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 |
|---|---|---|---|---|
| Inj ontruzant 10 mg HCPCS Q5112 | not published | not published | $40.92 – $40.92 | 1 |
| Inj pantoprazole(hikma) 40mg HCPCS J2471 | $62.44 | $78.04 | $39.80 – $69.82 | 17 |
| Inj, panzyga, 500 mg HCPCS J1576 | not published | not published | $68.74 – $68.74 | 1 |
| Inj., patisiran, 0.1 mg HCPCS J0222 | not published | not published | $100.73 – $100.73 | 1 |
| Inj pegfilgrastim-bmez 0.5mg HCPCS Q5120 | $3,305.64 | $4,132.04 | $327.13 – $3,718.84 | 17 |
| Inj pozelimab-bbfg, 1 mg HCPCS J9376 | not published | not published | $90.87 – $90.87 | 1 |
| Inj sebelipase alfa 1 mg HCPCS J2840 | not published | not published | $510.50 – $510.50 | 1 |
| Inj, sutimlimab-jome, 10 mg HCPCS J1302 | not published | not published | $18.49 – $18.49 | 1 |
| Inj, taliglucerace alfa 10 u HCPCS J3060 | not published | not published | $43.39 – $43.39 | 1 |
| Inj. teprotumumab-trbw 10 mg HCPCS J3241 | not published | not published | $350.36 – $350.36 | 1 |
| Inj testosterone cypionate HCPCS J1071 | $65.40 | $81.75 | $40.23 – $70.59 | 17 |
| Inj., tildrakizumab, 1 mg HCPCS J3245 | not published | not published | $138.49 – $138.49 | 1 |
| Inj, tislelizumab-jsgr HCPCS J9329 | not published | not published | $66.09 – $66.09 | 1 |
| Inj, tofidence, 1 mg HCPCS Q5133 | not published | not published | $5.55 – $5.55 | 1 |
| Inj, tyenne, 1 mg HCPCS Q5135 | not published | not published | $5.15 – $5.15 | 1 |
| Inj velmanase alfa-tycv 1 mg HCPCS J0217 | not published | not published | $450.34 – $450.34 | 1 |
| Inj., vestronidase alfa-vjbk HCPCS J3397 | not published | not published | $263.70 – $263.70 | 1 |
| Inj. viltolarsen HCPCS J1427 | not published | not published | $56.40 – $56.40 | 1 |
| Inj. xembify, 100 mg HCPCS J1558 | not published | not published | $14.59 – $14.59 | 1 |
| Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years CPT 36569 | $2,640.80 | $3,301.00 | $1,693.41 – $2,970.90 | 17 |
| Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides) CPT 36561 | $6,914.40 | $8,643.00 | $4,433.86 – $7,778.70 | 17 |
| In situ hybridization per specimen initial single probe stain CPT 88365 | $407.20 | $509.00 | $261.12 – $458.10 | 17 |
| Insulin total CPT 83525 | $115.20 | $144.00 | $73.87 – $129.60 | 17 |
| Intrinsic factor antibody CPT 86340 | $56.80 | $71.00 | $36.42 – $63.90 | 17 |
| Intubation endotracheal emergency procedure CPT 31500 | $480.00 | $600.00 | $307.80 – $540.00 | 17 |
| Iopamidol 250 mg iodine/ml (51 %) intravenous solution HCPCS Q9966 | $20.00 | $25.00 | $12.83 – $22.50 | 17 |
| Iopamidol 300 mg iodine/ml (61 %) intravenous solution HCPCS Q9967 | $100.00 | $125.00 | $11.80 – $20.70 | 17 |
| Ipratropium bromide non-comp HCPCS J7644 | $5.29 | $6.61 | $2.61 – $4.58 | 17 |
| Iron CPT 83540 | $64.00 | $80.00 | $41.04 – $72.00 | 17 |
| Iron binding capacity CPT 83550 | $72.80 | $91.00 | $46.68 – $81.90 | 17 |
| Iron dextran 50 mg/ml injection solution HCPCS J1750 | $87.64 | $109.55 | $56.20 – $98.60 | 17 |
| Iron sucrose 20 mg iron/ml intravenous solution (wrapper) HCPCS J1756 | $66.59 | $83.23 | $42.29 – $74.19 | 17 |
| Irrigation implantable venous access device for drug delivery systems CPT 96523 | $172.00 | $215.00 | $60.80 – $140.40 | 17 |
| IV Fluids (each additional hour) CPT 96361 | $163.20 | $204.00 | $104.65 – $183.60 | 17 |
| IV Fluids (first hour) CPT 96360 | $530.40 | $663.00 | $340.12 – $596.70 | 17 |
| Ivig non-lyophilized, nos HCPCS J1599 | not published | not published | $156.45 – $156.45 | 1 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $184.00 | $230.00 | $47.20 – $207.00 | 17 |
| IV Medicine Infusion (additional drug) CPT 96367 | $206.40 | $258.00 | $68.80 – $232.20 | 17 |
| IV Medicine Infusion (each additional hour) CPT 96366 | $179.20 | $224.00 | $48.80 – $201.60 | 17 |
| IV Medicine Infusion (first hour) CPT 96365 | $528.00 | $660.00 | $151.20 – $594.00 | 17 |
| IV Push Injection (each additional drug) CPT 96375 | $128.00 | $160.00 | $12.83 – $22.50 | 17 |
| IV Push Injection (first drug) CPT 96374 | $228.00 | $285.00 | $12.83 – $22.50 | 17 |
| Ivp w/nephrotomography CPT 74415 | $1,183.20 | $1,479.00 | $758.73 – $1,331.10 | 17 |
| Ivp w/wo kub w/wo tomography CPT 74400 | $1,095.20 | $1,369.00 | $702.30 – $1,232.10 | 17 |
| Jaw Joint (TMJ) X-ray (both sides, open and closed) CPT 70330 | $465.60 | $582.00 | $298.57 – $523.80 | 17 |
| Jaw (Mandible) X-ray (complete) CPT 70110 | $514.40 | $643.00 | $329.86 – $578.70 | 17 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $48.80 | $61.00 | $31.29 – $54.90 | 17 |
| Ketorolac (Toradol) Pain Shot, 15 mg HCPCS J1885 | $61.39 | $76.73 | $38.81 – $68.09 | 17 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $921.60 | $1,152.00 | $590.98 – $1,036.80 | 17 |
| Kidney (Retroperitoneal) Ultrasound (limited) CPT 76775 | $720.00 | $900.00 | $461.70 – $810.00 | 17 |
| Kit gene analys d816 variant CPT 81273 | $526.40 | $658.00 | $337.55 – $592.20 | 17 |
| Knee MRI (with and without contrast) CPT 73723 | $4,055.20 | $5,069.00 | $1,215.50 – $4,562.10 | 17 |
| Knee MRI (with contrast) CPT 73722 | $3,369.60 | $4,212.00 | $1,222.10 – $3,790.80 | 17 |
| Knee MRI (without contrast) CPT 73721 | $3,053.60 | $3,817.00 | $1,156.10 – $3,435.30 | 17 |
| Knee X-ray CPT 73564 | $533.60 | $667.00 | $342.17 – $600.30 | 17 |
| Knee X-ray (1 to 2 views, both knees) CPT 73560 | $322.40 | $403.00 | $206.74 – $362.70 | 17 |
| Knee X-ray (3 views, both knees) CPT 73562 | $376.80 | $471.00 | $241.62 – $423.90 | 17 |
| Knee X-ray (standing, both knees) CPT 73565 | $328.80 | $411.00 | $210.84 – $369.90 | 17 |
| Ko elastic w/joints pre ots HCPCS L1812 | $114.40 | $143.00 | $73.36 – $128.70 | 17 |
| Labetalol 5 mg/ml IV (wrapper) HCPCS J1920 | $60.38 | $75.47 | $38.72 – $67.92 | 17 |
| Lactate dehydrogenase (ldh) CPT 83615 | $62.40 | $78.00 | $40.01 – $70.20 | 17 |
| Lactated ringers intravenous solution HCPCS J7120 | $86.40 | $108.00 | $55.40 – $97.20 | 17 |
| Lactic acid CPT 83605 | $58.40 | $73.00 | $37.45 – $65.70 | 17 |
| Lactoferrin fecal qualitative CPT 83630 | $119.20 | $149.00 | $76.44 – $134.10 | 17 |
| Lanreotide 120 mg/0.5 ml subcutaneous syringe HCPCS J1930 | $12,807.27 | $16,009.08 | $8,212.66 – $14,408.17 | 17 |
| Large Joint Injection or Fluid Draw (both sides) CPT 20610 | $883.20 | $1,104.00 | $566.35 – $993.60 | 17 |
| Laronidase injection HCPCS J1931 | not published | not published | $39.41 – $39.41 | 1 |
| Lead capillary CPT 83655 | $100.00 | $125.00 | $20.01 – $35.10 | 17 |
| Leg Artery Ultrasound (complete, both legs) CPT 93925 | $1,280.80 | $1,601.00 | $821.31 – $1,440.90 | 17 |
| Leg CT Scan (with contrast, both legs) CPT 73701 | $1,866.40 | $2,333.00 | $893.20 – $2,099.70 | 17 |
| Leg CT Scan (without contrast, both legs) CPT 73700 | $2,195.20 | $2,744.00 | $705.10 – $2,469.60 | 17 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $1,326.40 | $1,658.00 | $850.55 – $1,492.20 | 17 |
| Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 | $72.24 | $90.29 | $46.32 – $81.26 | 17 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | $298.42 | $373.02 | $191.36 – $335.72 | 17 |
| Levalbuterol non-comp unit HCPCS J7614 | $7.78 | $9.72 | $3.43 – $6.01 | 17 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $61.47 | $76.83 | $39.10 – $68.59 | 17 |
| Levetiracetam therapeutic drug level CPT 80177 | $146.40 | $183.00 | $93.88 – $164.70 | 17 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $111.62 | $139.52 | $54.02 – $94.78 | 17 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | $323.33 | $404.16 | $126.09 – $221.20 | 17 |
| Lidocaine (pf) 10 mg/ml (1 %) injection solution HCPCS J2003 | $63.55 | $79.43 | $9.29 – $16.29 | 17 |
| Lipase CPT 83690 | $95.20 | $119.00 | $61.05 – $107.10 | 17 |
| Lipoprotein direct measurement hdl CPT 83718 | $56.00 | $70.00 | $35.91 – $63.00 | 17 |
| Lipoprotein direct measurement ldl CPT 83721 | $56.80 | $71.00 | $36.42 – $63.90 | 17 |
| Lithium therapeutic drug level CPT 80178 | $76.80 | $96.00 | $49.25 – $86.40 | 17 |
| Liver Function Test CPT 80076 | $118.40 | $148.00 | $75.92 – $133.20 | 17 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $20.00 | $25.00 | $12.83 – $22.50 | 17 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $61.23 | $76.53 | $38.71 – $67.91 | 17 |
| Low-Dose Lung Cancer Screening CT Scan CPT 71271 | $1,058.40 | $1,323.00 | $678.70 – $1,190.70 | 17 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $2,624.80 | $3,281.00 | $893.20 – $2,952.90 | 17 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | not published | not published | $1,215.50 – $1,215.50 | 1 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $2,539.20 | $3,174.00 | $705.10 – $2,856.60 | 17 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $4,430.40 | $5,538.00 | $1,215.50 – $4,984.20 | 17 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $3,362.40 | $4,203.00 | $1,215.50 – $3,782.70 | 17 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $3,128.80 | $3,911.00 | $1,156.10 – $3,519.90 | 17 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $425.60 | $532.00 | $272.92 – $478.80 | 17 |
| Lower Back (Lumbar Spine) X-ray (4 or more views) CPT 72110 | $617.60 | $772.00 | $396.04 – $694.80 | 17 |
| Lower Leg (Shin) X-ray (both sides) CPT 73590 | $337.60 | $422.00 | $216.49 – $379.80 | 17 |
| Lumizyme injection HCPCS J0221 | not published | not published | $205.76 – $205.76 | 1 |
| Lung Function Test Before and After an Inhaler CPT 94060 | $562.40 | $703.00 | $360.64 – $632.70 | 17 |
| Lung function test (mbc/mvv) CPT 94200 | $244.80 | $306.00 | $156.98 – $275.40 | 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.