Hospital

Sanford Bagley Medical Center

Sanford Bagley Medical Center in Bagley, MN publishes cash prices for 192 common procedures listed here, from its own machine-readable price file updated Mar 4, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Minnesota median for 171 of 188 procedures and below it for 17. By typical cash price it ranks #81 of 85 Minnesota hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

203 4th Street NW, Bagley, MN 56621 Collected Sep 23, 2026 Source price file Check a bill from this hospital (218) 694-6501

Critical access hospital (rural, 25 beds or fewer) Nonprofit hospital Emergency department CCN 241328 · CMS hospital register NPI 1932472255

Financial assistance

Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply

Sanford Bagley Medical Center is a nonprofit hospital in the CMS register. Under section 501(r) of the federal tax code it must have a written Financial Assistance Policy with a free application, publish both on its website, and charge patients who qualify no more than the amounts generally billed to insured patients for emergency and other medically necessary care. Who qualifies depends on household income; the policy states the limits.

You can apply up to 240 days after the first bill. Before collection actions such as credit reporting or a lawsuit, the hospital must tell you about the policy and wait at least 120 days after that bill. Ask the billing office for the policy and the application before you pay, or search the hospital's website for “financial assistance”. Letters you can copy.

Source: IRS, section 501(r) requirements for nonprofit hospitals.

State law

This state limits hospital bills for lower-income patients

Minnesota law (Minn. Stat. §144.589): a hospital may not charge an uninsured patient whose household income is under $125,000 more than the lowest amount it would be paid for the same service by a private insurer, counting the insured patient's share. If the cash price below is higher, ask the billing office to apply this limit. Each hospital's page here shows the range of insurer rates in its own file (the "Insurers pay" column), a starting point when you ask. Other states' laws.

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 1 action for a hospital named Sanford Bagley Medical Center in Bagley, MN:

  • Jun 12, 2025 Met requirements

Met requirements: CMS reviewed the hospital and found it met the requirements, so no further action was taken.

A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.

Scans and imaging

ProcedureCash priceList priceInsurers payvs MinnesotaOff list
Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN WO THEN W CONT $2,673.60 $3,342.00 $186.92–$3,141.48 53% above 20%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN WO THEN W CONT $2,673.60 $3,342.00 $1,838.10–$3,161.53 — 20%
Abdominal X-ray, 2 views CPT 74019 RAD EXAM ABDOMEN 2 VWS $437.60 $547.00 $111.66–$514.18 59% above 20%
Abdominal X-ray, 2 views inpatient CPT 74019 RAD EXAM ABDOMEN 2 VWS $437.60 $547.00 $300.85–$517.46 — 20%
Ankle X-ray, complete, 3 or more views CPT 73610 RAD EXAM ANKLE MIN 3 VWS $513.60 $642.00 $92.45–$603.48 122% above 20%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 RAD EXAM ANKLE MIN 3 VWS $513.60 $642.00 $353.10–$607.33 — 20%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 LIMITED BILAT PHYSIOLOGIC STUDIES EXT ART 1-2 LVLS $507.20 $634.00 $135.35–$595.96 — 20%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 LIMITED BILAT PHYSIOLOGIC STUDIES EXT ART 1-2 LVLS $507.20 $634.00 $348.70–$599.76 — 20%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT EXT UPPER WO CONT $1,744.80 $2,181.00 $111.66–$2,050.14 38% above 20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT EXT UPPER WO CONT $1,744.80 $2,181.00 $1,199.55–$2,063.23 — 20%
Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE AND OR JNT IMG WHOLE BODY $1,857.60 $2,322.00 $421.92–$2,182.68 52% above 20%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM BONE AND OR JNT IMG WHOLE BODY $1,857.60 $2,322.00 $1,277.10–$2,196.61 — 20%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABD PELVIS W CONTRAST+WO IF PERFORM $4,071.20 $5,089.00 $374.99–$4,783.66 60% above 20%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA ABD PELVIS W CONTRAST+WO IF PERFORM $4,071.20 $5,089.00 $2,798.95–$4,814.19 — 20%
CT angiography (CTA) of the head CPT 70496 CTA HEAD W CONT WO IF PERF $2,606.40 $3,258.00 $186.92–$3,062.52 44% above 20%
CT angiography (CTA) of the head inpatient CPT 70496 CTA HEAD W CONT WO IF PERF $2,606.40 $3,258.00 $1,791.90–$3,082.07 — 20%
CT angiography (CTA) of the neck CPT 70498 CT ANGIO NECK W CON+WO IF PERF $2,615.20 $3,269.00 $186.92–$3,072.86 49% above 20%
CT angiography (CTA) of the neck inpatient CPT 70498 CT ANGIO NECK W CON+WO IF PERF $2,615.20 $3,269.00 $1,797.95–$3,092.47 — 20%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST WCONT +WO IF PERF $2,758.40 $3,448.00 $186.92–$3,241.12 51% above 20%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST WCONT +WO IF PERF $2,758.40 $3,448.00 $1,896.40–$3,261.81 — 20%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD PELVIS WO CONTRAST $3,476.00 $4,345.00 $253.81–$4,084.30 68% above 20%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD PELVIS WO CONTRAST $3,476.00 $4,345.00 $2,389.75–$4,110.37 — 20%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD PELVIS W CONTRAST $4,016.00 $5,020.00 $374.99–$4,718.80 60% above 20%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD PELVIS W CONTRAST $4,016.00 $5,020.00 $2,761.00–$4,748.92 — 20%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD PELVIS WO THEN W CONT $4,288.80 $5,361.00 $374.99–$5,039.34 59% above 20%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD PELVIS WO THEN W CONT $4,288.80 $5,361.00 $2,948.55–$5,071.51 — 20%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W CONTRAST $2,364.00 $2,955.00 $186.92–$2,777.70 71% above 20%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W CONTRAST $2,364.00 $2,955.00 $1,625.25–$2,795.43 — 20%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN WO CONTRAST $1,928.80 $2,411.00 $111.66–$2,266.34 64% above 20%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN WO CONTRAST $1,928.80 $2,411.00 $1,326.05–$2,280.81 — 20%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL WO CONT $1,876.00 $2,345.00 $111.66–$2,204.30 49% above 20%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL WO CONT $1,876.00 $2,345.00 $1,289.75–$2,218.37 — 20%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONTRAST $1,863.20 $2,329.00 $111.66–$2,189.26 48% above 20%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO CONTRAST $1,863.20 $2,329.00 $1,280.95–$2,203.23 — 20%
CT scan of the head with contrast CPT 70460 CT HEAD W CONTRAST $2,047.20 $2,559.00 $186.92–$2,405.46 58% above 20%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD W CONTRAST $2,047.20 $2,559.00 $1,407.45–$2,420.81 — 20%
CT scan of the head without and with contrast CPT 70470 CT HEAD WO THEN W CONTRAST $2,363.20 $2,954.00 $186.92–$2,776.76 49% above 20%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD WO THEN W CONTRAST $2,363.20 $2,954.00 $1,624.70–$2,794.48 — 20%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE WO CONT $1,996.80 $2,496.00 $111.66–$2,346.24 47% above 20%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE WO CONT $1,996.80 $2,496.00 $1,372.80–$2,361.22 — 20%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL SPINE WO CONTRAST $1,996.80 $2,496.00 $111.66–$2,346.24 39% above 20%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERVICAL SPINE WO CONTRAST $1,996.80 $2,496.00 $1,372.80–$2,361.22 — 20%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CONTRAST $2,002.40 $2,503.00 $186.92–$2,352.82 41% above 20%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W CONTRAST $2,002.40 $2,503.00 $1,376.65–$2,367.84 — 20%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 DUP CAROTID BILAT $1,036.00 $1,295.00 $253.81–$1,217.30 — 20%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 DUP CAROTID BILAT $1,036.00 $1,295.00 $712.25–$1,225.07 — 20%
Chest CT scan without and with contrast CPT 71270 CT THORAX DIAGNOSTIC WO THEN W CONTRAST $2,644.00 $3,305.00 $186.92–$3,106.70 66% above 20%
Chest CT scan without and with contrast inpatient CPT 71270 CT THORAX DIAGNOSTIC WO THEN W CONTRAST $2,644.00 $3,305.00 $1,817.75–$3,126.53 — 20%
Chest X-ray, 2 views CPT 71046 RAD EXAM CHEST 2 VWS $386.40 $483.00 $92.45–$454.02 71% above 20%
Chest X-ray, 2 views inpatient CPT 71046 RAD EXAM CHEST 2 VWS $386.40 $483.00 $265.65–$456.92 — 20%
Chest X-ray, single view CPT 71045 RAD EXAM CHEST SINGLE VW $307.20 $384.00 $92.45–$360.96 52% above 20%
Chest X-ray, single view inpatient CPT 71045 RAD EXAM CHEST SINGLE VW $307.20 $384.00 $211.20–$363.26 — 20%
Collarbone (clavicle) X-ray, complete CPT 73000 RAD EXAM CLAVICLE COMPL $365.60 $457.00 $92.45–$429.58 83% above 20%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 RAD EXAM CLAVICLE COMPL $365.60 $457.00 $251.35–$432.32 — 20%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEUM $420.80 $526.00 $111.66–$494.44 19% below 20%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITONEUM $420.80 $526.00 $289.30–$497.60 — 20%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BONE DENSITY DEXA AXIAL SKELET $530.40 $663.00 $111.66–$623.22 43% above 20%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BONE DENSITY DEXA AXIAL SKELET $530.40 $663.00 $364.65–$627.20 — 20%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 BONE DENSITY DEXA APPEND SKEL $284.00 $355.00 $85.95–$333.70 42% above 20%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 BONE DENSITY DEXA APPEND SKEL $284.00 $355.00 $195.25–$335.83 — 20%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX DIAGNOSTIC WO CONTRAST $1,964.80 $2,456.00 $111.66–$2,308.64 54% above 20%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT THORAX DIAGNOSTIC WO CONTRAST $1,964.80 $2,456.00 $1,350.80–$2,323.38 — 20%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT THORAX DIAGNOSTIC WITH CONTRAST $2,296.80 $2,871.00 $186.92–$2,698.74 57% above 20%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT THORAX DIAGNOSTIC WITH CONTRAST $2,296.80 $2,871.00 $1,579.05–$2,715.97 — 20%
Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO DX BILAT INCL CAD $588.00 $735.00 $177.94–$690.90 — 20%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO DX BILAT INCL CAD $588.00 $735.00 $404.25–$695.31 — 20%
Diagnostic mammogram, one breast one side CPT 77065 MAMMO DX UNILAT INCL CAD $458.40 $573.00 $138.72–$538.62 47% above 20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO DX UNILAT INCL CAD $458.40 $573.00 $315.15–$542.06 — 20%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 DUPLEX VENOUS EXT CMPL BILAT $1,243.20 $1,554.00 $253.81–$1,460.76 — 20%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 DUPLEX VENOUS EXT CMPL BILAT $1,243.20 $1,554.00 $854.70–$1,470.08 — 20%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO (2D) COMPLETE W DOPPLER & COLOR $2,280.00 $2,850.00 $575.70–$2,679.00 58% above 20%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO (2D) COMPLETE W DOPPLER & COLOR $2,280.00 $2,850.00 $1,567.50–$2,696.10 — 20%
Elbow X-ray, 2 views CPT 73070 RAD EXAM ELBOW 2 VWS $388.80 $486.00 $92.45–$456.84 91% above 20%
Elbow X-ray, 2 views inpatient CPT 73070 RAD EXAM ELBOW 2 VWS $388.80 $486.00 $267.30–$459.76 — 20%
Elbow X-ray, complete, 3 or more views CPT 73080 RAD EXAM ELBOW COMPL MIN 3 VWS $437.60 $547.00 $92.45–$514.18 88% above 20%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 RAD EXAM ELBOW COMPL MIN 3 VWS $437.60 $547.00 $300.85–$517.46 — 20%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT SELLA FOSSA EAR WO CONTRAST $1,824.00 $2,280.00 $111.66–$2,143.20 52% above 20%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBIT SELLA FOSSA EAR WO CONTRAST $1,824.00 $2,280.00 $1,254.00–$2,156.88 — 20%
Facial bones X-ray, complete, 3 or more views CPT 70150 RAD EXAM FACIAL BONES COMPL MIN 3 VWS $570.40 $713.00 $111.66–$670.22 124% above 20%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 RAD EXAM FACIAL BONES COMPL MIN 3 VWS $570.40 $713.00 $392.15–$674.50 — 20%
Forearm X-ray (radius and ulna), 2 views CPT 73090 RAD EXAM FOREARM 2 VWS $391.20 $489.00 $92.45–$459.66 93% above 20%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 RAD EXAM FOREARM 2 VWS $391.20 $489.00 $268.95–$462.59 — 20%
Hand X-ray, 2 views CPT 73120 RAD EXAM HAND 2 VWS $348.80 $436.00 $105.56–$409.84 83% above 20%
Hand X-ray, 2 views inpatient CPT 73120 RAD EXAM HAND 2 VWS $348.80 $436.00 $239.80–$412.46 — 20%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 RAD EXAM CALCANEUS MIN 2 VWS $408.00 $510.00 $92.45–$479.40 128% above 20%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 RAD EXAM CALCANEUS MIN 2 VWS $408.00 $510.00 $280.50–$482.46 — 20%
Knee X-ray, 3 views CPT 73562 RAD EXAM KNEE 3 VWS $532.80 $666.00 $92.45–$626.04 126% above 20%
Knee X-ray, 3 views inpatient CPT 73562 RAD EXAM KNEE 3 VWS $532.80 $666.00 $366.30–$630.04 — 20%
Knee X-ray, complete, 4 or more views CPT 73564 RAD EXAM KNEE COMPL 4 + VWS $640.80 $801.00 $111.66–$752.94 128% above 20%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 RAD EXAM KNEE COMPL 4 + VWS $640.80 $801.00 $440.55–$757.75 — 20%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT EXT LOWER WO CONT $1,751.20 $2,189.00 $111.66–$2,057.66 33% above 20%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT EXT LOWER WO CONT $1,751.20 $2,189.00 $1,203.95–$2,070.79 — 20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABD LIMITED $743.20 $929.00 $111.66–$873.26 68% above 20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABD LIMITED $743.20 $929.00 $510.95–$878.83 — 20%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US LMTD JNT OR FOC EVAL REAL TIME WIMAGE DOC $238.40 $298.00 $72.15–$280.12 31% below 20%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US LMTD JNT OR FOC EVAL REAL TIME WIMAGE DOC $238.40 $298.00 $163.90–$281.91 — 20%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT THORAX LW DOSE LUNG CA SCR NO CONTRAST $542.40 $678.00 $111.66–$637.32 32% below 20%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT THORAX LW DOSE LUNG CA SCR NO CONTRAST $542.40 $678.00 $372.90–$641.39 — 20%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 RAD EXAM TIBIA FIBULA 2 VWS $532.80 $666.00 $92.45–$626.04 151% above 20%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 RAD EXAM TIBIA FIBULA 2 VWS $532.80 $666.00 $366.30–$630.04 — 20%
MR angiography (MRA) of the head without contrast CPT 70544 MRA HEAD WO CONTRAST $3,235.20 $4,044.00 $253.81–$3,801.36 52% above 20%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA HEAD WO CONTRAST $3,235.20 $4,044.00 $2,224.20–$3,825.62 — 20%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LOWER EXT JT WO CONTRAST $2,974.40 $3,718.00 $253.81–$3,494.92 51% above 20%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI LOWER EXT JT WO CONTRAST $2,974.40 $3,718.00 $2,044.90–$3,517.23 — 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 $3,810.40 $4,763.00 $374.99–$4,477.22 48% above 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 $3,810.40 $4,763.00 $2,619.65–$4,505.80 — 20%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN WO CONTRAST $2,804.80 $3,506.00 $253.81–$3,295.64 31% above 20%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN WO CONTRAST $2,804.80 $3,506.00 $1,928.30–$3,316.68 — 20%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN WO THEN W CONT $3,850.40 $4,813.00 $374.99–$4,524.22 31% above 20%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN WO THEN W CONT $3,850.40 $4,813.00 $2,647.15–$4,553.10 — 20%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO CONTRAST $3,083.20 $3,854.00 $253.81–$3,622.76 48% above 20%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO CONTRAST $3,083.20 $3,854.00 $2,119.70–$3,645.88 — 20%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN WO THEN W CONT $3,930.40 $4,913.00 $374.99–$4,618.22 35% above 20%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN WO THEN W CONT $3,930.40 $4,913.00 $2,702.15–$4,647.70 — 20%
MRI of the lower back, no contrast dye CPT 72148 MRI L SPINE WO CONTRAST $2,872.80 $3,591.00 $253.81–$3,375.54 41% above 20%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI L SPINE WO CONTRAST $2,872.80 $3,591.00 $1,975.05–$3,397.09 — 20%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI L SPINE WO THEN W CONT $4,034.40 $5,043.00 $374.99–$4,740.42 52% above 20%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI L SPINE WO THEN W CONT $4,034.40 $5,043.00 $2,773.65–$4,770.68 — 20%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI T SPINE WO CONTRAST $2,976.00 $3,720.00 $253.81–$3,496.80 44% above 20%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI T SPINE WO CONTRAST $2,976.00 $3,720.00 $2,046.00–$3,519.12 — 20%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI C SPINE WO THEN W CONT $4,034.40 $5,043.00 $374.99–$4,740.42 61% above 20%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI C SPINE WO THEN W CONT $4,034.40 $5,043.00 $2,773.65–$4,770.68 — 20%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI C SPINE WO CONTRAST $2,959.20 $3,699.00 $253.81–$3,477.06 47% above 20%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI C SPINE WO CONTRAST $2,959.20 $3,699.00 $2,034.45–$3,499.25 — 20%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS WO THEN W CONT $3,837.60 $4,797.00 $374.99–$4,509.18 44% above 20%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS WO THEN W CONT $3,837.60 $4,797.00 $2,638.35–$4,537.96 — 20%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS WO CONTRAST $2,744.00 $3,430.00 $253.81–$3,224.20 30% above 20%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS WO CONTRAST $2,744.00 $3,430.00 $1,886.50–$3,244.78 — 20%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI UPPER EXT JT WO CONTRAST $3,040.80 $3,801.00 $253.81–$3,572.94 43% above 20%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI UPPER EXT JT WO CONTRAST $3,040.80 $3,801.00 $2,090.55–$3,595.75 — 20%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 RAD EXAM SPINE CERV 4 OR 5 VWS $604.00 $755.00 $111.66–$709.70 94% above 20%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 RAD EXAM SPINE CERV 4 OR 5 VWS $604.00 $755.00 $415.25–$714.23 — 20%
Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISSUE NECK W CONTRAST $2,211.20 $2,764.00 $186.92–$2,598.16 62% above 20%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SOFT TISSUE NECK W CONTRAST $2,211.20 $2,764.00 $1,520.20–$2,614.74 — 20%
Neck soft tissue CT scan without contrast CPT 70490 CT SOFT TISSUE NECK WO CON $1,799.20 $2,249.00 $111.66–$2,114.06 58% above 20%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SOFT TISSUE NECK WO CON $1,799.20 $2,249.00 $1,236.95–$2,127.55 — 20%
Neck soft tissue X-ray CPT 70360 RAD EXAM NECK SOFT TISSUE $328.80 $411.00 $92.45–$386.34 87% above 20%
Neck soft tissue X-ray inpatient CPT 70360 RAD EXAM NECK SOFT TISSUE $328.80 $411.00 $226.05–$388.81 — 20%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM MYOCARDIAL SPECT MULT STDY $3,842.40 $4,803.00 $1,370.75–$4,514.82 41% above 20%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM MYOCARDIAL SPECT MULT STDY $3,842.40 $4,803.00 $2,641.65–$4,543.64 — 20%
Pelvic CT scan without contrast CPT 72192 CT PELVIS WO CONTRAST $1,715.20 $2,144.00 $111.66–$2,015.36 30% above 20%
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS WO CONTRAST $1,715.20 $2,144.00 $1,179.20–$2,028.22 — 20%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC LIMITED $410.40 $513.00 $111.66–$482.22 21% above 20%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIC LIMITED $410.40 $513.00 $282.15–$485.30 — 20%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC COMPLETE $772.00 $965.00 $111.66–$907.10 58% above 20%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC COMPLETE $772.00 $965.00 $530.75–$912.89 — 20%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREG UTER 1ST TRI SGL $426.40 $533.00 $111.66–$501.02 1% below 20%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US PREG UTER 1ST TRI SGL $426.40 $533.00 $293.15–$504.22 — 20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB REAL TIME LTD $344.00 $430.00 $104.10–$404.20 2% above 20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB REAL TIME LTD $344.00 $430.00 $236.50–$406.78 — 20%
Rib X-ray, one side, 2 views one side CPT 71100 RAD EXAM RIBS UNILAT 2 VWS $412.80 $516.00 $92.45–$485.04 102% above 20%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RAD EXAM RIBS UNILAT 2 VWS $412.80 $516.00 $283.80–$488.14 — 20%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RAD EXAM RIBS UNILAT W CHEST MIN 3 VWS $503.20 $629.00 $111.66–$591.26 73% above 20%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RAD EXAM RIBS UNILAT W CHEST MIN 3 VWS $503.20 $629.00 $345.95–$595.03 — 20%
Screening mammogram, both breasts both sides CPT 77067 MAMMO SCREEN BILAT INCL CAD $487.20 $609.00 $165.00–$572.46 — 20%
Screening mammogram, both breasts one side CPT 77067 MAMMO SCREEN UNILAT INCL CAD M52 $487.20 $609.00 $165.00–$572.46 48% above 20%
Screening mammogram, both breasts inpatient both sides CPT 77067 MAMMO SCREEN BILAT INCL CAD $487.20 $609.00 $334.95–$576.11 — 20%
Screening mammogram, both breasts inpatient one side CPT 77067 MAMMO SCREEN UNILAT INCL CAD M52 $487.20 $609.00 $334.95–$576.11 — 20%
Shoulder X-ray, complete, 2 or more views CPT 73030 RAD EXAM SHOULDER COMPL MIN 2 VWS $530.40 $663.00 $92.45–$623.22 125% above 20%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 RAD EXAM SHOULDER COMPL MIN 2 VWS $530.40 $663.00 $364.65–$627.20 — 20%
Sinus X-ray, complete, 3 or more views CPT 70220 RAD EXAM SINUSES PARANASAL COMPL MIN 3 VWS $473.60 $592.00 $92.45–$556.48 103% above 20%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 RAD EXAM SINUSES PARANASAL COMPL MIN 3 VWS $473.60 $592.00 $325.60–$560.03 — 20%
Skull X-ray, fewer than 4 views CPT 70250 RAD EXAM SKULL < 4 VWS $410.40 $513.00 $111.66–$482.22 83% above 20%
Skull X-ray, fewer than 4 views inpatient CPT 70250 RAD EXAM SKULL < 4 VWS $410.40 $513.00 $282.15–$485.30 — 20%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 RAD EXAM FEMUR MIN 2 VWS $556.00 $695.00 $92.45–$653.30 145% above 20%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 RAD EXAM FEMUR MIN 2 VWS $556.00 $695.00 $382.25–$657.47 — 20%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT THORACIC SPINE WO CONT $1,924.00 $2,405.00 $111.66–$2,260.70 44% above 20%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT THORACIC SPINE WO CONT $1,924.00 $2,405.00 $1,322.75–$2,275.13 — 20%
Toe X-ray, 2 or more views CPT 73660 RAD EXAM TOES MIN 2 VWS $322.40 $403.00 $92.45–$378.82 74% above 20%
Toe X-ray, 2 or more views inpatient CPT 73660 RAD EXAM TOES MIN 2 VWS $322.40 $403.00 $221.65–$381.24 — 20%
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL $379.20 $474.00 $111.66–$445.56 5% below 20%
Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL $379.20 $474.00 $260.70–$448.40 — 20%
Transvaginal ultrasound during pregnancy CPT 76817 US PG UTR TRANSVAG $371.20 $464.00 $111.66–$436.16 4% above 20%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US PG UTR TRANSVAG $371.20 $464.00 $255.20–$438.94 — 20%
Ultrasound of the abdomen, complete CPT 76700 US ABD COMPLETE $940.80 $1,176.00 $111.66–$1,105.44 56% above 20%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABD COMPLETE $940.80 $1,176.00 $646.80–$1,112.50 — 20%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM $614.40 $768.00 $111.66–$721.92 37% above 20%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM $614.40 $768.00 $422.40–$726.53 — 20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUE HEAD NECK $426.40 $533.00 $111.66–$501.02 2% below 20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SOFT TISSUE HEAD NECK $426.40 $533.00 $293.15–$504.22 — 20%
Upper arm X-ray (humerus), 2 views CPT 73060 RAD EXAM HUMERUS MIN 2 VWS $532.80 $666.00 $92.45–$626.04 150% above 20%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 RAD EXAM HUMERUS MIN 2 VWS $532.80 $666.00 $366.30–$630.04 — 20%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 DUPLEX VENOUS EXT LTD UNILAT $878.40 $1,098.00 $111.66–$1,032.12 62% above 20%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 DUPLEX VENOUS EXT LTD UNILAT $878.40 $1,098.00 $603.90–$1,038.71 — 20%
Wrist X-ray, 2 views CPT 73100 RAD EXAM WRIST 2 VWS $349.60 $437.00 $92.45–$410.78 77% above 20%
Wrist X-ray, 2 views inpatient CPT 73100 RAD EXAM WRIST 2 VWS $349.60 $437.00 $240.35–$413.40 — 20%
Wrist X-ray, complete, 3 or more views CPT 73110 RAD EXAM WRIST COMPL MIN 3 VWS $510.40 $638.00 $92.45–$599.72 120% above 20%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 RAD EXAM WRIST COMPL MIN 3 VWS $510.40 $638.00 $350.90–$603.55 — 20%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 RAD EXAM HIP UNILAT W PELV WHEN PERF 2 OR 3 VWS $350.40 $438.00 $92.45–$411.72 27% above 20%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 RAD EXAM HIP UNILAT W PELV WHEN PERF 2 OR 3 VWS $350.40 $438.00 $240.90–$414.35 — 20%
X-ray of the abdomen, 1 view CPT 74018 RAD EXAM ABDOMEN 1 VW $357.60 $447.00 $92.45–$420.18 70% above 20%
X-ray of the abdomen, 1 view inpatient CPT 74018 RAD EXAM ABDOMEN 1 VW $357.60 $447.00 $245.85–$422.86 — 20%
X-ray of the ankle, 2 views CPT 73600 RAD EXAM ANKLE 2 VWS $348.00 $435.00 $92.45–$408.90 70% above 20%
X-ray of the ankle, 2 views inpatient CPT 73600 RAD EXAM ANKLE 2 VWS $348.00 $435.00 $239.25–$411.51 — 20%
X-ray of the finger(s), 2 or more views CPT 73140 RAD EXAM FINGER(S) MIN 2 VWS $319.20 $399.00 $92.45–$375.06 64% above 20%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 RAD EXAM FINGER(S) MIN 2 VWS $319.20 $399.00 $219.45–$377.45 — 20%
X-ray of the foot, 2 views CPT 73620 RAD EXAM FOOT 2 VWS $371.20 $464.00 $92.45–$436.16 94% above 20%
X-ray of the foot, 2 views inpatient CPT 73620 RAD EXAM FOOT 2 VWS $371.20 $464.00 $255.20–$438.94 — 20%
X-ray of the foot, complete, 3 or more views CPT 73630 RAD EXAM FOOT MIN 3 VWS $438.40 $548.00 $92.45–$515.12 98% above 20%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 RAD EXAM FOOT MIN 3 VWS $438.40 $548.00 $301.40–$518.41 — 20%
X-ray of the hand, 3 or more views CPT 73130 RAD EXAM HAND MIN 3 VWS $505.60 $632.00 $92.45–$594.08 130% above 20%
X-ray of the hand, 3 or more views inpatient CPT 73130 RAD EXAM HAND MIN 3 VWS $505.60 $632.00 $347.60–$597.87 — 20%
X-ray of the knee, 1 or 2 views CPT 73560 RAD EXAM KNEE 1 OR 2 VWS $446.40 $558.00 $92.45–$524.52 106% above 20%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 RAD EXAM KNEE 1 OR 2 VWS $446.40 $558.00 $306.90–$527.87 — 20%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 RAD EXAM SPINE LUMB 2 OR 3 VWS $444.00 $555.00 $111.66–$521.70 72% above 20%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 RAD EXAM SPINE LUMB 2 OR 3 VWS $444.00 $555.00 $305.25–$525.03 — 20%
X-ray of the lower back, 4 or more views CPT 72110 RAD EXAM SPINE LUMB MIN 4 VWS $627.20 $784.00 $111.66–$736.96 89% above 20%
X-ray of the lower back, 4 or more views inpatient CPT 72110 RAD EXAM SPINE LUMB MIN 4 VWS $627.20 $784.00 $431.20–$741.66 — 20%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 RAD EXAM SPINE THOR 2 VWS $405.60 $507.00 $111.66–$476.58 73% above 20%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 RAD EXAM SPINE THOR 2 VWS $405.60 $507.00 $278.85–$479.62 — 20%
X-ray of the nasal bones, 3 or more views CPT 70160 RAD EXAM NASAL BONES COMPL MIN 3 VWS $404.80 $506.00 $92.45–$475.64 85% above 20%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 RAD EXAM NASAL BONES COMPL MIN 3 VWS $404.80 $506.00 $278.30–$478.68 — 20%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 RAD EXAM SPINE CERV 2 OR 3 VWS $451.20 $564.00 $92.45–$530.16 83% above 20%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 RAD EXAM SPINE CERV 2 OR 3 VWS $451.20 $564.00 $310.20–$533.54 — 20%
X-ray of the pelvis, 1 or 2 views CPT 72170 RAD EXAM PELVIS 1 OR 2 VWS $351.20 $439.00 $106.28–$412.66 58% above 20%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 RAD EXAM PELVIS 1 OR 2 VWS $351.20 $439.00 $241.45–$415.29 — 20%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 RAD EXAM SACRUM COCCYX MIN 2 VWS $404.80 $506.00 $92.45–$475.64 83% above 20%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 RAD EXAM SACRUM COCCYX MIN 2 VWS $404.80 $506.00 $278.30–$478.68 — 20%

Lab tests

ProcedureCash priceList priceInsurers payvs MinnesotaOff list
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURGICAL PATH LEVEL IV 88305 $176.00 $220.00 $79.75–$206.80 27% above 20%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURGICAL PATH LEVEL IV 88305 $176.00 $220.00 $121.00–$208.12 — 20%
Pap test (liquid-based, automated screening with review) CPT 88175 CYTO CERV THN AUTO 88175 $97.60 $122.00 $29.54–$114.68 15% above 20%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 CYTO CERV THN AUTO 88175 $97.60 $122.00 $67.10–$115.41 — 20%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTO CERV THN MAN 88142 $70.40 $88.00 $21.30–$82.72 9% below 20%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CYTO CERV THN MAN 88142 $70.40 $88.00 $48.40–$83.25 — 20%
Urinalysis without microscope exam, automated CPT 81003 DOT URINE AUTO DIPSTICK 81003 $9.60 $12.00 $2.91–$11.28 63% below 20%
Urinalysis without microscope exam, automated inpatient CPT 81003 DOT URINE AUTO DIPSTICK 81003 $9.60 $12.00 $6.60–$11.35 — 20%

Surgery and procedures

ProcedureCash priceList priceInsurers payvs MinnesotaOff list
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 ED 27786 CLSD TX ANKLE FX WO MANIP $580.00 $725.00 $175.52–$681.50 29% above 20%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 ED 27786 CLSD TX ANKLE FX WO MANIP $580.00 $725.00 $398.75–$685.85 — 20%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 ED 28470 CLSD TX METATARSAL FX WO MANIP $489.60 $612.00 $148.17–$575.28 32% above 20%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 ED 28470 CLSD TX METATARSAL FX WO MANIP $489.60 $612.00 $336.60–$578.95 — 20%
Cardioversion, elective (restoring heart rhythm) CPT 92960 ED 92960 CARDIOVERSION $1,792.00 $2,240.00 $542.30–$2,105.60 71% above 20%
Cardioversion, elective (restoring heart rhythm) CPT 92960 ED 92960 CARDIOVERSION ELECTIVE EXTERNAL $1,792.00 $2,240.00 $542.30–$2,105.60 71% above 20%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 ED 92960 CARDIOVERSION $1,792.00 $2,240.00 $1,232.00–$2,119.04 — 20%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 ED 92960 CARDIOVERSION ELECTIVE EXTERNAL $1,792.00 $2,240.00 $1,232.00–$2,119.04 — 20%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 ED 25600 CLSD TX DISTAL RADIAL FX $492.80 $616.00 $149.13–$579.04 at median 20%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 ED 25600 CLSD TX DISTAL RADIAL FX $492.80 $616.00 $338.80–$582.74 — 20%
Earwax removal by irrigation (rinsing), one ear CPT 69209 ED 69209 RMVL IMPACTED CERUMEN IRRIGATION LAVAGE UNI $158.40 $198.00 $47.94–$186.12 105% above 20%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 ED 69209 RMVL IMPACTED CERUMEN IRRIGATION LAVAGE UNI $158.40 $198.00 $108.90–$187.31 — 20%
Earwax removal with instruments, one ear CPT 69210 ED 69210 REMV IMPACTED EAR WAX INSTRUMENT UNI $192.00 $240.00 $58.10–$225.60 56% above 20%
Earwax removal with instruments, one ear inpatient CPT 69210 ED 69210 REMV IMPACTED EAR WAX INSTRUMENT UNI $192.00 $240.00 $132.00–$227.04 — 20%
Incision and drainage of a simple or single skin abscess CPT 10060 ED 10060 I&D SKIN ABSCESS SMPL $556.00 $695.00 $168.26–$653.30 94% above 20%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 ED 10060 I&D SKIN ABSCESS SMPL $556.00 $695.00 $382.25–$657.47 — 20%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 ED 20550 INJECT SLG TENDON SHEATH LIGAMENT APONEUROSISA $543.20 $679.00 $164.39–$638.26 47% above 20%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 ED 20550 INJECT SLG TENDON SHEATH LIGAMENT APONEUROSISA $543.20 $679.00 $373.45–$642.33 — 20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 SURG 20610 INJ MAJOR JOINT BURSA WO US GUID $276.80 $346.00 $83.77–$325.24 23% below 20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ED 20610 ASP INJ JOINT BURSA MAJOR WO US GUID $856.00 $1,070.00 $259.05–$1,005.80 137% above 20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 SURG 20610 ARTHROCENTESIS ASP INJ MJR JNT BURSA WO US GUID $856.00 $1,070.00 $259.05–$1,005.80 137% above 20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 SURG 20610 INJ MAJOR JOINT BURSA WO US GUID $276.80 $346.00 $190.30–$327.32 — 20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ED 20610 ASP INJ JOINT BURSA MAJOR WO US GUID $856.00 $1,070.00 $588.50–$1,012.22 — 20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 SURG 20610 ARTHROCENTESIS ASP INJ MJR JNT BURSA WO US GUID $856.00 $1,070.00 $588.50–$1,012.22 — 20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ED 20605 ASP INJ JOINT BURSA INTERMED WO US GUID $657.60 $822.00 $199.01–$772.68 115% above 20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ED 20605 ASP INJ JOINT BURSA INTERMED WO US GUID $657.60 $822.00 $452.10–$777.61 — 20%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ED 20600 ASP INJ JOINT BURSA SMALL WO US GUID $666.40 $833.00 $201.67–$783.02 106% above 20%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ED 20600 ASP INJ JOINT BURSA SMALL WO US GUID $666.40 $833.00 $458.15–$788.02 — 20%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 ED 12031 LYR CLSR OF WND 2.5CM OR < $884.80 $1,106.00 $267.76–$1,039.64 95% above 20%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 ED 12031 LYR CLSR OF WND 2.5CM OR < $884.80 $1,106.00 $608.30–$1,046.28 — 20%
Nail removal (partial or complete), one nail CPT 11730 ED 11730 REMV OF NAIL PLATE $421.60 $527.00 $127.59–$495.38 57% above 20%
Nail removal (partial or complete), one nail inpatient CPT 11730 ED 11730 REMV OF NAIL PLATE $421.60 $527.00 $289.85–$498.54 — 20%
Occipital nerve block (injection for headaches) CPT 64405 ED 64405 INJ NERVE BLOCK GR OCCPTAL $871.20 $1,089.00 $263.65–$1,023.66 42% above 20%
Occipital nerve block (injection for headaches) inpatient CPT 64405 ED 64405 INJ NERVE BLOCK GR OCCPTAL $871.20 $1,089.00 $598.95–$1,030.19 — 20%
Paracentesis with imaging guidance CPT 49083 SURG 49083 ABD PARACENTESIS W IMAGING $2,092.80 $2,616.00 $633.33–$2,459.04 135% above 20%
Paracentesis with imaging guidance inpatient CPT 49083 SURG 49083 ABD PARACENTESIS W IMAGING $2,092.80 $2,616.00 $1,438.80–$2,474.74 — 20%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 ED 11750 REMV OF NAIL BED $1,176.80 $1,471.00 $356.13–$1,382.74 130% above 20%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 ED 11750 REMV OF NAIL BED $1,176.80 $1,471.00 $809.05–$1,391.57 — 20%
Removal of a foreign object under the skin, simple CPT 10120 ED 10120 INC&REMV FB SMPL $858.40 $1,073.00 $259.77–$1,008.62 112% above 20%
Removal of a foreign object under the skin, simple inpatient CPT 10120 ED 10120 INC&REMV FB SMPL $858.40 $1,073.00 $590.15–$1,015.06 — 20%
Short arm cast (elbow to hand) CPT 29075 ED 29075 APPL CAST FOREARM ARM $330.40 $413.00 $99.99–$388.22 26% above 20%
Short arm cast (elbow to hand) inpatient CPT 29075 ED 29075 APPL CAST FOREARM ARM $330.40 $413.00 $227.15–$390.70 — 20%
Short arm splint (forearm and hand) CPT 29125 ED 29125 APPL SPLINT FOREARM $352.00 $440.00 $106.52–$413.60 77% above 20%
Short arm splint (forearm and hand) inpatient CPT 29125 ED 29125 APPL SPLINT FOREARM $352.00 $440.00 $242.00–$416.24 — 20%
Short leg cast (below the knee) CPT 29405 ED 29405 APPL CAST SHORT LEG $378.40 $473.00 $114.51–$444.62 27% above 20%
Short leg cast (below the knee) inpatient CPT 29405 ED 29405 APPL CAST SHORT LEG $378.40 $473.00 $260.15–$447.46 — 20%
Short leg splint (calf to foot) CPT 29515 ED 29515 APPL SPLINT SHORT LEG $369.60 $462.00 $111.85–$434.28 66% above 20%
Short leg splint (calf to foot) inpatient CPT 29515 ED 29515 APPL SPLINT SHORT LEG $369.60 $462.00 $254.10–$437.05 — 20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 ED 12001 RPR SUPERFCL WND 2.5CM OR< $469.60 $587.00 $142.11–$551.78 69% above 20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 ED 12001 RPR SUPERFCL WND 2.5CM OR< $469.60 $587.00 $322.85–$555.30 — 20%
Spinal tap (lumbar puncture), diagnostic CPT 62270 ED 62270 SPINAL TAP LUMBAR DIAG $1,302.40 $1,628.00 $394.14–$1,530.32 77% above 20%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SURG 62270 SPINAL PUNCTURE LUMBAR DIAG $1,302.40 $1,628.00 $394.14–$1,530.32 77% above 20%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 ED 62270 SPINAL TAP LUMBAR DIAG $1,302.40 $1,628.00 $895.40–$1,540.09 — 20%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SURG 62270 SPINAL PUNCTURE LUMBAR DIAG $1,302.40 $1,628.00 $895.40–$1,540.09 — 20%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 ED 12002 RPR SUPERFCL WND 2.6-7.5CM $492.80 $616.00 $149.13–$579.04 53% above 20%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 ED 12002 RPR SUPERFCL WND 2.6-7.5CM $492.80 $616.00 $338.80–$582.74 — 20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 ED 12011 RPR SUPERFCL WND 2.5CM OR< $489.60 $612.00 $148.17–$575.28 70% above 20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 ED 12011 RPR SUPERFCL WND 2.5CM OR< $489.60 $612.00 $336.60–$578.95 — 20%
Thoracentesis with imaging guidance CPT 32555 ED 32555 THORACENTESIS W IMAGING $1,852.00 $2,315.00 $560.46–$2,176.10 101% above 20%
Thoracentesis with imaging guidance inpatient CPT 32555 ED 32555 THORACENTESIS W IMAGING $1,852.00 $2,315.00 $1,273.25–$2,189.99 — 20%
Trigger point injections, 1 or 2 muscles CPT 20552 ED 20552 INJ 1-2 MUSC GRPS $706.40 $883.00 $213.77–$830.02 122% above 20%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 ED 20552 INJ 1-2 MUSC GRPS $706.40 $883.00 $485.65–$835.32 — 20%

Doctor visits and therapy

ProcedureCash priceList priceInsurers payvs MinnesotaOff list
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLOOD $936.80 $1,171.00 $283.50–$1,100.74 33% above 20%
Blood transfusion (giving blood or blood components) CPT 36430 ED 36430 TRANSFUSION BLOOD $936.80 $1,171.00 $283.50–$1,100.74 33% above 20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLOOD $936.80 $1,171.00 $644.05–$1,107.77 — 20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 ED 36430 TRANSFUSION BLOOD $936.80 $1,171.00 $644.05–$1,107.77 — 20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEB INITIAL TX $130.40 $163.00 $39.46–$213.56 12% above 20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEB SUBSEQ TX $130.40 $163.00 $39.46–$213.56 12% above 20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 ED 94640 NEBULIZER TREATMENT $134.40 $168.00 $40.67–$213.56 15% above 20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 ED 94640 NON OR PRES'D INHALATION TX $148.00 $185.00 $44.79–$213.56 27% above 20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI SUBSEQ TX $168.00 $210.00 $50.84–$213.56 44% above 20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEB SUBSEQ TX $130.40 $163.00 $89.65–$154.20 — 20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEB INITIAL TX $130.40 $163.00 $89.65–$154.20 — 20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 ED 94640 NEBULIZER TREATMENT $134.40 $168.00 $92.40–$158.93 — 20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 ED 94640 NON OR PRES'D INHALATION TX $148.00 $185.00 $101.75–$175.01 — 20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI SUBSEQ TX $168.00 $210.00 $115.50–$198.66 — 20%
Critical care, first 30 to 74 minutes CPT 99291 ED 99291 CRITICAL CARE E&M 30-74 MIN $2,949.60 $3,687.00 $884.74–$3,465.78 85% above 20%
Critical care, first 30 to 74 minutes inpatient CPT 99291 ED 99291 CRITICAL CARE E&M 30-74 MIN $2,949.60 $3,687.00 $2,027.85–$3,487.90 — 20%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 EKG 12 LEAD W INTERP & REPORT $128.80 $161.00 $38.98–$151.34 26% below 20%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 EKG 12 LEAD W INTERP & REPORT $128.80 $161.00 $88.55–$152.31 — 20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG TRACING WO INTERP $260.80 $326.00 $62.37–$306.44 51% above 20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ECG TRACING WO INTERP $260.80 $326.00 $179.30–$308.40 — 20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED 99281 EMER CASE LEVEL I $315.20 $394.00 $92.45–$370.36 55% above 20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ED 99281 EMER CASE LEVEL I $315.20 $394.00 $216.70–$372.72 — 20%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED 99282 EMER CASE LEVEL II $501.60 $627.00 $151.80–$589.38 67% above 20%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ED 99282 EMER CASE LEVEL II $501.60 $627.00 $344.85–$593.14 — 20%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED 99283 EMER CASE LEVEL III $888.00 $1,110.00 $268.73–$1,043.40 84% above 20%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ED 99283 EMER CASE LEVEL III $888.00 $1,110.00 $610.50–$1,050.06 — 20%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED 99284 EMER CASE LEVEL IV $1,411.20 $1,764.00 $427.06–$1,658.16 81% above 20%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ED 99284 EMER CASE LEVEL IV $1,411.20 $1,764.00 $970.20–$1,668.74 — 20%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED 99285 EMER CASE LEVEL V $2,052.80 $2,566.00 $621.23–$2,412.04 77% above 20%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ED 99285 EMER CASE LEVEL V $2,052.80 $2,566.00 $1,411.30–$2,427.44 — 20%
Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIAC STRESS TEST TRACING $1,175.20 $1,469.00 $326.96–$1,380.86 63% above 20%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CARDIAC STRESS TEST TRACING $1,175.20 $1,469.00 $807.95–$1,389.67 — 20%
Family therapy with the patient, 50 minutes CPT 90847 PSYCH THERAPY FAMILY WPATIENT $540.00 $675.00 $163.42–$634.50 178% above 20%
Family therapy with the patient, 50 minutes inpatient CPT 90847 PSYCH THERAPY FAMILY WPATIENT $540.00 $675.00 $371.25–$638.55 — 20%
Family therapy without the patient, 50 minutes CPT 90846 PSYCH THERAPY FAMILY WO PATIENT $540.00 $675.00 $163.42–$634.50 195% above 20%
Family therapy without the patient, 50 minutes inpatient CPT 90846 PSYCH THERAPY FAMILY WO PATIENT $540.00 $675.00 $371.25–$638.55 — 20%
Group psychotherapy session CPT 90853 PSYCH THERAPY GROUP $1,400.00 $1,750.00 $97.13–$1,645.00 1566% above 20%
Group psychotherapy session inpatient CPT 90853 PSYCH THERAPY GROUP $1,400.00 $1,750.00 $962.50–$1,655.50 — 20%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRAT INITIAL 31-60MINS $541.60 $677.00 $163.90–$636.38 99% above 20%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 ED 96360 IV INFUS THERAPY HYDRATION FLUIDS INITIAL 31 MIN-1HR $541.60 $677.00 $163.90–$636.38 99% above 20%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRAT INITIAL 31-60MINS $541.60 $677.00 $372.35–$640.44 — 20%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 ED 96360 IV INFUS THERAPY HYDRATION FLUIDS INITIAL 31 MIN-1HR $541.60 $677.00 $372.35–$640.44 — 20%
IV infusion of a medicine, first hour CPT 96365 ED 96365 IV INFUS THER PROPH DIAG INITIAL UP TO 1HR $620.00 $775.00 $151.20–$728.50 90% above 20%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION TX PROPH DX INIT TO 1HR $620.00 $775.00 $151.20–$728.50 90% above 20%
IV infusion of a medicine, first hour inpatient CPT 96365 ED 96365 IV INFUS THER PROPH DIAG INITIAL UP TO 1HR $620.00 $775.00 $426.25–$733.15 — 20%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION TX PROPH DX INIT TO 1HR $620.00 $775.00 $426.25–$733.15 — 20%
IV push of a medicine, first drug CPT 96374 IV PUSH INITIAL $340.00 $425.00 $88.80–$399.50 85% above 20%
IV push of a medicine, first drug CPT 96374 ED 96374 THER PROPH DIAG INJ IV PUSH INITIAL $340.00 $425.00 $88.80–$399.50 85% above 20%
IV push of a medicine, first drug inpatient CPT 96374 IV PUSH INITIAL $340.00 $425.00 $233.75–$402.05 — 20%
IV push of a medicine, first drug inpatient CPT 96374 ED 96374 THER PROPH DIAG INJ IV PUSH INITIAL $340.00 $425.00 $233.75–$402.05 — 20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 CDMR ED 96372 INJECT SQ IM SELF ADM MED GY $20.00 $25.00 $6.05–$74.73 74% below 20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 CDMR INJECT SQ IM SELF ADM MED GY $20.00 $25.00 $6.05–$74.73 74% below 20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 SC IM INJECTION $119.20 $149.00 $34.40–$140.06 54% above 20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 ED 96372 THER PROPH DIAG INJECTION SQ IM $144.00 $180.00 $34.40–$169.20 86% above 20%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 CDMR ED 96372 INJECT SQ IM SELF ADM MED GY $20.00 $25.00 $13.75–$23.65 — 20%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 CDMR INJECT SQ IM SELF ADM MED GY $20.00 $25.00 $13.75–$23.65 — 20%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 SC IM INJECTION $119.20 $149.00 $81.95–$140.95 — 20%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 ED 96372 THER PROPH DIAG INJECTION SQ IM $144.00 $180.00 $99.00–$170.28 — 20%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSC RE ED EA 15MIN 97112 $132.80 $166.00 $63.25–$156.04 64% above 20%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSC RE ED EA 15MIN 97112 $132.80 $166.00 $91.30–$157.04 — 20%
New patient office visit, about 30 minutes CPT 99203 NEW PATIENT LEVEL 3 $203.20 $254.00 $61.49–$238.76 74% above 20%
New patient office visit, about 30 minutes inpatient CPT 99203 NEW PATIENT LEVEL 3 $203.20 $254.00 $139.70–$240.28 — 20%
New patient office visit, about 45 minutes CPT 99204 NEW PATIENT LEVEL 4 $268.80 $336.00 $81.35–$315.84 57% above 20%
New patient office visit, about 45 minutes inpatient CPT 99204 NEW PATIENT LEVEL 4 $268.80 $336.00 $184.80–$317.86 — 20%
New patient office visit, about 60 minutes CPT 99205 NEW PATIENT LEVEL 5 $328.00 $410.00 $99.26–$385.40 37% above 20%
New patient office visit, about 60 minutes inpatient CPT 99205 NEW PATIENT LEVEL 5 $328.00 $410.00 $225.50–$387.86 — 20%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PATIENT LEVEL 2 $141.60 $177.00 $42.85–$166.38 86% above 20%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 NEW PATIENT LEVEL 2 $141.60 $177.00 $97.35–$167.44 — 20%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT INITIAL INDIVIDUAL15 MIN $57.60 $72.00 $17.43–$67.68 6% below 20%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MNT INITIAL INDIVIDUAL15 MIN $57.60 $72.00 $39.60–$68.11 — 20%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW COMPLEXITY 97165 $268.80 $336.00 $81.35–$315.84 59% above 20%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW COMPLEXITY 97165 $268.80 $336.00 $184.80–$317.86 — 20%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH COMPLEXITY 97163 $340.80 $426.00 $103.13–$400.44 70% above 20%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEXITY 97163 $340.80 $426.00 $234.30–$403.00 — 20%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMPLEXITY 97161 $268.80 $336.00 $115.50–$315.84 60% above 20%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEXITY 97161 $268.80 $336.00 $184.80–$317.86 — 20%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MODERATE COMPLEXITY 97162 $304.00 $380.00 $92.00–$357.20 58% above 20%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MODERATE COMPLEXITY 97162 $304.00 $380.00 $209.00–$359.48 — 20%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 15 MIN 97140 $132.80 $166.00 $63.25–$156.04 57% above 20%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY 15 MIN 97140 $132.80 $166.00 $91.30–$157.04 — 20%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THER EXERCISE EA 15 MIN 97110 $128.00 $160.00 $63.25–$150.40 41% above 20%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THER EXERCISE EA 15 MIN 97110 $128.00 $160.00 $88.00–$151.36 — 20%
Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY W/PATIENT 16-37 MINUTES $480.00 $600.00 $145.26–$564.00 320% above 20%
Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY W/PATIENT 16-37 MINUTES $480.00 $600.00 $330.00–$567.60 — 20%
Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY W/PATIENT 38-52 MINUTES $520.00 $650.00 $157.37–$611.00 244% above 20%
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY W/PATIENT 38-52 MINUTES $520.00 $650.00 $357.50–$614.90 — 20%
Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY W/PATIENT 53+ MINUTES $528.00 $660.00 $159.79–$620.40 184% above 20%
Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY W/PATIENT 53+ MINUTES $528.00 $660.00 $363.00–$624.36 — 20%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO CONSULT 3-10 MIN $48.00 $60.00 $14.53–$56.40 40% above 20%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO CONSULT 3-10 MIN $48.00 $60.00 $33.00–$56.76 — 20%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 ESTAB LEVEL 5 $316.80 $396.00 $95.87–$372.24 81% above 20%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 ESTAB LEVEL 5 $316.80 $396.00 $217.80–$374.62 — 20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 ESTAB LEVEL 3 $193.60 $242.00 $58.59–$227.48 45% above 20%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 ESTAB LEVEL 3 $193.60 $242.00 $133.10–$228.93 — 20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ESTAB LEVEL 4 $253.60 $317.00 $76.75–$297.98 127% above 20%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 ESTAB LEVEL 4 $253.60 $317.00 $174.35–$299.88 — 20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ESTAB LEVEL 2 $126.40 $158.00 $38.25–$148.52 37% above 20%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 ESTAB LEVEL 2 $126.40 $158.00 $86.90–$149.47 — 20%
Speech and language evaluation CPT 92523 SPEECH EVAL LANG COMP EXPRESSION 92523 $471.20 $589.00 $142.60–$553.66 46% above 20%
Speech and language evaluation inpatient CPT 92523 SPEECH EVAL LANG COMP EXPRESSION 92523 $471.20 $589.00 $323.95–$557.19 — 20%
Speech therapy session, individual CPT 92507 SPEECH THERAPY TX 92507 $306.40 $383.00 $167.75–$360.02 44% above 20%
Speech therapy session, individual inpatient CPT 92507 SPEECH THERAPY TX 92507 $306.40 $383.00 $210.65–$362.32 — 20%
Spirometry (breathing test) CPT 94010 PFT SCREEN SPIROMETRY (NO BD) $312.00 $390.00 $94.42–$366.60 91% above 20%
Spirometry (breathing test) inpatient CPT 94010 PFT SCREEN SPIROMETRY (NO BD) $312.00 $390.00 $214.50–$368.94 — 20%
Spirometry before and after a bronchodilator CPT 94060 PFT SCREEN SPIROMETRY (WITH BD) $630.40 $788.00 $190.77–$740.72 98% above 20%
Spirometry before and after a bronchodilator inpatient CPT 94060 PFT SCREEN SPIROMETRY (WITH BD) $630.40 $788.00 $433.40–$745.45 — 20%
Therapeutic activities (functional training), 15 minutes CPT 97530 THER ACTIVITIES EA15 MIN 97530 $132.80 $166.00 $60.50–$156.04 71% above 20%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THER ACTIVITIES EA15 MIN 97530 $132.80 $166.00 $91.30–$157.04 — 20%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY $261.60 $327.00 $79.17–$307.38 29% above 20%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY $261.60 $327.00 $179.85–$309.34 — 20%

Vaccines

ProcedureCash priceList priceInsurers payvs MinnesotaOff list
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 Diph, Acellular Pert & Tet Tox Inj 15 LF-23 MCG-5 LF/0.5ML $74.75 $93.43 $22.62–$87.82 41% above 20%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 Diph, Acellular Pert & Tet Tox Inj 15 LF-23 MCG-5 LF/0.5ML $74.75 $93.43 $51.39–$88.38 — 20%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Hepatitis B Vaccine (Recombinant) Susp 10 MCG/ML $79.76 $99.69 $24.13–$93.71 29% below 20%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 Hepatitis B Vaccine (Recombinant) Susp 10 MCG/ML $79.76 $99.69 $54.83–$94.31 — 20%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Influenza Virus Vac Split High-Dose PF Susp Pref Syr 0.5ML $61.20 $76.49 $18.52–$71.90 6% below 20%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Influenza Virus Vac Split High-Dose PF Susp Pref Syr 0.5ML $61.20 $76.49 $42.07–$72.36 — 20%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 Pneumococcal 13-Valent Conjugate Vaccine Inj $238.11 $297.63 $72.06–$279.77 12% below 20%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 Pneumococcal 13-Valent Conjugate Vaccine Inj $238.11 $297.63 $163.70–$281.56 — 20%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumococcal Vaccine Polyvalent Inj Soln 25 MCG/0.5ML $125.08 $156.34 $37.85–$146.96 1% below 20%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Pneumococcal Vaccine Polyvalent Inj Soln 25 MCG/0.5ML $125.08 $156.34 $85.99–$147.90 — 20%
Rabies vaccine, one dose CPT 90675 Rabies Vaccine, PCEC For Inj $401.36 $501.69 $121.46–$471.59 22% below 20%
Rabies vaccine, one dose inpatient CPT 90675 Rabies Vaccine, PCEC For Inj $401.36 $501.69 $275.93–$474.60 — 20%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tet Tox-Diph-Acell Pertuss Ad Inj 5-2-15.5 LF-LF-MCG/0.5ML $81.16 $101.44 $24.56–$95.35 3% above 20%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 ED 90715 TDAP 7 YRS OR OLDER IM $88.80 $111.00 $26.87–$104.34 13% above 20%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tet Tox-Diph-Acell Pertuss Ad Inj 5-2-15.5 LF-LF-MCG/0.5ML $81.16 $101.44 $55.79–$95.96 — 20%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 ED 90715 TDAP 7 YRS OR OLDER IM $88.80 $111.00 $61.05–$105.01 — 20%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN PNEUMOCOCCAL VAC $96.80 $121.00 $29.29–$113.74 134% above 20%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN HEPATITIS B VACCINE $96.80 $121.00 $29.29–$113.74 134% above 20%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ED G0008 ADMIN INFLUENZA VIRUS VACCINE $96.80 $121.00 $29.29–$113.74 134% above 20%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ED 90471 IMMUNE ADMIN 1 VACCINE $96.80 $121.00 $29.29–$113.74 134% above 20%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUN ADMIN 1 VACCINE $96.80 $121.00 $29.29–$113.74 134% above 20%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN INFLUENZA VIR VAC $96.80 $121.00 $29.29–$113.74 134% above 20%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ED 90471 IMMUNE ADMIN 1 VACCINE $96.80 $121.00 $66.55–$114.47 — 20%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ED G0008 ADMIN INFLUENZA VIRUS VACCINE $96.80 $121.00 $66.55–$114.47 — 20%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN HEPATITIS B VACCINE $96.80 $121.00 $66.55–$114.47 — 20%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUN ADMIN 1 VACCINE $96.80 $121.00 $66.55–$114.47 — 20%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN INFLUENZA VIR VAC $96.80 $121.00 $66.55–$114.47 — 20%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN PNEUMOCOCCAL VAC $96.80 $121.00 $66.55–$114.47 — 20%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUN ADMIN EA ADDL VACCINE $54.40 $68.00 $16.46–$63.92 115% above 20%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ED 90472 IMMUN ADMIN EA ADDL VACCINE $64.80 $81.00 $19.61–$76.14 156% above 20%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUN ADMIN EA ADDL VACCINE $54.40 $68.00 $37.40–$64.33 — 20%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ED 90472 IMMUN ADMIN EA ADDL VACCINE $64.80 $81.00 $44.55–$76.63 — 20%
Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More
Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More
List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More
Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More
Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.
Off list How much lower the cash price is than the list price.
No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More
At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More
Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.

Source file: https://sthpiprd.blob.core.windows.net/machine-readable-files/8387/411266009_sanford-bagley-medical-center_standardcharges.csv