Jacobson Memorial Hospital Care Center
Jacobson Memorial Hospital Care Center in Elgin, ND publishes cash prices for 216 common procedures listed here, from its own machine-readable price file updated Mar 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the North Dakota median for 104 of 213 procedures and above it for 100. By typical cash price it ranks #12 of 22 North Dakota hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.
601 East St N, Elgin, ND 58533 Collected Sep 27, 2026 Source price file (701) 584-2792
Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 351314 · CMS hospital register
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs North Dakota | Off list |
|---|---|---|---|---|---|
| Ankle X-ray, complete, 3 or more views CPT 73610 RAD EXAM ANKLE MIN 3 VWS | $114.00 | $152.00 | $91.20–$212.80 | 32% below | 25% |
| Breast ultrasound, complete, one breast one side CPT 76641 US UNILATERAL BREAST COMPLETE | $290.25 | $387.00 | $232.20–$541.80 | 15% below | 25% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US UNILATERAL BREAST LIMITED | $222.75 | $297.00 | $178.20–$415.80 | 14% below | 25% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST WCONT +WO IF PERF | $1,900.09 | $2,533.45 | $1,520.07–$3,546.83 | 11% below | 25% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD PELVIS WO CONTRAST | $996.19 | $1,328.25 | $796.95–$1,859.55 | 25% below | 25% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD PELVIS W CONTRAST | $2,164.01 | $2,885.35 | $1,731.21–$4,039.49 | 11% below | 25% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD PELVIS WO THEN W CONT | $2,446.05 | $3,261.40 | $1,956.84–$4,565.96 | 15% below | 25% |
| CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W CONTRAST | $1,478.25 | $1,971.00 | $1,182.60–$2,759.40 | 6% below | 25% |
| CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN WO CONTRAST | $830.25 | $1,107.00 | $664.20–$1,549.80 | 25% below | 25% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL WO CONT | $901.31 | $1,201.75 | $721.05–$1,682.45 | 15% below | 25% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONTRAST | $794.36 | $1,059.15 | $635.49–$1,482.81 | 16% below | 25% |
| CT scan of the head with contrast CPT 70460 CT HEAD W CONTRAST | $843.00 | $1,124.00 | $674.40–$1,573.60 | 34% below | 25% |
| CT scan of the head without and with contrast CPT 70470 CT HEAD WO THEN W CONTRAST | $1,050.00 | $1,400.00 | $840.00–$1,960.00 | 27% below | 25% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE WO CONT | $1,110.04 | $1,480.05 | $888.03–$2,072.07 | 14% below | 25% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL SPINE WO CONTRAST | $1,118.66 | $1,491.55 | $894.93–$2,088.17 | 15% below | 25% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CONTRAST | $1,484.25 | $1,979.00 | $1,187.40–$2,770.60 | 6% below | 25% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 DUP CAROTID BILAT | $714.00 | $952.00 | $571.20–$1,332.80 | — | 25% |
| Chest X-ray, 2 views CPT 71046 RAD EXAM CHEST 2 VWS | $108.67 | $144.90 | $86.94–$202.86 | 31% below | 25% |
| Chest X-ray, single view CPT 71045 RAD EXAM CHEST SINGLE VW | $78.49 | $104.65 | $62.79–$146.51 | 41% below | 25% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEUM | $362.25 | $483.00 | $289.80–$676.20 | 10% below | 25% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 BONE DENSITY DEXA AXIAL SKELET | $195.00 | $260.00 | $156.00–$364.00 | 27% below | 25% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX DIAGNOSTIC WO CONTRAST | $1,019.47 | $1,359.30 | $815.58–$1,903.02 | 13% below | 25% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT THORAX DIAGNOSTIC WITH CONTRAST | $1,317.04 | $1,756.05 | $1,053.63–$2,458.47 | 7% below | 25% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO DX BILAT INCL CAD | $478.50 | $638.00 | $382.80–$893.20 | — | 25% |
| Diagnostic mammogram, one breast one side CPT 77065 MAMMO DX UNILAT INCL CAD | $374.25 | $499.00 | $299.40–$698.60 | 3% below | 25% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 DUPLEX VENOUS EXT CMPL BILAT | $762.00 | $1,016.00 | $609.60–$1,422.40 | — | 25% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO (2D) COMPLETE W DOPPLER & COLOR | $621.86 | $829.15 | $497.49–$1,160.81 | 24% below | 25% |
| Knee X-ray, 3 views CPT 73562 RAD EXAM KNEE 3 VWS | $126.75 | $169.00 | $101.40–$236.60 | 36% below | 25% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABD LIMITED | $284.25 | $379.00 | $227.40–$530.60 | 25% below | 25% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT THORAX LW DOSE LUNG CA SCR NO CONTRAST | $737.25 | $983.00 | $589.80–$1,376.20 | 12% above | 25% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LOWER EXT JT WO CONTRAST | $1,892.32 | $2,523.10 | $1,513.86–$3,532.34 | 2% below | 25% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LOWER EXT JT WO THEN W CONT | $2,633.25 | $3,511.00 | $2,106.60–$4,915.40 | 8% below | 25% |
| MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN WO CONTRAST | $1,145.25 | $1,527.00 | $916.20–$2,137.80 | 40% below | 25% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO CONTRAST | $1,119.00 | $1,492.00 | $895.20–$2,088.80 | 32% below | 25% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN WO THEN W CONT | $2,881.61 | $3,842.15 | $2,305.29–$5,379.01 | 1% above | 25% |
| MRI of the lower back, no contrast dye CPT 72148 MRI L SPINE WO CONTRAST | $1,825.91 | $2,434.55 | $1,460.73–$3,408.37 | at median | 25% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI L SPINE WO THEN W CONT | $2,457.75 | $3,277.00 | $1,966.20–$4,587.80 | 25% below | 25% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI T SPINE WO CONTRAST | $1,587.75 | $2,117.00 | $1,270.20–$2,963.80 | 19% below | 25% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI C SPINE WO THEN W CONT | $2,461.50 | $3,282.00 | $1,969.20–$4,594.80 | 20% below | 25% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI C SPINE WO CONTRAST | $1,711.20 | $2,281.60 | $1,368.96–$3,194.24 | 8% below | 25% |
| MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS WO THEN W CONT | $2,688.75 | $3,585.00 | $2,151.00–$5,019.00 | 13% below | 25% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS WO CONTRAST | $2,071.50 | $2,762.00 | $1,657.20–$3,866.80 | 2% above | 25% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI UPPER EXT JT WO CONTRAST | $1,845.75 | $2,461.00 | $1,476.60–$3,445.40 | 5% below | 25% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC LIMITED | $313.50 | $418.00 | $250.80–$585.20 | 1% below | 25% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC COMPLETE | $333.00 | $444.00 | $266.40–$621.60 | 15% below | 25% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PG UTR 2-3TRI SGL 1ST | $378.75 | $505.00 | $303.00–$707.00 | 17% below | 25% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREG UTER 1ST TRI SGL | $300.00 | $400.00 | $240.00–$560.00 | 20% below | 25% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB REAL TIME LTD | $254.25 | $339.00 | $203.40–$474.60 | 8% below | 25% |
| Screening mammogram, both breasts both sides CPT 77067 MAMMO SCREEN BILAT INCL CAD | $395.25 | $527.00 | $316.20–$737.80 | — | 25% |
| Screening mammogram, both breasts one side CPT 77067 MAMMO SCREEN UNILAT INCL CAD M52 | $395.25 | $527.00 | $316.20–$737.80 | 15% above | 25% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 RAD EXAM SHOULDER COMPL MIN 2 VWS | $102.00 | $136.00 | $81.60–$190.40 | 41% below | 25% |
| Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL | $369.00 | $492.00 | $295.20–$688.80 | 19% below | 25% |
| Transvaginal ultrasound during pregnancy CPT 76817 US PG UTR TRANSVAG | $243.75 | $325.00 | $195.00–$455.00 | 18% below | 25% |
| Ultrasound of the abdomen, complete CPT 76700 US ABD COMPLETE | $369.75 | $493.00 | $295.80–$690.20 | 27% below | 25% |
| Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM | $336.75 | $449.00 | $269.40–$628.60 | 13% below | 25% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUE HEAD NECK | $362.25 | $483.00 | $289.80–$676.20 | 20% below | 25% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 DUPLEX VENOUS EXT LTD UNILAT | $525.75 | $701.00 | $420.60–$981.40 | 6% below | 25% |
| Wrist X-ray, complete, 3 or more views CPT 73110 RAD EXAM WRIST COMPL MIN 3 VWS | $129.75 | $173.00 | $103.80–$242.20 | 30% below | 25% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 RAD EXAM HIP UNILAT W PELV WHEN PERF 2 OR 3 VWS | $144.75 | $193.00 | $115.80–$270.20 | 25% below | 25% |
| X-ray of the abdomen, 1 view CPT 74018 RAD EXAM ABDOMEN 1 VW | $85.50 | $114.00 | $68.40–$159.60 | 25% below | 25% |
| X-ray of the ankle, 2 views CPT 73600 RAD EXAM ANKLE 2 VWS | $99.75 | $133.00 | $79.80–$186.20 | 34% below | 25% |
| X-ray of the finger(s), 2 or more views CPT 73140 RAD EXAM FINGER(S) MIN 2 VWS | $123.75 | $165.00 | $99.00–$231.00 | 22% below | 25% |
| X-ray of the foot, 2 views CPT 73620 RAD EXAM FOOT 2 VWS | $85.50 | $114.00 | $68.40–$159.60 | 46% below | 25% |
| X-ray of the foot, complete, 3 or more views CPT 73630 RAD EXAM FOOT MIN 3 VWS | $106.50 | $142.00 | $85.20–$198.80 | 35% below | 25% |
| X-ray of the hand, 3 or more views CPT 73130 RAD EXAM HAND MIN 3 VWS | $113.25 | $151.00 | $90.60–$211.40 | 42% below | 25% |
| X-ray of the knee, 1 or 2 views CPT 73560 RAD EXAM KNEE 1 OR 2 VWS | $106.50 | $142.00 | $85.20–$198.80 | 43% below | 25% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 RAD EXAM SPINE LUMB 2 OR 3 VWS | $116.25 | $155.00 | $93.00–$217.00 | 32% below | 25% |
| X-ray of the lower back, 4 or more views CPT 72110 RAD EXAM SPINE LUMB MIN 4 VWS | $154.50 | $206.00 | $123.60–$288.40 | 34% below | 25% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 RAD EXAM SPINE THOR 2 VWS | $92.25 | $123.00 | $73.80–$172.20 | 36% below | 25% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 RAD EXAM SPINE CERV 2 OR 3 VWS | $115.50 | $154.00 | $92.40–$215.60 | 27% below | 25% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 RAD EXAM PELVIS 1 OR 2 VWS | $97.50 | $130.00 | $78.00–$182.00 | 34% below | 25% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 RAD EXAM SACRUM COCCYX MIN 2 VWS | $95.25 | $127.00 | $76.20–$177.80 | 35% below | 25% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs North Dakota | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 TRANSFERASE ALANINE AMINO ALT SGPT 84460 | $28.50 | $38.00 | $22.80–$53.20 | 30% below | 25% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 AST 84450 | $27.75 | $37.00 | $22.20–$51.80 | 38% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH 86003 | $26.25 | $35.00 | $21.00–$49.00 | 82% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN ON PANEL 86003 | $26.25 | $35.00 | $21.00–$49.00 | 82% above | 25% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITR PEP AB(CCP) 86200 | $101.25 | $135.00 | $81.00–$189.00 | 78% above | 25% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CONNECT TISS CYCLIC CITRULLINATED PEPTIDE AB 86200.003 | $101.25 | $135.00 | $81.00–$189.00 | 78% above | 25% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 CONNECT TISSUE ANTINUCLEAR AB 86038.007 | $63.75 | $85.00 | $51.00–$119.00 | 12% above | 25% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODY SCRE86038 | $63.75 | $85.00 | $51.00–$119.00 | 12% above | 25% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT-PRO B-TYPE NATRIURETIC PEPTIDE 83880.900 | $200.25 | $267.00 | $160.20–$373.80 | 6% below | 25% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE 83880 | $294.45 | $392.60 | $235.56–$549.64 | 38% above | 25% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL 80048 | $63.45 | $84.60 | $50.76–$118.44 | 14% below | 25% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURGICAL PATH LEVEL IV 88305 | $162.75 | $217.00 | $130.20–$303.80 | 44% above | 25% |
| Blood culture for bacteria CPT 87040 CULTURE BACTERIAL BLOOD AEROBIC W/ID ISOLATES 87040 | $54.00 | $72.00 | $43.20–$100.80 | 29% below | 25% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 INSURANCE DRAW FEE | $17.25 | $23.00 | $13.80–$32.20 | at median | 25% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE 36415 | $22.50 | $30.00 | $18.00–$42.00 | 31% above | 25% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE QUANT BLOOD (EXCEPT REAGENT STRIP) 82947 | $21.75 | $29.00 | $17.40–$40.60 | 16% below | 25% |
| Blood lead test CPT 83655 LEAD 83655 | $63.75 | $85.00 | $51.00–$119.00 | 115% above | 25% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG QUAL 84703 | $14.25 | $19.00 | $11.40–$26.60 | 79% below | 25% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING SEROLOGIC ABO 86900 | $15.75 | $21.00 | $12.60–$29.40 | 60% below | 25% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C REACTIVE PROTEIN QUANT 86140 | $27.75 | $37.00 | $22.20–$51.80 | 12% above | 25% |
| C. difficile toxin gene test (stool PCR) CPT 87493 INF AGENT DET NUCLEIC ACID CLOSTRIDIUM AMP PROBE 87493 | $184.50 | $246.00 | $147.60–$344.40 | at median | 25% |
| CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9PANCREATIC CANCER86301 | $109.50 | $146.00 | $87.60–$204.40 | 8% above | 25% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 86304 | $109.50 | $146.00 | $87.60–$204.40 | 4% above | 25% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 CDMR SARS-COV-2 COVID-19 AMP PRB 87635 | $133.50 | $178.00 | $106.80–$249.20 | 11% above | 25% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 INFECT AGNT NUCLEIC ACID DNA RNA CHLAMYDIA TRACH AMPLIF PROBE 87491 | $184.50 | $246.00 | $147.60–$344.40 | 61% above | 25% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACH OTHER THAN OCULAR PERITONEAL 87491.902 | $184.50 | $246.00 | $147.60–$344.40 | 61% above | 25% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL 80061 | $100.43 | $133.90 | $80.34–$187.46 | 48% above | 25% |
| Complete blood count (CBC) with differential CPT 85025 COMPLETE CBC W/AUTO DIFF WBC 85025 | $58.27 | $77.70 | $46.62–$108.78 | at median | 25% |
| Complete blood count (CBC), no differential CPT 85027 BLOOD COUNT COMPLETE AUTOMATED 85027 | $33.75 | $45.00 | $27.00–$63.00 | 26% below | 25% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL 80053 | $79.20 | $105.60 | $63.36–$147.84 | 17% below | 25% |
| D-dimer blood test (blood clot marker) CPT 85379 FIBRIN DEGRADATION PRODUCTS D-DIMER QUANT 85379 | $51.75 | $69.00 | $41.40–$96.60 | 31% below | 25% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SULFATE 82627 | $117.75 | $157.00 | $94.20–$219.80 | 24% above | 25% |
| Estradiol blood test CPT 82670 ESTRADIOL TOTAL 82670 | $147.00 | $196.00 | $117.60–$274.40 | 84% above | 25% |
| FSH (follicle-stimulating hormone) test CPT 83001 GONADOTROPIN FOLLICLE STIMULATING HORMONE (FSH) 83001 | $97.50 | $130.00 | $78.00–$182.00 | at median | 25% |
| FSH (follicle-stimulating hormone) test CPT 83001 FSH W TANNER STAGES 83001.900 | $97.50 | $130.00 | $78.00–$182.00 | at median | 25% |
| Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN 83993 | $208.50 | $278.00 | $166.80–$389.20 | 77% above | 25% |
| Ferritin blood test (iron stores) CPT 82728 ASSAY OF FERRITIN 82728 | $71.25 | $95.00 | $57.00–$133.00 | at median | 25% |
| Folate (folic acid) blood test CPT 82746 FOLATE 82746 | $77.25 | $103.00 | $61.80–$144.20 | 6% below | 25% |
| Free T3 thyroid hormone test CPT 84481 T3 FREE 84481 | $101.25 | $135.00 | $81.00–$189.00 | 18% above | 25% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 ASSAY OF FREE THYROXINE 84439 | $45.75 | $61.00 | $36.60–$85.40 | 31% above | 25% |
| Free testosterone test CPT 84402 TESTOSTERONE FREE MEASURED 84402.901 | $133.50 | $178.00 | $106.80–$249.20 | 122% above | 25% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL | $168.00 | $224.00 | $134.40–$313.60 | 27% below | 25% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE POST GLUCOSE DOSE 82950 | $25.50 | $34.00 | $20.40–$47.60 | 35% below | 25% |
| Glucose tolerance test, 3 samples CPT 82951 GLUC TOL 3 SPEC & DOSE 82951 | $68.25 | $91.00 | $54.60–$127.40 | 28% below | 25% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHEA OTHER THAN OCULAR PERITONEAL 87591.902 | $184.50 | $246.00 | $147.60–$344.40 | 114% above | 25% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 INFECT AGNT NUCLEIC ACID DNA RNA NEISSERIA GONORRHOEAE AMPLIF PROBE 87591 | $184.50 | $246.00 | $147.60–$344.40 | 114% above | 25% |
| H. pylori stool antigen test CPT 87338 H PYLORI AG STOOL 87338 | $75.00 | $100.00 | $60.00–$140.00 | 23% below | 25% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV 1 RNA PCR QNT 87536 | $421.50 | $562.00 | $337.20–$786.80 | 100% above | 25% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 AG WHIV-1 & HIV-2 AB 87389/G0475 | $122.25 | $163.00 | $97.80–$228.20 | 18% above | 25% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 INFECT AGNT DNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES 87624 | $183.75 | $245.00 | $147.00–$343.00 | 90% above | 25% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCOSYLATED A1C 83036 | $72.83 | $97.10 | $58.26–$135.94 | 4% above | 25% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY (HBSAB) 86706 | $56.25 | $75.00 | $45.00–$105.00 | 64% above | 25% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 INFECT AGNT ATGN DETECT IA HEPATITIS B SURFACE ANTIGEN 87340 | $52.50 | $70.00 | $42.00–$98.00 | 4% above | 25% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY 86803 | $75.00 | $100.00 | $60.00–$140.00 | 67% above | 25% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 INFECT AGNT DETECT NUC ACID HEP C QUANT 87522 | $225.00 | $300.00 | $180.00–$420.00 | 74% above | 25% |
| Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLX VIR1 IGG 86695 | $26.25 | $35.00 | $21.00–$49.00 | 21% below | 25% |
| Herpes blood test, HSV-2 antibody CPT 86696 HERPES SMPLX VIR 2 IGG 86696 | $37.50 | $50.00 | $30.00–$70.00 | 22% below | 25% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HISEN 86141 | $68.25 | $91.00 | $54.60–$127.40 | at median | 25% |
| Homocysteine blood test CPT 83090 HOMOCYSTINE 83090 | $89.25 | $119.00 | $71.40–$166.60 | 51% above | 25% |
| Insulin blood test CPT 83525 INSULIN LEVEL 83525 | $60.75 | $81.00 | $48.60–$113.40 | 5% above | 25% |
| Iron blood test (serum iron) CPT 83540 IRON 83540 | $33.75 | $45.00 | $27.00–$63.00 | 5% above | 25% |
| Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY 83550 | $46.50 | $62.00 | $37.20–$86.80 | at median | 25% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL 80069 | $46.50 | $62.00 | $37.20–$86.80 | 31% below | 25% |
| LH (luteinizing hormone) test CPT 83002 GONADOTROPIN LUTEINIZING HORMONE (LH) 83002 | $97.50 | $130.00 | $78.00–$182.00 | 1% below | 25% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE 83690 | $36.75 | $49.00 | $29.40–$68.60 | 27% below | 25% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL 80076 | $43.50 | $58.00 | $34.80–$81.20 | 40% below | 25% |
| Lyme disease antibody test CPT 86618 LYMES TOTAL 86618 | $90.00 | $120.00 | $72.00–$168.00 | 125% above | 25% |
| Magnesium blood test CPT 83735 MAGNESIUM RBC SO 83735.900 | $33.75 | $45.00 | $27.00–$63.00 | 65% above | 25% |
| Magnesium blood test CPT 83735 MAGNESIUM 83735 | $40.50 | $54.00 | $32.40–$75.60 | 99% above | 25% |
| Measles (rubeola) antibody test CPT 86765 ANTIBODY RUBEOLA 86765 | $68.25 | $91.00 | $54.60–$127.40 | 24% above | 25% |
| Mono test (heterophile antibody, Monospot) CPT 86308 MONOSCREEN 86308 | $27.75 | $37.00 | $22.20–$51.80 | 27% below | 25% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE 84154 | $95.25 | $127.00 | $76.20–$177.80 | 56% above | 25% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 ASSAY OF PSA TOTAL 84153 | $96.75 | $129.00 | $77.40–$180.60 | 49% above | 25% |
| Pap test (liquid-based, automated screening with review) CPT 88175 CYTO CERV THN AUTO 88175 | $139.50 | $186.00 | $111.60–$260.40 | 16% above | 25% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTO CERV THN MAN 88142 | $107.25 | $143.00 | $85.80–$200.20 | 18% above | 25% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT 83970 | $217.50 | $290.00 | $174.00–$406.00 | 5% above | 25% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL PLASMA WHOLE BLOOD (PTT) 85730 | $31.50 | $42.00 | $25.20–$58.80 | at median | 25% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 LUPUS ANTICOAG PANEL PTT 85730.900 | $31.50 | $42.00 | $25.20–$58.80 | at median | 25% |
| Progesterone blood test CPT 84144 PROGESTERONE 84144 | $109.50 | $146.00 | $87.60–$204.40 | at median | 25% |
| Prolactin blood test CPT 84146 MACROPROLACTIN 84146 | $102.00 | $136.00 | $81.60–$190.40 | 109% above | 25% |
| Prolactin blood test CPT 84146 PROLACTIN 84146 | $102.00 | $136.00 | $81.60–$190.40 | 109% above | 25% |
| Prothrombin time (PT/INR) clotting test CPT 85610 LUPUS ANTICOAG PANEL PT 85610.900 | $24.75 | $33.00 | $19.80–$46.20 | 24% above | 25% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PT INR FINGERSTICK-QW 85610 | $24.75 | $33.00 | $19.80–$46.20 | 24% above | 25% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME 85610 | $32.17 | $42.90 | $25.74–$60.06 | 61% above | 25% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCR PRESUMP DIRECT OPTICAL OBS 80305 | $75.00 | $100.00 | $60.00–$140.00 | at median | 25% |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A B DIRECT 87804 | $82.50 | $110.00 | $66.00–$154.00 | 2% below | 25% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 RPD GROUP A STREP SCREEN 87880 | $82.50 | $110.00 | $66.00–$154.00 | 1% above | 25% |
| Rheumatoid factor (RF) test CPT 86431 RA FACTOR QUANT 86431 | $30.00 | $40.00 | $24.00–$56.00 | 17% below | 25% |
| Rubella antibody test (immunity check) CPT 86762 ANTIBODY RUBELLA 86762 | $75.75 | $101.00 | $60.60–$141.40 | 69% above | 25% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 CDMR BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3 82274 | $84.00 | $112.00 | $67.20–$156.80 | 46% above | 25% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL 86592 | $23.25 | $31.00 | $18.60–$43.40 | at median | 25% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST CELL MEDIATED IMMUNITY 86480 | $290.25 | $387.00 | $232.20–$541.80 | 160% above | 25% |
| Testosterone blood test, total (not free testosterone) CPT 84403 ASSAY OF TESTOSTERONE TOTAL 84403 | $135.75 | $181.00 | $108.60–$253.40 | 123% above | 25% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL 84403.900 | $135.75 | $181.00 | $108.60–$253.40 | 123% above | 25% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL MEASURED 84403.902 | $135.75 | $181.00 | $108.60–$253.40 | 123% above | 25% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 ANTITHYROID AB ANTI TPO 86376 | $76.50 | $102.00 | $61.20–$142.80 | 39% above | 25% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE (TSH) 84443 | $126.00 | $168.00 | $100.80–$235.20 | 44% above | 25% |
| Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS BY NUCLEIC ACID DETECTION 87661 | $177.75 | $237.00 | $142.20–$331.80 | 168% above | 25% |
| Uric acid blood test CPT 84550 ASSAY OF BLOOD/URIC ACID 84550 | $24.00 | $32.00 | $19.20–$44.80 | 35% below | 25% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS AUTO W/SCOPE 81001 | $16.50 | $22.00 | $13.20–$30.80 | 54% below | 25% |
| Urinalysis without microscope exam, automated CPT 81003 URINE AUTO NO MICRO SGL ANALYT | $12.75 | $17.00 | $10.20–$23.80 | 26% below | 25% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS-DIPSTICK ONLY 81003 | $12.75 | $17.00 | $10.20–$23.80 | 26% below | 25% |
| Urinalysis without microscope exam, automated CPT 81003 DOT URINE AUTO DIPSTICK 81003 | $15.75 | $21.00 | $12.60–$29.40 | 9% below | 25% |
| Urinalysis without microscope exam, manual CPT 81002 CLINITEST DIPSTICK TABLET81002 | $17.25 | $23.00 | $13.80–$32.20 | 4% below | 25% |
| Urine culture for bacteria, with colony count CPT 87086 CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE 87086 | $60.53 | $80.70 | $48.42–$112.98 | 6% below | 25% |
| Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST 81025 | $43.50 | $58.00 | $34.80–$81.20 | 22% below | 25% |
| Vitamin B12 (cobalamin) blood test CPT 82607 CYANOCOBALAMIN VITAMIN B-12 82607 | $79.50 | $106.00 | $63.60–$148.40 | 1% below | 25% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY 82306 | $192.75 | $257.00 | $154.20–$359.80 | 99% above | 25% |
| Zinc blood test CPT 84630 ZINC 84630.900 | $60.75 | $81.00 | $48.60–$113.40 | 130% above | 25% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN CHORIONIC HCG QUANTITATIVE 84702 | $79.50 | $106.00 | $63.60–$148.40 | 9% above | 25% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs North Dakota | Off list |
|---|---|---|---|---|---|
| Cardioversion, elective (restoring heart rhythm) CPT 92960 ED 92960 CARDIOVERSION | $528.00 | $704.00 | $422.40–$985.60 | 48% below | 25% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 TX RM 17000 DESTRUCT PREMALG LESN 1ST | $269.25 | $359.00 | $215.40–$502.60 | 83% above | 25% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 TX RM 69209 REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT | $113.25 | $151.00 | $90.60–$211.40 | 61% above | 25% |
| Earwax removal with instruments, one ear CPT 69210 ED 69210 REMV IMPACTED EAR WAX INSTRUMENT UNI | $114.00 | $152.00 | $91.20–$212.80 | 25% above | 25% |
| Earwax removal with instruments, one ear CPT 69210 TX RM 69210 REMOVAL IMPACTED CERUMEN EAR WAX | $114.00 | $152.00 | $91.20–$212.80 | 25% above | 25% |
| Incision and drainage of a simple or single skin abscess CPT 10060 ED 10060 I&D SKIN ABSCESS SMPL | $270.75 | $361.00 | $216.60–$505.40 | 7% above | 25% |
| Incision and drainage of a simple or single skin abscess CPT 10060 TX RM 10060 I&D ABSCESS SIMPLE | $270.75 | $361.00 | $216.60–$505.40 | 7% above | 25% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 TX RM 20550 INJ SINGLE TENDON LIGAMENT | $407.25 | $543.00 | $325.80–$760.20 | 118% above | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 TX RM 20610 ARTHROCENT ASP INJ JOINT BURSA MAJOR WO US GUID | $407.25 | $543.00 | $325.80–$760.20 | 62% above | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ED 20610 ASP INJ JOINT BURSA MAJOR WO US GUID | $407.25 | $543.00 | $325.80–$760.20 | 62% above | 25% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 TX RM 11981 INSERTION DRUG DELIV IMPLANT | $168.00 | $224.00 | $134.40–$313.60 | 13% below | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 TX RM 20605 ARTHRO ASP INJ JOINT BURSA INTERMED WO US GUID | $407.25 | $543.00 | $325.80–$760.20 | 34% above | 25% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 TX RM 20600 DRAIN INJ JOINT BURSA WO US | $407.25 | $543.00 | $325.80–$760.20 | 52% above | 25% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 ED 12031 LYR CLSR OF WND 2.5CM OR < | $517.50 | $690.00 | $414.00–$966.00 | 23% above | 25% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 TX RM 11400 EXC BENIGN LESN BGN TRUNK ARM LEG 0.5CM< | $931.50 | $1,242.00 | $745.20–$1,738.80 | 76% above | 25% |
| Nail removal (partial or complete), one nail CPT 11730 TX RM 11730 REMOV NAIL PLATE PART COMP SGL | $270.75 | $361.00 | $216.60–$505.40 | 12% above | 25% |
| Nail removal (partial or complete), one nail CPT 11730 ED 11730 REMV OF NAIL PLATE | $270.75 | $361.00 | $216.60–$505.40 | 12% above | 25% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 TX RM 11750 REMOVE NAIL BED PERMANENT | $517.50 | $690.00 | $414.00–$966.00 | 26% above | 25% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 ED 11750 REMV OF NAIL BED | $524.25 | $699.00 | $419.40–$978.60 | 28% above | 25% |
| Removal of a foreign object under the skin, simple CPT 10120 ED 10120 INC&REMV FB SMPL | $517.50 | $690.00 | $414.00–$966.00 | 26% above | 25% |
| Short arm splint (forearm and hand) CPT 29125 ED 29125 APPL SPLINT FOREARM | $175.50 | $234.00 | $140.40–$327.60 | at median | 25% |
| Short arm splint (forearm and hand) CPT 29125 TX RM 29125 APPLY FOREARM SPLIT STATIC | $175.50 | $234.00 | $140.40–$327.60 | at median | 25% |
| Short leg splint (calf to foot) CPT 29515 TX RM 29515 APPLY SHORT LEG SPLINT | $222.00 | $296.00 | $177.60–$414.40 | 9% above | 25% |
| Short leg splint (calf to foot) CPT 29515 ED 29515 APPL SPLINT SHORT LEG | $521.25 | $695.00 | $417.00–$973.00 | 156% above | 25% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 ED 12001 RPR SUPERFCL WND 2.5CM OR< | $269.25 | $359.00 | $215.40–$502.60 | 5% above | 25% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 TX RM 12001 RPR SUPRFICIAL WND <= 2.5CM | $270.75 | $361.00 | $216.60–$505.40 | 6% above | 25% |
| Skin biopsy, punch, one lesion CPT 11104 TX RM 11104 PUNCH BX SKIN SINGLE LESION | $517.50 | $690.00 | $414.00–$966.00 | 72% above | 25% |
| Skin tag removal, up to 15 tags CPT 11200 TX RM 11200 REMOVE SKIN TAG UP TO 15 | $270.75 | $361.00 | $216.60–$505.40 | 33% above | 25% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 ED 12002 RPR SUPERFCL WND 2.6-7.5CM | $269.25 | $359.00 | $215.40–$502.60 | 27% above | 25% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 TX RM 12002 REPAIR LAC SIMPLE SCALP HAND FOOT GENITAL 2.6 TO 7.5CM | $270.75 | $361.00 | $216.60–$505.40 | 28% above | 25% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 ED 12011 RPR SUPERFCL WND 2.5CM OR< | $269.25 | $359.00 | $215.40–$502.60 | 6% above | 25% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 TX RM 12011 REPAIR LAC SIMPLE FACE/EAR/LIPS <2.5CM | $270.75 | $361.00 | $216.60–$505.40 | 7% above | 25% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TX RM 11102 TANGENTIAL BX SKIN SINGLE LESION | $270.75 | $361.00 | $216.60–$505.40 | 36% above | 25% |
| Thoracentesis with imaging guidance CPT 32555 SURG 32555 THORACENTESIS W IMAGING | $792.75 | $1,057.00 | $634.20–$1,479.80 | at median | 25% |
| Trigger point injections, 1 or 2 muscles CPT 20552 TX RM 20552 INJ TRIGGER PT 1-2 MUSCLE(S) | $407.25 | $543.00 | $325.80–$760.20 | 34% above | 25% |
| Wart removal, up to 14 warts CPT 17110 TX RM 17110 DESTRUCT BENIGN LESN 1-14 | $270.75 | $361.00 | $216.60–$505.40 | 33% above | 25% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 ED 11042 DEBR SKN SUBQ TISS 20 CM < | $517.50 | $690.00 | $414.00–$966.00 | 26% above | 25% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 TX RM 11042 DEBR SKIN SUBQ TISSUE | $517.50 | $690.00 | $414.00–$966.00 | 26% above | 25% |
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 TRANSFUSION BLOOD | $3,326.66 | $4,435.55 | $2,661.33–$6,209.77 | 345% above | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 ED 94640 NON OR PRES'D INHALATION TX | $60.75 | $81.00 | $48.60–$113.40 | 53% below | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEB RX PFT | $60.75 | $81.00 | $48.60–$113.40 | 53% below | 25% |
| Critical care, first 30 to 74 minutes CPT 99291 ED 99291 CRITICAL CARE E&M 30-74 MIN | $1,895.87 | $2,527.83 | $1,516.70–$3,538.96 | 117% above | 25% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG TRACING WO INTERP | $55.69 | $74.25 | $44.55–$103.95 | 54% below | 25% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED 99281 EMER CASE LEVEL I | $198.11 | $264.15 | $158.49–$369.81 | 52% above | 25% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED 99282 EMER CASE LEVEL II | $356.31 | $475.08 | $285.05–$665.11 | 55% above | 25% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED 99283 EMER CASE LEVEL III | $623.00 | $830.67 | $498.40–$1,162.94 | 68% above | 25% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED 99284 EMER CASE LEVEL IV | $958.10 | $1,277.46 | $766.48–$1,788.44 | 45% above | 25% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED 99285 EMER CASE LEVEL V | $1,379.48 | $1,839.30 | $1,103.58–$2,575.02 | 38% above | 25% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRAT INITIAL 31-60MINS | $267.53 | $356.70 | $214.02–$499.38 | 17% below | 25% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 ED 96360 IV INFUS THERAPY HYDRATION FLUIDS INITIAL 31 MIN-1HR | $372.75 | $497.00 | $298.20–$695.80 | 16% above | 25% |
| IV infusion of a medicine, first hour CPT 96365 ED 96365 IV INFUS THER PROPH DIAG INITIAL UP TO 1HR | $372.75 | $497.00 | $298.20–$695.80 | 5% below | 25% |
| IV infusion of a medicine, first hour CPT 96365 IV INFUSION TX PROPH DX INIT TO 1HR | $1,738.91 | $2,318.55 | $1,391.13–$3,245.97 | 343% above | 25% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 ED 96372 THER PROPH DIAG INJECTION SQ IM | $114.00 | $152.00 | $91.20–$212.80 | 225% above | 25% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 SC IM INJECTION | $4,452.62 | $5,936.83 | $3,562.10–$8,311.56 | 12586% above | 25% |
| Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSC RE ED EA 15MIN 97112 | $115.50 | $154.00 | $92.40–$215.60 | 4% above | 25% |
| Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW COMPLEXITY 97165 | $295.50 | $394.00 | $236.40–$551.60 | 14% above | 25% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH COMPLEXITY 97163 | $309.75 | $413.00 | $247.80–$578.20 | 3% above | 25% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMPLEXITY 97161 | $276.00 | $368.00 | $220.80–$515.20 | 5% above | 25% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MODERATE COMPLEXITY 97162 | $293.25 | $391.00 | $234.60–$547.40 | 6% above | 25% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 15 MIN 97140 | $97.50 | $130.00 | $78.00–$182.00 | 5% below | 25% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THER EXERCISE EA 15 MIN 97110 | $106.50 | $142.00 | $85.20–$198.80 | at median | 25% |
| Speech and language evaluation CPT 92523 SPEECH EVAL LANG COMP EXPRESSION 92523 | $756.00 | $1,008.00 | $604.80–$1,411.20 | 56% above | 25% |
| Speech therapy session, individual CPT 92507 SPEECH THERAPY TX 92507 | $261.00 | $348.00 | $208.80–$487.20 | 10% above | 25% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 THER ACTIVITIES EA15 MIN 97530 | $132.00 | $176.00 | $105.60–$246.40 | 15% above | 25% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY | $348.75 | $465.00 | $279.00–$651.00 | 32% above | 25% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY NURSING | $348.75 | $465.00 | $279.00–$651.00 | 32% above | 25% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs North Dakota | Off list |
|---|---|---|---|---|---|
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN INFLUENZA VIR VAC | $51.00 | $68.00 | $40.80–$95.20 | 127% above | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ED 90471 IMMUNE ADMIN 1 VACCINE | $52.50 | $70.00 | $42.00–$98.00 | 133% above | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUN ADMIN 1 VACCINE | $53.25 | $71.00 | $42.60–$99.40 | 137% above | 25% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ED 90472 IMMUN ADMIN EA ADDL VACCINE | $37.50 | $50.00 | $30.00–$70.00 | 28% above | 25% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUN ADMIN EA ADDL VACCINE | $37.50 | $50.00 | $30.00–$70.00 | 28% above | 25% |
Source file: https://c0646bfd-6d8a-4859-b3e4-deaab1755134.usrfiles.com/ugd/c0646b_29458d89e0d74059b9cc73adf6458d9c.json