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 |
|---|---|---|---|---|
| Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper) HCPCS J1171 | $62.34 | $77.92 | $39.97 – $70.13 | 17 |
| Hyqvia 100mg immuneglobulin HCPCS J1575 | not published | not published | $17.81 – $17.81 | 1 |
| Iaadi respiratory synctial virus CPT 87280 | $66.40 | $83.00 | $42.58 – $74.70 | 17 |
| Icatibant injection HCPCS J1744 | not published | not published | $93.19 – $93.19 | 1 |
| Idursulfase injection HCPCS J1743 | not published | not published | $548.06 – $548.06 | 1 |
| Ihc/icc per specimen each multiplex antibody stain CPT 88344 | $128.00 | $160.00 | $82.08 – $144.00 | 17 |
| Ihc/icc per specimen initial single antibody stain CPT 88342 | $173.60 | $217.00 | $110.81 – $194.40 | 17 |
| Immobilizer shldr cntor adlt HCPCS L3670 | $39.20 | $49.00 | $17.96 – $31.50 | 17 |
| Immobilizer shldr dlx str 24-36in med HCPCS L1830 | $87.20 | $109.00 | $31.29 – $54.90 | 17 |
| Immune complex assay CPT 86332 | $59.20 | $74.00 | $37.96 – $66.60 | 17 |
| Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution HCPCS J1569 | not published | not published | $50.63 – $110.38 | 2 |
| Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution HCPCS J1566 | not published | not published | $83.74 – $83.74 | 1 |
| Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution HCPCS J1568 | not published | not published | $49.91 – $49.91 | 1 |
| Immunoassay tumor antigen quantitative ca 125 CPT 86304 | $101.60 | $127.00 | $65.15 – $114.30 | 17 |
| Immunoassay tumor antigen quantitative ca 19-9 CPT 86301 | $101.60 | $127.00 | $65.15 – $114.30 | 17 |
| Immunodiff gel qual ea antigen/ab CPT 86331 | $46.40 | $58.00 | $20.52 – $36.00 | 17 |
| Immunofixation electrophoresis serum CPT 86334 | $158.40 | $198.00 | $101.57 – $178.20 | 17 |
| Imuglucerase injection HCPCS J1786 | not published | not published | $44.44 – $44.44 | 1 |
| Infect ag eia influenza a or b ea CPT 87400 | $79.20 | $99.00 | $50.79 – $89.10 | 17 |
| Infect ag ia optc obs influenza CPT 87804 | $65.60 | $82.00 | $42.07 – $73.80 | 17 |
| Infect ag if influenza a CPT 87276 | $77.60 | $97.00 | $49.76 – $87.30 | 17 |
| Infect ag if influenza b CPT 87275 | $53.60 | $67.00 | $34.37 – $60.30 | 17 |
| Infect ag if varicella zoster CPT 87290 | $108.80 | $136.00 | $69.77 – $122.40 | 17 |
| Infect ag na influenza r/amp 1st 2 types CPT 87502 | $248.80 | $311.00 | $159.54 – $279.90 | 17 |
| Infect ag na orthopoxvirus amp prb each CPT 87593 | $151.20 | $189.00 | $96.96 – $170.10 | 17 |
| Infect ag phenotype na hiv-1 1-10 drugs CPT 87903 | $1,262.40 | $1,578.00 | $809.51 – $1,420.20 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin CPT 87324 | $116.00 | $145.00 | $74.39 – $130.50 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step cryptosporidium CPT 87328 | $112.80 | $141.00 | $72.33 – $126.90 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step giardia CPT 87329 | $117.60 | $147.00 | $63.10 – $110.70 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool CPT 87338 | $186.40 | $233.00 | $119.53 – $209.70 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn CPT 87340 | $84.00 | $105.00 | $53.87 – $94.50 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization CPT 87341 | $67.20 | $84.00 | $43.09 – $75.60 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies CPT 87389 | $138.40 | $173.00 | $88.75 – $155.70 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step rotavirus CPT 87425 | $98.40 | $123.00 | $63.10 – $110.70 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin CPT 87427 | $96.00 | $120.00 | $61.56 – $108.00 | 17 |
| Infectious agent nucleic acid amplified probe CPT 87798 | $125.60 | $157.00 | $55.40 – $97.20 | 17 |
| Infectious agent nucleic acid amplified probe chlamydia trachomatis CPT 87491 | $173.60 | $217.00 | $73.36 – $128.70 | 17 |
| Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s) CPT 87493 | $178.40 | $223.00 | $114.40 – $200.70 | 17 |
| Infectious agent nucleic acid amplified probe hsv-1 CPT 87529 | $173.60 | $217.00 | $111.32 – $195.30 | 17 |
| Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus CPT 87641 | $107.20 | $134.00 | $68.74 – $120.60 | 17 |
| Infectious agent nucleic acid amplified probe neisseria gonorrhoeae CPT 87591 | $99.20 | $124.00 | $55.40 – $97.20 | 17 |
| Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 CPT 87635 | $124.80 | $156.00 | $80.03 – $140.40 | 17 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b CPT 87636 | $349.60 | $437.00 | $224.18 – $393.30 | 17 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv CPT 87637 | $460.80 | $576.00 | $295.49 – $518.40 | 17 |
| Infectious agent nucleic acid amplified probe streptococcus group a CPT 87651 | $105.60 | $132.00 | $67.72 – $118.80 | 17 |
| Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae CPT 87494 | $270.40 | $338.00 | $128.76 – $225.90 | 17 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | $1,227.20 | $1,534.00 | $786.94 – $1,380.60 | 17 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets CPT 87505 | $58.40 | $73.00 | $37.45 – $65.70 | 17 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | $275.20 | $344.00 | $66.18 – $116.10 | 17 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | $100.00 | $125.00 | $64.13 – $112.50 | 17 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $137.60 | $172.00 | $88.24 – $154.80 | 17 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $413.60 | $517.00 | $265.22 – $465.30 | 17 |
| Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets CPT 87631 | $348.00 | $435.00 | $223.16 – $391.50 | 17 |
| Infliximab 100 mg intravenous solution HCPCS J1745 | $1,881.76 | $2,352.20 | $32.81 – $900.70 | 17 |
| Infliximab-axxq 100 mg intravenous solution HCPCS Q5121 | not published | not published | $21.68 – $21.68 | 1 |
| Infliximab-dyyb 100 mg intravenous solution HCPCS Q5103 | not published | not published | $13.88 – $13.88 | 1 |
| Inj, acetaminophen (b braun) HCPCS J0136 | $173.29 | $216.61 | $55.56 – $97.48 | 17 |
| Inj acetaminophen -fresenius HCPCS J0134 | $108.34 | $135.42 | $69.47 – $121.88 | 17 |
| Inj, adzynma, 10 iu HCPCS J7171 | not published | not published | $35.25 – $35.25 | 1 |
| Inj anifrolumab-fnia 1mg HCPCS J0491 | not published | not published | $17.63 – $17.63 | 1 |
| Inj. asceniv HCPCS J1554 | not published | not published | $500.66 – $500.66 | 1 |
| Inj aval alfa-nqpt 4mg HCPCS J0219 | not published | not published | $79.24 – $79.24 | 1 |
| Inj., benralizumab, 1 mg HCPCS J0517 | $7,828.28 | $9,785.34 | $170.48 – $8,806.81 | 17 |
| Inj, cefepime hcl (b braun) HCPCS J0703 | $139.30 | $174.12 | $89.32 – $156.71 | 17 |
| Inj., cerliponase alfa 1 mg HCPCS J0567 | not published | not published | $116.40 – $116.40 | 1 |
| Inj, cipaglucosidase, 5 mg HCPCS J1203 | not published | not published | $89.74 – $89.74 | 1 |
| Inj cutaquig 100 mg HCPCS J1551 | not published | not published | $14.78 – $14.78 | 1 |
| Inj cuvitru, 100 mg HCPCS J1555 | not published | not published | $17.14 – $17.14 | 1 |
| Inj, daptomycin (baxter) HCPCS J0874 | $181.63 | $227.03 | $116.47 – $204.33 | 17 |
| Inj, donanemab-azbt, 2 mg HCPCS J0175 | not published | not published | $4.16 – $4.16 | 1 |
| Injection, burosumab-twza 1m HCPCS J0584 | not published | not published | $478.43 – $478.43 | 1 |
| Injection, casimersen, 10 mg HCPCS J1426 | not published | not published | $160.00 – $160.00 | 1 |
| Injection, daratumumab 10 mg HCPCS J9145 | not published | not published | $78.01 – $78.01 | 1 |
| Injection, edaravone, 1 mg HCPCS J1301 | not published | not published | $22.58 – $22.58 | 1 |
| Injection, renflexis HCPCS Q5104 | $707.41 | $884.26 | $27.68 – $741.44 | 17 |
| Injection, ruconest HCPCS J0596 | not published | not published | $35.36 – $35.36 | 1 |
| Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides) CPT 64450 | $1,210.40 | $1,513.00 | $409.89 – $719.10 | 17 |
| Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 | $500.00 | $625.00 | $320.63 – $562.50 | 17 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 | $112.00 | $140.00 | $33.60 – $126.00 | 17 |
| Inj efgart-alfa 2mg hya-qvfc HCPCS J9334 | not published | not published | $33.75 – $33.75 | 1 |
| Inj eflapegrastim-xnst 0.1mg HCPCS J1449 | not published | not published | $23.18 – $23.18 | 1 |
| Inj, eteplirsen, 10 mg HCPCS J1428 | not published | not published | $160.00 – $160.00 | 1 |
| Inj, evinacumab-dgnb, 5mg HCPCS J1305 | not published | not published | $189.83 – $189.83 | 1 |
| Inj. fe derisomaltose 10 mg HCPCS J1437 | $3,160.69 | $3,950.86 | $2,026.79 – $3,555.77 | 17 |
| Inj givosiran 0.5 mg HCPCS J0223 | not published | not published | $114.26 – $114.26 | 1 |
| Inj golodirsen 10 mg HCPCS J1429 | not published | not published | $160.00 – $160.00 | 1 |
| Inj., haegarda 10 units HCPCS J0599 | not published | not published | $14.43 – $14.43 | 1 |
| Inj. herceptin hylecta, 10mg HCPCS J9356 | not published | not published | $76.42 – $76.42 | 1 |
| Inj herzuma 10 mg HCPCS Q5113 | not published | not published | $72.41 – $72.41 | 1 |
| Inj hydroxocobalamin IV 25mg HCPCS J3424 | $1,498.47 | $1,873.08 | $960.89 – $1,685.77 | 17 |
| Inj., ibalizumab-uiyk, 10 mg HCPCS J1746 | not published | not published | $78.53 – $78.53 | 1 |
| Inj, imm glob bivigam, 500mg HCPCS J1556 | not published | not published | $76.58 – $76.58 | 1 |
| Inj. inebilizumab-cdon, 1 mg HCPCS J1823 | not published | not published | $493.54 – $493.54 | 1 |
| Inj ivig privigen 500 mg HCPCS J1459 | not published | not published | $49.50 – $96.58 | 2 |
| Inj., lanadelumab-flyo, 1 mg HCPCS J0593 | not published | not published | $89.54 – $89.54 | 1 |
| Inj, lecanemab-irmb, 1 mg HCPCS J0174 | not published | not published | $1.35 – $1.35 | 1 |
| Inj, lidocaine w epinephrine HCPCS J2004 | $14.04 | $17.54 | $8.97 – $15.73 | 17 |
| Inj. lumasiran, 0.5 mg HCPCS J0224 | not published | not published | $323.89 – $323.89 | 1 |
| Inj ogivri 10 mg HCPCS Q5114 | not published | not published | $64.87 – $64.87 | 1 |
| Inj olipudase alfa-rpcp 1mg HCPCS J0218 | not published | not published | $389.78 – $389.78 | 1 |
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.