Sanford Wheaton
Sanford Wheaton in Wheaton, MN publishes cash prices for 32 common procedures listed here, from its own machine-readable price file updated Mar 4, 2026. Click a procedure to compare it with other hospitals nearby.
401 12th St N, Wheaton, MN 56296-1070 Collected Sep 23, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD PELVIS W CONTRAST | $2,488.80 | $3,111.00 | 20% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD PELVIS W CONTRAST | $2,488.80 | $3,111.00 | 20% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONTRAST | $1,663.20 | $2,079.00 | 20% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO CONTRAST | $1,663.20 | $2,079.00 | 20% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CONTRAST | $2,115.20 | $2,644.00 | 20% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W CONTRAST | $2,115.20 | $2,644.00 | 20% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO DX BILAT INCL CAD | $523.20 | $654.00 | 20% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO DX BILAT INCL CAD | $523.20 | $654.00 | 20% |
| Diagnostic mammogram, one breast one side CPT 77065 MAMMO DX UNILAT INCL CAD | $409.60 | $512.00 | 20% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO DX UNILAT INCL CAD | $409.60 | $512.00 | 20% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LOWER EXT JT WO CONTRAST | $2,514.40 | $3,143.00 | 20% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI LOWER EXT JT WO CONTRAST | $2,514.40 | $3,143.00 | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LOWER EXT JT WO THEN W CONT | $3,506.40 | $4,383.00 | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI LOWER EXT JT WO THEN W CONT | $3,506.40 | $4,383.00 | 20% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO CONTRAST | $2,676.80 | $3,346.00 | 20% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO CONTRAST | $2,676.80 | $3,346.00 | 20% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN WO THEN W CONT | $3,704.80 | $4,631.00 | 20% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN WO THEN W CONT | $3,704.80 | $4,631.00 | 20% |
| MRI of the lower back, no contrast dye CPT 72148 MRI L SPINE WO CONTRAST | $2,809.60 | $3,512.00 | 20% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI L SPINE WO CONTRAST | $2,809.60 | $3,512.00 | 20% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PG UTR 2-3TRI SGL 1ST | $764.80 | $956.00 | 20% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PG UTR 2-3TRI SGL 1ST | $764.80 | $956.00 | 20% |
| Screening mammogram, both breasts both sides CPT 77067 MAMMO SCREEN BILAT INCL CAD | $452.80 | $566.00 | 20% |
| Screening mammogram, both breasts one side CPT 77067 MAMMO SCREEN UNILAT INCL CAD M52 | $452.80 | $566.00 | 20% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 MAMMO SCREEN BILAT INCL CAD | $452.80 | $566.00 | 20% |
| Screening mammogram, both breasts inpatient one side CPT 77067 MAMMO SCREEN UNILAT INCL CAD M52 | $452.80 | $566.00 | 20% |
| Sleep study in a lab (polysomnography) CPT 95810 PSG 4+ PARAMETERS | $3,907.20 | $4,884.00 | 20% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 PSG 4+ PARAMETERS | $3,907.20 | $4,884.00 | 20% |
| Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL | $680.80 | $851.00 | 20% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL | $680.80 | $851.00 | 20% |
| Ultrasound of the abdomen, complete CPT 76700 US ABD COMPLETE | $897.60 | $1,122.00 | 20% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US ABD COMPLETE | $897.60 | $1,122.00 | 20% |
| X-ray of the lower back, 4 or more views CPT 72110 RAD EXAM SPINE LUMB MIN 4 VWS | $547.20 | $684.00 | 20% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 RAD EXAM SPINE LUMB MIN 4 VWS | $547.20 | $684.00 | 20% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL 80048 | $107.20 | $134.00 | 20% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL 80048 | $107.20 | $134.00 | 20% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL 80061 | $102.40 | $128.00 | 20% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL 80061 | $102.40 | $128.00 | 20% |
| Complete blood count (CBC) with differential CPT 85025 COMPLETE CBC W/AUTO DIFF WBC 85025 | $89.60 | $112.00 | 20% |
| Complete blood count (CBC) with differential inpatient CPT 85025 COMPLETE CBC W/AUTO DIFF WBC 85025 | $89.60 | $112.00 | 20% |
| Complete blood count (CBC), no differential CPT 85027 BLOOD COUNT COMPLETE AUTOMATED 85027 | $65.60 | $82.00 | 20% |
| Complete blood count (CBC), no differential inpatient CPT 85027 BLOOD COUNT COMPLETE AUTOMATED 85027 | $65.60 | $82.00 | 20% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL 80053 | $123.20 | $154.00 | 20% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL 80053 | $123.20 | $154.00 | 20% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL 80069 | $105.60 | $132.00 | 20% |
| Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL 80069 | $105.60 | $132.00 | 20% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL 80076 | $113.60 | $142.00 | 20% |
| Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL 80076 | $113.60 | $142.00 | 20% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE 84154 | $72.00 | $90.00 | 20% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE 84154 | $72.00 | $90.00 | 20% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 CDMR ASSAY OF PSA TOTAL 84153 | $89.60 | $112.00 | 20% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 CDMR ASSAY OF PSA TOTAL 84153 | $89.60 | $112.00 | 20% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 LUPUS ANTICOAG PANEL PTT 85730.900 | $16.00 | $20.00 | 20% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL PLASMA WHOLE BLOOD (PTT) 85730 | $56.80 | $71.00 | 20% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 LUPUS ANTICOAG PANEL PTT 85730.900 | $16.00 | $20.00 | 20% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME PARTIAL PLASMA WHOLE BLOOD (PTT) 85730 | $56.80 | $71.00 | 20% |
| Prothrombin time (PT/INR) clotting test CPT 85610 LUPUS ANTICOAG PANEL PT 85610.900 | $12.00 | $15.00 | 20% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PT INR FINGERSTICK-QW 85610 | $52.00 | $65.00 | 20% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME 85610 | $52.00 | $65.00 | 20% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 LUPUS ANTICOAG PANEL PT 85610.900 | $12.00 | $15.00 | 20% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME 85610 | $52.00 | $65.00 | 20% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT INR FINGERSTICK-QW 85610 | $52.00 | $65.00 | 20% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE (TSH) 84443 | $104.00 | $130.00 | 20% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE (TSH) 84443 | $104.00 | $130.00 | 20% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS AUTO W/SCOPE 81001 | $62.40 | $78.00 | 20% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS AUTO W/SCOPE 81001 | $62.40 | $78.00 | 20% |
| Urinalysis without microscope exam, automated CPT 81003 URINE AUTO NO MICRO SGL ANALYT | $24.00 | $30.00 | 20% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS-DIPSTICK ONLY 81003 | $28.80 | $36.00 | 20% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINE AUTO NO MICRO SGL ANALYT | $24.00 | $30.00 | 20% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS-DIPSTICK ONLY 81003 | $28.80 | $36.00 | 20% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| New patient office visit, about 30 minutes CPT 99203 NEW PATIENT LEVEL 3 | $186.40 | $233.00 | 20% |
| New patient office visit, about 30 minutes inpatient CPT 99203 NEW PATIENT LEVEL 3 | $186.40 | $233.00 | 20% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THER EXERCISE EA 15 MIN 97110 | $112.00 | $140.00 | 20% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THER EXERCISE EA 15 MIN 97110 | $112.00 | $140.00 | 20% |
Source file: https://sthpiprd.blob.core.windows.net/machine-readable-files/8380/450409348_sanford-wheaton_standardcharges.csv