Monument Health Custer Hospital
Listed in its price file as “Monument Health Network Inc”.
Monument Health Custer Hospital in Custer, SD publishes cash prices for 297 common procedures listed here, from its own machine-readable price file updated Oct 20, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the South Dakota median for 85 of 297 procedures and below it for 70. By typical cash price it ranks #13 of 24 South Dakota hospitals and #4 of 5 hospitals in the Rapid City, SD area, cheapest first. Select a procedure to compare it with other hospitals nearby.
1220 Montgomery St Custer SD 57730 Collected Oct 22, 2026 Source price file Check a bill from this hospital (605) 673-9400
Critical access hospital (rural, 25 beds or fewer) Nonprofit hospital Emergency department CCN 431323 · CMS hospital register NPI 1871560516
Financial assistance
Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply
Monument Health Custer Hospital 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.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs South Dakota | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 CT scan of abdomen before and after contrast | $3,413.60 | $4,267.00 | $1,066.75–$4,224.33 | 7% above | 20% |
| Abdominal X-ray, 2 views CPT 74019 X-ray of abdomen, 2 views | $472.80 | $591.00 | $42.23–$585.09 | 6% above | 20% |
| Ankle X-ray, complete, 3 or more views CPT 73610 X-ray of ankle, minimum of 3 views | $280.00 | $350.00 | $47.10–$346.50 | 4% below | 20% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Ultrasound study of arm and leg arteries | $512.80 | $641.00 | $160.25–$634.59 | at median | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT scan of arm without contrast | $2,068.00 | $2,585.00 | $646.25–$2,559.15 | at median | 20% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 Single contrast X-ray of esophagus | $875.20 | $1,094.00 | $116.94–$1,083.06 | 6% above | 20% |
| Bone scan, whole body (nuclear medicine) CPT 78306 Nuclear medicine study of bone and/or joint whole body | $2,284.80 | $2,856.00 | $387.64–$2,827.44 | 16% above | 20% |
| Breast ultrasound, complete, one breast CPT 76641 Complete ultrasound scan of 1 breast | $563.20 | $704.00 | $113.69–$696.96 | at median | 20% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 Limited ultrasound scan of 1 breast | $562.40 | $703.00 | $87.17–$695.97 | at median | 20% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT scan of blood vessels of abdomen and pelvis with contrast | $4,052.80 | $5,066.00 | $1,266.50–$5,015.34 | at median | 20% |
| CT angiography (CTA) of the head CPT 70496 CT scan of blood vessels of head with contrast | $2,649.60 | $3,312.00 | $828.00–$3,278.88 | 10% below | 20% |
| CT angiography (CTA) of the neck CPT 70498 CT scan of blood vessels of neck with contrast | $2,803.20 | $3,504.00 | $876.00–$3,468.96 | 5% below | 20% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT scan of blood vessels of chest with contrast | $2,736.00 | $3,420.00 | $855.00–$3,385.80 | 5% below | 20% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT scan of blood vessels and grafts of heart with contrast | $3,602.40 | $4,503.00 | $1,125.75–$4,457.97 | at median | 20% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT scan of heart with evaluation of blood vessel calcium | $261.60 | $327.00 | $81.75–$323.73 | at median | 20% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT scan of abdomen and pelvis without contrast | $3,567.20 | $4,459.00 | $1,114.75–$4,414.41 | 6% below | 20% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT scan of abdomen and pelvis with contrast | $4,688.80 | $5,861.00 | $1,465.25–$5,802.39 | at median | 20% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT scan of abdomen and pelvis before and after contrast | $4,544.00 | $5,680.00 | $1,420.00–$5,623.20 | 9% below | 20% |
| CT scan of the abdomen with contrast CPT 74160 CT scan of abdomen with contrast | $3,043.20 | $3,804.00 | $951.00–$3,765.96 | 5% above | 20% |
| CT scan of the abdomen without contrast CPT 74150 CT scan of abdomen without contrast | $1,937.60 | $2,422.00 | $605.50–$2,397.78 | 2% below | 20% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT scan of face without contrast | $1,789.60 | $2,237.00 | $559.25–$2,214.63 | 8% below | 20% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT scan head or brain without contrast | $1,854.40 | $2,318.00 | $579.50–$2,294.82 | 6% below | 20% |
| CT scan of the head with contrast CPT 70460 CT scan head or brain with contrast | $2,232.80 | $2,791.00 | $697.75–$2,763.09 | at median | 20% |
| CT scan of the head without and with contrast CPT 70470 CT scan of head or brain before and after contrast | $2,804.00 | $3,505.00 | $876.25–$3,469.95 | at median | 20% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT scan of lower spine without contrast | $1,947.20 | $2,434.00 | $608.50–$2,409.66 | 18% below | 20% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT scan of upper spine without contrast | $1,991.20 | $2,489.00 | $622.25–$2,464.11 | 12% below | 20% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT scan of pelvis with contrast | $2,208.80 | $2,761.00 | $690.25–$2,733.39 | 1% below | 20% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 Ultrasound of both sides of head and neck blood flow | $1,251.20 | $1,564.00 | $391.00–$1,548.36 | at median | 20% |
| Chest CT scan without and with contrast CPT 71270 CT scan of chest before and after contrast | $2,924.80 | $3,656.00 | $914.00–$3,619.44 | at median | 20% |
| Chest X-ray, 2 views CPT 71046 X-ray of chest, 2 views | $374.40 | $468.00 | $37.90–$463.32 | 1% above | 20% |
| Chest X-ray, single view CPT 71045 X-ray of chest, 1 view | $349.60 | $437.00 | $28.15–$432.63 | 18% above | 20% |
| Collarbone (clavicle) X-ray, complete CPT 73000 X-ray of collar bone | $251.20 | $314.00 | $39.52–$310.86 | at median | 20% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Complete ultrasound scan behind abdominal cavity | $880.80 | $1,101.00 | $122.36–$1,089.99 | at median | 20% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA bone density measurement of hip, pelvis, spine | $588.00 | $735.00 | $47.10–$727.65 | at median | 20% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA bone density measurement of forearm, finger, hand, or foot | $180.80 | $226.00 | $35.19–$223.74 | at median | 20% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 Ultrasound scan of pregnant uterus with detailed fetal anatomic examination, single or first fetus | $583.20 | $729.00 | $130.48–$721.71 | 15% below | 20% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT scan of chest without contrast | $1,991.20 | $2,489.00 | $622.25–$2,464.11 | 5% below | 20% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT scan of chest with contrast | $2,668.80 | $3,336.00 | $834.00–$3,302.64 | at median | 20% |
| Diagnostic mammogram, both breasts CPT 77066 Diagnostic mammography of both breasts | $580.80 | $726.00 | $181.50–$718.74 | at median | 20% |
| Diagnostic mammogram, one breast CPT 77065 Diagnostic mammography of 1 breast | $424.80 | $531.00 | $132.75–$525.69 | at median | 20% |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 Ultrasound of leg arteries or artery grafts | $1,251.20 | $1,564.00 | $391.00–$1,548.36 | at median | 20% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 Ultrasound study of arm or leg veins with compression and maneuvers | $1,251.20 | $1,564.00 | $391.00–$1,548.36 | at median | 20% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Ultrasound of heart with color-depicted blood flow, rate, direction and valve function | $2,399.20 | $2,999.00 | $749.75–$2,969.01 | at median | 20% |
| Elbow X-ray, 2 views CPT 73070 X-ray of elbow, 2 views | $270.40 | $338.00 | $34.65–$334.62 | at median | 20% |
| Elbow X-ray, complete, 3 or more views CPT 73080 X-ray of elbow, minimum of 3 views | $336.80 | $421.00 | $39.52–$416.79 | at median | 20% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT scan of cranial cavity without contrast | $1,991.20 | $2,489.00 | $622.25–$2,464.11 | 5% below | 20% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 X-ray of face bones, minimum of 3 views | $354.40 | $443.00 | $56.85–$438.57 | 2% below | 20% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 X-ray of forearm, 2 views | $310.40 | $388.00 | $35.19–$384.12 | 1% above | 20% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Nuclear medicine study of liver and bile duct system | $2,430.40 | $3,038.00 | $441.78–$3,007.62 | 26% above | 20% |
| Hand X-ray, 2 views CPT 73120 X-ray of hand, 2 views | $291.20 | $364.00 | $37.90–$360.36 | 9% above | 20% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 X-ray of heel, minimum of 2 views | $204.80 | $256.00 | $34.11–$253.44 | 2% below | 20% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 Sleep study including heart rate, breathing, airflow, and effort | $838.40 | $1,048.00 | $262.00–$1,037.52 | at median | 20% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Sleep study in sleep lab with continuous airway pressure (6 years or older) | $4,762.40 | $5,953.00 | $1,488.25–$5,893.47 | 4% above | 20% |
| Knee X-ray, 3 views CPT 73562 X-ray of knee, 3 views | $304.00 | $380.00 | $51.97–$376.20 | 8% below | 20% |
| Knee X-ray, complete, 4 or more views CPT 73564 X-ray of knee, 4 or more views | $328.00 | $410.00 | $58.47–$405.90 | 7% below | 20% |
| Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT scan of leg without contrast | $1,991.20 | $2,489.00 | $622.25–$2,464.11 | 2% below | 20% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Limited ultrasound scan of abdomen | $880.80 | $1,101.00 | $99.08–$1,089.99 | 7% above | 20% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 Limited ultrasound scan of joint or other extremity structure except blood vessels | $630.40 | $788.00 | $15.16–$780.12 | 5% above | 20% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 Low dose CT scan of chest for lung cancer screening | $177.60 | $222.00 | $55.50–$219.78 | 80% below | 20% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 X-ray of lower leg, 2 views | $335.20 | $419.00 | $38.98–$414.81 | at median | 20% |
| MR angiography (MRA) of the head without contrast CPT 70544 MRI scan of blood vessels of head without contrast | $3,258.40 | $4,073.00 | $276.11–$4,032.27 | 11% above | 20% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI scan of leg joint without contrast | $3,169.60 | $3,962.00 | $990.50–$3,922.38 | at median | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI scan of leg joint before and after contrast | $4,168.00 | $5,210.00 | $1,302.50–$5,157.90 | at median | 20% |
| MRI of the abdomen without contrast CPT 74181 MRI scan of abdomen without contrast | $3,580.80 | $4,476.00 | $1,119.00–$4,431.24 | 9% above | 20% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI scan of abdomen before and after contrast | $4,354.40 | $5,443.00 | $1,360.75–$5,388.57 | at median | 20% |
| MRI of the brain, no contrast dye CPT 70551 MRI scan of brain without contrast | $3,210.40 | $4,013.00 | $1,003.25–$3,972.87 | 2% above | 20% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI scan of brain before and after contrast | $4,320.00 | $5,400.00 | $1,350.00–$5,346.00 | at median | 20% |
| MRI of the lower back, no contrast dye CPT 72148 MRI scan of lower spinal canal without contrast | $3,269.60 | $4,087.00 | $1,021.75–$4,046.13 | at median | 20% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI scan of lower spinal canal before and after contrast | $4,410.40 | $5,513.00 | $1,378.25–$5,457.87 | at median | 20% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI scan of middle spinal canal without contrast | $3,269.60 | $4,087.00 | $1,021.75–$4,046.13 | at median | 20% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI scan of upper spinal canal before and after contrast | $4,293.60 | $5,367.00 | $1,341.75–$5,313.33 | at median | 20% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI scan of upper spinal canal without contrast | $3,269.60 | $4,087.00 | $1,021.75–$4,046.13 | at median | 20% |
| MRI of the pelvis without and with contrast CPT 72197 MRI scan of pelvis before and after contrast | $4,309.60 | $5,387.00 | $1,346.75–$5,333.13 | at median | 20% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI scan of pelvis without contrast | $3,821.60 | $4,777.00 | $1,194.25–$4,729.23 | 6% above | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI scan of arm joint without contrast | $3,590.40 | $4,488.00 | $1,122.00–$4,443.12 | 10% above | 20% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 X-ray of upper spine, 4-5 views | $532.80 | $666.00 | $66.05–$659.34 | at median | 20% |
| Neck soft tissue CT scan with contrast CPT 70491 CT scan of soft tissue of neck with contrast | $2,516.00 | $3,145.00 | $786.25–$3,113.55 | at median | 20% |
| Neck soft tissue CT scan without contrast CPT 70490 CT scan of soft tissue of neck without contrast | $1,956.00 | $2,445.00 | $611.25–$2,420.55 | 4% below | 20% |
| Neck soft tissue X-ray CPT 70360 X-ray of soft tissue of neck | $386.40 | $483.00 | $37.36–$478.17 | 22% above | 20% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Nuclear medicine studies of heart muscle at rest and with stress and SPECT | $3,480.80 | $4,351.00 | $597.16–$4,307.49 | 14% below | 20% |
| Pelvic CT scan without contrast CPT 72192 CT scan of pelvis without contrast | $1,802.40 | $2,253.00 | $563.25–$2,230.47 | 6% below | 20% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Limited ultrasound scan of pelvis | $405.60 | $507.00 | $36.27–$501.93 | 11% below | 20% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Complete ultrasound scan of pelvis | $1,029.60 | $1,287.00 | $103.95–$1,274.13 | 4% above | 20% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Ultrasound scan of pregnant uterus (14 weeks or more), single or first fetus | $488.80 | $611.00 | $127.23–$604.89 | 38% below | 20% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 Ultrasound scan of pregnant uterus (less than 14 weeks), single or first fetus | $496.00 | $620.00 | $105.03–$613.80 | 21% below | 20% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Limited ultrasound of pregnant uterus | $408.80 | $511.00 | $74.17–$505.89 | 18% below | 20% |
| Rib X-ray, one side, 2 views CPT 71100 X-ray of ribs on side of body, 2 views | $322.40 | $403.00 | $42.77–$398.97 | 4% below | 20% |
| Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 X-ray of ribs on side of body, minimum of 3 views | $428.00 | $535.00 | $48.73–$529.65 | 9% below | 20% |
| Screening mammogram, both breasts CPT 77067 Screening mammography | $484.80 | $606.00 | $151.50–$599.94 | at median | 20% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 X-ray of shoulder, minimum of 2 views | $342.40 | $428.00 | $41.69–$423.72 | at median | 20% |
| Sinus X-ray, complete, 3 or more views CPT 70220 X-ray of paranasal sinus, minimum of 3 views | $345.60 | $432.00 | $44.94–$427.68 | 15% below | 20% |
| Skull X-ray, fewer than 4 views CPT 70250 X-ray of skull, 1-3 views | $473.60 | $592.00 | $44.94–$586.08 | 15% above | 20% |
| Sleep study in a lab (polysomnography) CPT 95810 Sleep study in sleep lab (6 years or older) | $4,656.80 | $5,821.00 | $1,455.25–$5,762.79 | 7% above | 20% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 Ultrasound of heart with continuous electrocardiogram (ECG) during rest, exercise and/or drug induced stress with review and report | $2,314.40 | $2,893.00 | $723.25–$2,864.07 | at median | 20% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 Imaging for evaluation of swallowing function | $783.20 | $979.00 | $168.38–$969.21 | 10% above | 20% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 X-ray of thigh bone, minimum 2 views | $252.00 | $315.00 | $44.39–$311.85 | 20% below | 20% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 CT scan of middle spine without contrast | $1,991.20 | $2,489.00 | $622.25–$2,464.11 | 13% below | 20% |
| Toe X-ray, 2 or more views CPT 73660 X-ray of toe, minimum of 2 views | $248.80 | $311.00 | $37.36–$307.89 | at median | 20% |
| Transvaginal pelvic ultrasound CPT 76830 Ultrasound scan of uterus, ovaries, tubes, cervix and pelvic area through vagina | $580.80 | $726.00 | $120.19–$718.74 | at median | 20% |
| Transvaginal ultrasound during pregnancy CPT 76817 Vaginal ultrasound of pregnant uterus | $512.00 | $640.00 | $83.38–$633.60 | 16% below | 20% |
| Ultrasound of the abdomen, complete CPT 76700 Complete ultrasound scan of abdomen | $1,153.60 | $1,442.00 | $129.94–$1,427.58 | 4% above | 20% |
| Ultrasound of the scrotum and testicles CPT 76870 Ultrasound scan of scrotum | $984.80 | $1,231.00 | $116.94–$1,218.69 | 19% above | 20% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Ultrasound scan of head and neck soft tissue | $821.60 | $1,027.00 | $139.68–$1,016.73 | 2% above | 20% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Single contrast X-ray of upper digestive tract | $983.20 | $1,229.00 | $142.93–$1,216.71 | at median | 20% |
| Upper arm X-ray (humerus), 2 views CPT 73060 X-ray of upper arm, minimum of 2 views | $293.60 | $367.00 | $39.52–$363.33 | at median | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 Ultrasound study of one arm or leg veins with compression and maneuvers | $973.60 | $1,217.00 | $304.25–$1,204.83 | at median | 20% |
| Wrist X-ray, 2 views CPT 73100 X-ray of wrist, 2 views | $239.20 | $299.00 | $42.23–$296.01 | at median | 20% |
| Wrist X-ray, complete, 3 or more views CPT 73110 X-ray of wrist, minimum of 3 views | $298.40 | $373.00 | $53.60–$369.27 | at median | 20% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 X-ray of hip, 2-3 views | $256.00 | $320.00 | $59.55–$316.80 | 17% below | 20% |
| X-ray of the abdomen, 1 view CPT 74018 X-ray of abdomen, 1 view | $326.40 | $408.00 | $34.65–$403.92 | 3% above | 20% |
| X-ray of the ankle, 2 views CPT 73600 X-ray of ankle, 2 views | $286.40 | $358.00 | $40.06–$354.42 | 3% above | 20% |
| X-ray of the finger(s), 2 or more views CPT 73140 X-ray of finger, minimum of 2 views | $219.20 | $274.00 | $51.43–$271.26 | 8% below | 20% |
| X-ray of the foot, 2 views CPT 73620 X-ray of foot, 2 views | $281.60 | $352.00 | $34.11–$348.48 | 1% above | 20% |
| X-ray of the foot, complete, 3 or more views CPT 73630 X-ray of foot, minimum of 3 views | $289.60 | $362.00 | $42.77–$358.38 | at median | 20% |
| X-ray of the hand, 3 or more views CPT 73130 X-ray of hand, minimum of 3 views | $300.00 | $375.00 | $47.10–$371.25 | at median | 20% |
| X-ray of the knee, 1 or 2 views CPT 73560 X-ray of knee, 1-2 views | $270.40 | $338.00 | $42.77–$334.62 | 3% below | 20% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-ray of lower and sacral spine, 2-3 views | $388.80 | $486.00 | $48.18–$481.14 | 3% below | 20% |
| X-ray of the lower back, 4 or more views CPT 72110 X-ray of lower and sacral spine, minimum of 4 views | $582.40 | $728.00 | $63.89–$720.72 | at median | 20% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 X-ray of middle spine, 2 views | $351.20 | $439.00 | $37.90–$434.61 | 5% below | 20% |
| X-ray of the nasal bones, 3 or more views CPT 70160 X-ray of nose bones, minimum of 3 views | $252.00 | $315.00 | $49.27–$311.85 | 20% below | 20% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-ray of upper spine, 2-3 views | $354.40 | $443.00 | $47.64–$438.57 | 4% below | 20% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 X-ray of pelvis, 1-2 views | $316.80 | $396.00 | $31.94–$392.04 | at median | 20% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X-ray of sacrum and tailbone, minimum of 2 views | $276.00 | $345.00 | $39.52–$341.55 | 14% below | 20% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs South Dakota | Off list |
|---|---|---|---|---|---|
| Balloon dilation of the maxillary sinus opening, one side CPT 31295 Dilation of nasal sinus using an endoscope | $7,839.20 | $9,799.00 | $2,449.75–$9,701.01 | at median | 20% |
| Botox injections for chronic migraine CPT 64615 Injection of chemical for paralysis of facial and neck nerve muscles on both sides of face | $686.40 | $858.00 | $214.50–$849.42 | at median | 20% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 Biopsy of breast and placement of locating device using X-ray with needle, first growth | $2,172.00 | $2,715.00 | $678.75–$2,687.85 | at median | 20% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 Closed treatment of broken outside lower leg bone at ankle | $654.40 | $818.00 | $204.50–$809.82 | at median | 20% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 Closed treatment of broken bone in forefoot or midfoot | $573.60 | $717.00 | $179.25–$709.83 | at median | 20% |
| Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 Correction of bunion with alignment correction of midfoot bone toward toe area | $4,262.40 | $5,328.00 | $1,332.00–$5,274.72 | at median | 20% |
| Bunion correction with removal of part of the big toe joint CPT 28292 Correction of bunion | $4,262.40 | $5,328.00 | $1,332.00–$5,274.72 | at median | 20% |
| Cardiac catheterization with coronary angiogram one side CPT 93458 Insertion of tube in left lower heart chamber and coronary artery for diagnosis with review by radiologist | $9,688.80 | $12,111.00 | $3,027.75–$11,989.89 | at median | 20% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 External shock to heart to regulate heart beat | $1,465.60 | $1,832.00 | $458.00–$1,813.68 | at median | 20% |
| Carpal tunnel release, open surgery CPT 64721 Release and/or relocation of hand nerve | $4,684.80 | $5,856.00 | $1,464.00–$5,797.44 | at median | 20% |
| Catheter ablation for atrial fibrillation CPT 93656 Comprehensive electrophysiologic evaluation with catheter destruction of abnormality causing atrial fibrillation (uncoordinated contraction of upper chambers of heart) by pulmonary vein isolation | $43,484.00 | $54,355.00 | $13,588.75–$53,811.45 | at median | 20% |
| Cervical biopsy CPT 57500 Biopsy of cervix or removal of growth | $1,712.80 | $2,141.00 | $535.25–$2,119.59 | 10% above | 20% |
| Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 Removal of foreskin (older than 28 days) | $1,764.00 | $2,205.00 | $551.25–$2,182.95 | at median | 20% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Removal of foreskin using clamp or device | $1,764.00 | $2,205.00 | $551.25–$2,182.95 | at median | 20% |
| Circumcision, surgical, older than a newborn CPT 54160 Removal of foreskin (28 days or younger) | $686.40 | $858.00 | $214.50–$849.42 | at median | 20% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 Closed treatment of broken forearm (radius) bone at the wrist area on the thumb side of the wrist without manipulation | $603.20 | $754.00 | $188.50–$746.46 | 1% above | 20% |
| Colonoscopy with polyp removal CPT 45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare | $2,934.40 | $3,668.00 | $917.00–$3,631.32 | 1% above | 20% |
| Colonoscopy with tissue sample CPT 45380 Biopsy of large bowel using a flexible endoscope | $1,766.40 | $2,208.00 | $552.00–$2,185.92 | at median | 20% |
| Colonoscopy, diagnostic CPT 45378 Diagnostic exam of large bowel using a flexible endoscope | $2,144.00 | $2,680.00 | $670.00–$2,653.20 | at median | 20% |
| Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 Biopsy of cervix using an endoscope with loop electrode | $6,132.00 | $7,665.00 | $1,916.25–$7,588.35 | at median | 20% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 Biopsy and scraping of cervix using an endoscope | $746.40 | $933.00 | $233.25–$923.67 | at median | 20% |
| Coronary stent placement, one artery CPT 92928 Insertion of stents with balloon dilation of coronary artery or branch, single artery or branch | $25,981.60 | $32,477.00 | $8,119.25–$32,152.23 | at median | 20% |
| Cystoscopy with ureteral stent placement CPT 52332 Insertion of stent in ureter using an endoscope | $4,346.40 | $5,433.00 | $1,358.25–$5,378.67 | at median | 20% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 Diagnostic exam of bladder and urethra using an endoscope | $1,589.60 | $1,987.00 | $496.75–$1,967.13 | 2% above | 20% |
| D&C (dilation and curettage), not related to pregnancy CPT 58120 Dilation and scraping of uterus | $7,586.40 | $9,483.00 | $2,370.75–$9,388.17 | 14% above | 20% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 Destruction of precancer skin growth, 1 growth | $456.00 | $570.00 | $142.50–$564.30 | 88% above | 20% |
| Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 Incision of eardrum with placement of eardrum tube under general anesthesia | $3,700.80 | $4,626.00 | $1,156.50–$4,579.74 | at median | 20% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 Incision of eardrum with insertion of eardrum tube under local or topical anesthesia | $741.60 | $927.00 | $231.75–$917.73 | at median | 20% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 Removal of impacted ear wax by washing | $167.20 | $209.00 | $52.25–$206.91 | 2% above | 20% |
| Earwax removal with instruments, one ear CPT 69210 Removal of impacted ear wax | $250.40 | $313.00 | $78.25–$309.87 | 50% above | 20% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 Biopsy of lining of uterus | $451.20 | $564.00 | $141.00–$558.36 | 6% above | 20% |
| Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 Incision of nasal sinus using an endoscope | $8,818.40 | $11,023.00 | $2,755.75–$10,912.77 | at median | 20% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 Injection of substance into middle or upper spine canal using imaging guidance | $1,913.60 | $2,392.00 | $598.00–$2,368.08 | at median | 20% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 Injection of lower or sacral spine facet joint using imaging guidance, single level | $1,984.00 | $2,480.00 | $620.00–$2,455.20 | at median | 20% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 Diagnostic exam of lower portion of large bowel using a flexible endoscope | $1,144.80 | $1,431.00 | $357.75–$1,416.69 | at median | 20% |
| Hammertoe correction surgery CPT 28285 Correction of toe joint deformity | $4,262.40 | $5,328.00 | $1,332.00–$5,274.72 | at median | 20% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 Removal of external hemorrhoids by rubber banding | $1,183.20 | $1,479.00 | $369.75–$1,464.21 | at median | 20% |
| Hemorrhoidectomy (internal and external), one area CPT 46255 Removal of single external and internal hemorrhoid group | $6,248.00 | $7,810.00 | $1,952.50–$7,731.90 | at median | 20% |
| Hysterectomy through an abdominal incision (total) CPT 58150 Removal of uterus and cervix through abdomen | $4,720.00 | $5,900.00 | $1,475.00–$5,841.00 | at median | 20% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Insertion of tube and introduction of contrast for X-ray of uterus and fallopian tubes | $458.40 | $573.00 | $143.25–$567.27 | at median | 20% |
| Hysteroscopy with endometrial ablation CPT 58563 Exam of uterus with destruction of lining of uterus using an endoscope | $6,700.00 | $8,375.00 | $2,093.75–$8,291.25 | at median | 20% |
| Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 Biopsy of lining of uterus and/or removal of polyp using an endoscope | $3,663.20 | $4,579.00 | $1,144.75–$4,533.21 | at median | 20% |
| IUD insertion (the device itself billed separately) CPT 58300 Insertion of IUD for pregnancy prevention | $379.20 | $474.00 | $118.50–$469.26 | at median | 20% |
| Incision and drainage of a simple or single skin abscess CPT 10060 Simple or single drainage of skin abscess | $583.20 | $729.00 | $182.25–$721.71 | 27% above | 20% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Injection into tendon or ligament | $844.80 | $1,056.00 | $264.00–$1,045.44 | 71% above | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Aspiration and/or injection of fluid from large joint | $688.00 | $860.00 | $215.00–$851.40 | at median | 20% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 Insertion of drug delivery implant into tissue | $308.00 | $385.00 | $96.25–$381.15 | at median | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Aspiration and/or injection of fluid from medium joint | $756.00 | $945.00 | $236.25–$935.55 | 56% above | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Aspiration and/or injection of fluid from small joint | $722.40 | $903.00 | $225.75–$893.97 | 51% above | 20% |
| Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 Removal of appendix using an endoscope | $12,716.00 | $15,895.00 | $3,973.75–$15,736.05 | at median | 20% |
| Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 Strengthening of muscle between esophagus and stomach by wrapping part of stomach around esophagus using an endoscope | $22,698.40 | $28,373.00 | $7,093.25–$28,089.27 | at median | 20% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less | $918.40 | $1,148.00 | $287.00–$1,136.52 | 32% above | 20% |
| Lower-back epidural injection, with imaging guidance CPT 62323 Injection of substance into lower spine canal using imaging guidance | $1,729.60 | $2,162.00 | $540.50–$2,140.38 | at median | 20% |
| Lower-back epidural injection, without imaging guidance CPT 62322 Injection of substance into lower spine canal | $1,620.00 | $2,025.00 | $506.25–$2,004.75 | 23% above | 20% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level | $1,885.60 | $2,357.00 | $589.25–$2,333.43 | at median | 20% |
| Miscarriage treatment with D&C, first trimester CPT 59820 Treatment of miscarriage during first trimester | $3,663.20 | $4,579.00 | $1,144.75–$4,533.21 | at median | 20% |
| Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals CPT 17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks | $1,239.20 | $1,549.00 | $387.25–$1,533.51 | at median | 20% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Removal of noncancer skin growth of body, arms, or legs, 0.5 cm or less | $1,546.40 | $1,933.00 | $483.25–$1,913.67 | 129% above | 20% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.5 cm or less | $923.20 | $1,154.00 | $288.50–$1,142.46 | 13% above | 20% |
| Nail removal (partial or complete), one nail CPT 11730 Simple separation of fingernail or toenail from nail bed, first nail | $473.60 | $592.00 | $148.00–$586.08 | 55% above | 20% |
| Occipital nerve block (injection for headaches) CPT 64405 Injection of anesthetic agent and/or steroid into upper neck and back of head nerve | $787.20 | $984.00 | $246.00–$974.16 | 3% above | 20% |
| Pacemaker implant (dual chamber) CPT 33208 Insertion of pacemaker and upper and lower heart chamber electrode | $28,425.60 | $35,532.00 | $8,883.00–$35,176.68 | at median | 20% |
| Paracentesis with imaging guidance CPT 49083 Drainage of fluid from abdominal cavity using imaging guidance | $2,312.80 | $2,891.00 | $722.75–$2,862.09 | 18% above | 20% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Permanent removal fingernail or toenail | $908.80 | $1,136.00 | $284.00–$1,124.64 | 7% above | 20% |
| Prostate biopsy CPT 55700 Biopsy of prostate gland | $4,941.60 | $6,177.00 | $1,544.25–$6,115.23 | at median | 20% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint | $4,508.80 | $5,636.00 | $1,409.00–$5,579.64 | 19% above | 20% |
| Removal of a breast lump, open surgery CPT 19120 Removal of growth and tissue of breast, duct, or nipple | $4,396.80 | $5,496.00 | $1,374.00–$5,441.04 | at median | 20% |
| Removal of a foreign object under the skin, simple CPT 10120 Removal of foreign body from tissue, accessed beneath the skin, simple | $872.00 | $1,090.00 | $272.50–$1,079.10 | 35% above | 20% |
| Septoplasty to straighten the nasal septum CPT 30520 Reshaping of nasal cartilage | $7,584.00 | $9,480.00 | $2,370.00–$9,385.20 | at median | 20% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 Shock wave crushing of kidney stones | $12,732.80 | $15,916.00 | $3,979.00–$15,756.84 | at median | 20% |
| Short arm cast (elbow to hand) CPT 29075 Application of elbow to finger cast | $608.80 | $761.00 | $190.25–$753.39 | 98% above | 20% |
| Short arm splint (forearm and hand) CPT 29125 Application of nonmoveable forearm to hand splint | $312.00 | $390.00 | $97.50–$386.10 | 21% above | 20% |
| Short leg cast (below the knee) CPT 29405 Application of short leg cast | $667.20 | $834.00 | $208.50–$825.66 | 114% above | 20% |
| Short leg splint (calf to foot) CPT 29515 Application of short leg splint from calf to foot | $380.00 | $475.00 | $118.75–$470.25 | 42% above | 20% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.5 cm or less | $473.60 | $592.00 | $148.00–$586.08 | 3% above | 20% |
| Skin biopsy, punch, one lesion CPT 11104 Punch biopsy, first skin growth | $466.40 | $583.00 | $145.75–$577.17 | at median | 20% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 Removal of cancer skin growth of body, arms, or legs, 0.5 cm or less | $923.20 | $1,154.00 | $288.50–$1,142.46 | 10% above | 20% |
| Skin tag removal, up to 15 tags CPT 11200 Removal of skin tag, 1-15 skin tags | $433.60 | $542.00 | $135.50–$536.58 | 10% above | 20% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 Removal of cerebrospinal fluid with lower back spinal tap for diagnostic test | $1,696.80 | $2,121.00 | $530.25–$2,099.79 | 67% above | 20% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.6-7.5 cm | $521.60 | $652.00 | $163.00–$645.48 | 5% above | 20% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less | $473.60 | $592.00 | $148.00–$586.08 | 3% above | 20% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 Biopsy of related skin growth, first growth | $466.40 | $583.00 | $145.75–$577.17 | 17% above | 20% |
| Thoracentesis with imaging guidance CPT 32555 Aspiration of fluid from chest cavity using imaging guidance | $1,989.60 | $2,487.00 | $621.75–$2,462.13 | 8% above | 20% |
| Trigger finger release surgery CPT 26055 Incision of tendon covering of finger | $3,943.20 | $4,929.00 | $1,232.25–$4,879.71 | 1% above | 20% |
| Trigger point injections, 1 or 2 muscles CPT 20552 Injection of trigger points, 1-2 muscles | $721.60 | $902.00 | $225.50–$892.98 | 43% above | 20% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 Biopsy of breast and placement of locating device using ultrasound, first growth | $3,779.20 | $4,724.00 | $1,181.00–$4,676.76 | 7% above | 20% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, less than 3.0 cm | $2,534.40 | $3,168.00 | $792.00–$3,136.32 | at median | 20% |
| Upper endoscopy (EGD) with biopsy CPT 43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope | $1,400.80 | $1,751.00 | $437.75–$1,733.49 | 5% below | 20% |
| Upper endoscopy (EGD), diagnostic CPT 43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope | $1,198.40 | $1,498.00 | $374.50–$1,483.02 | 4% below | 20% |
| Vasectomy, one or both sides, including follow-up semen testing CPT 55250 Removal of sperm duct | $2,732.80 | $3,416.00 | $854.00–$3,381.84 | at median | 20% |
| Vein ablation, radiofrequency, first vein CPT 36475 Destruction of first incompetent vein of arm or leg using radiofrequency and imaging guidance | $5,213.60 | $6,517.00 | $1,629.25–$6,451.83 | at median | 20% |
| Wart removal, up to 14 warts CPT 17110 Destruction of skin growth, 1-14 growths | $470.40 | $588.00 | $147.00–$582.12 | 103% above | 20% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Removal of skin and tissue, 20.0 sq cm or less | $1,073.60 | $1,342.00 | $335.50–$1,328.58 | 2% above | 20% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs South Dakota | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 Transfusion of blood or blood products | $966.40 | $1,208.00 | $302.00–$1,195.92 | at median | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Inhalation treatment for airway obstruction or sputum production | $260.00 | $325.00 | $81.25–$321.75 | 19% above | 20% |
| Chemotherapy IV infusion, first hour CPT 96413 Administration of chemotherapy into vein, 1 hour or less | $753.60 | $942.00 | $235.50–$932.58 | at median | 20% |
| Comprehensive eye exam by an eye doctor, new patient CPT 92004 New patient complete exam of visual system | $321.60 | $402.00 | $100.50–$397.98 | at median | 20% |
| Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 Comprehensive hearing and speech recognition test | $335.20 | $419.00 | $104.75–$414.81 | at median | 20% |
| Critical care, first 30 to 74 minutes CPT 99291 Critical care, first 30-74 minutes | $2,462.40 | $3,078.00 | $769.50–$3,047.22 | at median | 20% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 Critical care, first 30-74 minutes | $2,462.40 | $3,078.00 | $769.50–$3,047.22 | — | 20% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 Measurement of brain wave activity (EEG), awake and drowsy | $1,009.60 | $1,262.00 | $315.50–$1,249.38 | at median | 20% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 Routine electrocardiogram (ECG) using at least 12 leads with interpretation and report | $40.80 | $51.00 | $12.75–$50.49 | 50% below | 20% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Routine electrocardiogram (ECG) using at least 12 leads with tracing | $241.60 | $302.00 | $75.50–$298.98 | at median | 20% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Emergency department visit for problem that may not require health care professional | $274.40 | $343.00 | $85.75–$339.57 | at median | 20% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 Emergency department visit for problem that may not require health care professional | $274.40 | $343.00 | $85.75–$339.57 | — | 20% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Emergency department visit with straightforward medical decision making | $437.60 | $547.00 | $136.75–$541.53 | at median | 20% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 Emergency department visit with straightforward medical decision making | $437.60 | $547.00 | $136.75–$541.53 | — | 20% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Emergency department visit with low level of medical decision making | $701.60 | $877.00 | $219.25–$868.23 | at median | 20% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 Emergency department visit with low level of medical decision making | $701.60 | $877.00 | $219.25–$868.23 | — | 20% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Emergency department visit with moderate level of medical decision making | $1,138.40 | $1,423.00 | $355.75–$1,408.77 | 4% above | 20% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 Emergency department visit with moderate level of medical decision making | $1,138.40 | $1,423.00 | $355.75–$1,408.77 | — | 20% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Emergency department visit with high level of medical decision making | $1,622.40 | $2,028.00 | $507.00–$2,007.72 | 2% above | 20% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Emergency department visit with high level of medical decision making | $1,622.40 | $2,028.00 | $507.00–$2,007.72 | — | 20% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Exercise or drug-induced heart stress test with electrocardiogram (ECG) | $1,412.80 | $1,766.00 | $441.50–$1,748.34 | 21% above | 20% |
| Family therapy with the patient, 50 minutes CPT 90847 Family psychotherapy with patient, 50 minutes | $307.20 | $384.00 | $96.00–$380.16 | at median | 20% |
| Family therapy without the patient, 50 minutes CPT 90846 Family psychotherapy without patient, 50 minutes | $307.20 | $384.00 | $96.00–$380.16 | at median | 20% |
| Group psychotherapy session CPT 90853 Group psychotherapy | $188.80 | $236.00 | $59.00–$233.64 | at median | 20% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Infusion into a vein for hydration, 31-60 minutes | $432.00 | $540.00 | $135.00–$529.20 | at median | 20% |
| IV infusion of a medicine, first hour CPT 96365 Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less | $444.00 | $555.00 | $138.75–$538.91 | at median | 20% |
| IV push of a medicine, first drug CPT 96374 Injection of drug or substance into vein | $349.60 | $437.00 | $84.80–$424.33 | at median | 20% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection of drug or substance under skin or into muscle | $100.00 | $125.00 | $31.25–$121.38 | 12% above | 20% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 Psychiatric diagnostic evaluation | $307.20 | $384.00 | $96.00–$380.16 | at median | 20% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 Nerve conduction, 7-8 studies | $568.80 | $711.00 | $177.75–$703.89 | at median | 20% |
| Neuromuscular re-education, 15 minutes CPT 97112 Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | $22.40 | $28.00 | $7.00–$121.50 | 81% below | 20% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Therapy procedure for nutrition management, each 15 minutes | $68.00 | $85.00 | $21.25–$84.15 | 25% above | 20% |
| Occupational therapy evaluation, low complexity CPT 97165 Evaluation for occupational therapy, typically 30 minutes | $262.40 | $328.00 | $82.00–$324.72 | at median | 20% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Evaluation for physical therapy, typically 45 minutes | $262.40 | $328.00 | $82.00–$324.72 | 12% below | 20% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Evaluation for physical therapy, typically 20 minutes | $206.40 | $258.00 | $64.50–$255.42 | 5% below | 20% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Evaluation for physical therapy, typically 30 minutes | $262.40 | $328.00 | $82.00–$324.72 | at median | 20% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Therapy procedure using manual technique, each 15 minutes | $98.40 | $123.00 | $30.75–$121.77 | 16% below | 20% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | $19.20 | $24.00 | $6.00–$121.50 | 84% below | 20% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 Established patient periodic preventive medicine examination (18-39 years) | $1,088.00 | $1,360.00 | $340.00–$1,346.40 | 211% above | 20% |
| Psychiatric evaluation with medical services CPT 90792 Psychiatric diagnostic evaluation with medical services | $307.20 | $384.00 | $96.00–$380.16 | at median | 20% |
| Psychotherapy for crisis, first 60 minutes CPT 90839 Psychotherapy for crisis, first hour | $388.00 | $485.00 | $121.25–$480.15 | at median | 20% |
| Psychotherapy session, 30 minutes CPT 90832 Psychotherapy, 30 minutes | $304.00 | $380.00 | $95.00–$376.20 | at median | 20% |
| Psychotherapy session, 45 minutes CPT 90834 Psychotherapy, 45 minutes | $332.00 | $415.00 | $103.75–$410.85 | 13% above | 20% |
| Psychotherapy session, 60 minutes CPT 90837 Psychotherapy, 1 hour | $368.00 | $460.00 | $115.00–$455.40 | at median | 20% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 Smoking and tobacco use intermediate counseling, 3-10 minutes | $69.60 | $87.00 | $21.75–$86.13 | 63% above | 20% |
| Speech and language evaluation CPT 92523 Evaluation of speech sound production with evaluation of language comprehension and expression | $423.20 | $529.00 | $121.50–$523.71 | at median | 20% |
| Speech therapy session, individual CPT 92507 Treatment of speech, language, voice, communication, and/or hearing processing disorder | $200.80 | $251.00 | $62.75–$248.49 | 28% below | 20% |
| Spirometry (breathing test) CPT 94010 Test to measure expiratory airflow and volume | $318.40 | $398.00 | $99.50–$394.02 | at median | 20% |
| Spirometry before and after a bronchodilator CPT 94060 Test to measure expiratory airflow and volume changes before and after medication administration | $579.20 | $724.00 | $181.00–$716.76 | 5% above | 20% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 Therapy procedure using functional activities | $91.20 | $114.00 | $28.50–$121.50 | 23% below | 20% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs South Dakota | Off list |
|---|---|---|---|---|---|
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 Influenza vaccine, inactivated | $136.00 | $170.00 | $42.50–$168.30 | 74% above | 20% |
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 Severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine, mRNA-LNP, 50 mcg/0.5 mL dosage, for intramuscular use | $206.40 | $258.00 | $64.50–$255.42 | at median | 20% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 Varicella vaccine | $198.40 | $248.00 | $62.00–$245.52 | 14% below | 20% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 Diphtheria, tetanus, acellular pertussis, and polio vaccine | $72.00 | $90.00 | $22.50–$89.10 | 22% below | 20% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 Diphtheria, tetanus, acellular pertussis, hepatitis B, and polio vaccine | $105.60 | $132.00 | $33.00–$130.68 | 14% below | 20% |
| Flu shot, recombinant, egg-free (Flublok) CPT 90673 Influenza vaccine, trivalent derived from recombinant DNA | $57.60 | $72.00 | $18.00–$71.28 | at median | 20% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Influenza vaccine, trivalent, split virus, preservative-free, 0.5 mL dosage | $16.80 | $21.00 | $5.25–$20.79 | 46% below | 20% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 Human Papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent | $304.80 | $381.00 | $95.25–$377.19 | 21% below | 20% |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 Hepatitis A and hepatitis B vaccine | $146.40 | $183.00 | $45.75–$181.17 | 14% below | 20% |
| Hepatitis A vaccine, adult dose CPT 90632 Hepatitis A vaccine adult dosage | $96.00 | $120.00 | $30.00–$118.80 | 22% below | 20% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 Hepatitis A vaccine pediatric or adolescent dosage | $46.40 | $58.00 | $14.50–$57.42 | 2% below | 20% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Hepatitis B vaccine, adult dosage (3 dose schedule) | $82.40 | $103.00 | $25.75–$101.97 | 8% below | 20% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 Hepatitis B vaccine, pediatric or adolescent dosage (3 dose schedule) | $39.20 | $49.00 | $12.25–$48.51 | 12% below | 20% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 Haemophilus influenzae type b vaccine, PRP-OMP conjugate | $40.80 | $51.00 | $12.75–$50.49 | at median | 20% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 Haemophilus influenzae type b vaccine, PRP-T conjugate | $39.20 | $49.00 | $12.25–$48.51 | at median | 20% |
| Japanese encephalitis vaccine (Ixiaro), 2-dose schedule CPT 90738 Japanese encephalitis vaccine | $371.20 | $464.00 | $116.00–$459.36 | at median | 20% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 Measles, mumps, and rubella vaccine | $105.60 | $132.00 | $33.00–$130.68 | at median | 20% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 Meningococcal vaccine, serogroups A, C, W, Y, diphtheria toxoid carrier vaccine | $180.00 | $225.00 | $56.25–$222.75 | 5% below | 20% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup B | $239.20 | $299.00 | $74.75–$296.01 | 10% below | 20% |
| Mpox and smallpox vaccine (Jynneos), 2-dose schedule CPT 90611 Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 mL dosage, suspension, for subcutaneous use | $472.00 | $590.00 | $147.50–$584.10 | at median | 20% |
| Nasal spray flu vaccine, live (FluMist) CPT 90660 Influenza vaccine, trivalent for nasal administration | $52.80 | $66.00 | $16.50–$65.34 | at median | 20% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 Pneumococcal vaccine, 13-valent | $270.40 | $338.00 | $84.50–$334.62 | at median | 20% |
| Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 Pneumococcal conjugate vaccine, 15 valent (PCV15), for intramuscular use | $316.80 | $396.00 | $99.00–$392.04 | 5% below | 20% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Pneumococcal conjugate vaccine, 20 valent (PCV20), for intramuscular use | $316.80 | $396.00 | $99.00–$392.04 | at median | 20% |
| Pneumonia vaccine, 21-valent conjugate (Capvaxive) CPT 90684 Pneumococcal conjugate vaccine, 21 valent (PCV21), for intramuscular use | $341.60 | $427.00 | $106.75–$422.73 | at median | 20% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumococcal vaccine, 23-valent | $141.60 | $177.00 | $44.25–$175.23 | at median | 20% |
| Polio vaccine, inactivated (IPV) CPT 90713 Poliovirus vaccine | $44.00 | $55.00 | $13.75–$54.45 | at median | 20% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 Respiratory syncytial virus antibody, 1.0 mL dosage for injection into muscle | $768.80 | $961.00 | $240.25–$951.39 | at median | 20% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 Respiratory syncytial virus antibody, 0.5 mL dosage for injection into muscle | $768.80 | $961.00 | $240.25–$951.39 | at median | 20% |
| Rabies vaccine, one dose CPT 90675 Rabies vaccine for injection into muscle | $506.40 | $633.00 | $158.25–$626.67 | 2% below | 20% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 Rotavirus vaccine, pentavalent | $103.20 | $129.00 | $32.25–$127.71 | 1% below | 20% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Diphtheria and tetanus vaccine (7 years or older) | $40.80 | $51.00 | $12.75–$50.49 | 37% below | 20% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Diphtheria, tetanus, and acellular pertussis vaccine (7 years or older) | $41.60 | $52.00 | $13.00–$51.48 | 51% below | 20% |
| Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 Typhoid vaccine for injection into muscle | $136.00 | $170.00 | $42.50–$168.30 | at median | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Administration of vaccine | $72.80 | $91.00 | $22.75–$90.09 | 40% above | 20% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Administration of vaccine, each additional vaccine | $72.80 | $91.00 | $22.75–$90.09 | 45% above | 20% |
| Yellow fever vaccine, live CPT 90717 Yellow fever vaccine | $319.20 | $399.00 | $99.75–$395.01 | at median | 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://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbCCHCUSTERSD&type=CDMWithoutLabel&fileType=CSV