Pembina County Memorial Hospital
Listed in its price file as “Pembina County Memorial Hospital Association”.
Pembina County Memorial Hospital in Cavalier, ND publishes cash prices for 123 common procedures listed here, from its own machine-readable price file updated Nov 13, 2025. Compared with other hospitals in the state, its outpatient cash prices are below the North Dakota median for 69 of 121 procedures and above it for 48. By typical cash price it ranks #14 of 33 North Dakota hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.
301 Mountain Street East, Cavalier, ND 58220 Collected Sep 27, 2026 Source price file Check a bill from this hospital (701) 265-8461
Critical access hospital (rural, 25 beds or fewer) Nonprofit hospital Emergency department CCN 351319 · CMS hospital register NPI 1760542500
The price file shows no self-pay discount
For 266 of the 266 prices listed here, the cash price in Pembina County Memorial Hospital's file equals its full list price (chargemaster), so the file publishes no self-pay discount. That is why it compares as expensive. Many hospitals still reduce bills for uninsured patients or offer financial assistance based on income: before a planned visit, ask the billing office for its self-pay rate and discount policy in writing. Other US hospitals whose cash price is their full list price.
Financial assistance
Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply
Pembina County Memorial 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 North Dakota | Off list |
|---|---|---|---|---|---|
| Abdominal X-ray, 2 views CPT 74019 HC XRAY ABDOMEN 2 VIEWS | $143.00 | $143.00 | $77.52–$126.48 | 18% below | — |
| Abdominal X-ray, 2 views inpatient CPT 74019 HC XRAY ABDOMEN 2 VIEWS | $143.00 | $143.00 | $77.52–$126.48 | — | — |
| Ankle X-ray, complete, 3 or more views CPT 73610 HC ANKLE MIN 3 VIEWS | $132.00 | $132.00 | $71.25–$125.00 | 14% below | — |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 HC ANKLE MIN 3 VIEWS | $132.00 | $132.00 | $71.25–$125.00 | — | — |
| CT angiography (CTA) of the head CPT 70496 HC CTA HEAD | $2,032.00 | $2,032.00 | $893.20–$1,341.34 | 1% above | — |
| CT angiography (CTA) of the head inpatient CPT 70496 HC CTA HEAD | $2,032.00 | $2,032.00 | $893.20–$1,341.34 | — | — |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CTA CHEST | $2,066.00 | $2,066.00 | $893.20–$1,399.09 | 2% below | — |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CTA CHEST | $2,066.00 | $2,066.00 | $893.20–$1,399.09 | — | — |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT ABD/PELVIS W/O CONTRAST | $1,108.00 | $1,108.00 | $601.35–$1,108.00 | 33% below | — |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC CT ABD/PELVIS W/O CONTRAST | $1,108.00 | $1,108.00 | $601.35–$1,108.00 | — | — |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABD/PELVIS W/CONTRAST | $2,234.00 | $2,234.00 | $1,212.39–$2,020.65 | 10% below | — |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT ABD/PELVIS W/CONTRAST | $2,234.00 | $2,234.00 | $1,212.39–$2,020.65 | — | — |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT ABD/PELVIS W/O&W CONTRAST | $2,552.00 | $2,552.00 | $1,438.56–$1,834.00 | 11% below | — |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC CT ABD/PELVIS W/O&W CONTRAST | $2,552.00 | $2,552.00 | $1,438.56–$1,834.00 | — | — |
| CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT FACIAL BONES W/O DYE | $944.00 | $944.00 | $532.21–$623.18 | 12% below | — |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT FACIAL BONES W/O DYE | $944.00 | $944.00 | $532.21–$623.18 | — | — |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT BRAIN W/O DYE | $864.00 | $864.00 | $468.54–$725.76 | 17% below | — |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT BRAIN W/O DYE | $864.00 | $864.00 | $468.54–$725.76 | — | — |
| CT scan of the head without and with contrast CPT 70470 HC CT BRAIN W/WO DYE | $1,252.00 | $1,252.00 | $796.38 | 15% below | — |
| CT scan of the head without and with contrast inpatient CPT 70470 HC CT BRAIN W/WO DYE | $1,252.00 | $1,252.00 | $796.38 | — | — |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT SPINE CERVICAL W/O DYE | $1,279.00 | $1,279.00 | $705.10–$844.31 | 5% below | — |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC CT SPINE CERVICAL W/O DYE | $1,279.00 | $1,279.00 | $705.10–$844.31 | — | — |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS W/DYE | $1,724.00 | $1,724.00 | $1,137.54 | 8% above | — |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT PELVIS W/DYE | $1,724.00 | $1,724.00 | $1,137.54 | — | — |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 HC CAROTID DOPPLER | $701.00 | $701.00 | $394.86–$420.73 | at median | — |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 HC CAROTID DOPPLER | $701.00 | $701.00 | $394.86–$420.73 | — | — |
| Chest CT scan without and with contrast CPT 71270 HC CT THORAX W+WO CONTRAST | $1,750.00 | $1,750.00 | $1,154.87 | 2% above | — |
| Chest CT scan without and with contrast inpatient CPT 71270 HC CT THORAX W+WO CONTRAST | $1,750.00 | $1,750.00 | $1,154.87 | — | — |
| Chest X-ray, 2 views CPT 71046 HC XRAY CHEST 2 VIEWS | $110.00 | $110.00 | $59.28–$104.00 | 36% below | — |
| Chest X-ray, 2 views inpatient CPT 71046 HC XRAY CHEST 2 VIEWS | $110.00 | $110.00 | $59.28–$104.00 | — | — |
| Chest X-ray, single view CPT 71045 HC XRAY CHEST 1 VIEW | $83.00 | $83.00 | $45.03–$56.21 | 42% below | — |
| Chest X-ray, single view inpatient CPT 71045 HC XRAY CHEST 1 VIEW | $83.00 | $83.00 | $45.03–$56.21 | — | — |
| Collarbone (clavicle) X-ray, complete CPT 73000 HC CLAVICLE COMPLETE | $110.00 | $110.00 | $65.12–$72.10 | 24% below | — |
| Collarbone (clavicle) X-ray, complete inpatient CPT 73000 HC CLAVICLE COMPLETE | $110.00 | $110.00 | $65.12–$72.10 | — | — |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US RETROPERIT (RENAL LAAA) | $528.00 | $528.00 | $290.40–$443.52 | 21% above | — |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC US RETROPERIT (RENAL LAAA) | $528.00 | $528.00 | $290.40–$443.52 | — | — |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC DEXASCAN | $224.00 | $224.00 | $109.31–$188.79 | 23% below | — |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HC DEXASCAN | $224.00 | $224.00 | $109.31–$188.79 | — | — |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HC DEXA BONE DENSITY PERIPHERAL | $217.00 | $217.00 | $105.89 | 87% above | — |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 HC DEXA BONE DENSITY PERIPHERAL | $217.00 | $217.00 | $105.89 | — | — |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT THORAX WO CONTRAST | $1,117.00 | $1,117.00 | $605.91–$988.59 | 8% below | — |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT THORAX WO CONTRAST | $1,117.00 | $1,117.00 | $605.91–$988.59 | — | — |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT THORAX W CONTRAST | $1,398.00 | $1,398.00 | $758.67–$922.64 | 1% below | — |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CT THORAX W CONTRAST | $1,398.00 | $1,398.00 | $758.67–$922.64 | — | — |
| Diagnostic mammogram, both breasts both sides CPT 77066 HC DIAGNOSTIC MAMMO CAD BILATERAL | $599.00 | $599.00 | $354.61–$415.22 | — | — |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC DIAGNOSTIC MAMMO CAD BILATERAL | $599.00 | $599.00 | $354.61–$415.22 | — | — |
| Duplex ultrasound of the leg veins, both legs CPT 93970 HC VENOUS IMAGING | $699.00 | $699.00 | $393.68–$460.97 | 4% below | — |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 HC VENOUS IMAGING | $699.00 | $699.00 | $393.68–$460.97 | — | — |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC TTE W/DOPPLER COMPLETE | $693.00 | $693.00 | $376.20–$660.00 | 8% below | — |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC TTE W/DOPPLER COMPLETE | $693.00 | $693.00 | $376.20–$660.00 | — | — |
| Elbow X-ray, 2 views CPT 73070 HC ELBOW 2 VIEWS | $109.00 | $109.00 | $62.99–$71.39 | 22% below | — |
| Elbow X-ray, 2 views inpatient CPT 73070 HC ELBOW 2 VIEWS | $109.00 | $109.00 | $62.99–$71.39 | — | — |
| Elbow X-ray, complete, 3 or more views CPT 73080 HC ELBOW MIN 3 VIEWS | $134.00 | $134.00 | $75.18–$127.00 | 16% below | — |
| Elbow X-ray, complete, 3 or more views inpatient CPT 73080 HC ELBOW MIN 3 VIEWS | $134.00 | $134.00 | $75.18–$127.00 | — | — |
| Eye socket (orbit) CT scan without contrast CPT 70480 HC CT ORBITS/FOSSA/SELLA/IAC | $1,653.00 | $1,653.00 | $962.66–$978.58 | 20% above | — |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 HC CT ORBITS/FOSSA/SELLA/IAC | $1,653.00 | $1,653.00 | $962.66–$978.58 | — | — |
| Facial bones X-ray, complete, 3 or more views CPT 70150 HC FACIAL BONES MIN 3 VIEWS | $160.00 | $160.00 | $89.98 | 17% below | — |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 HC FACIAL BONES MIN 3 VIEWS | $160.00 | $160.00 | $89.98 | — | — |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 HC FOREARM 2 VIEWS | $104.00 | $104.00 | $56.43–$92.07 | 31% below | — |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 HC FOREARM 2 VIEWS | $104.00 | $104.00 | $56.43–$92.07 | — | — |
| Hand X-ray, 2 views CPT 73120 HC HAND 2 VIEWS | $110.00 | $110.00 | $74.49 | 26% below | — |
| Hand X-ray, 2 views inpatient CPT 73120 HC HAND 2 VIEWS | $110.00 | $110.00 | $74.49 | — | — |
| Knee X-ray, 3 views both sides CPT 73562 HC KNEE MIN 3 VIEWS BILATERAL | $147.00 | $147.00 | $80.99–$117.60 | — | — |
| Knee X-ray, 3 views CPT 73562 HC KNEE MIN 3 VIEWS | $147.00 | $147.00 | $80.99–$117.60 | 21% below | — |
| Knee X-ray, 3 views inpatient both sides CPT 73562 HC KNEE MIN 3 VIEWS BILATERAL | $147.00 | $147.00 | $80.99–$117.60 | — | — |
| Knee X-ray, 3 views inpatient CPT 73562 HC KNEE MIN 3 VIEWS | $147.00 | $147.00 | $80.99–$117.60 | — | — |
| Knee X-ray, complete, 4 or more views CPT 73564 HC KNEE 4 OR MORE VIEWS | $165.00 | $165.00 | $108.83–$157.00 | 15% below | — |
| Knee X-ray, complete, 4 or more views inpatient CPT 73564 HC KNEE 4 OR MORE VIEWS | $165.00 | $165.00 | $108.83–$157.00 | — | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US ECHO EXAM OF ABDOMEN | $414.00 | $414.00 | $227.92–$394.00 | 7% above | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US ECHO EXAM OF ABDOMEN | $414.00 | $414.00 | $227.92–$394.00 | — | — |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC US XTR NON-VASC LMTD | $174.00 | $174.00 | $97.68–$117.83 | 20% below | — |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HC US XTR NON-VASC LMTD | $174.00 | $174.00 | $97.68–$117.83 | — | — |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC LDCT FOR LUNG CANCER SCREEN | $1,584.00 | $1,584.00 | $902.88–$1,098.02 | 115% above | — |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC LDCT FOR LUNG CANCER SCREEN | $1,584.00 | $1,584.00 | $902.88–$1,098.02 | — | — |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 HC TIBIA FIBULA 2 VIEW | $114.00 | $114.00 | $63.94–$108.00 | 29% below | — |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 HC TIBIA FIBULA 2 VIEW | $114.00 | $114.00 | $63.94–$108.00 | — | — |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI-LOWER EXT JOINT W/O DYE | $1,773.00 | $1,773.00 | $1,010.61–$1,648.89 | 8% below | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI-LOWER EXT JOINT W/O DYE | $1,773.00 | $1,773.00 | $1,010.61–$1,648.89 | — | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI LOWER EXT JOINT W/WO DYE | $2,993.00 | $2,993.00 | $1,215.50–$1,743.06 | 1% below | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI LOWER EXT JOINT W/WO DYE | $2,993.00 | $2,993.00 | $1,215.50–$1,743.06 | — | — |
| MRI of the abdomen without contrast CPT 74181 HC MRI-ABDOMEN W/O DYE | $1,930.00 | $1,930.00 | $1,089.53 | 2% below | — |
| MRI of the abdomen without contrast inpatient CPT 74181 HC MRI-ABDOMEN W/O DYE | $1,930.00 | $1,930.00 | $1,089.53 | — | — |
| MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI ABDOMEN W/WO DYE | $3,264.00 | $3,264.00 | $1,771.56–$2,154.46 | 1% above | — |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI ABDOMEN W/WO DYE | $3,264.00 | $3,264.00 | $1,771.56–$2,154.46 | — | — |
| MRI of the brain, no contrast dye CPT 70551 HC MRI-BRAIN/BRAIN STEM | $1,717.00 | $1,717.00 | $967.92–$1,162.75 | at median | — |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI-BRAIN/BRAIN STEM | $1,717.00 | $1,717.00 | $967.92–$1,162.75 | — | — |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI-BRAIN W/WO DYE | $2,895.00 | $2,895.00 | $1,571.49–$2,431.80 | 4% below | — |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI-BRAIN W/WO DYE | $2,895.00 | $2,895.00 | $1,571.49–$2,431.80 | — | — |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI-L-SPINE W/O DYE | $1,574.00 | $1,574.00 | $897.18–$1,574.00 | 19% below | — |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI-L-SPINE W/O DYE | $1,574.00 | $1,574.00 | $897.18–$1,574.00 | — | — |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI-T-SPINE W/O DYE | $1,574.00 | $1,574.00 | $931.81–$1,463.82 | 24% below | — |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI-T-SPINE W/O DYE | $1,574.00 | $1,574.00 | $931.81–$1,463.82 | — | — |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI C-SPINE W/WO DYE | $3,041.00 | $3,041.00 | $2,554.44 | 3% below | — |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MRI C-SPINE W/WO DYE | $3,041.00 | $3,041.00 | $2,554.44 | — | — |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI-C-SPINE W/O DYE | $1,649.00 | $1,649.00 | $894.90–$1,460.10 | 14% below | — |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI-C-SPINE W/O DYE | $1,649.00 | $1,649.00 | $894.90–$1,460.10 | — | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI-UPPER EXT JOINT W/O DYE | $1,773.00 | $1,773.00 | $1,010.61–$1,200.67 | 8% below | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HC MRI-UPPER EXT JOINT W/O DYE | $1,773.00 | $1,773.00 | $1,010.61–$1,200.67 | — | — |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC CERVICAL SPINE 4 OR 5 VIEWS | $197.00 | $197.00 | $129.62–$162.69 | 10% below | — |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 HC CERVICAL SPINE 4 OR 5 VIEWS | $197.00 | $197.00 | $129.62–$162.69 | — | — |
| Neck soft tissue X-ray CPT 70360 HC SOFT TISSUE NECK | $110.00 | $110.00 | $72.09 | 25% below | — |
| Neck soft tissue X-ray inpatient CPT 70360 HC SOFT TISSUE NECK | $110.00 | $110.00 | $72.09 | — | — |
| Pelvic CT scan without contrast CPT 72192 HC CT PELVIS W/O DYE | $1,052.00 | $1,052.00 | $602.56–$693.89 | 14% below | — |
| Pelvic CT scan without contrast inpatient CPT 72192 HC CT PELVIS W/O DYE | $1,052.00 | $1,052.00 | $602.56–$693.89 | — | — |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US PELVIC LIMITED | $126.00 | $126.00 | $71.04–$120.00 | 60% below | — |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC US PELVIC LIMITED | $126.00 | $126.00 | $71.04–$120.00 | — | — |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US PELVIC COMPLETE | $483.00 | $483.00 | $266.11–$437.00 | 12% above | — |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC US PELVIC COMPLETE | $483.00 | $483.00 | $266.11–$437.00 | — | — |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US PREGNANCY >=14WKS SNGL FETUS | $553.00 | $553.00 | $364.62 | 16% above | — |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US PREGNANCY >=14WKS SNGL FETUS | $553.00 | $553.00 | $364.62 | — | — |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC US OB COMPLETE(<14 WKS) | $471.00 | $471.00 | $318.96 | 21% above | — |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HC US OB COMPLETE(<14 WKS) | $471.00 | $471.00 | $318.96 | — | — |
| Screening mammogram, both breasts both sides CPT 77067 HC SCREENING MAMMO CAD BILATERAL | $495.00 | $495.00 | $87.65–$393.53 | — | — |
| Screening mammogram, both breasts inpatient both sides CPT 77067 HC SCREENING MAMMO CAD BILATERAL | $495.00 | $495.00 | $87.65–$393.53 | — | — |
| Shoulder X-ray, complete, 2 or more views CPT 73030 HC SHOULDER MIN 2 VIEWS | $111.00 | $111.00 | $60.74–$93.24 | 37% below | — |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 HC SHOULDER MIN 2 VIEWS | $111.00 | $111.00 | $60.74–$93.24 | — | — |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 HC X-RAY EXAM FEMUR 2/> | $129.00 | $129.00 | $69.54–$122.00 | 22% below | — |
| Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 HC X-RAY EXAM FEMUR 2/> | $129.00 | $129.00 | $69.54–$122.00 | — | — |
| Toe X-ray, 2 or more views CPT 73660 HC TOE MIN 2 VIEWS | $122.00 | $122.00 | $67.10–$80.41 | 5% below | — |
| Toe X-ray, 2 or more views inpatient CPT 73660 HC TOE MIN 2 VIEWS | $122.00 | $122.00 | $67.10–$80.41 | — | — |
| Transvaginal pelvic ultrasound CPT 76830 HC US TRANSVAGINAL | $482.00 | $482.00 | $265.53–$436.05 | 4% above | — |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC US TRANSVAGINAL | $482.00 | $482.00 | $265.53–$436.05 | — | — |
| Transvaginal ultrasound during pregnancy CPT 76817 HC US TRANSVAGINAL(OB) | $328.00 | $328.00 | $216.27 | at median | — |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC US TRANSVAGINAL(OB) | $328.00 | $328.00 | $216.27 | — | — |
| Ultrasound of the abdomen, complete CPT 76700 HC US EXAM ABDOMEN COMPLETE | $515.00 | $515.00 | $293.55–$357.00 | 1% above | — |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HC US EXAM ABDOMEN COMPLETE | $515.00 | $515.00 | $293.55–$357.00 | — | — |
| Ultrasound of the scrotum and testicles CPT 76870 HC US SCROTUM | $388.00 | $388.00 | $218.72–$308.46 | 6% below | — |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 HC US SCROTUM | $388.00 | $388.00 | $218.72–$308.46 | — | — |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US EXAM HEAD/NECK | $482.00 | $482.00 | $235.21–$457.90 | at median | — |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US EXAM HEAD/NECK | $482.00 | $482.00 | $235.21–$457.90 | — | — |
| Upper arm X-ray (humerus), 2 views CPT 73060 HC HUMERUS 2 VIEWS | $115.00 | $115.00 | $62.13–$75.55 | 18% below | — |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HC HUMERUS 2 VIEWS | $115.00 | $115.00 | $62.13–$75.55 | — | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC UNILAT/LTD VENOUS | $428.00 | $428.00 | $231.99–$282.13 | 21% below | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC UNILAT/LTD VENOUS | $428.00 | $428.00 | $231.99–$282.13 | — | — |
| Wrist X-ray, 2 views CPT 73100 HC WRIST 2 VIEWS | $124.00 | $124.00 | $81.79 | 22% below | — |
| Wrist X-ray, 2 views inpatient CPT 73100 HC WRIST 2 VIEWS | $124.00 | $124.00 | $81.79 | — | — |
| Wrist X-ray, complete, 3 or more views CPT 73110 HC WRIST COMP MIN 3 VIEWS | $150.00 | $150.00 | $80.94–$98.43 | 17% below | — |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 HC WRIST COMP MIN 3 VIEWS | $150.00 | $150.00 | $80.94–$98.43 | — | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HC X-RAY EXAM HIP UNI 2-3 VW | $184.00 | $184.00 | $89.79–$154.56 | 10% below | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 HC X-RAY EXAM HIP UNI 2-3 VW | $184.00 | $184.00 | $89.79–$154.56 | — | — |
| X-ray of the abdomen, 1 view CPT 74018 HC XRAY ABDOMEN 1 VIEW | $102.00 | $102.00 | $55.29–$67.25 | 27% below | — |
| X-ray of the abdomen, 1 view inpatient CPT 74018 HC XRAY ABDOMEN 1 VIEW | $102.00 | $102.00 | $55.29–$67.25 | — | — |
| X-ray of the ankle, 2 views CPT 73600 HC X-RAY ANKLE 2 VIEWS | $120.00 | $120.00 | $71.04 | 18% below | — |
| X-ray of the ankle, 2 views inpatient CPT 73600 HC X-RAY ANKLE 2 VIEWS | $120.00 | $120.00 | $71.04 | — | — |
| X-ray of the finger(s), 2 or more views CPT 73140 HC FINGER MIN 2 VIEWS | $142.00 | $142.00 | $80.97–$113.40 | 10% below | — |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 HC FINGER MIN 2 VIEWS | $142.00 | $142.00 | $80.97–$113.40 | — | — |
| X-ray of the foot, 2 views CPT 73620 HC FOOT 2 VIEWS | $104.00 | $104.00 | $58.61–$70.42 | 26% below | — |
| X-ray of the foot, 2 views inpatient CPT 73620 HC FOOT 2 VIEWS | $104.00 | $104.00 | $58.61–$70.42 | — | — |
| X-ray of the foot, complete, 3 or more views CPT 73630 HC FOOT MIN 3 VIEWS | $122.00 | $122.00 | $59.53–$97.44 | 17% below | — |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 HC FOOT MIN 3 VIEWS | $122.00 | $122.00 | $59.53–$97.44 | — | — |
| X-ray of the hand, 3 or more views CPT 73130 HC HAND MIN 3 VIEWS | $130.00 | $130.00 | $71.15–$103.32 | 25% below | — |
| X-ray of the hand, 3 or more views inpatient CPT 73130 HC HAND MIN 3 VIEWS | $130.00 | $130.00 | $71.15–$103.32 | — | — |
| X-ray of the knee, 1 or 2 views CPT 73560 HC KNEE 1 OR 2 VIEWS | $126.00 | $126.00 | $68.40–$95.40 | 25% below | — |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 HC KNEE 1 OR 2 VIEWS | $126.00 | $126.00 | $68.40–$95.40 | — | — |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC LUMBAR SPINE 2 VIEWS | $135.00 | $135.00 | $72.96–$128.00 | 30% below | — |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC LUMBAR SPINE 2 VIEWS | $135.00 | $135.00 | $72.96–$128.00 | — | — |
| X-ray of the lower back, 4 or more views CPT 72110 HC LUMBAR SPINE COM | $187.00 | $187.00 | $102.97–$105.38 | 21% below | — |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC LUMBAR SPINE COM | $187.00 | $187.00 | $102.97–$105.38 | — | — |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC SPINE THORACIC 2 VIEWS | $121.00 | $121.00 | $65.55–$79.71 | 23% below | — |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC SPINE THORACIC 2 VIEWS | $121.00 | $121.00 | $65.55–$79.71 | — | — |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC CERVICAL SPINE 2/3 VIEWS | $146.00 | $146.00 | $79.23–$132.05 | 11% below | — |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC CERVICAL SPINE 2/3 VIEWS | $146.00 | $146.00 | $79.23–$132.05 | — | — |
| X-ray of the pelvis, 1 or 2 views CPT 72170 HC PELVIS | $126.00 | $126.00 | $69.54–$122.00 | 19% below | — |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC PELVIS | $126.00 | $126.00 | $69.54–$122.00 | — | — |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs North Dakota | Off list |
|---|---|---|---|---|---|
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC SURGICAL PATH-LEVEL IV | $246.00 | $246.00 | $133.38–$217.62 | 100% above | — |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC SURGICAL PATH-LEVEL IV | $246.00 | $246.00 | $133.38–$217.62 | — | — |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 PR COLLECTION VENOUS BLOOD VENIPUNCTURE | $23.00 | $23.00 | $10.83–$23.00 | 28% above | — |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 PR COLLECTION VENOUS BLOOD VENIPUNCTURE | $23.00 | $23.00 | $10.83–$23.00 | — | — |
| Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS | $129.00 | $129.00 | $69.54–$113.46 | 26% above | — |
| Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS | $129.00 | $129.00 | $69.54–$113.46 | — | — |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs North Dakota | Off list |
|---|---|---|---|---|---|
| Gallbladder removal, laparoscopic CPT 47562 HC LAPAROSCOPIC CHOLECYSTECTOMY | $10,264.00 | $10,264.00 | $5,571.75–$6,776.03 | 11% above | — |
| Gallbladder removal, laparoscopic inpatient CPT 47562 HC LAPAROSCOPIC CHOLECYSTECTOMY | $10,264.00 | $10,264.00 | $5,571.75–$6,776.03 | — | — |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC I & D ABSCESS, SMPL | $385.00 | $385.00 | $187.88–$253.71 | 24% above | — |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC I & D ABSCESS, SMPL | $385.00 | $385.00 | $187.88–$253.71 | — | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US | $536.00 | $536.00 | $362.97 | 40% above | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US | $536.00 | $536.00 | $362.97 | — | — |
| Short leg splint (calf to foot) CPT 29515 HC APPLY LOWER LEG SPLINT | $209.00 | $209.00 | $117.81–$192.71 | 15% below | — |
| Short leg splint (calf to foot) inpatient CPT 29515 HC APPLY LOWER LEG SPLINT | $209.00 | $209.00 | $117.81–$192.71 | — | — |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs North Dakota | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 HC BLOOD ADMIN 2+ HRS | $927.00 | $927.00 | $510.24–$539.43 | 22% above | — |
| Blood transfusion (giving blood or blood components) CPT 36430 HC BLOOD ADMIN 0-2 HRS | $927.00 | $927.00 | $510.24–$539.43 | 22% above | — |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC BLOOD ADMIN 2+ HRS | $927.00 | $927.00 | $510.24–$539.43 | — | — |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC BLOOD ADMIN 0-2 HRS | $927.00 | $927.00 | $510.24–$539.43 | — | — |
| Chemotherapy IV infusion, first hour CPT 96413 HC CHEMO,IV INFUSION,1 HR | $708.00 | $708.00 | $399.01–$467.22 | at median | — |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 HC CHEMO,IV INFUSION,1 HR | $708.00 | $708.00 | $399.01–$467.22 | — | — |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC ROUTINE EKG | $66.00 | $66.00 | $35.34–$62.00 | 44% below | — |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC ROUTINE EKG | $66.00 | $66.00 | $35.34–$62.00 | — | — |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC ED LEVEL I | $229.00 | $229.00 | $124.26–$218.00 | 16% above | — |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC ED LEVEL I | $229.00 | $229.00 | $124.26–$218.00 | — | — |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC ED LEVEL II | $312.00 | $312.00 | $152.25–$297.00 | 3% above | — |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC ED LEVEL II | $312.00 | $312.00 | $152.25–$297.00 | — | — |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC ED LEVEL III | $516.00 | $516.00 | $279.87–$491.00 | 4% above | — |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC ED LEVEL III | $516.00 | $516.00 | $279.87–$491.00 | — | — |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC ED LEVEL IV | $869.00 | $869.00 | $471.39–$827.00 | 6% above | — |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC ED LEVEL IV | $869.00 | $869.00 | $471.39–$827.00 | — | — |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC ED LEVEL V | $1,434.00 | $1,434.00 | $699.79–$1,365.00 | 16% above | — |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC ED LEVEL V | $1,434.00 | $1,434.00 | $699.79–$1,365.00 | — | — |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC HYDRATION IV INFUSION,INIT | $460.00 | $460.00 | $249.66–$386.40 | 30% above | — |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC HYDRATION IV INFUSION,INIT | $460.00 | $460.00 | $249.66–$386.40 | — | — |
| IV infusion of a medicine, first hour CPT 96365 HC THER/PROPH/DIAG IV INF,INIT | $520.00 | $520.00 | $282.15–$415.80 | 26% above | — |
| IV infusion of a medicine, first hour inpatient CPT 96365 HC THER/PROPH/DIAG IV INF,INIT | $520.00 | $520.00 | $282.15–$415.80 | — | — |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC THER/PROPH/DIAG INJ,SC/IM | $147.00 | $147.00 | $79.80–$97.04 | 67% above | — |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC THER/PROPH/DIAG INJ,SC/IM | $147.00 | $147.00 | $79.80–$97.04 | — | — |
| New patient office visit, about 30 minutes CPT 99203 PR OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES | $236.00 | $236.00 | $233.76 | at median | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 PR OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES | $236.00 | $236.00 | $233.76 | — | — |
| New patient office visit, about 45 minutes CPT 99204 PR OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES | $375.00 | $375.00 | $151.00–$269.00 | 6% above | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 PR OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES | $375.00 | $375.00 | $151.00–$269.00 | — | — |
| New patient office visit, about 60 minutes CPT 99205 PR OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES | $491.00 | $491.00 | $297.56 | 14% above | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 PR OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES | $491.00 | $491.00 | $297.56 | — | — |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 PR OFFICE/OUTPATIENT NEW SF MDM 15 MINUTES | $157.00 | $157.00 | $213.76 | 4% below | — |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 PR OFFICE/OUTPATIENT NEW SF MDM 15 MINUTES | $157.00 | $157.00 | $213.76 | — | — |
| Occupational therapy evaluation, low complexity CPT 97165 HC OT EVAL LOW COMPLEX 30 MIN | $370.00 | $370.00 | $204.63–$359.00 | 41% above | — |
| Occupational therapy evaluation, low complexity CPT 97165 HC DRIVING TRAINING LOW COMPLEX 30 MIN | $370.00 | $370.00 | $204.63–$359.00 | 41% above | — |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 HC OT EVAL LOW COMPLEX 30 MIN | $370.00 | $370.00 | $204.63–$359.00 | — | — |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 HC DRIVING TRAINING LOW COMPLEX 30 MIN | $370.00 | $370.00 | $204.63–$359.00 | — | — |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC PT EVAL HIGH COMPLEX 45 MIN | $345.00 | $345.00 | $198.29 | 11% above | — |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC PT EVAL HIGH COMPLEX 45 MIN | $345.00 | $345.00 | $198.29 | — | — |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC PT EVAL LOW COMPLEX 20 MIN | $324.00 | $324.00 | $178.95–$231.00 | 23% above | — |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC PT EVAL LOW COMPLEX 20 MIN | $324.00 | $324.00 | $178.95–$231.00 | — | — |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC PT EVAL MOD COMPLEX 30 MIN | $335.00 | $335.00 | $184.94–$272.53 | 20% above | — |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC PT EVAL MOD COMPLEX 30 MIN | $335.00 | $335.00 | $184.94–$272.53 | — | — |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC MANUAL THERAPY 15MIN | $120.00 | $120.00 | $68.67–$116.00 | 15% above | — |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC MANUAL THERAPY 15MIN | $120.00 | $120.00 | $68.67–$116.00 | — | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC THERAP EX 15MIN | $131.00 | $131.00 | $72.39–$127.00 | 20% above | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC THERAP EX 15MIN | $131.00 | $131.00 | $72.39–$127.00 | — | — |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 PR OFFICE/OUTPATIENT ESTABLISHED HIGH MDM 40 MIN | $451.00 | $451.00 | $151.00–$254.96 | 21% above | — |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 PR OFFICE/OUTPATIENT ESTABLISHED HIGH MDM 40 MIN | $451.00 | $451.00 | $151.00–$254.96 | — | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 PR OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20 MIN | $229.00 | $229.00 | $151.00–$215.67 | 18% above | — |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 PR OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20 MIN | $229.00 | $229.00 | $151.00–$215.67 | — | — |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 PR OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN | $336.00 | $336.00 | $151.00–$320.00 | 24% above | — |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 PR OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN | $336.00 | $336.00 | $151.00–$320.00 | — | — |
| Speech and language evaluation CPT 92523 HC EVAL OF SPEECH SOUND LANG COMPREHEN | $873.00 | $873.00 | $505.03–$605.16 | 53% above | — |
| Speech and language evaluation inpatient CPT 92523 HC EVAL OF SPEECH SOUND LANG COMPREHEN | $873.00 | $873.00 | $505.03–$605.16 | — | — |
| Speech therapy session, individual CPT 92507 HC SPEECH/HEARING THERAPY INDIV | $326.00 | $326.00 | $192.99–$326.00 | 22% above | — |
| Speech therapy session, individual inpatient CPT 92507 HC SPEECH/HEARING THERAPY INDIV | $326.00 | $326.00 | $192.99–$326.00 | — | — |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HC THERAP ACTIVITY 15MIN | $170.00 | $170.00 | $100.92–$121.00 | 44% above | — |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC THERAP ACTIVITY 15MIN | $170.00 | $170.00 | $100.92–$121.00 | — | — |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC PHLEBOTOMY IN INFUSION CTR | $440.00 | $440.00 | $248.05–$351.96 | 57% above | — |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC PHLEBOTOMY IN INFUSION CTR | $440.00 | $440.00 | $248.05–$351.96 | — | — |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs North Dakota | Off list |
|---|---|---|---|---|---|
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 PR SARSCOV2 VACCINE 50 MCG/0.5 ML FOR IM USE | $175.00 | $175.00 | $106.33–$162.75 | 21% above | — |
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 COVID-19 mRNA Vaccine-Moderna IM Susp Pref Syr 50 MCG/0.5ML | $190.00 | $190.00 | $106.33–$162.75 | 31% above | — |
| COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 PR SARSCOV2 VACCINE 50 MCG/0.5 ML FOR IM USE | $175.00 | $175.00 | $106.33–$162.75 | — | — |
| COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 COVID-19 mRNA Vaccine-Moderna IM Susp Pref Syr 50 MCG/0.5ML | $190.00 | $190.00 | $106.33–$162.75 | — | — |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 PR IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE | $35.00 | $35.00 | $21.90 | 17% above | — |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Influenza Virus Vaccine Split PF Susp Pref Syringe 0.5 ML | $35.00 | $35.00 | $21.90 | 17% above | — |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 PR IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE | $35.00 | $35.00 | $21.90 | — | — |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Influenza Virus Vaccine Split PF Susp Pref Syringe 0.5 ML | $35.00 | $35.00 | $21.90 | — | — |
| Hepatitis A vaccine, adult dose CPT 90632 Hepatitis A Vaccine Susp Prefilled Syr 1440 EL Unit/ML | $112.57 | $112.57 | $66.75 | 20% above | — |
| Hepatitis A vaccine, adult dose CPT 90632 PR HEPA VACCINE ADULT DOSE FOR INTRAMUSCULAR USE | $112.75 | $112.75 | $66.75 | 20% above | — |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 Hepatitis A Vaccine Susp Prefilled Syr 1440 EL Unit/ML | $112.57 | $112.57 | $66.75 | — | — |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 PR HEPA VACCINE ADULT DOSE FOR INTRAMUSCULAR USE | $112.75 | $112.75 | $66.75 | — | — |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Hepatitis B Vaccine (Recombinant) Susp Pref Syr 20 MCG/ML | $94.66 | $94.66 | $55.71 | at median | — |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 PR HEPB VACCINE ADULT 3 DOSE SCHEDULE FOR IM USE | $94.75 | $94.75 | $55.71 | at median | — |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 Hepatitis B Vaccine (Recombinant) Susp Pref Syr 20 MCG/ML | $94.66 | $94.66 | $55.71 | — | — |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 PR HEPB VACCINE ADULT 3 DOSE SCHEDULE FOR IM USE | $94.75 | $94.75 | $55.71 | — | — |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 PR TD VACCINE PRSRV FREE 7 YRS OR OLDER FOR IM USE | $49.00 | $49.00 | $33.96 | 1% below | — |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 PR TD VACCINE PRSRV FREE 7 YRS OR OLDER FOR IM USE | $49.00 | $49.00 | $33.96 | — | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tet-Diph-Acell Pertuss Ad Pref Syr 5-2-15.5 LF-MCG/0.5ML | $54.50 | $54.50 | $40.92–$59.43 | 22% below | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tet-Diph-Acell Pertuss Ad Pref Syr 5-2.5-18.5 LF-MCG/0.5ML | $70.70 | $70.70 | $40.92–$59.43 | 2% above | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 PR TDAP VACCINE 7 YRS/> IM | $70.75 | $70.75 | $40.92–$59.43 | 2% above | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tet-Diph-Acell Pertuss Ad Pref Syr 5-2-15.5 LF-MCG/0.5ML | $54.50 | $54.50 | $40.92–$59.43 | — | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tet-Diph-Acell Pertuss Ad Pref Syr 5-2.5-18.5 LF-MCG/0.5ML | $70.70 | $70.70 | $40.92–$59.43 | — | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 PR TDAP VACCINE 7 YRS/> IM | $70.75 | $70.75 | $40.92–$59.43 | — | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC IMMUNIZATION ADMINISTRATION | $20.99 | $20.99 | $12.42–$17.63 | 59% below | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 PR IM ADM PRQ ID SUBQ/IM NJXS 1 VACCINE | $25.00 | $25.00 | $12.42–$17.63 | 51% below | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC IMMUNIZATION ADMINISTRATION | $20.99 | $20.99 | $12.42–$17.63 | — | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 PR IM ADM PRQ ID SUBQ/IM NJXS 1 VACCINE | $25.00 | $25.00 | $12.42–$17.63 | — | — |
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.