Hospital

SMP Health - St. Aloisius

Listed in its price file as “SMP Health - St. Aloisius dba SMP Health - St. Aloisius”.

SMP Health - St. Aloisius in Harvey, ND publishes cash prices for 287 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 above the North Dakota median for 192 of 279 procedures and below it for 75. By typical cash price it ranks #19 of 25 North Dakota hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

325 E Brewster St, Harvey, ND 58341 Collected Sep 27, 2026 Source price file (701) 324-4651

Critical access hospital (rural, 25 beds or fewer) Emergency department CMS star rating 1 of 5 CCN 351327 · CMS hospital register

Scans and imaging

ProcedureCash price List priceInsurers payvs North DakotaOff list
Ankle X-ray, complete, 3 or more views one side CPT 73610 Xr Ankle Complete 3+ Views Left $208.00 $231.00 $144.00 7% above 10%
Ankle X-ray, complete, 3 or more views one side CPT 73610 Xr Ankle Complete 3+ Views Right $208.00 $231.00 $144.00 7% above 10%
Bone scan, whole body (nuclear medicine) CPT 78306 Nm Bone Imaging Whole Body $1,393.00 $1,548.00 $966.00 27% above 10%
Breast ultrasound, complete, one breast both sides CPT 76641 Us Breast Complete Bilat $392.00 $436.00 $272.00 — 10%
Breast ultrasound, complete, one breast one side CPT 76641 Us Breast Complete Right $392.00 $436.00 $272.00 8% above 10%
Breast ultrasound, complete, one breast one side CPT 76641 Us Breast Complete Left $392.00 $436.00 $272.00 8% above 10%
Breast ultrasound, limited (one breast or one area) both sides CPT 76642 Us Breast Limited Bilat $327.00 $363.00 $226.00 — 10%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 Smph Ct Angio Chest $2,195.00 $2,439.00 $1,522.00 2% above 10%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 Ct Abdomen And Pelvis W/o Contrast $1,715.00 $1,905.00 $1,189.00 18% above 10%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT scan of abdomen and pelvis with contrast $2,481.00 $2,757.00 $1,720.00 at median 10%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Smph Ct Abdomen And Pelvis W/ + W/o Contrast $3,157.00 $3,508.00 $2,189.00 8% above 10%
CT scan of the abdomen with contrast CPT 74160 Ct Abdomen W/ Contrast $1,509.00 $1,677.00 $1,046.00 7% below 10%
CT scan of the abdomen without contrast CPT 74150 Ct Abdomen W/o Contrast $1,246.00 $1,384.00 $863.00 4% above 10%
CT scan of the face and sinuses, no contrast dye CPT 70486 Ct Maxillofacial W/o Contrast $1,185.00 $1,317.00 $822.00 9% above 10%
CT scan of the head or brain, no contrast dye CPT 70450 CT scan $1,185.00 $1,317.00 $822.00 13% above 10%
CT scan of the head with contrast CPT 70460 Ct Head W/ Contrast $1,244.00 $1,382.00 $862.00 3% below 10%
CT scan of the head without and with contrast CPT 70470 Ct Head W/ + W/o Contrast $1,557.00 $1,730.00 $1,079.00 6% above 10%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 Ct Spine Lumbar W/o Contrast $1,377.00 $1,530.00 $955.00 7% above 10%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 Ct Spine Cervical W/o Contrast $1,377.00 $1,530.00 $955.00 4% above 10%
CT scan of the pelvis, with contrast dye CPT 72193 CT scan of pelvis with contrast $1,509.00 $1,677.00 $1,046.00 5% below 10%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 Us Carotid Duplex Bilateral $785.00 $872.00 $544.00 — 10%
Chest X-ray, 2 views CPT 71046 Xr Chest 2 Views $241.00 $268.00 $167.00 50% above 10%
Chest X-ray, single view CPT 71045 Xr Chest 1 View $185.00 $206.00 $129.00 37% above 10%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Us Renal $473.00 $525.00 $328.00 16% above 10%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 Bd Bone Density Dexa Axial Skeleton $188.00 $209.00 $130.00 29% below 10%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 Smph Ct Chest W/o Contrast $1,302.00 $1,447.00 $903.00 9% above 10%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 Smph Ct Chest W/ Contrast $1,557.00 $1,730.00 $1,079.00 9% above 10%
Diagnostic mammogram, both breasts CPT 77066 Mammography of both breasts $637.00 $708.00 $442.00 22% above 10%
Diagnostic mammogram, one breast CPT 77065 Mammography of one breast $517.00 $574.00 $358.00 33% above 10%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Us Lower Ext Venous Duplex Bilateral $782.00 $869.00 $542.00 — 10%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Us Echocardiogram Complete $842.00 $936.00 $584.00 1% above 10%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Nm Hepatobiliary Imaging $1,575.00 $1,750.00 $1,092.00 19% above 10%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 95811 Sleep Study C-pap Attended Charge $2,991.00 $3,323.00 $2,073.00 25% above 10%
Knee X-ray, 3 views one side CPT 73562 Xr Knee 3 Views Right $225.00 $250.00 $156.00 10% above 10%
Knee X-ray, 3 views one side CPT 73562 Xr Knee 3 Views Left $225.00 $250.00 $156.00 10% above 10%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 76705 Us Abdomen Limited $371.00 $412.00 $257.00 1% below 10%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 Ct Low Dose Lung Screening $266.00 $295.00 $184.00 59% below 10%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI scan of leg joint $2,147.00 $2,386.00 $1,489.00 10% above 10%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Mri Le Joint W/ + W/o Contrast Right $3,425.00 $3,806.00 $2,375.00 13% above 10%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Mri Le Joint W/ + W/o Contrast Left $3,425.00 $3,806.00 $2,375.00 13% above 10%
MRI of the abdomen without contrast CPT 74181 Mri Abdomen W/o Contrast $2,195.00 $2,439.00 $1,522.00 14% above 10%
MRI of the abdomen, without and then with contrast dye CPT 74183 Mri Abdomen W/ + W/o Contrast $3,421.00 $3,801.00 $2,371.00 6% above 10%
MRI of the brain, no contrast dye CPT 70551 Mri Brain W/o Contrast $2,229.00 $2,477.00 $1,545.00 35% above 10%
MRI of the brain, with and without contrast dye CPT 70553 MRI Scan $3,298.00 $3,664.00 $2,286.00 2% above 10%
MRI of the lower back, no contrast dye CPT 72148 MRI scan of lower spinal canal $2,074.00 $2,304.00 $1,437.00 6% above 10%
MRI of the lower back, without and then with contrast dye CPT 72158 Mri Spine Lumbar W/ + W/o Contrast $3,240.00 $3,600.00 $2,246.00 2% below 10%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 Mri Spine Thoracic W/o Contrast $2,074.00 $2,304.00 $1,437.00 4% above 10%
MRI of the neck (cervical spine) without and with contrast CPT 72156 Mri Spine Cervical W/ + W/o Contrast $3,246.00 $3,607.00 $2,250.00 at median 10%
MRI of the neck (cervical spine), no contrast dye CPT 72141 Mri Spine Cervical W/o Contrast $1,953.00 $2,170.00 $1,354.00 at median 10%
MRI of the pelvis without and with contrast CPT 72197 Mri Pelvis W/ + W/o Contrast $3,413.00 $3,792.00 $2,366.00 6% above 10%
MRI of the pelvis, no contrast dye CPT 72195 Mri Pelvis W/o Contrast $2,552.00 $2,836.00 $1,769.00 11% above 10%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Ue Joint W/o Contrast Left $2,094.00 $2,327.00 $1,452.00 8% above 10%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Ue Joint W/o Contrast Right $2,094.00 $2,327.00 $1,452.00 8% above 10%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Nm Myocardial Spect Multiple Studies $3,512.00 $3,902.00 $2,434.00 78% above 10%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Us Pelvic Ltd $199.00 $221.00 $138.00 37% below 10%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Us Pelvic Complete $433.00 $481.00 $300.00 11% above 10%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 Smph Us Ob < 14 Weeks Single $423.00 $470.00 $293.00 12% above 10%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Us Ob Limited $339.00 $377.00 $235.00 19% above 10%
Screening mammogram, both breasts both sides CPT 77067 Mammography, screening, bilateral $524.00 $582.00 $363.00 — 10%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 Xr Shoulder Complete 2+ Views Left $225.00 $250.00 $156.00 26% above 10%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 Xr Shoulder Complete 2+ Views Right $225.00 $250.00 $156.00 26% above 10%
Sleep study in a lab (polysomnography) CPT 95810 Sleep study $2,826.00 $3,140.00 $1,959.00 19% above 10%
Transvaginal pelvic ultrasound CPT 76830 Ultrasound pelvis through vagina $488.00 $542.00 $338.00 6% above 10%
Transvaginal ultrasound during pregnancy CPT 76817 Us Ob Transvaginal $329.00 $366.00 $228.00 10% above 10%
Ultrasound of the abdomen, complete CPT 76700 Ultrasound of abdomen $484.00 $538.00 $336.00 5% below 10%
Ultrasound of the scrotum and testicles CPT 76870 Us Scrotum (Contents) $441.00 $490.00 $306.00 14% above 10%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Us Soft Tissue Head/neck $491.00 $545.00 $340.00 8% above 10%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Us Lower Ext Venous Duplex Left $520.00 $578.00 $361.00 6% below 10%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Us Lower Ext Venous Duplex Right $520.00 $578.00 $361.00 6% below 10%
Wrist X-ray, complete, 3 or more views one side CPT 73110 Xr Wrist Complete 3+ Views Left $208.00 $231.00 $144.00 12% above 10%
Wrist X-ray, complete, 3 or more views one side CPT 73110 Xr Wrist Complete 3+ Views Right $208.00 $231.00 $144.00 12% above 10%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Xr Hip 2-3 Views W/ap Pelvis Right $240.00 $267.00 $167.00 20% above 10%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Xr Hip 2-3 Views W/ap Pelvis Left $240.00 $267.00 $167.00 20% above 10%
X-ray of the abdomen, 1 view CPT 74018 Xr Abdomen Kub 1 View $204.00 $227.00 $142.00 71% above 10%
X-ray of the ankle, 2 views one side CPT 73600 Xr Ankle 2 Views Right $193.00 $214.00 $134.00 20% above 10%
X-ray of the ankle, 2 views one side CPT 73600 Xr Ankle 2 Views Left $193.00 $214.00 $134.00 20% above 10%
X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger(s) 2+ Views Right $166.00 $184.00 $115.00 4% above 10%
X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger(s) 2+ Views Left $166.00 $184.00 $115.00 4% above 10%
X-ray of the foot, 2 views one side CPT 73620 Xr Foot 2 Views Left $193.00 $214.00 $134.00 20% above 10%
X-ray of the foot, 2 views one side CPT 73620 Xr Foot 2 Views Right $193.00 $214.00 $134.00 20% above 10%
X-ray of the foot, complete, 3 or more views one side CPT 73630 Xr Foot Complete 3+ Views Right $208.00 $231.00 $144.00 8% above 10%
X-ray of the foot, complete, 3 or more views one side CPT 73630 Xr Foot Complete 3+ Views Left $208.00 $231.00 $144.00 8% above 10%
X-ray of the hand, 3 or more views one side CPT 73130 Xr Hand Complete 3+ Views Right $208.00 $231.00 $144.00 4% above 10%
X-ray of the hand, 3 or more views one side CPT 73130 Xr Hand Complete 3+ Views Left $208.00 $231.00 $144.00 4% above 10%
X-ray of the knee, 1 or 2 views one side CPT 73560 Xr Knee 1 Or 2 Views Left $204.00 $227.00 $142.00 9% above 10%
X-ray of the knee, 1 or 2 views one side CPT 73560 Xr Knee 1 Or 2 Views Right $204.00 $227.00 $142.00 9% above 10%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Xr Spine Lumbosacral 2 Or 3 Views $260.00 $289.00 $180.00 51% above 10%
X-ray of the lower back, 4 or more views CPT 72110 X-Ray of lower back $366.00 $407.00 $254.00 54% above 10%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 Xr Spine Thoracic 2 Views $253.00 $281.00 $175.00 63% above 10%
X-ray of the nasal bones, 3 or more views CPT 70160 Xr Nasal Bones 3+ Views $232.00 $258.00 $161.00 55% above 10%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Xr Spine Cervical 2 Or 3 Views $233.00 $259.00 $162.00 45% above 10%
X-ray of the pelvis, 1 or 2 views CPT 72170 Xr Pelvis 1 Or 2 Views $204.00 $227.00 $142.00 34% above 10%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Xr Sacrum/coccyx 2+ Views $233.00 $259.00 $162.00 60% above 10%

Lab tests

ProcedureCash price List priceInsurers payvs North DakotaOff list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alt $43.00 $48.00 $30.00 at median 10%
AST (aspartate aminotransferase) enzyme test CPT 84450 Aspartate Aminotransferase $41.00 $46.00 $29.00 9% below 11%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute Hepatitis Panel $101.00 $112.00 $70.00 54% below 10%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Panel, Acute With Reflex Npl $101.00 $112.00 $70.00 54% below 10%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 $12.00 $13.00 $8.00 17% below 8%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergens, Food, Comprehensive Profile 1 Npl $12.00 $13.00 $8.00 17% below 8%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Drugs, Penicillin G (Major) Npl $32.00 $35.00 $22.00 122% above 9%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergens, Drugs, Penicillin V (Minor) Npl $32.00 $35.00 $22.00 122% above 9%
Allergy blood test, specific IgE, per allergen CPT 86003 Smph Allergen Individual Npl $35.00 $39.00 $24.00 143% above 10%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrullinated Peptide Ab, Igg Npl $86.00 $95.00 $59.00 25% above 9%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Ccp (Cyclic Citrullinated Peptide) Igg Plab $86.00 $95.00 $59.00 25% above 9%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Ana With Reflex To Eleven Autoabs Npl $26.00 $29.00 $18.00 57% below 10%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Ana Direct Npl $96.00 $107.00 $67.00 59% above 10%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Bnp $257.00 $286.00 $178.00 9% above 10%
Basic metabolic panel (blood test) CPT 80048 Basic metabolic panel $65.00 $72.00 $45.00 13% below 10%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 88305 Ap Bill Surgical Pathology Level Iv Complexity $112.00 $124.00 $77.00 1% below 10%
Blood culture for bacteria CPT 87040 Blood Culture Id By Pcr Npl $68.00 $75.00 $47.00 16% below 9%
Blood culture for bacteria CPT 87040 Blood Culture #1 Plab $82.00 $91.00 $57.00 1% above 10%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Collection: Venous Draw $17.00 $19.00 $12.00 1% below 11%
Blood glucose (sugar) test CPT 82947 Glucose Lvl $33.00 $37.00 $23.00 20% above 11%
Blood lead test CPT 83655 Lead, Blood Capillary Npl $91.00 $101.00 $63.00 107% above 10%
Blood lead test CPT 83655 Lead, Blood Venous Npl $91.00 $101.00 $63.00 107% above 10%
Blood lead test CPT 83655 Lead Npl $96.00 $107.00 $67.00 118% above 10%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 B-hcg Ql $59.00 $66.00 $41.00 14% below 11%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Abo/rh $22.00 $24.00 $15.00 44% below 8%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Ref Abo/rh $22.00 $24.00 $15.00 44% below 8%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-reactive Protein $42.00 $47.00 $29.00 32% above 11%
C. difficile toxin gene test (stool PCR) CPT 87493 C. Difficile By Pcr Confirmation Npl $263.00 $292.00 $182.00 39% above 10%
CA 19-9 blood test (tumor marker) CPT 86301 Cancer Antigen. Gi (19-9) Npl $50.00 $56.00 $35.00 51% below 11%
CA-125 blood test (ovarian cancer marker) CPT 86304 Cancer Antigen 125 Npl $48.00 $53.00 $33.00 56% below 9%
CA-125 blood test (ovarian cancer marker) CPT 86304 Ca-125 Plab $48.00 $53.00 $33.00 56% below 9%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Sars-cov-2 (Covid-19) Rna (Id Now) $128.00 $142.00 $89.00 5% above 10%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 C Trachomatis By Tma Final Npl $42.00 $47.00 $29.00 63% below 11%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Ct/gc/tv (Bd Max) $44.00 $49.00 $31.00 62% below 10%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 N Gonorrhea By Tma Final Npl $203.00 $225.00 $140.00 77% above 10%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Trachomatis $273.00 $303.00 $189.00 139% above 10%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Blood test, lipids $110.00 $122.00 $76.00 42% above 10%
Complete blood count (CBC) with differential CPT 85025 Complete blood cell count (CBC), with differential white blood cells, automated $61.00 $68.00 $42.00 at median 10%
Complete blood count (CBC), no differential CPT 85027 Complete blood cell count (CBC), automated $61.00 $68.00 $42.00 30% above 10%
Comprehensive metabolic panel (blood test) CPT 80053 Blood test, comprehensive group of blood chemicals $96.00 $107.00 $67.00 1% below 10%
D-dimer blood test (blood clot marker) CPT 85379 Ddimer $73.00 $81.00 $51.00 4% below 10%
DHEA sulfate (DHEA-S) blood test CPT 82627 Dhea-s Npl $48.00 $53.00 $33.00 51% below 9%
DHEA sulfate (DHEA-S) blood test CPT 82627 Dhea-s Plab $48.00 $53.00 $33.00 51% below 9%
Estradiol blood test CPT 82670 Estradiol Npl $96.00 $107.00 $67.00 9% below 10%
Estradiol blood test CPT 82670 Estradiol, Adult Plab $96.00 $107.00 $67.00 9% below 10%
FSH (follicle-stimulating hormone) test CPT 83001 Follicle Stimulating Hormone Npl $66.00 $73.00 $46.00 32% below 10%
FSH (follicle-stimulating hormone) test CPT 83001 Fsh Plab $66.00 $73.00 $46.00 32% below 10%
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin, Fecal Npl $251.00 $279.00 $174.00 67% above 10%
Ferritin blood test (iron stores) CPT 82728 Ferritin Npl $22.00 $24.00 $15.00 70% below 8%
Ferritin blood test (iron stores) CPT 82728 Ferritin $22.00 $24.00 $15.00 70% below 8%
Folate (folic acid) blood test CPT 82746 Folate Level $96.00 $107.00 $67.00 15% above 10%
Free T3 thyroid hormone test CPT 84481 T3 Uptake Npl $50.00 $56.00 $35.00 46% below 11%
Free T3 thyroid hormone test CPT 84481 T3 Free $50.00 $56.00 $35.00 46% below 11%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Free T4 Level $73.00 $81.00 $51.00 55% above 10%
Free testosterone test CPT 84402 Testosterone Free, Females Or Children Npl $197.00 $219.00 $137.00 174% above 10%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 Bill Only General Health Panel $289.00 $321.00 $200.00 19% above 10%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Gluc 1 Hr $35.00 $39.00 $24.00 11% below 10%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria Gonorrhoeae $115.00 $128.00 $80.00 14% above 10%
H. pylori stool antigen test CPT 87338 Helicobacter Pylori Antigen, Fecal Plab $109.00 $121.00 $75.00 6% above 10%
H. pylori stool antigen test CPT 87338 Helicobacter Pylori Stool Antigen Npl $109.00 $121.00 $75.00 6% above 10%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Hiv-1 Viral Load Pcr Plab $218.00 $242.00 $151.00 17% below 10%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Hiv By Quant Naat Npl $218.00 $242.00 $151.00 17% below 10%
HIV-1 and HIV-2 antibody test CPT 86703 Hiv 1/2 Antibody $90.00 $100.00 $62.00 14% above 10%
HIV-1 and HIV-2 antibody test CPT 86703 Exposure Panel (Source Patient) Npl $90.00 $100.00 $62.00 14% above 10%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Hiv 1&2 Ab Diff,supplemental W/reflx Npl $84.00 $93.00 $58.00 28% below 10%
HPV test for high-risk types, one combined (pooled) result CPT 87624 Hpv High Risk Screen Plab $230.00 $255.00 $159.00 134% above 10%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c $78.00 $87.00 $54.00 9% above 10%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hgb A1c W/eag $78.00 $87.00 $54.00 9% above 10%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Antibody Plab $77.00 $86.00 $54.00 37% above 10%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hiv Rapid Npl $88.00 $98.00 $61.00 71% above 10%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hiv, Rapid Npl $88.00 $98.00 $61.00 71% above 10%
Hepatitis C antibody blood test (screening) CPT 86803 Exposure Panel (Healtcare Worker) Npl $112.00 $124.00 $77.00 79% above 10%
Hepatitis C antibody blood test (screening) CPT 86803 .Hcv Ab By Cia Reflex Test Npl $112.00 $124.00 $77.00 79% above 10%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hcv By Quant Naat Npl $414.00 $460.00 $287.00 216% above 10%
Herpes blood test, HSV-1 antibody CPT 86695 Hsv 1&2 Ab W/ Rfx Glycoprotein G Npl $86.00 $96.00 $60.00 81% above 10%
Herpes blood test, HSV-2 antibody CPT 86696 Hsv 2 Glyco G Ab,igg Npl $51.00 $57.00 $36.00 13% below 11%
Herpes blood test, HSV-2 antibody CPT 86696 Hsv I/ii Igg Npl $127.00 $141.00 $88.00 117% above 10%
High-sensitivity CRP (hs-CRP) test CPT 86141 Crp, Highly Sensitive Plab $59.00 $66.00 $41.00 14% below 11%
Homocysteine blood test CPT 83090 Homocystine, Total Npl $133.00 $148.00 $92.00 44% above 10%
Homocysteine blood test CPT 83090 Homocysteine Total Plab $133.00 $148.00 $92.00 44% above 10%
Insulin blood test CPT 83525 Insulin Npl $41.00 $46.00 $29.00 29% below 11%
Insulin blood test CPT 83525 Insulin, Fasting Plab $41.00 $46.00 $29.00 29% below 11%
Iron blood test (serum iron) CPT 83540 Iron Npl $11.00 $12.00 $7.00 67% below 8%
Iron blood test (serum iron) CPT 83540 Iron $11.00 $12.00 $7.00 67% below 8%
Iron-binding capacity (TIBC) test CPT 83550 Total Iron Binding Capacity $62.00 $69.00 $43.00 33% above 10%
Iron-binding capacity (TIBC) test CPT 83550 Tibc Npl $62.00 $69.00 $43.00 33% above 10%
Kidney function blood test panel CPT 80069 Kidney function panel test $65.00 $72.00 $45.00 5% below 10%
LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone Plab $145.00 $161.00 $100.00 41% above 10%
LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone Npl $145.00 $161.00 $100.00 41% above 10%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase Level $56.00 $62.00 $39.00 4% above 10%
Liver function blood test panel CPT 80076 Liver function blood test $64.00 $71.00 $44.00 11% below 10%
Lyme disease antibody test CPT 86618 Lyme Eia Igm $55.00 $61.00 $38.00 16% above 10%
Lyme disease antibody test CPT 86618 Borrelia Burgdorferi Ab, Total(lyme) Npl $71.00 $79.00 $49.00 49% above 10%
Lyme disease antibody test CPT 86618 B. Burgdorferi Vise1/pepc10abs Elisa $81.00 $90.00 $56.00 71% above 10%
Lyme disease antibody test CPT 86618 Lyme Antibody Npl $115.00 $128.00 $80.00 142% above 10%
Lyme disease antibody test CPT 86618 Lyme Disease Total Antibody With Reflex To Immunoblot Plab $129.00 $143.00 $89.00 172% above 10%
Magnesium blood test CPT 83735 Magnesium,urn-per 24h Npl $48.00 $53.00 $33.00 100% above 9%
Magnesium blood test CPT 83735 Magnesium Level $79.00 $88.00 $55.00 229% above 10%
Mono test (heterophile antibody, Monospot) CPT 86308 Mono Scrn $35.00 $39.00 $24.00 12% below 10%
Mono test (heterophile antibody, Monospot) CPT 86308 Mycophenolic Acid Npl $83.00 $92.00 $57.00 108% above 10%
Obstetric blood test panel CPT 80055 Obstetric blood test panel $216.00 $240.00 $150.00 29% below 10%
PSA (prostate-specific antigen) blood test, free CPT 84154 Total prostate-specific antigen (PSA) test $29.00 $32.00 $20.00 55% below 9%
PSA (prostate-specific antigen) blood test, total CPT 84153 Total prostate-specific antigen (PSA) test $142.00 $158.00 $99.00 58% above 10%
Pap test (liquid-based, automated screening with review) CPT 88175 Gyn Cytology Npl $169.00 $188.00 $117.00 34% above 10%
Parathyroid hormone (PTH) blood test CPT 83970 Pth, Without Calcium Plab $62.00 $69.00 $43.00 70% below 10%
Partial thromboplastin time (PTT) clotting test CPT 85730 Coagulation assessment blood test $48.00 $53.00 $33.00 50% above 9%
Progesterone blood test CPT 84144 Progesterone Plab $77.00 $85.00 $53.00 33% below 9%
Progesterone blood test CPT 84144 Progesterone Npl $77.00 $85.00 $53.00 33% below 9%
Prolactin blood test CPT 84146 Prolactin Npl $69.00 $77.00 $48.00 8% below 10%
Prolactin blood test CPT 84146 Prolactin Plab $69.00 $77.00 $48.00 8% below 10%
Prothrombin time (PT/INR) clotting test CPT 85610 Blood test, clotting time $70.00 $78.00 $49.00 183% above 10%
Rapid flu test (influenza antigen) CPT 87804 Flu A&b $108.00 $120.00 $75.00 27% above 10%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Strep A Rapid $106.00 $118.00 $74.00 28% above 10%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor Plab $21.00 $23.00 $14.00 42% below 9%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor Npl $21.00 $23.00 $14.00 42% below 9%
Rubella antibody test (immunity check) CPT 86762 Rubella Igg Antibody Plab $112.00 $124.00 $77.00 82% above 10%
Rubella antibody test (immunity check) CPT 86762 Rubella Antibody, Igg Npl $112.00 $124.00 $77.00 82% above 10%
Stool ova and parasites exam CPT 87177 Ova & Parasites By Immunoassay Npl $70.00 $78.00 $49.00 43% above 10%
Stool ova and parasites exam CPT 87177 Ova And Parasite Exam Plab $70.00 $78.00 $49.00 43% above 10%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rpr $33.00 $37.00 $23.00 25% above 11%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rpr (Rapid Plasma Reagin) Plab $34.00 $38.00 $24.00 29% above 11%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 .Rpr Titer Npl $34.00 $38.00 $24.00 29% above 11%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Tb Interferon Antigen Plab $164.00 $182.00 $114.00 17% above 10%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Quantiferon Tb Plus Npl $164.00 $182.00 $114.00 17% above 10%
Testosterone blood test, total (not free testosterone) CPT 84403 Smph Testosterone, Total $90.00 $100.00 $62.00 24% above 10%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total Plab $90.00 $100.00 $62.00 24% above 10%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone, Total Npl $90.00 $100.00 $62.00 24% above 10%
Thyroid peroxidase (TPO) antibody test CPT 86376 Microsomal Antibody (Tpo) Npl $113.00 $125.00 $78.00 86% above 10%
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Autoantibodies Npl $143.00 $159.00 $99.00 135% above 10%
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Stimulating Immunoglobulin Npl $143.00 $159.00 $99.00 135% above 10%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Blood test, thyroid stimulating hormone (TSH) $131.00 $146.00 $91.00 28% above 10%
Trichomonas test (NAAT) CPT 87661 Nhc Positive Std Panel Npl $141.00 $157.00 $98.00 67% above 10%
Uric acid blood test CPT 84550 Uric Acid $38.00 $42.00 $26.00 3% below 10%
Urinalysis with microscope exam, automated CPT 81001 Urinalysis test using microscope $62.00 $69.00 $43.00 72% above 10%
Urinalysis with microscope exam, manual CPT 81000 Urinalysis test using microscope $43.00 $48.00 $30.00 54% above 10%
Urinalysis without microscope exam, manual CPT 81002 Urinalysis test $22.00 $24.00 $15.00 8% above 8%
Urine culture for bacteria, with colony count CPT 87086 C Urine $84.00 $93.00 $58.00 24% above 10%
Urine pregnancy test, read by color change CPT 81025 U B-hcg Ql $57.00 $63.00 $39.00 3% below 10%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Level $99.00 $110.00 $69.00 23% above 10%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 25-hydroxyvitamin D Lcms D2+d3 Lc $219.00 $243.00 $152.00 36% above 10%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D, 25 Npl $221.00 $246.00 $153.00 37% above 10%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25 Hydroxy Level $221.00 $246.00 $153.00 37% above 10%
Zinc blood test CPT 84630 Zinc Npl $41.00 $46.00 $29.00 28% above 11%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Beta-hcg, Quant Tumor Marker Npl $45.00 $50.00 $31.00 41% below 10%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Hcg, Beta Subunit, Quant. Npl $112.00 $124.00 $77.00 47% above 10%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Beta Hcg Quantitative $112.00 $124.00 $77.00 47% above 10%

Surgery and procedures

ProcedureCash price List priceInsurers payvs North DakotaOff list
Adenoid removal (adenoidectomy), child under 12 CPT 42830 Adenoidectomy, Primary; Younger Than Age 12 $5,415.00 $6,017.00 $3,754.00 11% above 10%
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 Arthroscopy Knee With Acl Reconstruction $5,297.00 $5,885.00 $3,672.00 — 10%
Arthroscopic rotator cuff repair of the shoulder CPT 29827 Arthroscopy Shoulder With Rotator Cuff Repair $11,724.00 $13,027.00 $8,128.00 at median 10%
Balloon dilation of the maxillary sinus opening, one side CPT 31295 Excision Tissue Endoscopy Maxillary Sinus $10,397.00 $11,552.00 $7,207.00 26% above 10%
Botox injections for chronic migraine both sides CPT 64615 64615 Chemodenervation Of Muscle(s); Muscle(s) Innervated Nerves, Bilateral $408.00 $453.00 $283.00 — 10%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 27786-distal Fibular W/o Manipulation $470.00 $522.00 $326.00 16% above 10%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 27786 Closed Treatment Of Distal Fibular Fracture (Lateral Malleolus); Without Manipulation $818.00 $909.00 $567.00 102% above 10%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 28470metatarsal W/o Manipulation $470.00 $522.00 $326.00 5% above 10%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 28470 Closed Treatment Of Metatarsal Fracture; Without Manipulation, Each $571.00 $634.00 $396.00 28% above 10%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 Correction, Hallux Valgus, With Or Without Sesamoidectomy, With Metatarsal Osteotomy 28296 $5,297.00 $5,885.00 $3,672.00 5% below 10%
Carpal tunnel release, open surgery CPT 64721 64721, Neuroplasty And/or Transposition Median Nerve At Carpal Tunnel $3,850.00 $4,278.00 $2,669.00 3% above 10%
Cataract surgery with lens implant CPT 66984 Removal of cataract with insertion of lens $5,072.00 $5,636.00 $3,516.00 22% above 10%
Cervical biopsy CPT 57500 57500 Biopsy Of Cervix, Single Or Multiple, Or Local Excision Of Lesion, W/ Or W/o Fulguration $347.00 $386.00 $241.00 51% below 10%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 25600-distal Radial W/o Manipulation $470.00 $522.00 $326.00 at median 10%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 25600 Closed Treatment Of Distal Radial Fracture; Without Manipulation $857.00 $952.00 $594.00 82% above 10%
Colonoscopy with polyp removal CPT 45385 Removal of polyps or growths of large bowel using an endoscope $2,932.00 $3,258.00 $2,033.00 45% above 10%
Colonoscopy with tissue sample CPT 45380 Biopsy exam of large bowel using an endoscope $2,785.00 $3,094.00 $1,930.00 51% above 10%
Colonoscopy, diagnostic CPT 45378 Diagnostic exam of large bowel using an endoscope $2,738.00 $3,042.00 $1,898.00 192% above 10%
Complex cataract surgery with lens implant CPT 66982 Extraction Cataract With Intraocular Lens Insertion $5,072.00 $5,636.00 $3,516.00 22% above 10%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 17000 Destruction Premalignant Lesions; First Lesion $175.00 $194.00 $121.00 3% below 10%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 17000-destruction Premalignant Lesions $345.00 $383.00 $239.00 91% above 10%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 Myringotomy With Tympanostomy Tubes $2,968.00 $3,298.00 $2,058.00 41% above 10%
Earwax removal by irrigation (rinsing), one ear CPT 69209 69209-cerumen Irrigation/lavage $41.00 $45.00 $28.00 33% below 9%
Earwax removal with instruments, one ear CPT 69210 69210-cerumen W/ Instrumentation $148.00 $164.00 $102.00 32% above 10%
Earwax removal with instruments, one ear one side CPT 69210 69210 Removal Impacted Cerumen Requiring Instrumentation, Unilateral $127.00 $141.00 $88.00 13% above 10%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 58100-endometrial Biopsy $248.00 $276.00 $172.00 20% above 10%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 49593 Repair Ant Abd Hernia(s) 3-10cm, Reducible $7,335.00 $8,150.00 $5,085.00 193% above 10%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 Repair Hernia Umbilical $6,804.00 $7,560.00 $4,717.00 355% above 10%
Gallbladder removal, laparoscopic CPT 47562 Removal of gallbladder using an endoscope $2,008.00 $2,231.00 $1,392.00 at median 10%
Hammertoe correction surgery CPT 28285 Repair Hammer Toe $5,578.00 $6,198.00 $3,867.00 25% above 10%
Incision and drainage of a simple or single skin abscess CPT 10060 10060-i&d Abscess/cyst/hematoma Simple $356.00 $395.00 $246.00 26% above 10%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 Repair of groin hernia patient age 5 years or older $1,450.00 $1,611.00 $1,005.00 at median 10%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 20550 Injection(s); Single Tendon Sheath, Or Ligament, Aponeurosis (Eg, Plantar Fascia) $141.00 $157.00 $98.00 11% below 10%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 20550inj Single Tendon/ligament $517.00 $574.00 $358.00 225% above 10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 Arthrocentesis, Aspiration And/or Injection, Major Joint Or Bursa; Without Ultrasound Guidance $161.00 $179.00 $112.00 11% below 10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610-major Joint Aspirate/inject W/o Us $529.00 $588.00 $367.00 194% above 10%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605 Arthrocentesis, Aspiration And/or Injection, Intermediate Joint Or Bursa (Eg, Temporomandibula $135.00 $150.00 $94.00 28% below 10%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605-intermediate Aspiration/inj W/o Us $517.00 $574.00 $358.00 177% above 10%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600 Arthrocentesis, Aspiration And/or Injection, Small Joint Or Bursa (Eg, Fingers, Toes); Without $131.00 $145.00 $90.00 29% below 10%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600-small Joint Aspirate/inject W/o Us $517.00 $574.00 $358.00 180% above 10%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 Arthroscopy Knee With Meniscal Repair $5,297.00 $5,885.00 $3,672.00 9% below 10%
Knee arthroscopy with meniscus trim CPT 29881 Removal of one knee cartilage using an endoscope $5,297.00 $5,885.00 $3,672.00 5% below 10%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 Arthroscopy Knee With Meniscectomy $5,297.00 $5,885.00 $3,672.00 9% below 10%
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 Removal of recurring cataract in lens capsule using laser $1,365.00 $1,517.00 $946.00 28% above 10%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 12031 Repair Intermediate S/a/t/e 2.5 Cm/< Techfee $461.00 $512.00 $319.00 2% below 10%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 12031 Repair, Intermediate; Wounds Of Scalp, Axillae, Trunk, Extremities; <2.5cm $636.00 $707.00 $441.00 36% above 10%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 12031-scalp/trunk/extremity Less Than/equal To 2.5 Cm $683.00 $759.00 $474.00 46% above 10%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 11400 Excision, Benign Lesion Including Margins, Except Skin Tag (Unless Listed Elsewhere), Trunk, A $332.00 $369.00 $230.00 5% below 10%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 11400-excision Lesion Benign Trunk/extremity <= 0.5 Cm $1,132.00 $1,258.00 $785.00 224% above 10%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 11440 Excision, Other Benign Lesion Including Margins, Except Skin Tag (Unless Listed Elsewhere), Fa $366.00 $407.00 $254.00 at median 10%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 11440-excise Lesion Benign Face Less Than/equal To 0.5 Cm $1,132.00 $1,258.00 $785.00 209% above 10%
Nail removal (partial or complete), one nail CPT 11730 11730 Avulsion Of Nail Plate, Partial Or Complete, Simple; Single $291.00 $323.00 $202.00 at median 10%
Nail removal (partial or complete), one nail CPT 11730 11730-avulsion Nail Plate Single $345.00 $383.00 $239.00 19% above 10%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 11750 Exc Of Nail And Nail Matrix, Partial Or Complete, For Permanent Removal $633.00 $703.00 $439.00 48% above 10%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 11750-excision Nail & Matrix $900.00 $1,000.00 $624.00 111% above 10%
Removal of a breast lump, open surgery CPT 19120 Removal of one or more breast growth, open procedure $5,774.00 $6,416.00 $4,003.00 285% above 10%
Removal of a foreign object under the skin, simple CPT 10120 10120 Incision And Removal Of Foreign Body, Subcutaneous Tissues; Simple $407.00 $452.00 $282.00 at median 10%
Removal of a foreign object under the skin, simple CPT 10120 10120-subcutaneous Tissue Simple $683.00 $759.00 $474.00 67% above 10%
Septoplasty to straighten the nasal septum CPT 30520 30520 Septoplasty/submucous Resect W-w/o Cartilage Scoring/contour/repl W/gft $4,885.00 $5,428.00 $3,387.00 — 10%
Short arm cast (elbow to hand) CPT 29075 29075-cast Application Elbow To Finger (Short Arm) $492.00 $547.00 $341.00 80% above 10%
Short arm splint (forearm and hand) CPT 29125 29125 Application Of Short Arm Splint (Forearm To Hand); Static $172.00 $191.00 $119.00 1% below 10%
Short arm splint (forearm and hand) CPT 29125 29125-short Arm $255.00 $283.00 $177.00 47% above 10%
Short leg cast (below the knee) CPT 29405 29405-app Of Short Leg Cast (Below Knee To Toes) $510.00 $567.00 $354.00 87% above 10%
Short leg splint (calf to foot) CPT 29515 29515-short Leg $281.00 $312.00 $195.00 38% above 10%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 12001 Simple Repair Of Superficial Wounds Of Scalp, Neck, Axillae, External Genitalia, Trunk And/or $356.00 $395.00 $246.00 37% above 10%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 12001-scalp/neck/trunk/genital/extremity <= 2.5 Cm $356.00 $395.00 $246.00 37% above 10%
Skin biopsy, punch, one lesion CPT 11104 11104 Punch Biopsy Of Skin (Including Simple Closure, When Performed); Single Lesion $331.00 $368.00 $230.00 5% above 10%
Skin biopsy, punch, one lesion CPT 11104 Punch Biopsy $371.00 $412.00 $257.00 18% above 10%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 11600 Excision, Malignant Lesion Including Margins, Trunk, Arms, Or Legs; < 0.5cm $519.00 $577.00 $360.00 2% below 10%
Skin tag removal, up to 15 tags CPT 11200 11200 Removal Of Skin Tags, Multiple Fibrocutaneous Tags, Any Area; Up To And Including 15 Lesions $236.00 $262.00 $163.00 13% above 10%
Skin tag removal, up to 15 tags CPT 11200 11200-removal Skin Tag Up To 15 $236.00 $262.00 $163.00 13% 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 12002 Simple Repair Of Wounds; Scalp, Neck, Axillae, Genitalia, Trunk, Extremeties; 2.6-7.5cm $290.00 $322.00 $201.00 11% 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 12002 Rpr, Sim, Scalp/n/a/t/e; 2.6cm To 7.5cm $356.00 $395.00 $246.00 36% 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 12002-scalp/neck/trunk/genital/extremity 2.6-7.5 Cm $356.00 $395.00 $246.00 36% above 10%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 12011 Simple Repair Of Superficial Wounds Of Face, Ears, Eyelids, Nose, Lips And/or Mucous Membranes $291.00 $323.00 $202.00 11% above 10%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 12011 Simple Repair Of Superficial Wounds Of Face, Ears, Eyelids, Nose, Lips And/or Mucous Membrane $356.00 $395.00 $246.00 36% above 10%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 12011-face/ear/eyelid/nose/lip Less Than/equal To 2.5 Cm $356.00 $395.00 $246.00 36% above 10%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 11102-tangential Biopsy Of Skin $263.00 $292.00 $182.00 22% above 10%
Tonsil and adenoid removal, age 12 or older CPT 42821 42821 Tonsillectomy/adenoidectomy Age 12 And Over $5,415.00 $6,017.00 $3,754.00 11% above 10%
Tonsil and adenoid removal, child under 12 CPT 42820 Removal of tonsils and adenoid glands, patient younger than age 12 $10,065.00 $11,183.00 $6,977.00 11% above 10%
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 42826 Tonsillectomy, Primary Or Secondary; Age 12 Or > $5,415.00 $6,017.00 $3,754.00 at median 10%
Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 42825 Tonsillectomy, Primary Or Secondary; < Than Age 12 $10,065.00 $11,183.00 $6,977.00 — 10%
Trigger finger release surgery CPT 26055 26055 Incise Finger Tendon Sheath $2,606.00 $2,895.00 $1,806.00 7% below 10%
Trigger point injections, 1 or 2 muscles CPT 20552 20552 Injection(s); Single Or Multiple Trigger Point(s), 1 Or 2 Muscle(s) $148.00 $164.00 $102.00 45% below 10%
Trigger point injections, 1 or 2 muscles CPT 20552 20552-inject Trigger Point 1-2 Muscles $148.00 $164.00 $102.00 45% below 10%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 Esophagogastroduodenoscopy Balloon Dilatation $2,897.00 $3,219.00 $2,008.00 21% above 10%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 43249esophagogastroduodenoscopy $3,257.00 $3,619.00 $2,258.00 36% above 10%
Upper endoscopy (EGD) with biopsy CPT 43239 Biopsy exam of esophagus, stomach or small bowel using an endoscope $2,565.00 $2,850.00 $1,778.00 60% above 10%
Upper endoscopy (EGD), diagnostic CPT 43235 Diagnostic exam of esophagus, stomach or small bowel using an endoscope $2,489.00 $2,765.00 $1,725.00 64% above 10%
Wart removal, up to 14 warts CPT 17110 17110 Destruction (Eg, Laser Surgery, Electrosurgery, Cryosurgery, Chemosurgery, Surgical Curettemen $294.00 $327.00 $204.00 29% above 10%
Wart removal, up to 14 warts CPT 17110 17110destruction Benign; Up To 14 $345.00 $383.00 $239.00 51% above 10%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 11042 Debridement, Subcutaneous Tissue; First 20 Sq Cm Or Less $316.00 $351.00 $219.00 8% below 10%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 11042-sq Tissue Less Than/equal To 1st 20 Sq Cm $614.00 $682.00 $425.00 80% above 10%

Doctor visits and therapy

ProcedureCash price List priceInsurers payvs North DakotaOff list
Blood transfusion (giving blood or blood components) CPT 36430 36430 Blodd Admin2 Hrs $851.00 $946.00 $590.00 12% above 10%
Blood transfusion (giving blood or blood components) CPT 36430 1-4 Hoursblood Administration Charges $1,003.00 $1,114.00 $695.00 32% above 10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Nebulizer Treatmentclinic (Smp) $92.00 $102.00 $64.00 24% below 10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Rt Aero Large Volume, Cool Charge $99.00 $110.00 $69.00 18% below 10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Rt Aero Large Volume, Heated Charge $99.00 $110.00 $69.00 18% below 10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Rt Sputum Induction Initial Charge $152.00 $169.00 $105.00 26% above 10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Pres 94640 Nebulizer Treatmentclinic $152.00 $169.00 $105.00 26% above 10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 94640 Pressurized Or Nonpressurized Inhalation Treatment For Acute Airway Obstruction For Therapeuti $320.00 $356.00 $222.00 165% above 10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Rt Mini-neb Initial Charge $320.00 $356.00 $222.00 165% above 10%
Critical care, first 30 to 74 minutes CPT 99291 99291 Er-critical Care 30-74min $1,986.00 $2,207.00 $1,377.00 141% above 10%
Critical care, first 30 to 74 minutes CPT 99291 99291critical Care, 30-74 $2,047.00 $2,274.00 $1,419.00 148% above 10%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Electrocardiogram 12 Lead (Smp) $144.00 $160.00 $100.00 21% above 10%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281level 1 $204.00 $227.00 $142.00 88% above 10%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 11111ed No Charge $204.00 $227.00 $142.00 88% above 10%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99285 Erlevel Ii $289.00 $321.00 $200.00 55% above 10%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282level 2 $299.00 $332.00 $207.00 60% above 10%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283level 3 $526.00 $584.00 $364.00 76% above 10%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99285 Erlevel Iii $526.00 $584.00 $364.00 76% above 10%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99285 Erlevel Iv $825.00 $917.00 $572.00 58% above 10%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284level 4 $825.00 $917.00 $572.00 58% above 10%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285level 5 $1,288.00 $1,431.00 $893.00 67% above 10%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 Erlevel V $1,288.00 $1,431.00 $893.00 67% above 10%
Family therapy with the patient, 50 minutes CPT 90847 Family psychotherapy, including patient, 50 min $941.00 $1,045.00 $652.00 56% above 10%
Family therapy without the patient, 50 minutes CPT 90846 Family psychotherapy, not including patient, 50 min $905.00 $1,005.00 $627.00 78% above 10%
Group psychotherapy session CPT 90853 Group psychotherapy $842.00 $935.00 $583.00 82% above 10%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360-iv Hydration Initial 31 Min1 Hr $476.00 $529.00 $330.00 59% above 10%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360hydration, First Hour $491.00 $546.00 $341.00 64% above 10%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360-59 Iv Hydration Initial Addl Site W/ Modification $491.00 $546.00 $341.00 64% above 10%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 Iv Infusion, Hydration, Initial, 31 Min To 1 Hr $491.00 $545.00 $340.00 64% above 10%
IV infusion of a medicine, first hour CPT 96365 96365 Intravenous Infusion, For Therapy, Prophylaxis, Or Diagnosis (Specify Substance Or Drug); Ini $491.00 $545.00 $340.00 29% above 10%
IV infusion of a medicine, first hour CPT 96365 96365-59 Infusion Initial Addl Site W/ Modification $500.00 $555.00 $346.00 31% above 10%
IV infusion of a medicine, first hour CPT 96365 96365-infusion Drug Initial Up To 1 Hr Greater Than 15 Mins $500.00 $555.00 $346.00 31% above 10%
IV infusion of a medicine, first hour CPT 96365 Smp_health 96365 Iv Infusioninitial $500.00 $555.00 $346.00 31% above 10%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372-injection/sq/im $149.00 $166.00 $104.00 229% above 10%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 Therapeutic, Prophylactic, Or Diagnostic Injection (Specify Substance Or Drug); Subcutaneous O $149.00 $166.00 $104.00 229% above 10%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Amb Inj Med Admin Charge $149.00 $166.00 $104.00 229% above 10%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372-59 Sq/im Injection W/ Modification $149.00 $166.00 $104.00 229% above 10%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Smp_health 96372 Injectionsubq/im $149.00 $166.00 $104.00 229% above 10%
Neuromuscular re-education, 15 minutes CPT 97112 Ot Neuromuscular Reeducation Assistant Units $149.00 $166.00 $104.00 34% above 10%
Neuromuscular re-education, 15 minutes CPT 97112 Pt Neuromuscular Reeducation Assistant Units $149.00 $166.00 $104.00 34% above 10%
New patient office visit, about 30 minutes CPT 99203 New patient office or other outpatient visit, 30 min $286.00 $318.00 $198.00 29% above 10%
New patient office visit, about 45 minutes CPT 99204 New patient office or other outpatient visit, 45 min $435.00 $483.00 $301.00 48% above 10%
New patient office visit, about 60 minutes CPT 99205 New patient office or other outpatient visit, 60 min $547.00 $608.00 $379.00 43% above 10%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 Np Outpatient Visit Lvl 2 15-29 Min Charge $203.00 $225.00 $140.00 22% above 10%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 Office Call Video Newp Patient Minor $203.00 $225.00 $140.00 22% above 10%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 97802 Medical Nutrition Therapy Intial 15 Min Charge $79.00 $88.00 $55.00 21% below 10%
Occupational therapy evaluation, low complexity CPT 97165 Ot Evaluation Units, Low Complexity $419.00 $466.00 $291.00 60% above 10%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pt Evaluation Units, High Complexity $420.00 $467.00 $291.00 36% above 10%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Pt Evaluation Units, Low Complexity $432.00 $480.00 $299.00 64% above 10%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pt Evaluation Units, Moderate Complexity $432.00 $480.00 $299.00 54% above 10%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Pt Manual Therapy Assistant Units $122.00 $135.00 $84.00 16% above 10%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Ot Manual Therapy Assistant Units $122.00 $135.00 $84.00 16% above 10%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Physical therapy, therapeutic exercise $131.00 $146.00 $91.00 22% above 10%
Preventive checkup, new patient aged 18–39 CPT 99385 Initial new patient preventative medicine evaluation (18-39 years) $349.00 $388.00 $242.00 46% above 10%
Preventive checkup, new patient aged 40–64 CPT 99386 Initial new patient preventative medicine evaluation (40-64 years) $407.00 $452.00 $282.00 40% above 10%
Preventive checkup, new patient aged 65 or older CPT 99387 99387 Initial Comprehensive Prev Medicine Age 65 + Lvl 7 Charge $440.00 $489.00 $305.00 41% above 10%
Preventive checkup, returning patient aged 18–39 CPT 99395 99395 Periodic Comprehensive Medicine Ages 18-39 Lvl 5 Charge $316.00 $351.00 $219.00 45% above 10%
Preventive checkup, returning patient aged 40–64 CPT 99396 99396 Periodic Comprehensive Medicine Ages 40-64 Lvl 6 Charge $337.00 $374.00 $233.00 42% above 10%
Preventive checkup, returning patient aged 65 or older CPT 99397 99397 Periodic Comprehensive Medicine Ages 65+ Lvl 7 Charge $363.00 $403.00 $251.00 46% above 10%
Psychotherapy session, 30 minutes CPT 90832 Psychotherapy, 30 min $729.00 $810.00 $505.00 120% above 10%
Psychotherapy session, 45 minutes CPT 90834 Psychotherapy, 45 min $860.00 $955.00 $596.00 109% above 10%
Psychotherapy session, 60 minutes CPT 90837 Psychotherapy, 60 min $873.00 $970.00 $605.00 108% above 10%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Pres 99406 Tobacco Cessation Greater Than 3 Minutes $41.00 $45.00 $28.00 14% above 9%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 99406 Smoking/tobacco Cessation Counseling; 3-10 Min $41.00 $45.00 $28.00 14% above 9%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 Ep Outpatient Visit Lvl 5 40-54 Min Charge $385.00 $428.00 $267.00 12% above 10%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 Ep Outpatient Visit Lvl 3 20-29 Min Charge $196.00 $218.00 $136.00 6% above 10%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 Office Call Est Patient Moderate Video $196.00 $218.00 $136.00 6% above 10%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 Ep Outpatient Visit Lvl 4 30-39 Min Charge (Bh) $288.00 $320.00 $200.00 16% above 10%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 Level 4 Video Visit $288.00 $320.00 $200.00 16% above 10%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Pres Charge: Oupturinary Catheter Care $79.00 $88.00 $55.00 at median 10%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 Ep Outpatient Visit Lvl 2 10-19 Min Charge $121.00 $134.00 $84.00 53% above 10%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 Office Call Est Patient Minor Video $121.00 $134.00 $84.00 53% above 10%
Specialist consultation, low complexity or 30+ minutes CPT 99243 Patient office consultation, 40 min $324.00 $360.00 $225.00 3% above 10%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 Patient office consultation, 60 min $486.00 $540.00 $337.00 33% above 10%
Speech and language evaluation CPT 92523 Slp Eval Lang Comprehension,express Unit $998.00 $1,109.00 $692.00 75% above 10%
Speech therapy session, individual CPT 92507 Slp Auditory Processing Tx Units $332.00 $369.00 $230.00 25% above 10%
Spirometry (breathing test) CPT 94010 94010 Spirometry, W/ Graphic Record, Total/timed Vital Capacity, Expiratory Flow Rate Measurement(s) $92.00 $102.00 $64.00 35% below 10%
Spirometry (breathing test) CPT 94010 Rt Forced Vital Capacity (Fvc) Charge $136.00 $151.00 $94.00 4% below 10%
Spirometry before and after a bronchodilator CPT 94060 Rt Pre & Post Spiro Charge $269.00 $299.00 $187.00 16% below 10%
Therapeutic activities (functional training), 15 minutes CPT 97530 Pt Therapeutic Activity Assistant Units $168.00 $187.00 $117.00 43% above 10%
Therapeutic activities (functional training), 15 minutes CPT 97530 Ot Therapeutic Activities Assistant Units $168.00 $187.00 $117.00 43% above 10%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Ther Phleb $383.00 $425.00 $265.00 31% above 10%

Vaccines

ProcedureCash price List priceInsurers payvs North DakotaOff list
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Vaccine Pneumococcal 23-valent Conjugateamb Pneumococcal 23-valent Vaccine Charge $407.00 $452.00 $282.00 150% above 10%
Rabies vaccine, one dose CPT 90675 1 Ml Rabiesamb Rabies Vaccine Charge $882.00 $980.00 $611.00 36% above 10%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Initial Admin Charge 90471amb Only Admin Charge $46.00 $51.00 $32.00 2% below 10%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 Immuniz Admin 1 Vacc $70.00 $78.00 $49.00 49% above 10%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471-vaccine Administration $70.00 $78.00 $49.00 49% above 10%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471immuniz Admin 1 Vacc $70.00 $78.00 $49.00 49% above 10%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 Day Patient Immunization Administration Techfee $70.00 $78.00 $49.00 49% above 10%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Each Additional 90472admin Immunization Charge $29.00 $32.00 $20.00 5% below 9%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472-vaccine Administration Each Addl $29.00 $32.00 $20.00 5% below 9%

Source file: https://secure.claraprice.net/price-transparency/KPBN-1760641089324/machine-readable/450226729_smp-health---st-aloisius_standardcharges.json