Flow cytometry one marker technical component CPT 88184 | $558.40 | $698.00 | $132.87 – $233.10 | 17 |
| Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback HCPCS J1450 | $177.43 | $221.78 | $55.23 – $96.89 | 17 |
| Fluidotherapy charges pt CPT 97022 | $144.00 | $180.00 | $92.34 – $162.00 | 17 |
| Fluorescent antibody titer dna CPT 86256 | $56.80 | $71.00 | $36.42 – $63.90 | 17 |
| Fmri brain by phys/psych CPT 70555 | not published | not published | $1,156.10 – $1,156.10 | 1 |
| Fmri brain by tech CPT 70554 | not published | not published | $1,156.10 – $1,156.10 | 1 |
| Folic acid CPT 82746 | $116.80 | $146.00 | $74.90 – $131.40 | 17 |
| Folic acid 5 mg/ml injection solution HCPCS J1808 | $60.13 | $75.16 | $38.56 – $67.64 | 17 |
| Fomepizole 1 gram/ml intravenous solution HCPCS J1451 | $885.60 | $1,107.00 | $567.89 – $996.30 | 17 |
| Foot X-ray CPT 73630 | $351.20 | $439.00 | $225.21 – $395.10 | 17 |
| Foot X-ray (2 views, both feet) CPT 73620 | $260.00 | $325.00 | $166.73 – $292.50 | 17 |
| Forearm X-ray (both sides) CPT 73090 | $337.60 | $422.00 | $216.49 – $379.80 | 17 |
| Fosphenytoin 50 mg pe/ml injection (wrapper) HCPCS Q2009 | $88.73 | $110.91 | $39.47 – $69.24 | 17 |
| _fragile x methylation-sendout CPT 81244 | $120.80 | $151.00 | $77.46 – $135.90 | 17 |
| Fresh frozen plasma frozen within 8 hours of collection each unit HCPCS P9017 | $275.20 | $344.00 | $176.47 – $309.60 | 17 |
| Fresh frozen plasma thawing ea un CPT 86927 | $68.00 | $85.00 | $43.61 – $76.50 | 17 |
| Fructosamine glycated protein CPT 82985 | $51.20 | $64.00 | $32.83 – $57.60 | 17 |
| Full Spine X-ray (Scoliosis Survey) CPT 72082 | $604.00 | $755.00 | $387.32 – $679.50 | 17 |
| Furosemide 10 mg/ml injection solution HCPCS J1938 | $61.56 | $76.94 | $38.65 – $67.81 | 17 |
| Gadobutrol 1 mmol/ml intravenous solution (wrapper) HCPCS A9585 | $132.00 | $165.00 | $84.65 – $148.50 | 17 |
| Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper) HCPCS A9579 | $264.00 | $330.00 | $56.43 – $99.00 | 17 |
| Gallbladder and Bile Duct Scan (HIDA Scan) CPT 78226 | $1,928.00 | $2,410.00 | $1,236.33 – $2,169.00 | 17 |
| Gallbladder Function Scan (HIDA with Medication) CPT 78227 | $1,691.20 | $2,114.00 | $1,084.48 – $1,902.60 | 17 |
| Galsulfase injection HCPCS J1458 | not published | not published | $493.88 – $493.88 | 1 |
| Gamma globulin > 10 cc inj HCPCS J1560 | not published | not published | $507.94 – $507.94 | 1 |
| Gamma globulin 1 cc inj HCPCS J1460 | not published | not published | $50.78 – $50.78 | 1 |
| Gammaglobulin iga CPT 82784 | $60.00 | $75.00 | $38.48 – $67.50 | 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.