Hospital

Southwest Healthcare Services

Southwest Healthcare Services in Bowman, ND publishes cash prices for 259 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are below the North Dakota median for 144 of 255 procedures and above it for 105. By typical cash price it ranks #11 of 22 North Dakota hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

802 2ND STREET NW STE 1, BOWMAN, ND, 58623 Collected Sep 27, 2026 Source price file (701) 523-6555

Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 351313 · CMS hospital register

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 2 actions for a hospital named Southwest Healthcare Services in Bowman, ND:

Sep 5, 2025 Corrective action plan requested
Jan 21, 2026 Case closed

Corrective action plan requested: CMS asked the hospital to submit a plan to fix the problems it found. Case closed: CMS closed the case after the hospital addressed the problems.

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

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs North Dakota	Off list
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 ANKLE/BRACHIAL INDICES 2 93922	$147.60	$164.00	—	47% below	10%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 ANKLE BRACHIAL INDICES	$208.80	$232.00	—	24% below	10%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US ABI LIMITED AT REST	$261.00	$290.00	—	5% below	10%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US ABI LIMITED AT REST	$261.00	$290.00	—	—	10%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA THORACIC AORTA CHEST W CONTRAST	$2,141.10	$2,379.00	—	at median	10%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST-CT ABD/PELVIS W CON	$2,141.10	$2,379.00	—	at median	10%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST W CONTRAST	$2,141.10	$2,379.00	—	at median	10%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA THORACIC AORTA CHEST W CONTRAST	$2,141.10	$2,379.00	—	—	10%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST W CONTRAST	$2,141.10	$2,379.00	—	—	10%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST-CT ABD/PELVIS W CON	$2,141.10	$2,379.00	—	—	10%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT RENAL STONE ABDOMEN PELVIS WO CONTR	$1,121.40	$1,246.00	—	15% below	10%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABDOMEN PELVIS W ORAL CONTRAST ONLY	$1,121.40	$1,246.00	—	15% below	10%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABDOMEN PELVIS WO CONTRAST	$1,121.40	$1,246.00	—	15% below	10%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABDOMEN PELVIS W ORAL CONTRAST ONLY	$1,121.40	$1,246.00	—	—	10%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT RENAL STONE ABDOMEN PELVIS WO CONTR	$1,121.40	$1,246.00	—	—	10%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABDOMEN PELVIS WO CONTRAST	$1,121.40	$1,246.00	—	—	10%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN PELVIS W CONTRAST	$2,437.20	$2,708.00	—	at median	10%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN PELVIS W CONTRAST	$2,437.20	$2,708.00	—	—	10%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT CHEST ABDOMEN PELVIS WO W CONTRAST PF	$1,540.80	$1,712.00	—	46% below	10%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN PELVIS WO W CONTRAST	$2,754.90	$3,061.00	—	4% below	10%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT HEMATURIA ABDOMEN PELVIS WO W CONTR	$2,754.90	$3,061.00	—	4% below	10%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT CHEST ABDOMEN PELVIS WO W CONTRAST PF	$1,540.80	$1,712.00	—	—	10%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT HEMATURIA ABDOMEN PELVIS WO W CONTR	$2,754.90	$3,061.00	—	—	10%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN PELVIS WO W CONTRAST	$2,754.90	$3,061.00	—	—	10%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN UPPER W CONTRAST	$1,916.10	$2,129.00	—	21% above	10%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN UPPER W CONTRAST	$1,916.10	$2,129.00	—	—	10%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN UPPER WO CONTRAST	$896.40	$996.00	—	20% below	10%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN UPPER WO CONTRAST	$896.40	$996.00	—	—	10%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUSES WO CONTRAST	$964.80	$1,072.00	—	9% below	10%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL WO CONTRAST	$964.80	$1,072.00	—	9% below	10%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT FACIAL BONES WO CONTRAST	$964.80	$1,072.00	—	9% below	10%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SINUSES WO CONTRAST	$964.80	$1,072.00	—	—	10%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT FACIAL BONES WO CONTRAST	$964.80	$1,072.00	—	—	10%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL WO CONTRAST	$964.80	$1,072.00	—	—	10%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONTRAST	$726.30	$807.00	—	23% below	10%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD CERVICAL SPINE WO CONTRAST	$726.30	$807.00	—	23% below	10%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO CONTRAST	$726.30	$807.00	—	—	10%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD CERVICAL SPINE WO CONTRAST	$726.30	$807.00	—	—	10%
CT scan of the head with contrast CPT 70460 CT HEAD W CONTRAST	$1,053.90	$1,171.00	—	17% below	10%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD W CONTRAST	$1,053.90	$1,171.00	—	—	10%
CT scan of the head without and with contrast CPT 70470 CT HEAD WO W CONTRAST	$1,268.10	$1,409.00	—	12% below	10%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD WO W CONTRAST	$1,268.10	$1,409.00	—	—	10%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE WO CONTRAST	$909.90	$1,011.00	—	29% below	10%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE WO CONTRAST	$909.90	$1,011.00	—	—	10%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT HEAD CERVICAL SPINE WO CONTRAST PF	$726.30	$807.00	—	45% below	10%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL SPINE WO CONTRAST	$917.10	$1,019.00	—	30% below	10%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT HEAD CERVICAL SPINE WO CONTRAST PF	$726.30	$807.00	—	—	10%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERVICAL SPINE WO CONTRAST	$917.10	$1,019.00	—	—	10%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CONTRAST	$1,922.40	$2,136.00	—	22% above	10%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W CONTRAST	$1,922.40	$2,136.00	—	—	10%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US CAROTID BILATERAL	$664.20	$738.00	—	—	10%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US MYOCARDIAL STRAIN	$90.00	$100.00	—	86% below	10%
Chest X-ray, 2 views CPT 71046 XR CHEST 2 VIEWS	$116.10	$129.00	—	27% below	10%
Chest X-ray, 2 views inpatient CPT 71046 XR CHEST 2 VIEWS	$116.10	$129.00	—	—	10%
Chest X-ray, single view CPT 71045 XR CHEST LATERAL DECUB 1 VIEW	$85.50	$95.00	—	36% below	10%
Chest X-ray, single view CPT 71045 XR BABYGRAM 1 VIEW CHEST ABDOMEN	$85.50	$95.00	—	36% below	10%
Chest X-ray, single view CPT 71045 XR CHEST 1 VIEW	$85.50	$95.00	—	36% below	10%
Chest X-ray, single view inpatient CPT 71045 XR CHEST LATERAL DECUB 1 VIEW	$85.50	$95.00	—	—	10%
Chest X-ray, single view inpatient CPT 71045 XR CHEST 1 VIEW	$85.50	$95.00	—	—	10%
Chest X-ray, single view inpatient CPT 71045 XR BABYGRAM 1 VIEW CHEST ABDOMEN	$85.50	$95.00	—	—	10%
Complete ultrasound of the back of the abdomen, such as both kidneys both sides CPT 76770 US KIDNEY BILAT RETRO COMP	$393.30	$437.00	—	—	10%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL COMPLETE	$393.30	$437.00	—	2% below	10%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient both sides CPT 76770 US KIDNEY BILAT RETRO COMP	$393.30	$437.00	—	—	10%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITONEAL COMPLETE	$393.30	$437.00	—	—	10%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 XR DEXA BONE DENSITY	$144.00	$160.00	—	46% below	10%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 XR DEXA BONE DENSITY	$144.00	$160.00	—	—	10%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST ABDOMEN PELVIS WO CONTRAST PF	$907.20	$1,008.00	—	22% below	10%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST WO CONTRAST	$907.20	$1,008.00	—	22% below	10%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST ABDOMEN PELVIS WO CONTRAST	$907.20	$1,008.00	—	22% below	10%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST FU LUNG CANCER SCREEN WO CONTR	$907.20	$1,008.00	—	22% below	10%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST ABDOMEN PELVIS WO CONTRAST PF	$907.20	$1,008.00	—	—	10%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST ABDOMEN PELVIS WO CONTRAST	$907.20	$1,008.00	—	—	10%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST WO CONTRAST	$907.20	$1,008.00	—	—	10%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST FU LUNG CANCER SCREEN WO CONTR	$907.20	$1,008.00	—	—	10%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST ABDOMEN PELVIS W CONTRAST	$1,244.70	$1,383.00	—	12% below	10%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W CONTRAST	$1,244.70	$1,383.00	—	12% below	10%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST ABDOMEN PELVIS W CONTRAST PF	$1,244.70	$1,383.00	—	12% below	10%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST W CONTRAST	$1,244.70	$1,383.00	—	—	10%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST ABDOMEN PELVIS W CONTRAST	$1,244.70	$1,383.00	—	—	10%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST ABDOMEN PELVIS W CONTRAST PF	$1,244.70	$1,383.00	—	—	10%
Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO DIGITAL BILAT DIAGNOSTIC	$568.80	$632.00	—	—	10%
Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO BILAT 3D DIAGNOSTIC	$582.30	$647.00	—	—	10%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO DIGITAL BILAT DIAGNOSTIC	$568.80	$632.00	—	—	10%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO BILAT 3D DIAGNOSTIC	$582.30	$647.00	—	—	10%
Diagnostic mammogram, one breast one side CPT 77065 MAMMO UNILAT 3D DIAGNOSTIC	$455.40	$506.00	—	19% above	10%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO UNILAT 3D DIAGNOSTIC	$455.40	$506.00	—	—	10%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US VENOUS EXTREMITY BILAT	$669.60	$744.00	—	—	10%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US ECHO W/STRAIN COMP	$905.40	$1,006.00	—	11% above	10%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US ECHOCARDIOGRAPHY COMPLETE	$905.40	$1,006.00	—	11% above	10%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 RT SLEEP STUDY AND CPAP TITRATION	$2,208.60	$2,454.00	—	5% below	10%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LIMITED	$318.60	$354.00	—	16% below	10%
Limited abdominal ultrasound of one organ or area, such as the gallbladder one side CPT 76705 US ABDOMEN RIGHT UPPER QUADRANT	$318.60	$354.00	—	16% below	10%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN LIMITED	$318.60	$354.00	—	—	10%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient one side CPT 76705 US ABDOMEN RIGHT UPPER QUADRANT	$318.60	$354.00	—	—	10%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT CHEST LUNG CANCER SCREEN WO CONTRAT	$247.50	$275.00	—	62% below	10%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT CHEST LUNG CANCER SCREEN WO CONTRAT	$247.50	$275.00	—	—	10%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN WO CONTRAST	$1,433.70	$1,593.00	—	25% below	10%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN WO W CONTRAST	$2,663.10	$2,959.00	—	17% below	10%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO CONTRAST	$1,400.40	$1,556.00	—	15% below	10%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN WO W CONTRAST	$2,359.80	$2,622.00	—	17% below	10%
MRI of the lower back, no contrast dye CPT 72148 MRI L SPINE WO CONTRAST	$1,354.50	$1,505.00	—	26% below	10%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI L SPINE WO W CONTRAST	$2,385.90	$2,651.00	—	28% below	10%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI T SPINE WO CONTRAST	$1,350.90	$1,501.00	—	31% below	10%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI C SPINE WO W CONTRAST	$2,392.20	$2,658.00	—	22% below	10%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI C SPINE WO CONTRAST	$1,350.90	$1,501.00	—	27% below	10%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS WO W CONTRAST	$2,655.90	$2,951.00	—	14% below	10%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS WO CONTRAST	$1,816.20	$2,018.00	—	11% below	10%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US BLADDER CAPACITY POSTVOID	$123.30	$137.00	—	61% below	10%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC LTD NON OB EG FOLLICLE	$123.30	$137.00	—	61% below	10%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIC LTD NON OB EG FOLLICLE	$123.30	$137.00	—	—	10%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US BLADDER CAPACITY POSTVOID	$123.30	$137.00	—	—	10%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC COMPLETE NON OB	$389.70	$433.00	—	at median	10%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC COMPLETE NON OB	$389.70	$433.00	—	—	10%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB 2ND/3RD TRIMESTER COMP	$469.80	$522.00	—	2% above	10%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB 2ND/3RD TRIMESTER COMP	$469.80	$522.00	—	—	10%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB 1ST TRIMESTER < 14 WEEKS	$375.30	$417.00	—	at median	10%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB 1ST TRIMESTER < 14 WEEKS	$375.30	$417.00	—	—	10%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB LTD FETAL VIABILITY	$268.20	$298.00	—	3% below	10%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB LTD FETAL VIABILITY	$268.20	$298.00	—	—	10%
Screening mammogram, both breasts both sides CPT 77067 MAMMO DIGITAL BILAT SCREENING	$470.70	$523.00	—	—	10%
Screening mammogram, both breasts both sides CPT 77067 MAMMO BILAT 3D SCREENING	$481.50	$535.00	—	—	10%
Screening mammogram, both breasts inpatient both sides CPT 77067 MAMMO DIGITAL BILAT SCREENING	$470.70	$523.00	—	—	10%
Screening mammogram, both breasts inpatient both sides CPT 77067 MAMMO BILAT 3D SCREENING	$481.50	$535.00	—	—	10%
Sleep study in a lab (polysomnography) CPT 95810 RT SLEEP STUDY	$2,112.30	$2,347.00	—	6% below	10%
Transvaginal pelvic ultrasound CPT 76830 US PELVIC ENDOVAGINAL NON OB	$462.60	$514.00	—	2% above	10%
Transvaginal pelvic ultrasound inpatient CPT 76830 US PELVIC ENDOVAGINAL NON OB	$462.60	$514.00	—	—	10%
Transvaginal ultrasound during pregnancy CPT 76817 US OB ENDOVAGINAL	$304.20	$338.00	—	3% above	10%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB ENDOVAGINAL	$304.20	$338.00	—	—	10%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE	$423.00	$470.00	—	17% below	10%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE	$423.00	$470.00	—	—	10%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM	$377.10	$419.00	—	2% below	10%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM	$377.10	$419.00	—	—	10%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US NECK HEAD SOFT TISSUE	$453.60	$504.00	—	at median	10%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID	$453.60	$504.00	—	at median	10%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US THYROID	$453.60	$504.00	—	—	10%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US NECK HEAD SOFT TISSUE	$453.60	$504.00	—	—	10%
X-ray of the abdomen, 1 view CPT 74018 XR ABDOMEN 1 VIEW	$106.20	$118.00	—	7% below	10%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABDOMEN 1 VIEW	$106.20	$118.00	—	—	10%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR LUMBAR SPINE 2 OR 3 VIEWS	$145.80	$162.00	—	15% below	10%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR LUMBAR SPINE 2 OR 3 VIEWS	$145.80	$162.00	—	—	10%
X-ray of the lower back, 4 or more views CPT 72110 XR LUMBAR SPINE MIN 4 VIEWS	$192.60	$214.00	—	17% below	10%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR LUMBAR SPINE MIN 4 VIEWS	$192.60	$214.00	—	—	10%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR THORACIC SPINE 2 VIEWS	$115.20	$128.00	—	20% below	10%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR THORACIC SPINE 2 VIEWS	$115.20	$128.00	—	—	10%
X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES MIN 3 VIEWS	$149.40	$166.00	—	1% above	10%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NASAL BONES MIN 3 VIEWS	$149.40	$166.00	—	—	10%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR CERVICAL SPINE 2 OR 3 VIEWS	$144.00	$160.00	—	8% below	10%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR CERVICAL SPINE 2 OR 3 VIEWS	$144.00	$160.00	—	—	10%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS 1 OR 2 VIEWS	$97.20	$108.00	—	35% below	10%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS 1 OR 2 VIEWS	$97.20	$108.00	—	—	10%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM/COCCYX 2 VWS	$119.70	$133.00	—	18% below	10%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR SACRUM/COCCYX 2 VWS	$119.70	$133.00	—	—	10%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs North Dakota	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT	$36.90	$41.00	—	9% below	10%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT	$36.90	$41.00	—	—	10%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST	$36.00	$40.00	—	19% below	10%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST	$36.00	$40.00	—	—	10%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS ACUTE PANEL (ABC)	$325.80	$362.00	—	50% above	10%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS ACUTE PANEL (ABC)	$325.80	$362.00	—	—	10%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN TOMATO IGE	$36.00	$40.00	—	150% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN FOOD AVOCADO IGE	$36.00	$40.00	—	150% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN EGG YOLK IGE	$36.00	$40.00	—	150% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN COCONUT IGE	$36.00	$40.00	—	150% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 CHG ALLERGEN SPECIFIC IGE EACH	$36.00	$40.00	—	150% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN BANANA IGE	$36.00	$40.00	—	150% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 HYPERSENSITIVITY PNEUMONITIS PANEL 1	$36.00	$40.00	—	150% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN WHEAT IGE	$36.00	$40.00	—	150% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN MILK COWS IGE	$36.00	$40.00	—	150% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SHELLFISH IGE	$36.00	$40.00	—	150% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PECAN IGE	$36.00	$40.00	—	150% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN WALNUT IGE	$36.00	$40.00	—	150% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SOYBEAN IGE	$36.00	$40.00	—	150% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN ALMOND IGE	$36.00	$40.00	—	150% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PISTASHIO IGE	$36.00	$40.00	—	150% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CASHEW IGE	$36.00	$40.00	—	150% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PEANUT IGE	$36.00	$40.00	—	150% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN FOOD RICE IGE	$36.00	$40.00	—	150% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN HAZELNUT IGE	$36.00	$40.00	—	150% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN LATEX OCCUPATIONAL IGE	$36.00	$40.00	—	150% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN FOOD GRAPE IGE	$36.00	$40.00	—	150% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN GOAT MILK IGE	$36.00	$40.00	—	150% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN EGG WHITE IGE	$36.00	$40.00	—	150% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN MANGO IGE	$36.00	$40.00	—	150% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN ONION IGE	$36.00	$40.00	—	150% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PEACH IGE	$36.00	$40.00	—	150% above	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN BANANA IGE	$36.00	$40.00	—	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN ALMOND IGE	$36.00	$40.00	—	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN TOMATO IGE	$36.00	$40.00	—	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PISTASHIO IGE	$36.00	$40.00	—	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN MANGO IGE	$36.00	$40.00	—	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CASHEW IGE	$36.00	$40.00	—	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN EGG WHITE IGE	$36.00	$40.00	—	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PEANUT IGE	$36.00	$40.00	—	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PEACH IGE	$36.00	$40.00	—	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHG ALLERGEN SPECIFIC IGE EACH	$36.00	$40.00	—	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN COCONUT IGE	$36.00	$40.00	—	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN ONION IGE	$36.00	$40.00	—	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN FOOD GRAPE IGE	$36.00	$40.00	—	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PECAN IGE	$36.00	$40.00	—	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN GOAT MILK IGE	$36.00	$40.00	—	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN WALNUT IGE	$36.00	$40.00	—	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN LATEX OCCUPATIONAL IGE	$36.00	$40.00	—	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN HAZELNUT IGE	$36.00	$40.00	—	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SOYBEAN IGE	$36.00	$40.00	—	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HYPERSENSITIVITY PNEUMONITIS PANEL 1	$36.00	$40.00	—	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN EGG YOLK IGE	$36.00	$40.00	—	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN WHEAT IGE	$36.00	$40.00	—	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN FOOD AVOCADO IGE	$36.00	$40.00	—	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN FOOD RICE IGE	$36.00	$40.00	—	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN MILK COWS IGE	$36.00	$40.00	—	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SHELLFISH IGE	$36.00	$40.00	—	—	10%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATED PEPTIDE AB IGG/A	$90.00	$100.00	—	58% above	10%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINATED PEPTIDE AB IGG/A	$90.00	$100.00	—	—	10%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA WITH REFLEX	$83.70	$93.00	—	47% above	10%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA WITH REFLEX	$83.70	$93.00	—	—	10%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 PROBNP	$244.80	$272.00	—	15% above	10%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP	$244.80	$272.00	—	15% above	10%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP	$244.80	$272.00	—	—	10%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 PROBNP	$244.80	$272.00	—	—	10%
Basic metabolic panel (blood test) CPT 80048 BOWMAN VET BMP	$34.20	$38.00	—	54% below	10%
Basic metabolic panel (blood test) CPT 80048 BMP	$58.50	$65.00	—	21% below	10%
Basic metabolic panel (blood test) inpatient CPT 80048 BOWMAN VET BMP	$34.20	$38.00	—	—	10%
Basic metabolic panel (blood test) inpatient CPT 80048 BMP	$58.50	$65.00	—	—	10%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 CHG TISSUE EXAM LEVEL 4	$113.40	$126.00	—	at median	10%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 CHG TISSUE EXAM LEVEL 4	$113.40	$126.00	—	—	10%
Blood culture for bacteria CPT 87040 CULTURE BLOOD	$72.00	$80.00	—	5% below	10%
Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD	$72.00	$80.00	—	—	10%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$17.10	$19.00	—	at median	10%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 CHG BLOOD DRAW ON CALL	$45.00	$50.00	—	162% above	10%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE	$17.10	$19.00	—	—	10%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 CHG BLOOD DRAW ON CALL	$45.00	$50.00	—	—	10%
Blood glucose (sugar) test CPT 82947 BOWMAN VET GLUCOSE	$14.40	$16.00	—	44% below	10%
Blood glucose (sugar) test CPT 82947 GLUCOSE	$27.00	$30.00	—	5% above	10%
Blood glucose (sugar) test inpatient CPT 82947 BOWMAN VET GLUCOSE	$14.40	$16.00	—	—	10%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE	$27.00	$30.00	—	—	10%
Blood lead test CPT 83655 HEAVY METAL SCR LEAD	$83.70	$93.00	—	183% above	10%
Blood lead test CPT 83655 LEAD CAPILLARY	$83.70	$93.00	—	183% above	10%
Blood lead test CPT 83655 LEAD	$83.70	$93.00	—	183% above	10%
Blood lead test inpatient CPT 83655 HEAVY METAL SCR LEAD	$83.70	$93.00	—	—	10%
Blood lead test inpatient CPT 83655 LEAD	$83.70	$93.00	—	—	10%
Blood lead test inpatient CPT 83655 LEAD CAPILLARY	$83.70	$93.00	—	—	10%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG SERUM QUALITATIVE SENDOUT	$52.20	$58.00	—	23% below	10%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG URINE QUALITATIVE IN HOUSE	$52.20	$58.00	—	23% below	10%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG SERUM QUALITATIVE SENDOUT	$52.20	$58.00	—	—	10%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG URINE QUALITATIVE IN HOUSE	$52.20	$58.00	—	—	10%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB ABO	$20.70	$23.00	—	47% below	10%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB ABO	$20.70	$23.00	—	—	10%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP	$36.00	$40.00	—	45% above	10%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP	$36.00	$40.00	—	—	10%
C. difficile toxin gene test (stool PCR) CPT 87493 CLOSTRIDIUM DIFFICILE BY PCR	$254.70	$283.00	—	38% above	10%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 CLOSTRIDIUM DIFFICILE BY PCR	$254.70	$283.00	—	—	10%
CA 19-9 blood test (tumor marker) CPT 86301 CANCER ANTIGEN GI 19 9	$144.00	$160.00	—	42% above	10%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CANCER ANTIGEN GI 19 9	$144.00	$160.00	—	—	10%
CA-125 blood test (ovarian cancer marker) CPT 86304 CANCER ANTIGEN 125	$144.00	$160.00	—	36% above	10%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CANCER ANTIGEN 125	$144.00	$160.00	—	—	10%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID19 TRAVEL NPL PCR	$184.50	$205.00	—	54% above	10%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID19 RAPID NAAT INHOUSE	$185.40	$206.00	—	54% above	10%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID19 TRAVEL NPL PCR	$184.50	$205.00	—	—	10%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID19 RAPID NAAT INHOUSE	$185.40	$206.00	—	—	10%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHG CHLAMYDIA SCREEN	$63.00	$70.00	—	45% below	10%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHG CHLAMYDIA SCREEN	$63.00	$70.00	—	—	10%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE	$91.80	$102.00	—	35% above	10%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE	$91.80	$102.00	—	—	10%
Complete blood count (CBC) with differential CPT 85025 BOWMAN VET CBC	$34.20	$38.00	—	41% below	10%
Complete blood count (CBC) with differential CPT 85025 CHG CBC W AUTO DIFF	$54.00	$60.00	—	7% below	10%
Complete blood count (CBC) with differential inpatient CPT 85025 BOWMAN VET CBC	$34.20	$38.00	—	—	10%
Complete blood count (CBC) with differential inpatient CPT 85025 CHG CBC W AUTO DIFF	$54.00	$60.00	—	—	10%
Complete blood count (CBC), no differential CPT 85027 HEMOGRAM	$45.00	$50.00	—	1% below	10%
Complete blood count (CBC), no differential CPT 85027 CHG HEMOGRAM	$45.00	$50.00	—	1% below	10%
Complete blood count (CBC), no differential CPT 85027 CHG BLOOD SMEARS AUTO CBC	$45.00	$50.00	—	1% below	10%
Complete blood count (CBC), no differential inpatient CPT 85027 CHG BLOOD SMEARS AUTO CBC	$45.00	$50.00	—	—	10%
Complete blood count (CBC), no differential inpatient CPT 85027 HEMOGRAM	$45.00	$50.00	—	—	10%
Complete blood count (CBC), no differential inpatient CPT 85027 CHG HEMOGRAM	$45.00	$50.00	—	—	10%
Comprehensive metabolic panel (blood test) CPT 80053 BOWMAN VET CMP	$43.20	$48.00	—	54% below	10%
Comprehensive metabolic panel (blood test) CPT 80053 CMP	$72.00	$80.00	—	24% below	10%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 BOWMAN VET CMP	$43.20	$48.00	—	—	10%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 CMP	$72.00	$80.00	—	—	10%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEAS	$153.90	$171.00	—	62% above	10%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEAS	$153.90	$171.00	—	—	10%
Estradiol blood test CPT 82670 ESTRADIOL	$193.50	$215.00	—	142% above	10%
Estradiol blood test inpatient CPT 82670 ESTRADIOL	$193.50	$215.00	—	—	10%
FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE STIMULATING HORMONE	$126.90	$141.00	—	30% above	10%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FOLLICLE STIMULATING HORMONE	$126.90	$141.00	—	—	10%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN FECAL BY IMMUNOASSAY	$179.10	$199.00	—	52% above	10%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN FECAL BY IMMUNOASSAY	$179.10	$199.00	—	—	10%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$93.60	$104.00	—	31% above	10%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$93.60	$104.00	—	—	10%
Folate (folic acid) blood test CPT 82746 FOLATE	$100.80	$112.00	—	22% above	10%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE	$100.80	$112.00	—	—	10%
Free T3 thyroid hormone test CPT 84481 FREE T3	$115.20	$128.00	—	35% above	10%
Free T3 thyroid hormone test inpatient CPT 84481 FREE T3	$115.20	$128.00	—	—	10%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4	$63.00	$70.00	—	81% above	10%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4	$63.00	$70.00	—	—	10%
Free testosterone test CPT 84402 TESTOSTERONE FREE	$183.60	$204.00	—	206% above	10%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE	$183.60	$204.00	—	—	10%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$230.40	$256.00	—	at median	10%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL	$230.40	$256.00	—	—	10%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE TOLERANCE OB 1HR 50GM	$32.40	$36.00	—	17% below	10%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE TOLERANCE OB 1HR 50GM	$32.40	$36.00	—	—	10%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE UP TO 3 SPEC.	$86.40	$96.00	—	9% below	10%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE UP TO 3 SPEC.	$86.40	$96.00	—	—	10%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 CHG N GONORRHOEAE SCREEN	$63.00	$70.00	—	27% below	10%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 CHG N GONORRHOEAE SCREEN	$63.00	$70.00	—	—	10%
H. pylori stool antigen test CPT 87338 H PYLORI STOOL	$99.90	$111.00	—	2% above	10%
H. pylori stool antigen test inpatient CPT 87338 H PYLORI STOOL	$99.90	$111.00	—	—	10%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV SCREEN WITH REFLEX	$167.40	$186.00	—	61% above	10%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV RAPID OCCUPATIONAL EXPOSURE	$167.40	$186.00	—	61% above	10%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV SCREEN WITH REFLEX	$167.40	$186.00	—	—	10%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV RAPID OCCUPATIONAL EXPOSURE	$167.40	$186.00	—	—	10%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C	$67.50	$75.00	—	3% below	10%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C	$67.50	$75.00	—	—	10%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE ANTIGEN	$72.00	$80.00	—	43% above	10%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE ANTIGEN	$72.00	$80.00	—	—	10%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C VIR ABY SCRN RFLX RNA QUANT	$99.00	$110.00	—	121% above	10%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C VIR ABY SCRN RFLX RNA QUANT	$99.00	$110.00	—	—	10%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C QUANT	$297.00	$330.00	—	129% above	10%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C QUANT	$297.00	$330.00	—	—	10%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX 1	$91.80	$102.00	—	176% above	10%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX 1	$91.80	$102.00	—	—	10%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX 2	$134.10	$149.00	—	179% above	10%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX 2	$134.10	$149.00	—	—	10%
High-sensitivity CRP (hs-CRP) test CPT 86141 C REACTIVE PROTEIN HIGH SENSITIVITY	$90.00	$100.00	—	31% above	10%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C REACTIVE PROTEIN HIGH SENSITIVITY	$90.00	$100.00	—	—	10%
Insulin blood test CPT 83525 INSULIN	$79.20	$88.00	—	38% above	10%
Insulin blood test CPT 83525 INSULIN FREE SERUM IFS	$79.20	$88.00	—	38% above	10%
Insulin blood test inpatient CPT 83525 INSULIN	$79.20	$88.00	—	—	10%
Insulin blood test inpatient CPT 83525 INSULIN FREE SERUM IFS	$79.20	$88.00	—	—	10%
Iron blood test (serum iron) CPT 83540 IRON	$45.00	$50.00	—	41% above	10%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$45.00	$50.00	—	—	10%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING	$60.30	$67.00	—	30% above	10%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING	$60.30	$67.00	—	—	10%
Kidney function blood test panel CPT 80069 RENAL PANEL	$58.50	$65.00	—	13% below	10%
Kidney function blood test panel inpatient CPT 80069 RENAL PANEL	$58.50	$65.00	—	—	10%
LH (luteinizing hormone) test CPT 83002 LUTENIZING HORMONE	$126.90	$141.00	—	28% above	10%
LH (luteinizing hormone) test inpatient CPT 83002 LUTENIZING HORMONE	$126.90	$141.00	—	—	10%
Lipase blood test (pancreas enzyme) CPT 83690 BODY FLUID LIPASE	$47.70	$53.00	—	6% below	10%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$47.70	$53.00	—	6% below	10%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$47.70	$53.00	—	—	10%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 BODY FLUID LIPASE	$47.70	$53.00	—	—	10%
Liver function blood test panel CPT 80076 BOWMAN VET LIVER	$30.60	$34.00	—	58% below	10%
Liver function blood test panel CPT 80076 LIVER PROFILE	$54.90	$61.00	—	24% below	10%
Liver function blood test panel inpatient CPT 80076 BOWMAN VET LIVER	$30.60	$34.00	—	—	10%
Liver function blood test panel inpatient CPT 80076 LIVER PROFILE	$54.90	$61.00	—	—	10%
Lyme disease antibody test CPT 86618 LYMES DISEASE TOTAL	$117.90	$131.00	—	195% above	10%
Lyme disease antibody test inpatient CPT 86618 LYMES DISEASE TOTAL	$117.90	$131.00	—	—	10%
Magnesium blood test CPT 83735 URINE MAGNESIUM RANDOM	$29.70	$33.00	—	46% above	10%
Magnesium blood test CPT 83735 MAGNESIUM RBC	$46.80	$52.00	—	129% above	10%
Magnesium blood test CPT 83735 MAGNESIUM	$46.80	$52.00	—	129% above	10%
Magnesium blood test inpatient CPT 83735 URINE MAGNESIUM RANDOM	$29.70	$33.00	—	—	10%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$46.80	$52.00	—	—	10%
Magnesium blood test inpatient CPT 83735 MAGNESIUM RBC	$46.80	$52.00	—	—	10%
Measles (rubeola) antibody test CPT 86765 RUBEOLA IGM SHL	$89.10	$99.00	—	62% above	10%
Measles (rubeola) antibody test CPT 86765 MEASLES IMMUNE STATUS SHL	$89.10	$99.00	—	62% above	10%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA IGM SHL	$89.10	$99.00	—	—	10%
Measles (rubeola) antibody test inpatient CPT 86765 MEASLES IMMUNE STATUS SHL	$89.10	$99.00	—	—	10%
Mono test (heterophile antibody, Monospot) CPT 86308 MONONUCLEOSIS SCREEN	$36.00	$40.00	—	5% below	10%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONONUCLEOSIS SCREEN	$36.00	$40.00	—	—	10%
Obstetric blood test panel CPT 80055 PRENATAL PANEL WITH CBC & HBSAG	$326.70	$363.00	—	8% above	10%
Obstetric blood test panel inpatient CPT 80055 PRENATAL PANEL WITH CBC & HBSAG	$326.70	$363.00	—	—	10%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA PERCENTAGE FREE	$127.80	$142.00	—	109% above	10%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA PERCENTAGE FREE	$127.80	$142.00	—	—	10%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA DIAGNOSTIC	$127.80	$142.00	—	97% above	10%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL	$127.80	$142.00	—	97% above	10%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA DIAGNOSTIC	$127.80	$142.00	—	—	10%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL	$127.80	$142.00	—	—	10%
Pap test (liquid-based, automated screening with review) CPT 88175 CHG PAP SMEAR THIN PREP IMAGED	$181.80	$202.00	—	51% above	10%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 CHG PAP SMEAR THIN PREP IMAGED	$181.80	$202.00	—	—	10%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CHG PAP SMEAR THIN PREP	$139.50	$155.00	—	54% above	10%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CHG PAP SMEAR THIN PREP	$139.50	$155.00	—	—	10%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE INTACT WITH CALCIUM	$286.20	$318.00	—	38% above	10%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONE INTACT WITH CALCIUM	$286.20	$318.00	—	—	10%
Partial thromboplastin time (PTT) clotting test CPT 85730 LUPUS PANELPTT	$41.40	$46.00	—	31% above	10%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT	$41.40	$46.00	—	31% above	10%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT	$41.40	$46.00	—	—	10%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 LUPUS PANELPTT	$41.40	$46.00	—	—	10%
Progesterone blood test CPT 84144 PROGESTERONE	$144.90	$161.00	—	32% above	10%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$144.90	$161.00	—	—	10%
Prolactin blood test CPT 84146 PROLACTIN	$134.10	$149.00	—	175% above	10%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$134.10	$149.00	—	—	10%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME INR	$27.00	$30.00	—	35% above	10%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME INR	$27.00	$30.00	—	—	10%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCREEN URINE *IN HOUSE	$86.40	$96.00	—	15% above	10%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG SCREEN URINE *IN HOUSE	$86.40	$96.00	—	—	10%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA VIRUS SCN	$113.40	$126.00	—	35% above	10%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA VIRUS SCN	$113.40	$126.00	—	—	10%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR SCREEN	$39.60	$44.00	—	10% above	10%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR SCREEN	$39.60	$44.00	—	—	10%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGG	$99.00	$110.00	—	121% above	10%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGM SHL	$99.90	$111.00	—	123% above	10%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGG	$99.00	$110.00	—	—	10%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGM SHL	$99.90	$111.00	—	—	10%
Stool ova and parasites exam CPT 87177 OVA AND PARASITES WITH TRAVEL HISTORY	$62.10	$69.00	—	28% above	10%
Stool ova and parasites exam inpatient CPT 87177 OVA AND PARASITES WITH TRAVEL HISTORY	$62.10	$69.00	—	—	10%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD SCREEN	$29.70	$33.00	—	9% above	10%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD SCREEN	$29.70	$33.00	—	—	10%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 IFOB IMMUNOLOGICAL FECAL OCCULT BLOOD	$108.90	$121.00	—	89% above	10%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 IFOB IMMUNOLOGICAL FECAL OCCULT BLOOD	$108.90	$121.00	—	—	10%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR SCREEN	$29.70	$33.00	—	28% above	10%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR SCREEN	$29.70	$33.00	—	—	10%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERONE TB SHL	$430.20	$478.00	—	286% above	10%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERONE TB SHL	$430.20	$478.00	—	—	10%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL	$198.90	$221.00	—	227% above	10%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL	$198.90	$221.00	—	—	10%
Thyroid peroxidase (TPO) antibody test CPT 86376 TPO MICROSOMAL ANTIBODY	$72.00	$80.00	—	30% above	10%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 TPO MICROSOMAL ANTIBODY	$72.00	$80.00	—	—	10%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$117.00	$130.00	—	33% above	10%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH	$117.00	$130.00	—	—	10%
Uric acid blood test CPT 84550 URIC ACID	$31.50	$35.00	—	15% below	10%
Uric acid blood test inpatient CPT 84550 URIC ACID	$31.50	$35.00	—	—	10%
Urinalysis with microscope exam, automated CPT 81001 UA-COMPLETE WITH REFLEX TO CULTURE	$21.60	$24.00	—	40% below	10%
Urinalysis with microscope exam, automated CPT 81001 URINE MICROSCOPIC	$21.60	$24.00	—	40% below	10%
Urinalysis with microscope exam, automated CPT 81001 UA-COMPLETE NO REFLEX	$21.60	$24.00	—	40% below	10%
Urinalysis with microscope exam, automated CPT 81001 CHG UR COMPLETE	$21.60	$24.00	—	40% below	10%
Urinalysis with microscope exam, automated inpatient CPT 81001 UA-COMPLETE NO REFLEX	$21.60	$24.00	—	—	10%
Urinalysis with microscope exam, automated inpatient CPT 81001 UA-COMPLETE WITH REFLEX TO CULTURE	$21.60	$24.00	—	—	10%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINE MICROSCOPIC	$21.60	$24.00	—	—	10%
Urinalysis with microscope exam, automated inpatient CPT 81001 CHG UR COMPLETE	$21.60	$24.00	—	—	10%
Urinalysis without microscope exam, automated CPT 81003 CHG UA DIP ONLY	$15.30	$17.00	—	12% below	10%
Urinalysis without microscope exam, automated CPT 81003 UA DIP ONLY (DOT)	$15.30	$17.00	—	12% below	10%
Urinalysis without microscope exam, automated CPT 81003 KETONES URINE	$15.30	$17.00	—	12% below	10%
Urinalysis without microscope exam, automated inpatient CPT 81003 KETONES URINE	$15.30	$17.00	—	—	10%
Urinalysis without microscope exam, automated inpatient CPT 81003 UA DIP ONLY (DOT)	$15.30	$17.00	—	—	10%
Urinalysis without microscope exam, automated inpatient CPT 81003 CHG UA DIP ONLY	$15.30	$17.00	—	—	10%
Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE	$72.00	$80.00	—	12% above	10%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE URINE	$72.00	$80.00	—	—	10%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 WITH RELEX TO MMA	$104.40	$116.00	—	30% above	10%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 COBALAMIN	$104.40	$116.00	—	30% above	10%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12 WITH RELEX TO MMA	$104.40	$116.00	—	—	10%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12 COBALAMIN	$104.40	$116.00	—	—	10%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D2 D3 25 HYDROXY	$202.50	$225.00	—	109% above	10%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D2 D3 25 HYDROXY	$202.50	$225.00	—	—	10%
Zinc blood test CPT 84630 ZINC	$79.20	$88.00	—	200% above	10%
Zinc blood test inpatient CPT 84630 ZINC	$79.20	$88.00	—	—	10%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG SERUM QUANTITATIVE IN HOUSE	$104.40	$116.00	—	43% above	10%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG SERUM QUANTITATIVE IN HOUSE	$104.40	$116.00	—	—	10%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs North Dakota	Off list
Botox injections for chronic migraine CPT 64615 DENERVE MUS TRI CER SPIN BIL 64615	$148.50	$165.00	$363.44	48% below	10%
Botox injections for chronic migraine CPT 64615 DENERVE MUS FAC TRI CER SPI BIL 64615	$398.70	$443.00	—	39% above	10%
Botox injections for chronic migraine inpatient CPT 64615 DENERVE MUS FAC TRI CER SPI BIL 64615	$398.70	$443.00	—	—	10%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 FRACTURE DISTAL FIBULA	$372.60	$414.00	—	3% below	10%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 FX DISTAL FIB LAT MALLEO 27786	$725.40	$806.00	—	88% above	10%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 FX FOOT METATARSAL 28470	$396.00	$440.00	—	1% below	10%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRIC EX	$1,058.40	$1,176.00	—	4% above	10%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION	$1,058.40	$1,176.00	—	4% above	10%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION	$1,058.40	$1,176.00	—	—	10%
Cervical biopsy CPT 57500 ENDOCERVICAL POLYP REM 57500	$277.20	$308.00	—	65% below	10%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 FX DISTAL RADIAL (COLLES)	$372.60	$414.00	—	15% below	10%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 FX DISTAL RADIAL (COLLES) 25600	$621.00	$690.00	—	42% above	10%
Colonoscopy with polyp removal CPT 45385 COLONOSCOPY W/ SNARE PROFEE 45385	$437.40	$486.00	$363.44	78% below	10%
Colonoscopy with polyp removal CPT 45385 COLONOSCOPY W/ SNARE 45385	$1,968.30	$2,187.00	—	1% above	10%
Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY W/ SNARE 45385	$1,968.30	$2,187.00	—	—	10%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY W/ BIOPSY 45380	$345.60	$384.00	$363.44	57% below	10%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY W BIOPSY	$1,968.30	$2,187.00	—	147% above	10%
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY W BIOPSY	$1,968.30	$2,187.00	—	—	10%
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY 45378	$316.80	$352.00	$363.44	52% below	10%
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY SCREENING 45378	$1,495.80	$1,662.00	—	127% above	10%
Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY SCREENING 45378	$1,495.80	$1,662.00	—	—	10%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 CYROTHERAPY TO LESIONS 1 17000	$71.10	$79.00	—	52% below	10%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 CRYOTHERAPY LESIONS 1	$348.30	$387.00	—	137% above	10%
Earwax removal by irrigation (rinsing), one ear CPT 69209 EAR LAVAGE	$129.60	$144.00	—	85% above	10%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVE CERUMEN IRRIG/LAVAGE - UNILATERAL	$27.00	$30.00	—	62% below	10%
Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED CERUMEN INSTRUMENTATION	$81.90	$91.00	—	10% below	10%
Earwax removal with instruments, one ear CPT 69210 EAR WAX REMOVAL	$102.60	$114.00	—	13% above	10%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJ CER THOR SUB W/GUIDE 62321	$136.80	$152.00	$363.44	88% below	10%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJ CERV THOR SUBAR W/GUIDE 62321	$935.10	$1,039.00	—	18% below	10%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 INJ CERV THOR SUBAR W/GUIDE 62321	$935.10	$1,039.00	—	—	10%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJECT PARAVERTEBRAL FACET W/GUIDE 64493	$1,201.50	$1,335.00	—	8% below	10%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJECT PARAVERTEBRAL FACET W/GUIDE 64493	$1,201.50	$1,335.00	—	—	10%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY FLEXIBLE 45330	$97.20	$108.00	$363.44	90% below	10%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY DIAG INCL COLLECTION 4533	$1,352.70	$1,503.00	—	44% above	10%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOIDOSCOPY DIAG INCL COLLECTION 4533	$1,352.70	$1,503.00	—	—	10%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D SEBACEOUS CYST 10060	$225.00	$250.00	—	11% below	10%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D OF ABSCESS	$325.80	$362.00	—	29% above	10%
Incision and drainage of a simple or single skin abscess CPT 10060 I & D SEB / ABCESS	$348.30	$387.00	—	38% above	10%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECT TENDON OR LIGAMENT 20550	$95.40	$106.00	$363.44	49% below	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 INJECT JOINT - SHLDR HIP KNEE 20610	$75.60	$84.00	$363.44	70% below	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 INJECT MAJOR JOINT 20610	$75.60	$84.00	$363.44	70% below	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 INJECT- SHLDR HIP KNEE 20610	$397.80	$442.00	—	58% above	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 JOINT INJ; MAJOR JOINT 20610	$397.80	$442.00	—	58% above	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 INJECT-SHLDR HIP KNEE 20610	$397.80	$442.00	—	58% above	10%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 JOINT INJ ELB WRIS ANKLE 20605	$97.20	$108.00	—	68% below	10%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 INJECT-WRIST ELBO ANKL	$489.60	$544.00	—	61% above	10%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 INJECT- WRIST ELBO ANKL	$518.40	$576.00	—	71% above	10%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 INJECT- WRIST ELBO ANKL	$518.40	$576.00	—	—	10%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 INJECT FINGERS TOES 20600	$93.60	$104.00	—	65% below	10%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 INJECT- FINGER TOE	$518.40	$576.00	—	93% above	10%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 UP TO 2.5 CM 12031	$475.20	$528.00	—	13% above	10%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAC INTER SCALPHANDS 2.5	$671.40	$746.00	—	59% above	10%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAC INTER SCALP TRUNK	$671.40	$746.00	—	59% above	10%
Lower-back epidural injection, with imaging guidance CPT 62323 INJ LUMBAR OR SACRAL W/GUIDE 62323	$126.00	$140.00	$363.44	86% below	10%
Lower-back epidural injection, with imaging guidance CPT 62323 INJ LUMBAR OR SACRAL W/ GUIDE 62323	$935.10	$1,039.00	—	1% above	10%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 EPIDURAL LUMBAR OR SACRAL W/ GUIDE 64483	$189.00	$210.00	$363.44	79% below	10%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 EPIDURAL LUMBAR OR SACRAL W/GUIDE 64483	$1,201.50	$1,335.00	—	31% above	10%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 TRUNK ARM LEG 0.5 CM 11400	$205.20	$228.00	—	61% below	10%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC TRUNK/ARM/LEG	$1,206.90	$1,341.00	—	128% above	10%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 UP TO 0.5 CM 11440	$256.50	$285.00	—	37% below	10%
Nail removal (partial or complete), one nail CPT 11730 AVULSION OF NAIL PLATE 11730	$207.00	$230.00	—	14% below	10%
Nail removal (partial or complete), one nail CPT 11730 AVULSION OF NAIL PLATE	$325.80	$362.00	—	35% above	10%
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE PARTIAL OR COMPLETE	$348.30	$387.00	—	44% above	10%
Occipital nerve block (injection for headaches) CPT 64405 INJECT GREATER OCCIPITAL NERVE 64405	$64.80	$72.00	$363.44	79% below	10%
Occipital nerve block (injection for headaches) CPT 64405 INJECT GREATER OCCIPITAL NERVE 64405	$398.70	$443.00	—	31% above	10%
Occipital nerve block (injection for headaches) inpatient CPT 64405 INJECT GREATER OCCIPITAL NERVE 64405	$398.70	$443.00	—	—	10%
Paracentesis with imaging guidance CPT 49083 PARACENTESIS WITH GUDIE 49083	$184.50	$205.00	—	79% below	10%
Paracentesis with imaging guidance CPT 49083 US PARACENTESIS W IMAGING 49083	$1,534.50	$1,705.00	—	74% above	10%
Paracentesis with imaging guidance inpatient CPT 49083 US PARACENTESIS W IMAGING 49083	$1,534.50	$1,705.00	—	—	10%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 NAIL BED REMOVAL PERMANENT 11750	$288.00	$320.00	—	30% below	10%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION OF NAIL; PARTIAL OR COMPLETE	$671.40	$746.00	—	64% above	10%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTRUCT NERVE LUMBAR SACRAL EA 64635	$245.70	$273.00	$363.44	87% below	10%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTRUCT NERVE LUMBAR SACRAL EA 64635	$2,636.10	$2,929.00	—	40% above	10%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 DESTRUCT NERVE LUMBAR SACRAL EA 64635	$2,636.10	$2,929.00	—	—	10%
Removal of a breast lump, open surgery CPT 19120 REMOVAL OF BREAST LESION 19120	$905.40	$1,006.00	—	22% below	10%
Removal of a foreign object under the skin, simple CPT 10120 FOREIGN BODY SKIN 10120	$270.00	$300.00	—	34% below	10%
Removal of a foreign object under the skin, simple CPT 10120 FOREIGN BODY SKIN	$671.40	$746.00	—	64% above	10%
Removal of a foreign object under the skin, simple CPT 10120 INCISION/REMOVAL FOREIGN BODY; SUBQ	$671.40	$746.00	—	64% above	10%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLONOSCOPY SCRN LOW RISK G0121	$316.80	$352.00	$363.44	81% below	10%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLONOSCOPY MCR SCREEN HI RISK G0105	$316.80	$352.00	$363.44	82% below	10%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLONOSCOPY MCR HI RISK SCR G0105	$1,495.80	$1,662.00	—	14% below	10%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 COLONOSCOPY MCR HI RISK SCR G0105	$1,495.80	$1,662.00	—	—	10%
Short arm cast (elbow to hand) CPT 29075 APPLICATION SHORT ARM CAST 29075	$153.90	$171.00	—	43% below	10%
Short arm cast (elbow to hand) CPT 29075 APPLICATION OF CAST; SHORT ARM	$432.00	$480.00	—	60% above	10%
Short arm splint (forearm and hand) CPT 29125 APP OF SHORT ARM SPLINT PROFEE 29125	$118.80	$132.00	$363.44	28% below	10%
Short arm splint (forearm and hand) CPT 29125 APPLICATION SHORT ARM SPLINT	$208.80	$232.00	—	26% above	10%
Short leg cast (below the knee) CPT 29405 APPLICATION SHORT LEG CAST 29405	$144.90	$161.00	—	47% below	10%
Short leg splint (calf to foot) CPT 29515 APP OF SHORT LEG SPLINT PROFEE 29515	$86.40	$96.00	$363.44	53% below	10%
Short leg splint (calf to foot) CPT 29515 APPLICATION SHORT LEG SPLINT	$262.80	$292.00	—	44% above	10%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 UP TO 2.5 CM 12001 PROFEE	$167.40	$186.00	—	21% below	10%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR SC NE EXTR 2.5 OR LESS ER	$325.80	$362.00	—	53% above	10%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR S/N/A/G/T/E 2.5 CM OR LESS	$405.90	$451.00	—	91% above	10%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY SKIN SINGLE LESION 11104	$226.80	$252.00	—	24% below	10%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN - SINGLE LESION	$671.40	$746.00	—	124% above	10%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 UP TO 0.5 CM 11600	$301.50	$335.00	—	49% below	10%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXC OF MAL LESION T/A/L 0.5 CM OR LESS	$1,168.20	$1,298.00	—	97% above	10%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAG 11200	$163.80	$182.00	—	20% below	10%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAG UP TO 15	$324.90	$361.00	—	59% above	10%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS UP TO 15	$348.30	$387.00	—	71% above	10%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL FLUID TAP DIAGNOSTIC 62270	$235.80	$262.00	—	73% below	10%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL FLUID TAP DISGNOSTIC	$1,327.50	$1,475.00	—	53% above	10%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL FLUID TAP DISGNOSTIC	$1,327.50	$1,475.00	—	—	10%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 2.6 TO 7.5 CM 12002	$201.60	$224.00	—	5% below	10%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 LAC SCALPTRUNKHAND2.6-7.5	$325.80	$362.00	—	54% above	10%
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 SCLP NK EXT 2.6-7.5 CM	$348.30	$387.00	—	65% above	10%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 UP TO 2.5 CM 12011	$199.80	$222.00	—	21% below	10%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 LAC EARSEYELIDNOSELIP2.5C 12011	$325.80	$362.00	—	29% above	10%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 LACER FACE- UO TO 2.5CM 12011	$348.30	$387.00	—	38% above	10%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGETIAL BIOPSY SKIN (SHAVE SCOOP CURET	$183.60	$204.00	—	8% below	10%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGETIAL BIOP SKIN (SHAVE SCOOP CURET)	$348.30	$387.00	—	75% above	10%
Thoracentesis with imaging guidance CPT 32555 THORANCENTESIS W/ IMG GUIDE PROFEE 32555	$572.40	$636.00	$363.44	10% below	10%
Thoracentesis with imaging guidance CPT 32555 US THORACENTESIS W IMAGING GUIDANCE	$991.80	$1,102.00	—	56% above	10%
Thoracentesis with imaging guidance inpatient CPT 32555 US THORACENTESIS W IMAGING GUIDANCE	$991.80	$1,102.00	—	—	10%
Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINTS 1-2 MUSCLES 20552	$61.20	$68.00	$363.44	80% below	10%
Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER PT INJ 1-2 MUSCLE 20552	$397.80	$442.00	—	31% above	10%
Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT 1-2 MUSCLES 20552	$489.60	$544.00	—	61% above	10%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER PT INJ 1-2 MUSCLE 20552	$397.80	$442.00	—	—	10%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 EGD WITH DILATION LESS THAN 30 43249	$1,983.60	$2,204.00	—	17% below	10%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD WITH BIOPSY 43239	$237.60	$264.00	$363.44	79% below	10%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD W/ BIOPSY	$1,486.80	$1,652.00	—	31% above	10%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD W/ BIOPSY	$1,530.00	$1,700.00	—	35% above	10%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD W/ BIOPSY	$1,530.00	$1,700.00	—	—	10%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD 43235	$210.60	$234.00	$363.44	86% below	10%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD	$1,530.00	$1,700.00	—	4% above	10%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD	$1,530.00	$1,700.00	—	—	10%
Wart removal, up to 14 warts CPT 17110 BENIGN SKIN LESION REMOVAL 17110	$90.00	$100.00	—	56% below	10%
Wart removal, up to 14 warts CPT 17110 BENIGN LESION DESTRUCTION	$348.30	$387.00	—	71% above	10%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDMNT SUB Q SKIN 20 CM OR LESS 11042	$232.20	$258.00	—	43% below	10%

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 BLOOD TRANSFUSION	$734.40	$816.00	—	2% below	10%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANS 2 UNITS	$879.30	$977.00	—	18% above	10%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANS 3 UNITS & UP	$879.30	$977.00	—	18% above	10%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANS 1 UNIT	$879.30	$977.00	—	18% above	10%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADM 2 UNITS	$879.30	$977.00	—	18% above	10%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION	$734.40	$816.00	—	—	10%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANS 1 UNIT	$879.30	$977.00	—	—	10%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANS 3 UNITS & UP	$879.30	$977.00	—	—	10%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADM 2 UNITS	$879.30	$977.00	—	—	10%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANS 2 UNITS	$879.30	$977.00	—	—	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT NEBULIZER TREATMENT SUB 3RD FREQ	$117.00	$130.00	—	9% below	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT NEBULIZER TREATMENT SUBSEQUENT	$117.00	$130.00	—	9% below	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBULIZER TREATMENT	$117.00	$130.00	—	9% below	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT NEBULIZER TREATMENT INITIAL	$117.00	$130.00	—	9% below	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT NEBULIZER TREATMENT SUB 2ND FREQ	$117.00	$130.00	—	9% below	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT NEBULIZER TREATMENT SUB 2ND FREQ	$117.00	$130.00	—	—	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEBULIZER TREATMENT	$117.00	$130.00	—	—	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT NEBULIZER TREATMENT SUBSEQUENT	$117.00	$130.00	—	—	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT NEBULIZER TREATMENT INITIAL	$117.00	$130.00	—	—	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT NEBULIZER TREATMENT SUB 3RD FREQ	$117.00	$130.00	—	—	10%
Chemotherapy IV infusion, first hour CPT 96413 IV BIOLOGIC ADMIN 1 HR INTL	$736.20	$818.00	—	5% above	10%
Critical care, first 30 to 74 minutes CPT 99291 1ST HOUR (30 UP TO 74 MIN) 99291	$536.40	$596.00	$363.44	39% below	10%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE ER 30-74 MI	$2,047.50	$2,275.00	—	134% above	10%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 EKG (CLINIC) 93000	$25.20	$28.00	—	11% below	10%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG - MEDICARE 93005	$103.50	$115.00	—	14% below	10%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 RT EKG 93005	$103.50	$115.00	—	14% below	10%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge one side CPT 93005 EKG BY RT STAFF 93005	$103.50	$115.00	—	14% below	10%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 STRAIGHT FORWARD ER PROFEE 99281	$54.00	$60.00	$363.44	38% below	10%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER LEVEL 1	$180.00	$200.00	—	107% above	10%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 LOW COMPLEXITY PROFEE 99282	$72.00	$80.00	$363.44	45% below	10%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 BASIC ER LEVEL 2	$315.00	$350.00	—	139% above	10%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 MODERATE COMPLEXITY ER PROFEE 99283	$124.20	$138.00	$363.44	35% below	10%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 MODERATE ER LEVEL 3	$495.00	$550.00	—	158% above	10%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER COMPLEX PROFEE 99284	$210.60	$234.00	$363.44	36% below	10%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 URGENT ER LEVEL 4	$810.00	$900.00	—	148% above	10%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HIGH COMPLEXITY PROFEE 99285	$304.20	$338.00	$363.44	36% below	10%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HIGH COMPLEX ER LEVEL 5	$1,237.50	$1,375.00	—	161% above	10%
Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT; 50 MIN	$760.50	$845.00	—	43% above	10%
Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTHERAPY W/O PATIENT; 50 MIN	$724.50	$805.00	—	49% above	10%
Group psychotherapy session CPT 90853 GROUP PSYCHOTHERAPY	$661.50	$735.00	—	49% above	10%
Holter monitor, heart rhythm recording up to 48 hours, with report CPT 93224 ECG MONITOR RECORDING ANALYSIS & INTERP	$131.40	$146.00	—	—	10%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATE INT 31-60MIN	$372.60	$414.00	—	16% above	10%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION 1 HR	$372.60	$414.00	—	16% above	10%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATE INT 31-60 MIN 96360	$372.60	$414.00	—	16% above	10%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION INITIAL 31 MINS TO 1 HOUR	$410.40	$456.00	—	27% above	10%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATE INT 31-60 MIN 96360	$372.60	$414.00	—	—	10%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATE INT 31-60MIN	$372.60	$414.00	—	—	10%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION INITIAL 31 MINS TO 1 HOUR	$410.40	$456.00	—	—	10%
IV infusion of a medicine, first hour CPT 96365 MEYERS COCKTAIL INFUSION 96365	$135.00	$150.00	—	66% below	10%
IV infusion of a medicine, first hour CPT 96365 IV THERAPY NON CHEMO 1 HR	$372.60	$414.00	—	5% below	10%
IV infusion of a medicine, first hour CPT 96365 IV THERAPY NON CHEMO 1 HR	$372.60	$414.00	—	5% below	10%
IV infusion of a medicine, first hour CPT 96365 IV THERAPY NON CHEMO 1 HR 96365	$372.60	$414.00	—	5% below	10%
IV infusion of a medicine, first hour CPT 96365 IV THERAPY DIAG 1 HOUR	$410.40	$456.00	—	5% above	10%
IV infusion of a medicine, first hour inpatient CPT 96365 MEYERS COCKTAIL INFUSION 96365	$135.00	$150.00	—	—	10%
IV infusion of a medicine, first hour inpatient CPT 96365 IV THERAPY NON CHEMO 1 HR 96365	$372.60	$414.00	—	—	10%
IV infusion of a medicine, first hour inpatient CPT 96365 IV THERAPY NON CHEMO 1 HR	$372.60	$414.00	—	—	10%
IV infusion of a medicine, first hour inpatient CPT 96365 IV THERAPY DIAG 1 HOUR	$410.40	$456.00	—	—	10%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 CL-THERAPEUTIC/ DIAGNOSTIC INJECT 96372	$35.10	$39.00	—	at median	10%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION IM/SUBQ - ER	$120.60	$134.00	—	244% above	10%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION IM/SUBQ	$120.60	$134.00	—	244% above	10%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION IM/SUBQ 96372	$120.60	$134.00	—	244% above	10%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION/IM/SUBQ	$137.70	$153.00	—	292% above	10%
New patient office visit, about 30 minutes CPT 99203 OFFICE VISIT III NEW 99203	$198.00	$220.00	—	3% above	10%
New patient office visit, about 45 minutes CPT 99204 OFFICE VISIT IV NEW 99204	$293.40	$326.00	—	10% above	10%
New patient office visit, about 60 minutes CPT 99205 OFFICE VISIT V NEW 99205	$387.00	$430.00	—	17% above	10%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE VISIT II NEW 99202	$127.80	$142.00	—	7% below	10%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 NUTRITIONAL THERAPY-INITIAL EA 15 MINS	$156.60	$174.00	—	69% above	10%
Preventive checkup, new patient aged 18–39 CPT 99385 WELLNESS EXAM 18-39 (NP) 99385	$238.50	$265.00	—	86% above	10%
Preventive checkup, new patient aged 40–64 CPT 99386 WELLNESS EXAM 40-64 99386	$289.80	$322.00	—	107% above	10%
Preventive checkup, new patient aged 65 or older CPT 99387 PATIENT WELLNESS VISIT 65 AND OLDER 9938	$312.30	$347.00	—	111% above	10%
Preventive checkup, returning patient aged 18–39 CPT 99395 AGE 18-39 YEARS 99395	$217.80	$242.00	—	76% above	10%
Preventive checkup, returning patient aged 40–64 CPT 99396 PREVENTATIVE PHYSICAL AGE 40-64 YEARS 99	$236.70	$263.00	—	85% above	10%
Preventive checkup, returning patient aged 65 or older CPT 99397 WELLNESS EXAM 65+ (EST) 99397	$248.40	$276.00	—	90% above	10%
Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY W/ PATIENT; 30 MIN	$549.00	$610.00	—	77% above	10%
Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY W/ PATIENT; 45 MIN	$679.50	$755.00	—	76% above	10%
Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY W/ PATIENT; 60 MIN	$693.00	$770.00	—	77% above	10%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING AND TOBACCO CESSATION 3-10 MINS	$30.60	$34.00	—	15% below	10%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE VISIT V 99215	$360.00	$400.00	—	17% above	10%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE VISIT III 99213	$181.80	$202.00	—	20% above	10%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE VISIT IV 99214	$258.30	$287.00	—	35% above	10%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 COLLEGE PHYSICAL 99212	$22.50	$25.00	—	59% below	10%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE VISIT II 99212	$111.60	$124.00	—	106% above	10%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFFICE CONSULT MODERATE COMPLEXITY 99244	$135.00	$150.00	—	35% below	10%
Spirometry (breathing test) CPT 94010 RT INCENTIVE SPIROMETRY	$112.50	$125.00	—	30% below	10%
Spirometry (breathing test) CPT 94010 RT BASIC SPIROMETRY	$112.50	$125.00	—	30% below	10%
Spirometry (breathing test) inpatient CPT 94010 RT INCENTIVE SPIROMETRY	$112.50	$125.00	—	—	10%
Spirometry before and after a bronchodilator CPT 94060 RT PRE POST BRONCHODILATOR SPIROMETRY	$292.50	$325.00	—	9% below	10%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY	$427.50	$475.00	—	62% above	10%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY	$427.50	$475.00	—	—	10%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs North Dakota	Off list
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 COVID VACCINE +12 YRS; COM PFIZER 91320	$108.00	$120.00	—	42% below	10%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 CL-COVID COMIRNATY VACCINE IM 91320	$108.00	$120.00	—	42% below	10%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 COVID VACCINE ADM COMIRNATY 91320	$144.00	$160.00	—	23% below	10%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 COMIRNATY COVID VACCINE IM 91320	$144.00	$160.00	—	23% below	10%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 COVID VACCINE ADM COMIRNATY 91320	$144.00	$160.00	—	—	10%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 COMIRNATY COVID VACCINE IM 91320	$144.00	$160.00	—	—	10%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA (CHICK POX) 90716	$242.10	$269.00	—	48% above	10%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU SHOT	$22.50	$25.00	—	33% below	10%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 GARDASIL VACCINE	$389.70	$433.00	—	23% above	10%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 GARDASIL 9 90651	$405.90	$451.00	—	28% above	10%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 QUADRIVALENT HPV VACCINE(GARDASIL 9)	$606.24	$673.60	—	92% above	10%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A PER DOSE - ADULT 90632	$100.80	$112.00	—	75% above	10%
Hepatitis A vaccine, adult dose CPT 90632 CL-HEPATITIS A ADULT VACCINE IM(HAVRIX)	$176.94	$196.60	—	207% above	10%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITUS B PER DOSE - ADULT 90746	$102.60	$114.00	—	28% above	10%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU SHOT - HIGH DOSE	$34.20	$38.00	—	56% below	10%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR 90707	$140.40	$156.00	—	4% above	10%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCCAL VACCINE (BEXSERO) 90620	$325.80	$362.00	—	37% above	10%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ 90677	$481.50	$535.00	—	37% above	10%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 CL-PNEUMOCOCCAL POLYV VACCINE(PNEUMOVAX	$109.80	$122.00	—	27% below	10%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOVAX 2 YRS > 90732	$187.20	$208.00	—	24% above	10%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE 1 ML 90675	$594.90	$661.00	—	8% below	10%
Rabies vaccine, one dose CPT 90675 RABIES VIRUS VACCINE(IMOVAX)	$686.45	$762.72	—	7% above	10%
Rabies vaccine, one dose CPT 90675 CL-RABIES VIRUS VACCINE(IMOVAX)	$686.45	$762.72	—	7% above	10%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 SHINGLES HZV VACCINE IM (SHINGRIX) 90750	$275.40	$306.00	—	72% above	10%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 SHINGLES VACCINE IM(SHINGRIX)	$275.40	$306.00	—	72% above	10%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 CL-SHINGLES VACCINE IM(SHINGRIX)	$275.40	$306.00	—	72% above	10%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 SHINGLES VACCINE	$317.70	$353.00	—	98% above	10%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS & DIPTHERIA 7 YRS> IM 90714	$43.20	$48.00	—	23% below	10%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP INJ AGE 11-64 VACCINE(ADACEL)	$50.14	$55.71	—	28% below	10%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE 7 YRS > IM 90715	$56.70	$63.00	—	19% below	10%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE 7 YRS> IM	$61.20	$68.00	—	12% below	10%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 CL-TYPHOID VACCINE(TYPHIM VI)	$164.99	$183.32	—	at median	10%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VACCINE(TYPHIM VI)	$164.99	$183.32	—	at median	10%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 FLU SHOT INJECTION CLINIC	$22.50	$25.00	—	at median	10%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 FLU SHOT INJECTION OUTPT	$22.50	$25.00	—	at median	10%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJ ADMIN FEE VACCINE 90471	$45.00	$50.00	—	100% above	10%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN - 1 VACCINE	$120.60	$134.00	—	436% above	10%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJ ADMIN VAC	$120.60	$134.00	—	436% above	10%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IM/SUBQ VACCINE	$135.00	$150.00	—	500% above	10%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 EACH ADDL VACCINE 90472	$18.00	$20.00	—	38% below	10%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 EA ADD VACCINE 90472	$31.50	$35.00	—	8% above	10%

Source file: https://swhealthcare.net/file_download/inline/c967a943-4246-45d6-9ff2-8222bb15dc86