Sanford USD Medical Center
1305 W 18th St, Sioux Falls, SD · Sanford Health · · NPI 1821017880
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 |
|---|---|---|---|---|
| Devel tst phys/qhp 1st hr CPT 96112 | $412.80 | $516.00 | $69.23 – $464.40 | 14 |
| Device ablt adv novasure HCPCS C1886 | $13,500.00 | $16,875.00 | $1.00 – $1,568.70 | 11 |
| Device hemospray 7frx220cm endo hemostat min access HCPCS C1052 | $9,000.00 | $11,250.00 | $1.00 – $10,125.00 | 11 |
| Device intraute mirena HCPCS J7298 | $1,244.00 | $1,555.00 | $268.48 – $1,238.93 | 11 |
| Device sut capio slim opn HCPCS C2631 | $3,244.80 | $4,056.00 | $1.00 – $3,650.40 | 11 |
| Device tiss remov myosure reach HCPCS C1782 | $5,382.40 | $6,728.00 | $1.00 – $4,636.80 | 11 |
| Dev interrog remote 1/2/mlt CPT 93295 | not published | not published | $32.12 – $35.95 | 9 |
| Devise bowel pouch CPT 44316 | not published | not published | $401.78 – $1,413.39 | 9 |
| Devlopment test interpt&rep HCPCS G0451 | not published | not published | $11.65 – $95.28 | 9 |
| Dev tst admin phys/qhp ea addl 30 min CPT 96113 | $208.00 | $260.00 | $13.20 – $234.00 | 14 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | not published | not published | $31.62 – $92.45 | 9 |
| Dexametha opth insert 0.1 mg HCPCS J1096 | not published | not published | $1.00 – $112.65 | 9 |
| Dexamethasone 0.4 mg/0.1 ml intraocular injection - cnr HCPCS J1095 | not published | not published | $1.00 – $1.00 | 1 |
| Dexamethasone 4 mg tablet HCPCS J8540 | $53.56 | $66.95 | $0.28 – $1.00 | 11 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $316.32 | $395.40 | $0.60 – $2.04 | 11 |
| Dexamethasone intra implant HCPCS J7312 | not published | not published | $194.38 – $223.91 | 9 |
| Dexamethasone panel CPT 80420 | not published | not published | $153.79 – $331.51 | 9 |
| Dexmedetomidine film, 1 mcg HCPCS J1105 | not published | not published | $0.60 – $0.74 | 9 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | $904.56 | $1,130.70 | $59.91 – $414.90 | 14 |
| Dextran 40 infusion HCPCS J7100 | not published | not published | $1.00 – $1.00 | 1 |
| Dextran 75 infusion HCPCS J7110 | not published | not published | $1.00 – $1.00 | 1 |
| Dextroamphetamine HCPCS S0160 | not published | not published | $2.47 – $3.44 | 2 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | $125.44 | $156.80 | $1.00 – $141.12 | 11 |
| Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 | $125.44 | $156.80 | $1.00 – $141.12 | 11 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | $133.60 | $167.00 | $1.00 – $136.53 | 11 |
| Dextrose 5 % IV bolus HCPCS J7070 | $125.44 | $156.80 | $1.00 – $138.06 | 11 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | not published | not published | $21.12 – $45.52 | 9 |
| Diabetes (HbA1c) Test CPT 83036 | not published | not published | $9.22 – $19.89 | 9 |
| Diabetes training group per 30 min g0109 HCPCS G0136 | not published | not published | $8.99 – $30.68 | 9 |
| Diabetic custom molded shoe HCPCS A5501 | not published | not published | $247.21 – $279.79 | 9 |
| Diabetic shoe with wedge HCPCS A5504 | not published | not published | $42.04 – $47.52 | 9 |
| Diabetic shoe w/off set heel HCPCS A5506 | not published | not published | $42.04 – $47.52 | 9 |
| Diabetic shoe w/roller/rockr HCPCS A5503 | not published | not published | $42.04 – $47.52 | 9 |
| Diab manage trn ind/group HCPCS G0109 | $36.80 | $46.00 | $14.25 – $41.40 | 14 |
| Diab shoe for density insert HCPCS A5500 | not published | not published | $82.43 – $93.29 | 9 |
| Diab shoe w/metatarsal bar HCPCS A5505 | not published | not published | $42.04 – $47.52 | 9 |
| Diag bronchoscope/catheter CPT 31643 | not published | not published | $165.11 – $1,778.85 | 9 |
| Diag laparo separate proc 49320 CPT 49320 | not published | not published | $330.88 – $6,047.35 | 9 |
| Diagnostic anoscopy CPT 46601 | not published | not published | $56.62 – $411.01 | 9 |
| Diagnostic anoscopy & biopsy CPT 46607 | not published | not published | $123.83 – $1,236.80 | 9 |
| Diagnostic anoscopy spx 46600 CPT 46600 | $304.00 | $380.00 | $41.28 – $342.00 | 14 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | not published | not published | $31.81 – $31.81 | 1 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | not published | not published | $15.52 – $15.52 | 1 |
| Diagnostic laryngoscopy 31505 CPT 31505 | $306.40 | $383.00 | $49.60 – $344.70 | 14 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $558.40 | $698.00 | $68.57 – $628.20 | 14 |
| Diagnostic Mammogram (both breasts) CPT 77066 | not published | not published | $144.82 – $160.07 | 9 |
| Diagnostic Mammogram (one breast) CPT 77065 | not published | not published | $114.71 – $126.78 | 9 |
| Diagnostic radio unlisted proc CPT 76499 | $951.20 | $1,189.00 | $40.28 – $1,070.10 | 14 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | $14,717.60 | $18,397.00 | $1.00 – $16,557.30 | 14 |
| Dialysis one evaluation CPT 90945 | $1,328.00 | $1,660.00 | $196.31 – $1,494.00 | 14 |
| Dialysis repeated eval CPT 90947 | not published | not published | $108.32 – $120.50 | 9 |
| Dialysis training complete CPT 90989 | not published | not published | $305.66 – $305.66 | 1 |
| Dialysis training incompl CPT 90993 | not published | not published | $61.55 – $61.55 | 1 |
| Diathermy eg microwave CPT 97024 | not published | not published | $6.57 – $7.32 | 9 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | not published | not published | $1.00 – $1.00 | 1 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $313.77 | $392.21 | $1.00 – $180.98 | 11 |
| Dicyclomine injection HCPCS J0500 | $324.76 | $405.95 | $1.00 – $356.45 | 11 |
| Difelikefalin, esrd on dialy HCPCS J0879 | $540.00 | $675.00 | $0.06 – $607.50 | 14 |
| Diffusing capacity CPT 94729 | $408.80 | $511.00 | $1.00 – $459.90 | 14 |
| Digital analysis of eeg CPT 95957 | not published | not published | $1.00 – $293.52 | 9 |
| Digit nerve surgery add-on CPT 64778 | not published | not published | $1.00 – $178.09 | 9 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $416.32 | $520.40 | $1.00 – $352.39 | 11 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | $12,067.47 | $15,084.33 | $4,593.57 – $13,575.90 | 14 |
| Digoxin total therapeutic drug level CPT 80162 | not published | not published | $12.62 – $27.20 | 9 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | $374.24 | $467.80 | $1.00 – $386.59 | 11 |
| Dilate biliary duct/ampulla CPT 47542 | $4,858.40 | $6,073.00 | $1.00 – $5,465.70 | 14 |
| Dilate esophagus CPT 43453 | $3,715.20 | $4,644.00 | $85.88 – $4,179.60 | 14 |
| Dilate esophagus 1/mult pass CPT 43450 | not published | not published | $78.89 – $965.69 | 9 |
| Dilate ic vasospasm ea add vsl diff territory CPT 61642 | $2,932.80 | $3,666.00 | $279.97 – $3,299.40 | 14 |
| Dilate ic vasospasm ea add vsl same territory CPT 61641 | $4,609.60 | $5,762.00 | $139.98 – $5,185.80 | 14 |
| Dilate ic vasospasm init CPT 61640 | $10,529.60 | $13,162.00 | $398.42 – $11,845.80 | 14 |
| Dilate tear duct opening CPT 68801 | not published | not published | $79.22 – $417.59 | 9 |
| Dilate urethra stricture CPT 53600 | $564.80 | $706.00 | $62.58 – $635.40 | 14 |
| Dilate urethra stricture CPT 53601 | not published | not published | $52.59 – $133.88 | 9 |
| Dilate urethra stricture CPT 53605 | not published | not published | $62.91 – $3,621.42 | 9 |
| Dilate urethra stricture CPT 53621 | not published | not published | $70.90 – $255.37 | 9 |
| Dilation/female urethra/initial 53660 CPT 53660 | not published | not published | $41.28 – $163.71 | 9 |
| Dilation of anal sphincter CPT 45905 | $2,344.80 | $2,931.00 | $171.10 – $2,637.90 | 14 |
| Dilation of cervical canal 57800 CPT 57800 | $3,953.60 | $4,942.00 | $48.27 – $4,447.80 | 14 |
| Dilation of rectal stricture 45910 CPT 45910 | not published | not published | $193.73 – $1,236.80 | 9 |
| Dilation of salivary duct CPT 42660 | not published | not published | $86.55 – $534.71 | 9 |
| Dilation of urethra CPT 53661 | not published | not published | $39.94 – $133.88 | 9 |
| Dilation of urethra CPT 53665 | not published | not published | $37.28 – $2,134.73 | 9 |
| Dilation of vagina CPT 57400 | not published | not published | $130.15 – $3,276.65 | 9 |
| Dilation salivary duct 42650 CPT 42650 | not published | not published | $59.25 – $1,555.34 | 9 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | $2,191.20 | $2,739.00 | $85.88 – $2,465.10 | 14 |
| Dilator fascial 10fx20cm HCPCS C2627 | $1,353.60 | $1,692.00 | $1.00 – $1,522.80 | 11 |
| Dilat xst trc ndurlgc px CPT 50436 | $3,725.60 | $4,657.00 | $145.80 – $4,191.30 | 14 |
| Dilat xst trc new access rcs CPT 50437 | $6,207.20 | $7,759.00 | $241.33 – $6,983.10 | 14 |
| Diltiazem 5 mg/ml intravenous solution HCPCS J1163 | $319.28 | $399.09 | $16.65 – $56.66 | 11 |
| Dimecaprol injection HCPCS J0470 | not published | not published | $59.81 – $59.81 | 1 |
| Dimenhydrinate injection HCPCS J1240 | $313.77 | $392.21 | $1.00 – $352.99 | 11 |
| Dimethyl sulfoxide 50% 50 ml HCPCS J1212 | $381.48 | $476.85 | $9.71 – $819.49 | 14 |
| Diphenhydramine 12.5 mg/5 ml oral elixir HCPCS Q0163 | $0.82 | $1.02 | $0.27 – $1.00 | 11 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $313.24 | $391.55 | $1.00 – $350.59 | 11 |
| Diphtheria-tetanus toxoids 0.5 ml (peds) CPT 90702 | not published | not published | $1.00 – $1.00 | 1 |
| Dipyridamole injection HCPCS J1245 | $324.90 | $406.12 | $1.00 – $365.51 | 11 |
| Direct advanced life support CPT 99288 | not published | not published | $91.77 – $91.77 | 1 |
| Dir nsl mucous membrane test CPT 95065 | not published | not published | $17.78 – $41.21 | 9 |
| Disability dlco CPT 94727 | not published | not published | $44.61 – $163.71 | 9 |
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.