Hospital Fargo, ND-MN

Essentia Health Fargo

Essentia Health Fargo in Fargo, ND publishes cash prices for 379 common procedures listed here, from its own machine-readable price file updated Jan 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the North Dakota median for 223 of 367 procedures and below it for 134. By typical cash price it ranks #21 of 33 North Dakota hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

Essentia Health Fargo, 3000 32nd Ave S Fargo, ND 58103 Collected Sep 23, 2026 Source price file Check a bill from this hospital (701) 364-8000

Acute care hospital Nonprofit hospital Emergency department CMS star rating 3 of 5 CCN 350070 · CMS hospital register NPI 1215125463

Financial assistance

Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply

Essentia Health Fargo is a nonprofit hospital in the CMS register. Under section 501(r) of the federal tax code it must have a written Financial Assistance Policy with a free application, publish both on its website, and charge patients who qualify no more than the amounts generally billed to insured patients for emergency and other medically necessary care. Who qualifies depends on household income; the policy states the limits.

You can apply up to 240 days after the first bill. Before collection actions such as credit reporting or a lawsuit, the hospital must tell you about the policy and wait at least 120 days after that bill. Ask the billing office for the policy and the application before you pay, or search the hospital's website for “financial assistance”. Letters you can copy.

Source: IRS, section 501(r) requirements for nonprofit hospitals.

Scans and imaging

ProcedureCash priceList priceInsurers payvs North DakotaOff list
Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN W/O & W/DYE $1,867.50 $2,490.00 $667.32–$2,116.50 9% below 25%
Abdominal X-ray, 2 views CPT 74019 X-RAY EXAM ABDOMEN 2 VIEWS $127.50 $170.00 $45.56–$144.50 27% below 25%
Abdominal X-ray, 2 views inpatient CPT 74019 X-RAY EXAM ABDOMEN 2 VIEWS $127.50 $170.00 $72.91–$144.50 — 25%
Ankle X-ray, complete, 3 or more views CPT 73610 XRAY ANKLE MINIMUM 3 VWS $147.00 $196.00 $52.53–$166.60 4% below 25%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 XRAY ANKLE MINIMUM 3 VWS $147.00 $196.00 $84.06–$166.60 — 25%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 EXTREMITY STUDY $459.00 $612.00 $164.02–$520.20 56% above 25%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 EXTREMITY STUDY - VASCULAR DIAGNOSTICS $282.00 $376.00 $161.27–$319.60 — 25%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 EXTREMITY STUDY $459.00 $612.00 $262.49–$520.20 — 25%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT UPPER EXTREMITY W/O DYE $1,310.25 $1,747.00 $468.20–$1,484.95 4% above 25%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT UPPER EXTREMITY W/O DYE $1,310.25 $1,747.00 $749.29–$1,484.95 — 25%
Barium swallow (esophagus X-ray with contrast) CPT 74220 CONTRAST XRAY ESOPHAGUS; INCL SCOUT & DELAY (TC) $467.25 $623.00 $166.96–$529.55 30% above 25%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 CONTRAST XRAY ESOPHAGUS; INCL SCOUT & DELAY (TC) $467.25 $623.00 $267.20–$529.55 — 25%
Bone scan, whole body (nuclear medicine) CPT 78306 BONE SCAN, WHOLE BODY $1,261.50 $1,682.00 $450.78–$1,429.70 18% above 25%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 BONE SCAN, WHOLE BODY $1,261.50 $1,682.00 $721.41–$1,429.70 — 25%
Breast ultrasound, complete, one breast CPT 76641 ULTRASOUND BREAST COMPLETE $324.75 $433.00 $116.04–$368.05 8% below 25%
Breast ultrasound, limited (one breast or one area) CPT 76642 ULTRASOUND BREAST LIMITED $281.25 $375.00 $100.50–$318.75 6% below 25%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT ANGIO ABD&PELV W/O&W/DYE $3,307.50 $4,410.00 $1,181.88–$3,748.50 17% above 25%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT ANGIO ABD&PELV W/O&W/DYE $3,307.50 $4,410.00 $1,891.45–$3,748.50 — 25%
CT angiography (CTA) of the head CPT 70496 CT ANGIOGRAPHY, HEAD $1,960.50 $2,614.00 $700.55–$2,221.90 2% below 25%
CT angiography (CTA) of the head inpatient CPT 70496 CT ANGIOGRAPHY, HEAD $1,960.50 $2,614.00 $1,121.14–$2,221.90 — 25%
CT angiography (CTA) of the neck CPT 70498 CT ANGIOGRAPHY, NECK $1,997.25 $2,663.00 $713.68–$2,263.55 at median 25%
CT angiography (CTA) of the neck inpatient CPT 70498 CT ANGIOGRAPHY, NECK $1,997.25 $2,663.00 $1,142.16–$2,263.55 — 25%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIOGRAPHY, CHEST $2,052.00 $2,736.00 $733.25–$2,325.60 2% below 25%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIOGRAPHY, CHEST $2,052.00 $2,736.00 $1,173.47–$2,325.60 — 25%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT ANGIO HRT W/3D IMAGE $1,888.50 $2,518.00 $674.82–$2,140.30 at median 25%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT ANGIO HRT W/3D IMAGE $1,888.50 $2,518.00 $1,079.97–$2,140.30 — 25%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD & PELVIS W/O CONTRAST $2,289.75 $3,053.00 $818.20–$2,595.05 39% above 25%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD & PELVIS W/O CONTRAST $2,289.75 $3,053.00 $1,309.43–$2,595.05 — 25%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN&PELVIS W/CONTRAST $2,930.25 $3,907.00 $1,047.08–$3,320.95 19% above 25%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN&PELVIS W/CONTRAST $2,930.25 $3,907.00 $1,675.71–$3,320.95 — 25%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD&PELV 1+ SECTION/REGNS $3,027.75 $4,037.00 $1,081.92–$3,431.45 4% above 25%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD&PELV 1+ SECTION/REGNS $3,027.75 $4,037.00 $1,731.47–$3,431.45 — 25%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/DYE $1,534.50 $2,046.00 $548.33–$1,739.10 6% below 25%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W/DYE $1,534.50 $2,046.00 $877.53–$1,739.10 — 25%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O DYE $1,242.75 $1,657.00 $444.08–$1,408.45 at median 25%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O DYE $1,242.75 $1,657.00 $710.69–$1,408.45 — 25%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIALW/O DYE $1,429.50 $1,906.00 $510.81–$1,620.10 35% above 25%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIALW/O DYE $1,429.50 $1,906.00 $817.48–$1,620.10 — 25%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN W/O DYE $1,358.25 $1,811.00 $485.35–$1,539.35 26% above 25%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD/BRAIN W/O DYE $1,358.25 $1,811.00 $776.74–$1,539.35 — 25%
CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN W/DYE $1,378.50 $1,838.00 $492.58–$1,562.30 9% above 25%
CT scan of the head without and with contrast CPT 70470 CT HEAD/BRAIN W/O & W/DYE $1,659.00 $2,212.00 $592.82–$1,880.20 9% above 25%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD/BRAIN W/O & W/DYE $1,659.00 $2,212.00 $948.73–$1,880.20 — 25%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE W/O DYE $1,515.00 $2,020.00 $541.36–$1,717.00 16% above 25%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE W/O DYE $1,515.00 $2,020.00 $866.38–$1,717.00 — 25%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT NECK SPINE W/O DYE $1,644.75 $2,193.00 $587.72–$1,864.05 22% above 25%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT NECK SPINE W/O DYE $1,644.75 $2,193.00 $940.58–$1,864.05 — 25%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/DYE $1,474.50 $1,966.00 $526.89–$1,671.10 8% below 25%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/DYE $1,474.50 $1,966.00 $843.22–$1,671.10 — 25%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 CV CAROTID IMAGING-BILAT $695.25 $927.00 $248.44–$787.95 — 25%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 CV CAROTID IMAGING-BILAT $695.25 $927.00 $397.59–$787.95 — 25%
Chest CT scan without and with contrast CPT 71270 DIAGNOSTIC CT THORAX W&WO CONTRAST (TC) $1,698.00 $2,264.00 $606.75–$1,924.40 1% below 25%
Chest X-ray, 2 views CPT 71046 X-RAY EXAM CHEST 2 VIEWS $288.75 $385.00 $103.18–$327.25 67% above 25%
Chest X-ray, 2 views inpatient CPT 71046 X-RAY EXAM CHEST 2 VIEWS $288.75 $385.00 $165.13–$327.25 — 25%
Chest X-ray, single view CPT 71045 X-RAY EXAM CHEST 1 VIEW $277.50 $370.00 $99.16–$314.50 93% above 25%
Chest X-ray, single view inpatient CPT 71045 X-RAY EXAM CHEST 1 VIEW $277.50 $370.00 $158.69–$314.50 — 25%
Collarbone (clavicle) X-ray, complete CPT 73000 XRAY CLAVICLE COMPLETE $233.25 $311.00 $83.35–$264.35 65% above 25%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 XRAY CLAVICLE COMPLETE $233.25 $311.00 $133.39–$264.35 — 25%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL TC $435.75 $581.00 $155.71–$493.85 at median 25%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITONEAL TC $435.75 $581.00 $249.19–$493.85 — 25%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA, BONE DENSITY STUDY, HIPS/PELV/SPINE $291.00 $388.00 $103.98–$329.80 15% above 25%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA, BONE DENSITY STUDY, HIPS/PELV/SPINE $291.00 $388.00 $166.41–$329.80 — 25%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 OB US, DETAILED, SNGL FETUS $526.50 $702.00 $188.14–$596.70 6% above 25%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 OB US, DETAILED, SNGL FETUS $526.50 $702.00 $301.09–$596.70 — 25%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 DIAGNOSTIC CT THORAX W/O CONTRAST (TC) $1,414.50 $1,886.00 $505.45–$1,603.10 16% above 25%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 DIAGNOSTIC CT THORAX W/O CONTRAST (TC) $1,414.50 $1,886.00 $808.91–$1,603.10 — 25%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 DIAGNOSTIC CT THORAX W/ CONTRAST (TC) $1,602.75 $2,137.00 $572.72–$1,816.45 14% above 25%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 DIAGNOSTIC CT THORAX W/ CONTRAST (TC) $1,602.75 $2,137.00 $916.56–$1,816.45 — 25%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 ART LOWER EXTREMITY-BILAT $960.75 $1,281.00 $343.31–$1,088.85 — 25%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 ART LOWER EXTREMITY-BILAT $960.75 $1,281.00 $549.42–$1,088.85 — 25%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 VEN DUPLEX BILATERAL $981.00 $1,308.00 $350.54–$1,111.80 — 25%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 VEN DUPLEX BILATERAL $981.00 $1,308.00 $561.00–$1,111.80 — 25%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TTE W/DOPPLER, COMPLETE $1,696.50 $2,262.00 $606.22–$1,922.70 120% above 25%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 TTE W/DOPPLER, COMPLETE $1,696.50 $2,262.00 $970.17–$1,922.70 — 25%
Elbow X-ray, 2 views CPT 73070 XRAY ELBOW 2 VWS $229.50 $306.00 $82.01–$260.10 68% above 25%
Elbow X-ray, 2 views inpatient CPT 73070 XRAY ELBOW 2 VWS $229.50 $306.00 $131.24–$260.10 — 25%
Elbow X-ray, complete, 3 or more views CPT 73080 XRAY ELBOW 3+VWS TC $270.75 $361.00 $96.75–$306.85 67% above 25%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 XRAY ELBOW 3+VWS TC $270.75 $361.00 $154.83–$306.85 — 25%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT/EAR/FOSA W/O DYE $1,316.25 $1,755.00 $470.34–$1,491.75 5% below 25%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBIT/EAR/FOSA W/O DYE $1,316.25 $1,755.00 $752.72–$1,491.75 — 25%
Facial bones X-ray, complete, 3 or more views CPT 70150 XRAY FACIAL BONES MINIMUM 3 VWS $111.75 $149.00 $39.93–$126.65 43% below 25%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XRAY FACIAL BONES MINIMUM 3 VWS $111.75 $149.00 $63.91–$126.65 — 25%
Forearm X-ray (radius and ulna), 2 views CPT 73090 XRAY FOREARM 2 VWS $240.00 $320.00 $85.76–$272.00 64% above 25%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 XRAY FOREARM 2 VWS $240.00 $320.00 $137.25–$272.00 — 25%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBILIARY SYSTEM IMAGING $1,387.50 $1,850.00 $495.80–$1,572.50 17% above 25%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HEPATOBILIARY SYSTEM IMAGING $1,387.50 $1,850.00 $793.46–$1,572.50 — 25%
Hand X-ray, 2 views CPT 73120 XRAY HAND 2VWS TC $221.25 $295.00 $79.06–$250.75 57% above 25%
Hand X-ray, 2 views inpatient CPT 73120 XRAY HAND 2VWS TC $221.25 $295.00 $126.53–$250.75 — 25%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 XRAY CALCANEUS MINIMUM 2 VWS $135.75 $181.00 $48.51–$153.85 6% below 25%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 XRAY CALCANEUS MINIMUM 2 VWS $135.75 $181.00 $77.63–$153.85 — 25%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STUDY, UNATTENDED $479.25 $639.00 $171.25–$543.15 36% above 25%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 SLEEP STUDY, UNATTENDED $479.25 $639.00 $274.07–$543.15 — 25%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOMNOGRAPHY W/CPAP $3,217.50 $4,290.00 $1,149.72–$3,646.50 33% above 25%
Knee X-ray, 3 views CPT 73562 XRAY KNEE 3 VWS $163.50 $218.00 $58.42–$185.30 11% below 25%
Knee X-ray, 3 views inpatient CPT 73562 XRAY KNEE 3 VWS $163.50 $218.00 $93.50–$185.30 — 25%
Knee X-ray, complete, 4 or more views CPT 73564 XRAY KNEE 4 OR MORE VWS $187.50 $250.00 $67.00–$212.50 4% below 25%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 XRAY KNEE 4 OR MORE VWS $187.50 $250.00 $107.22–$212.50 — 25%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT LOWER EXTREMITY W/O DYE $1,503.00 $2,004.00 $537.07–$1,703.40 24% above 25%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT LOWER EXTREMITY W/O DYE $1,503.00 $2,004.00 $859.52–$1,703.40 — 25%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LIMITED TC $545.25 $727.00 $194.84–$617.95 40% above 25%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN LIMITED TC $545.25 $727.00 $311.81–$617.95 — 25%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US MUSCOSKELETAL LIMITED JOINT, TC $311.25 $415.00 $111.22–$352.75 28% above 25%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US EXT NON-VASC LIMITED, REALTIME W/ IMG TC $401.25 $535.00 $143.38–$454.75 66% above 25%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US MUSCOSKELETAL LIMITED JOINT, TC $311.25 $415.00 $177.99–$352.75 — 25%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US EXT NON-VASC LIMITED, REALTIME W/ IMG TC $401.25 $535.00 $229.46–$454.75 — 25%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 LOW DOSE CT LUNG CA SCREEN WO CONTRAST $1,197.00 $1,596.00 $427.73–$1,356.60 60% above 25%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 LOW DOSE CT LUNG CA SCREEN WO CONTRAST $1,197.00 $1,596.00 $684.52–$1,356.60 — 25%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 XRAY TIBIA & FIBULA 2 VWS $142.50 $190.00 $50.92–$161.50 10% below 25%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 XRAY TIBIA & FIBULA 2 VWS $142.50 $190.00 $81.49–$161.50 — 25%
MR angiography (MRA) of the head without contrast CPT 70544 MRA, HEAD W/OUT CONTRAST $2,201.25 $2,935.00 $786.58–$2,494.75 at median 25%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA, HEAD W/OUT CONTRAST $2,201.25 $2,935.00 $1,258.82–$2,494.75 — 25%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI, BREAST, W/WO CONTRAST MATERIAL; INCL CAD BILATERAL $2,607.75 $3,477.00 $931.84–$2,955.45 — 25%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LOW EXT JNT WO/CONT TC $2,256.75 $3,009.00 $806.41–$2,557.65 17% above 25%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI LOW EXT JNT WO/CONT TC $2,256.75 $3,009.00 $1,290.56–$2,557.65 — 25%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI,LWREXT,JNT W/O+W/CONT $2,682.75 $3,577.00 $958.64–$3,040.45 14% below 25%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI,LWREXT,JNT W/O+W/CONT $2,682.75 $3,577.00 $1,534.18–$3,040.45 — 25%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O TC $2,244.00 $2,992.00 $801.86–$2,543.20 16% above 25%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN W/O TC $2,244.00 $2,992.00 $1,283.27–$2,543.20 — 25%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI, ABDOMEN W/O+ W/CONTR $3,006.00 $4,008.00 $1,074.14–$3,406.80 7% below 25%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI, ABDOMEN W/O+ W/CONTR $3,006.00 $4,008.00 $1,719.03–$3,406.80 — 25%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO CONTRAST TC $2,223.00 $2,964.00 $794.35–$2,519.40 27% above 25%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO CONTRAST TC $2,223.00 $2,964.00 $1,271.26–$2,519.40 — 25%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W & WO CONTRAST $3,112.50 $4,150.00 $1,112.20–$3,527.50 3% above 25%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W & WO CONTRAST $3,112.50 $4,150.00 $1,779.94–$3,527.50 — 25%
MRI of the lower back, no contrast dye CPT 72148 MRI L SPINE WO CONTRAST $2,164.50 $2,886.00 $773.45–$2,453.10 12% above 25%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI L SPINE WO CONTRAST $2,164.50 $2,886.00 $1,237.81–$2,453.10 — 25%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI L SPINE W&WO CONTRAST $2,913.00 $3,884.00 $1,040.91–$3,301.40 6% below 25%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI L SPINE W&WO CONTRAST $2,913.00 $3,884.00 $1,665.85–$3,301.40 — 25%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI T SPINE WO CONTRAST $2,208.00 $2,944.00 $788.99–$2,502.40 6% above 25%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI T SPINE WO CONTRAST $2,208.00 $2,944.00 $1,262.68–$2,502.40 — 25%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI C SPINE W&WO CONTRAST $2,854.50 $3,806.00 $1,020.01–$3,235.10 7% below 25%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI C SPINE W&WO CONTRAST $2,854.50 $3,806.00 $1,632.39–$3,235.10 — 25%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI C-SPINE WO CONTRAST $2,205.00 $2,940.00 $787.92–$2,499.00 14% above 25%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI C-SPINE WO CONTRAST $2,205.00 $2,940.00 $1,260.97–$2,499.00 — 25%
MRI of the pelvis without and with contrast CPT 72197 MRI, PELVIS, W/O THEN W/ $2,898.00 $3,864.00 $1,035.55–$3,284.40 6% below 25%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI, PELVIS, W/O THEN W/ $2,898.00 $3,864.00 $1,657.27–$3,284.40 — 25%
MRI of the pelvis, no contrast dye CPT 72195 MRI,PELVIS W/OUT CONTRAST $2,174.25 $2,899.00 $776.93–$2,464.15 2% below 25%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI,PELVIS W/OUT CONTRAST $2,174.25 $2,899.00 $1,243.38–$2,464.15 — 25%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI UP EXTREMITY JOINT W/O TC $2,180.25 $2,907.00 $779.08–$2,470.95 13% above 25%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI UP EXTREMITY JOINT W/O TC $2,180.25 $2,907.00 $1,246.81–$2,470.95 — 25%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XRAY CERVICAL SPINE 4 OR 5 VWS $230.25 $307.00 $82.28–$260.95 2% above 25%
Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISSUE NECK W/DYE $1,494.00 $1,992.00 $533.86–$1,693.20 4% above 25%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SOFT TISSUE NECK W/DYE $1,494.00 $1,992.00 $854.37–$1,693.20 — 25%
Neck soft tissue CT scan without contrast CPT 70490 CT SOFT TISSUE NECK W/O DYE $1,227.00 $1,636.00 $438.45–$1,390.60 at median 25%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SOFT TISSUE NECK W/O DYE $1,227.00 $1,636.00 $701.68–$1,390.60 — 25%
Neck soft tissue X-ray CPT 70360 XRAY NECK, SOFT TISSUE $165.00 $220.00 $58.96–$187.00 13% above 25%
Neck soft tissue X-ray inpatient CPT 70360 XRAY NECK, SOFT TISSUE $165.00 $220.00 $94.36–$187.00 — 25%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HT MUSCLE IMAGE SPECT, MULT $2,911.50 $3,882.00 $1,040.38–$3,299.70 33% above 25%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HT MUSCLE IMAGE SPECT, MULT $2,911.50 $3,882.00 $1,664.99–$3,299.70 — 25%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET/CT SKULL-MID THIGH TC $4,414.50 $5,886.00 $1,577.45–$5,003.10 12% above 25%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET/CT SKULL-MID THIGH TC $4,414.50 $5,886.00 $2,524.51–$5,003.10 — 25%
Pelvic CT scan without contrast CPT 72192 CT PELVIS W/O DYE $1,415.25 $1,887.00 $505.72–$1,603.95 15% above 25%
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS W/O DYE $1,415.25 $1,887.00 $809.33–$1,603.95 — 25%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US FOLLICLES-LIMITED TC $384.00 $512.00 $137.22–$435.20 16% above 25%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US FOLLICLES-LIMITED TC $384.00 $512.00 $219.60–$435.20 — 25%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC TC COMPLETE $571.50 $762.00 $204.22–$647.70 26% above 25%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC TC COMPLETE $571.50 $762.00 $326.82–$647.70 — 25%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US,PREG. UTERUS,FETAL/MAT.EVAL.,>1ST TRIM.(>/= 14 WKS 0 DYS),TRANSABD;SINGLE/FIRST GEST., TECH $574.50 $766.00 $205.29–$651.10 13% above 25%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US,PREG. UTERUS,FETAL/MAT.EVAL.,>1ST TRIM.(>/= 14 WKS 0 DYS),TRANSABD;SINGLE/FIRST GEST., TECH $574.50 $766.00 $328.54–$651.10 — 25%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OB US < 14 WKS, SINGLE FETUS - RADIOLOGY, TECH $402.00 $536.00 $143.65–$455.60 at median 25%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 OB US < 14 WKS, SINGLE FETUS - RADIOLOGY, TECH $402.00 $536.00 $229.89–$455.60 — 25%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OB US, LIMITED, FETUS(S) $324.00 $432.00 $115.78–$367.20 1% above 25%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREGNANCY TC LIMITED $408.00 $544.00 $145.79–$462.40 27% above 25%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 OB US, LIMITED, FETUS(S) $324.00 $432.00 $185.28–$367.20 — 25%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US PREGNANCY TC LIMITED $408.00 $544.00 $233.32–$462.40 — 25%
Rib X-ray, one side, 2 views one side CPT 71100 XRAY RIBS UNILAT 2 VWS $116.25 $155.00 $41.54–$131.75 32% below 25%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XRAY RIBS UNILAT 2 VWS $116.25 $155.00 $66.48–$131.75 — 25%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XRAY RIBS UNILAT 2 VWS WITH PA CHEST $159.75 $213.00 $57.08–$181.05 15% below 25%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XRAY RIBS UNILAT 2 VWS WITH PA CHEST $159.75 $213.00 $91.36–$181.05 — 25%
Shoulder X-ray, complete, 2 or more views CPT 73030 XRAY SHOULDER MINIMUM 2 VWS $264.75 $353.00 $94.60–$300.05 50% above 25%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 XRAY SHOULDER MINIMUM 2 VWS $264.75 $353.00 $151.40–$300.05 — 25%
Sinus X-ray, complete, 3 or more views CPT 70220 XRAY SINUSES MINIMUM 3 VWS $120.75 $161.00 $43.15–$136.85 32% below 25%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XRAY SINUSES MINIMUM 3 VWS $120.75 $161.00 $69.05–$136.85 — 25%
Skull X-ray, fewer than 4 views CPT 70250 XRAY SKULL LESS THAN 4 VWS $194.25 $259.00 $69.41–$220.15 17% above 25%
Skull X-ray, fewer than 4 views inpatient CPT 70250 XRAY SKULL LESS THAN 4 VWS $194.25 $259.00 $111.09–$220.15 — 25%
Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAPHY, 4 OR MORE $2,941.50 $3,922.00 $1,051.10–$3,333.70 21% above 25%
Swallow study (modified barium swallow, video X-ray) CPT 74230 CONTRAST XRAY SWALLOWING FUNCT INT, CINE/VID; INCLSCOUT & DELAY (TC) $386.25 $515.00 $138.02–$437.75 23% below 25%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 CONTRAST XRAY SWALLOWING FUNCT INT, CINE/VID; INCLSCOUT & DELAY (TC) $386.25 $515.00 $220.88–$437.75 — 25%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 X-RAY EXAM FEMUR MIN 2 VWS $144.00 $192.00 $51.46–$163.20 13% below 25%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 X-RAY EXAM FEMUR MIN 2 VWS $144.00 $192.00 $82.35–$163.20 — 25%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT CHEST SPINE W/O DYE $1,427.25 $1,903.00 $510.00–$1,617.55 10% above 25%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT CHEST SPINE W/O DYE $1,427.25 $1,903.00 $816.20–$1,617.55 — 25%
Toe X-ray, 2 or more views CPT 73660 XRAY TOE(S) TC $129.00 $172.00 $46.10–$146.20 1% above 25%
Toe X-ray, 2 or more views inpatient CPT 73660 XRAY TOE(S) TC $129.00 $172.00 $73.77–$146.20 — 25%
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL TC $454.50 $606.00 $162.41–$515.10 6% below 25%
Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL TC $454.50 $606.00 $259.91–$515.10 — 25%
Transvaginal ultrasound during pregnancy CPT 76817 TRANSVAGINAL US, OBSTETRIC $304.50 $406.00 $108.81–$345.10 8% below 25%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 TRANSVAGINAL US, OBSTETRIC $304.50 $406.00 $174.13–$345.10 — 25%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN TC $732.00 $976.00 $261.57–$829.60 42% above 25%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN TC $732.00 $976.00 $418.61–$829.60 — 25%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM & CONTENTS TC $501.00 $668.00 $179.02–$567.80 21% above 25%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM & CONTENTS TC $501.00 $668.00 $286.51–$567.80 — 25%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US HEAD/NECK TC $407.25 $543.00 $145.52–$461.55 15% below 25%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US HEAD/NECK TC $407.25 $543.00 $232.89–$461.55 — 25%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 X-RAY EXAM, UPPER GI TRACT, INCL SCOUT & DELAY; SINGLE CONTRAST (TC) $498.00 $664.00 $177.95–$564.40 5% below 25%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 X-RAY EXAM, UPPER GI TRACT, INCL SCOUT & DELAY; SINGLE CONTRAST (TC) $498.00 $664.00 $284.79–$564.40 — 25%
Upper arm X-ray (humerus), 2 views CPT 73060 XRAY HUMERUS MINIMUM 2 VWS $255.00 $340.00 $91.12–$289.00 78% above 25%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 XRAY HUMERUS MINIMUM 2 VWS $255.00 $340.00 $145.83–$289.00 — 25%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 VEN DUPLEX LIMITED $456.75 $609.00 $163.21–$517.65 12% below 25%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 VENOUS DUPLEX SCAN UNI $628.50 $838.00 $224.58–$712.30 21% above 25%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 VEN DUPLEX LIMITED $456.75 $609.00 $261.20–$517.65 — 25%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 VENOUS DUPLEX SCAN UNI $628.50 $838.00 $359.42–$712.30 — 25%
Wrist X-ray, 2 views CPT 73100 XRAY WRIST 2 VWS $234.75 $313.00 $83.88–$266.05 50% above 25%
Wrist X-ray, 2 views inpatient CPT 73100 XRAY WRIST 2 VWS $234.75 $313.00 $134.25–$266.05 — 25%
Wrist X-ray, complete, 3 or more views CPT 73110 XRAY WRIST MINIMUM 3 VWS $259.50 $346.00 $92.73–$294.10 49% above 25%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 XRAY WRIST MINIMUM 3 VWS $259.50 $346.00 $148.40–$294.10 — 25%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 X-RAY EXAM HIP,UNILAT W/PELVIS 2-3 VWS $280.50 $374.00 $100.23–$317.90 37% above 25%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 X-RAY EXAM HIP,UNILAT W/PELVIS 2-3 VWS $280.50 $374.00 $160.41–$317.90 — 25%
X-ray of the abdomen, 1 view CPT 74018 X-RAY EXAM ABDOMEN 1 VIEW $135.75 $181.00 $48.51–$153.85 3% below 25%
X-ray of the abdomen, 1 view inpatient CPT 74018 X-RAY EXAM ABDOMEN 1 VIEW $135.75 $181.00 $77.63–$153.85 — 25%
X-ray of the ankle, 2 views CPT 73600 XRAY ANKLE 2 VWS $106.50 $142.00 $38.06–$120.70 27% below 25%
X-ray of the ankle, 2 views inpatient CPT 73600 XRAY ANKLE 2 VWS $106.50 $142.00 $60.90–$120.70 — 25%
X-ray of the finger(s), 2 or more views CPT 73140 XRAY FINGER(S) TC $173.25 $231.00 $61.91–$196.35 11% above 25%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 XRAY FINGER(S) TC $173.25 $231.00 $99.08–$196.35 — 25%
X-ray of the foot, 2 views CPT 73620 XRAY FOOT 2 VWS $140.25 $187.00 $50.12–$158.95 at median 25%
X-ray of the foot, 2 views inpatient CPT 73620 XRAY FOOT 2 VWS $140.25 $187.00 $80.20–$158.95 — 25%
X-ray of the foot, complete, 3 or more views CPT 73630 XRAY FOOT MINIMUM 3 VWS $149.25 $199.00 $53.33–$169.15 2% above 25%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 XRAY FOOT MINIMUM 3 VWS $149.25 $199.00 $85.35–$169.15 — 25%
X-ray of the hand, 3 or more views CPT 73130 XRAY HAND 3VWS TC $251.25 $335.00 $89.78–$284.75 53% above 25%
X-ray of the hand, 3 or more views inpatient CPT 73130 XRAY HAND 3VWS TC $251.25 $335.00 $143.68–$284.75 — 25%
X-ray of the knee, 1 or 2 views CPT 73560 XRAY KNEE 1 OR 2 VWS $142.50 $190.00 $50.92–$161.50 11% below 25%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 XRAY KNEE 1 OR 2 VWS $142.50 $190.00 $81.49–$161.50 — 25%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XRAY LUMBOSACRAL 2 OR 3 VWS $219.00 $292.00 $78.26–$248.20 13% above 25%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XRAY LUMBOSACRAL 2 OR 3 VWS $219.00 $292.00 $125.24–$248.20 — 25%
X-ray of the lower back, 4 or more views CPT 72110 XRAY LUMBOSACRAL MINIMUM 4 VWS $220.50 $294.00 $78.79–$249.90 7% below 25%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XRAY LUMBOSACRAL MINIMUM 4 VWS $220.50 $294.00 $126.10–$249.90 — 25%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XRAY THORACIC SPINE 2 VWS $151.50 $202.00 $54.14–$171.70 at median 25%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XRAY THORACIC SPINE 2 VWS $151.50 $202.00 $86.64–$171.70 — 25%
X-ray of the nasal bones, 3 or more views CPT 70160 XRAY NASAL BONES MINIMUM 3 VWS $102.75 $137.00 $36.72–$116.45 32% below 25%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XRAY CERVICAL SPINE 2 OR 3 VWS $180.75 $241.00 $64.59–$204.85 11% above 25%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XRAY CERVICAL SPINE 2 OR 3 VWS $180.75 $241.00 $103.36–$204.85 — 25%
X-ray of the pelvis, 1 or 2 views CPT 72170 XRAY PELVIS 1 OR 2 VWS $200.25 $267.00 $71.56–$226.95 30% above 25%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XRAY PELVIS 1 OR 2 VWS $200.25 $267.00 $114.52–$226.95 — 25%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XRAY SACRUM/ COCCYX MINIMUM 2 VWS $111.75 $149.00 $39.93–$126.65 27% below 25%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XRAY SACRUM/ COCCYX MINIMUM 2 VWS $111.75 $149.00 $63.91–$126.65 — 25%

Lab tests

ProcedureCash priceList priceInsurers payvs North DakotaOff list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 TRANSFERASE; ALANINE AMINO (ALT) (SGPT) $58.50 $78.00 $20.90–$66.30 44% above 25%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 TRANSFERASE; ALANINE AMINO (ALT) (SGPT) $58.50 $78.00 $33.45–$66.30 — 25%
AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSFERASE; ASPARTATE AMINO (AST) (SGOT) $59.25 $79.00 $21.17–$67.15 43% above 25%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 TRANSFERASE; ASPARTATE AMINO (AST) (SGOT) $59.25 $79.00 $33.88–$67.15 — 25%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL $264.00 $352.00 $94.34–$299.20 16% above 25%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS PANEL $264.00 $352.00 $150.97–$299.20 — 25%
Alkaline phosphatase (ALP) blood test CPT 84075 ASSAY ALKALINE PHOSPHATASE $69.00 $92.00 $24.66–$78.20 106% above 25%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ASSAY ALKALINE PHOSPHATASE $69.00 $92.00 $39.46–$78.20 — 25%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN SERUM $20.25 $27.00 $7.24–$22.95 79% below 25%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN SERUM $20.25 $27.00 $11.58–$22.95 — 25%
Ammonia blood test CPT 82140 AMMONIA $126.00 $168.00 $45.02–$142.80 154% above 25%
Ammonia blood test inpatient CPT 82140 AMMONIA $126.00 $168.00 $72.06–$142.80 — 25%
Amylase blood test CPT 82150 ASSAY OF AMYLASE $89.25 $119.00 $31.89–$101.15 96% above 25%
Amylase blood test inpatient CPT 82150 ASSAY OF AMYLASE $89.25 $119.00 $51.04–$101.15 — 25%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES $68.25 $91.00 $24.39–$77.35 7% above 25%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES $68.25 $91.00 $39.03–$77.35 — 25%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 ASSAY OF NATRIURETIC PEPTIDE $207.75 $277.00 $74.24–$235.45 10% below 25%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 ASSAY OF NATRIURETIC PEPTIDE $207.75 $277.00 $118.81–$235.45 — 25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 LAB CULTURE BACTERIA $80.25 $107.00 $28.68–$90.95 24% above 25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 LAB CULTURE BACTERIA $80.25 $107.00 $45.89–$90.95 — 25%
Basic metabolic panel (blood test) CPT 80048 LAB BASIC METABOLIC PANEL $104.25 $139.00 $37.25–$118.15 40% above 25%
Basic metabolic panel (blood test) inpatient CPT 80048 LAB BASIC METABOLIC PANEL $104.25 $139.00 $59.62–$118.15 — 25%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL $61.50 $82.00 $21.98–$69.70 75% above 25%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL $61.50 $82.00 $35.17–$69.70 — 25%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 LEVEL IV - SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATION , TECH $206.25 $275.00 $73.70–$233.75 67% above 25%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 LEVEL IV - SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATION , TECH $206.25 $275.00 $117.95–$233.75 — 25%
Blood culture for bacteria CPT 87040 BLOOD CULTURE FOR BACTERIA $168.75 $225.00 $60.30–$191.25 99% above 25%
Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE FOR BACTERIA $168.75 $225.00 $96.50–$191.25 — 25%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 OCC MED VENIPUNCTURE $11.25 $15.00 $4.02–$12.75 34% below 25%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE, LAB $24.00 $32.00 $8.58–$27.20 40% above 25%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE $24.00 $32.00 $8.58–$27.20 40% above 25%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COMMUNITY PARAMEDIC VENIPUNCTURE $24.00 $32.00 $8.58–$27.20 40% above 25%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 OCC MED VENIPUNCTURE $11.25 $15.00 $6.43–$12.75 — 25%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE, LAB $24.00 $32.00 $13.72–$27.20 — 25%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COMMUNITY PARAMEDIC VENIPUNCTURE $24.00 $32.00 $13.72–$27.20 — 25%
Blood glucose (sugar) test CPT 82947 ASSAY, GLUCOSE, BLOOD QUANT $55.50 $74.00 $19.83–$62.90 88% above 25%
Blood glucose (sugar) test inpatient CPT 82947 ASSAY, GLUCOSE, BLOOD QUANT $55.50 $74.00 $31.74–$62.90 — 25%
Blood lead test CPT 83655 LEAD $69.75 $93.00 $24.92–$79.05 52% above 25%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 GONADOTROPIN, CHORIONIC (HCG), QUALITATIVE $85.50 $114.00 $30.55–$96.90 33% above 25%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 GONADOTROPIN, CHORIONIC (HCG), QUALITATIVE $85.50 $114.00 $48.89–$96.90 — 25%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING ABO $90.75 $121.00 $32.43–$102.85 132% above 25%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING ABO $90.75 $121.00 $51.90–$102.85 — 25%
Blood urea nitrogen (BUN) test CPT 84520 ASSAY OF UREA NITROGEN $46.50 $62.00 $16.62–$52.70 26% above 25%
Blood urea nitrogen (BUN) test inpatient CPT 84520 ASSAY OF UREA NITROGEN $46.50 $62.00 $26.59–$52.70 — 25%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN $88.50 $118.00 $31.62–$100.30 146% above 25%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN $88.50 $118.00 $50.61–$100.30 — 25%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMPLIFIED PROBE $166.50 $222.00 $59.50–$188.70 13% below 25%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF AMPLIFIED PROBE $166.50 $222.00 $95.22–$188.70 — 25%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 $135.75 $181.00 $48.51–$153.85 24% above 25%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 $135.75 $181.00 $77.63–$153.85 — 25%
CA-125 blood test (ovarian cancer marker) CPT 86304 TUMOR ANTIGEN, CA-125 $143.25 $191.00 $51.19–$162.35 13% above 25%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 TUMOR ANTIGEN, CA-125 $143.25 $191.00 $81.92–$162.35 — 25%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ $135.75 $181.00 $48.51–$153.85 9% above 25%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ $135.75 $181.00 $77.63–$153.85 — 25%
Calcium blood test, total CPT 82310 CALCIUM TOTAL $68.25 $91.00 $24.39–$77.35 113% above 25%
Calcium blood test, total inpatient CPT 82310 CALCIUM TOTAL $68.25 $91.00 $39.03–$77.35 — 25%
Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC ANTIGEN $131.25 $175.00 $46.90–$148.75 6% above 25%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CARCINOEMBRYONIC ANTIGEN $131.25 $175.00 $75.06–$148.75 — 25%
Chickenpox (varicella) immunity blood test CPT 86787 OCC MED VARICELLA $34.50 $46.00 $12.33–$39.10 42% below 25%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOSTER ANTIBODY $81.75 $109.00 $29.21–$92.65 38% above 25%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 OCC MED VARICELLA $34.50 $46.00 $19.73–$39.10 — 25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS DNA, AMP PROBE $153.75 $205.00 $54.94–$174.25 at median 25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS DNA, AMP PROBE $153.75 $205.00 $87.92–$174.25 — 25%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE $110.25 $147.00 $39.40–$124.95 49% above 25%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE $110.25 $147.00 $63.05–$124.95 — 25%
Complete blood count (CBC) with differential CPT 85025 COMPLETE CBC W/AUTO DIFF WBC $127.50 $170.00 $45.56–$144.50 119% above 25%
Complete blood count (CBC) with differential inpatient CPT 85025 COMPLETE CBC W/AUTO DIFF WBC $127.50 $170.00 $72.91–$144.50 — 25%
Complete blood count (CBC), no differential CPT 85027 OCC MED, HEMOGRAM $16.50 $22.00 $5.90–$18.70 64% below 25%
Complete blood count (CBC), no differential CPT 85027 COMPLETE CBC AUTOMATED $75.75 $101.00 $27.07–$85.85 65% above 25%
Complete blood count (CBC), no differential inpatient CPT 85027 OCC MED, HEMOGRAM $16.50 $22.00 $9.44–$18.70 — 25%
Complete blood count (CBC), no differential inpatient CPT 85027 COMPLETE CBC AUTOMATED $75.75 $101.00 $43.32–$85.85 — 25%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL $191.25 $255.00 $68.34–$216.75 103% above 25%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL $191.25 $255.00 $109.37–$216.75 — 25%
Cortisol blood test, total CPT 82533 TOTAL CORTISOL $116.25 $155.00 $41.54–$131.75 114% above 25%
Cortisol blood test, total inpatient CPT 82533 TOTAL CORTISOL $116.25 $155.00 $66.48–$131.75 — 25%
Creatine kinase (CK) blood test, total CPT 82550 ASSAY OF CK (CPK) $72.00 $96.00 $25.73–$81.60 53% above 25%
Creatine kinase (CK) blood test, total inpatient CPT 82550 ASSAY OF CK (CPK) $72.00 $96.00 $41.17–$81.60 — 25%
Creatinine blood test CPT 82565 CREATININE; BLOOD $70.50 $94.00 $25.19–$79.90 78% above 25%
Creatinine blood test inpatient CPT 82565 CREATININE; BLOOD $70.50 $94.00 $40.32–$79.90 — 25%
D-dimer blood test (blood clot marker) CPT 85379 FIBRIN DEGRADATION QUANT $125.25 $167.00 $44.76–$141.95 70% above 25%
D-dimer blood test (blood clot marker) inpatient CPT 85379 FIBRIN DEGRADATION QUANT $125.25 $167.00 $71.63–$141.95 — 25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 SALICYLATE $48.75 $65.00 $17.42–$55.25 66% below 25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 ALCOHOL $104.25 $139.00 $37.25–$118.15 28% below 25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 ACETAMINOPHEN $113.25 $151.00 $40.47–$128.35 21% below 25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 URINE DRUG SCREEN $306.00 $408.00 $109.34–$346.80 112% above 25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 OB URINE DRUG SCREEN $306.00 $408.00 $109.34–$346.80 112% above 25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 SALICYLATE $48.75 $65.00 $27.88–$55.25 — 25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ACETAMINOPHEN $113.25 $151.00 $64.76–$128.35 — 25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 OB URINE DRUG SCREEN $306.00 $408.00 $174.99–$346.80 — 25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 URINE DRUG SCREEN $306.00 $408.00 $174.99–$346.80 — 25%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL $102.75 $137.00 $36.72–$116.45 85% above 25%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL $102.75 $137.00 $58.76–$116.45 — 25%
Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEEN-BARR ANTIBODY VIRAL CAPSID(VAC) $21.00 $28.00 $7.50–$23.80 75% below 25%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEEN-BARR ANTIBODY VIRAL CAPSID(VAC) $21.00 $28.00 $12.01–$23.80 — 25%
Estradiol blood test CPT 82670 ENDOCRINE E2 $129.00 $172.00 $46.10–$146.20 at median 25%
FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE STIMULATING HORMONE $106.50 $142.00 $38.06–$120.70 at median 25%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FOLLICLE STIMULATING HORMONE $106.50 $142.00 $60.90–$120.70 — 25%
Fecal calprotectin (stool inflammation test) CPT 83993 ASSAY FOR CALPROTECTIN FECAL $18.00 $24.00 $6.43–$20.40 89% below 25%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 ASSAY FOR CALPROTECTIN FECAL $18.00 $24.00 $10.29–$20.40 — 25%
Ferritin blood test (iron stores) CPT 82728 ASSAY OF FERRITIN $165.00 $220.00 $58.96–$187.00 76% above 25%
Ferritin blood test (iron stores) inpatient CPT 82728 ASSAY OF FERRITIN $165.00 $220.00 $94.36–$187.00 — 25%
Fibrinogen blood test CPT 85384 FIBRINOGEN $93.00 $124.00 $33.23–$105.40 69% above 25%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN $93.00 $124.00 $53.18–$105.40 — 25%
Folate (folic acid) blood test CPT 82746 FOLIC ACID (FOLATE), SERUM $145.50 $194.00 $51.99–$164.90 55% above 25%
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID (FOLATE), SERUM $145.50 $194.00 $83.21–$164.90 — 25%
Free T3 thyroid hormone test CPT 84481 TRIIODOTHYRONINE T3, FREE (FREE T3) $159.00 $212.00 $56.82–$180.20 57% above 25%
Free T3 thyroid hormone test inpatient CPT 84481 TRIIODOTHYRONINE T3, FREE (FREE T3) $159.00 $212.00 $90.93–$180.20 — 25%
Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXIN, FREE (FREE T4) $81.75 $109.00 $29.21–$92.65 31% above 25%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXIN, FREE (FREE T4) $81.75 $109.00 $46.75–$92.65 — 25%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 ASSAY OF GGT $75.75 $101.00 $27.07–$85.85 70% above 25%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 ASSAY OF GGT $75.75 $101.00 $43.32–$85.85 — 25%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL $276.00 $368.00 $98.62–$312.80 17% above 25%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL $276.00 $368.00 $157.84–$312.80 — 25%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE TEST $56.25 $75.00 $20.10–$63.75 59% above 25%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE TEST $56.25 $75.00 $32.17–$63.75 — 25%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST (GTT) $130.50 $174.00 $46.63–$147.90 43% above 25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE DNA, AMP PROBE $159.75 $213.00 $57.08–$181.05 4% above 25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEAE DNA, AMP PROBE $159.75 $213.00 $91.36–$181.05 — 25%
H. pylori stool antigen test CPT 87338 LAB H PYLORI STOOL AG $187.50 $250.00 $67.00–$212.50 88% above 25%
H. pylori stool antigen test inpatient CPT 87338 LAB H PYLORI STOOL AG $187.50 $250.00 $107.22–$212.50 — 25%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 DNA QUANT $76.50 $102.00 $27.34–$86.70 68% below 25%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 DNA QUANT $76.50 $102.00 $43.75–$86.70 — 25%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 ANTIGENS W/HIV 1/2 ANTIB $90.75 $121.00 $32.43–$102.85 22% below 25%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1 ANTIGENS W/HIV 1/2 ANTIB $90.75 $121.00 $51.90–$102.85 — 25%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HIGH-RISK TYPES $147.75 $197.00 $52.80–$167.45 52% above 25%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV HIGH-RISK TYPES $147.75 $197.00 $84.49–$167.45 — 25%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCOSYLATED HEMOGLOBIN TEST $75.00 $100.00 $26.80–$85.00 8% above 25%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 GLYCOSYLATED HEMOGLOBIN TEST $75.00 $100.00 $42.89–$85.00 — 25%
Hemoglobin blood test CPT 85018 HEMOGLOBIN $34.50 $46.00 $12.33–$39.10 49% above 25%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN $34.50 $46.00 $19.73–$39.10 — 25%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE ANTIBODY, TOTAL $110.25 $147.00 $39.40–$124.95 66% above 25%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE ANTIBODY, TOTAL $110.25 $147.00 $63.05–$124.95 — 25%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 OCC MED HEP B ANTIBODY $34.50 $46.00 $12.33–$39.10 39% below 25%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY $96.00 $128.00 $34.30–$108.80 71% above 25%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 OCC MED HEP B ANTIBODY $34.50 $46.00 $19.73–$39.10 — 25%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTIBODY $96.00 $128.00 $54.90–$108.80 — 25%
Hepatitis B surface antigen (HBsAg) test CPT 87340 OCC MED HEP B ANTIGEN $15.00 $20.00 $5.36–$17.00 72% below 25%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE ANTIGEN $115.50 $154.00 $41.27–$130.90 114% above 25%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 OCC MED HEP B ANTIGEN $15.00 $20.00 $8.58–$17.00 — 25%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE ANTIGEN $115.50 $154.00 $66.05–$130.90 — 25%
Hepatitis C antibody blood test (screening) CPT 86803 OCC MED HEP C ANTIBODY $58.50 $78.00 $20.90–$66.30 21% below 25%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY $114.75 $153.00 $41.00–$130.05 54% above 25%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 OCC MED HEP C ANTIBODY $58.50 $78.00 $33.45–$66.30 — 25%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY $114.75 $153.00 $65.62–$130.05 — 25%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C RNA QUANT $42.75 $57.00 $15.28–$48.45 67% below 25%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C RNA QUANT $42.75 $57.00 $24.45–$48.45 — 25%
Herpes blood test, HSV-1 antibody CPT 86695 LAB HSV IGM TITER PT 1 $21.75 $29.00 $7.77–$24.65 62% below 25%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 LAB HSV IGM TITER PT 1 $21.75 $29.00 $12.44–$24.65 — 25%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 $22.50 $30.00 $8.04–$25.50 67% below 25%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 2 $22.50 $30.00 $12.87–$25.50 — 25%
High-sensitivity CRP (hs-CRP) test CPT 86141 HIGH SENS CRP $79.50 $106.00 $28.41–$90.10 2% above 25%
Homocysteine blood test CPT 83090 HOMOCYSTEINE $195.75 $261.00 $69.95–$221.85 102% above 25%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE $195.75 $261.00 $111.94–$221.85 — 25%
Insulin blood test CPT 83525 ASSAY OF INSULIN TOTAL $62.25 $83.00 $22.24–$70.55 7% above 25%
Insulin blood test inpatient CPT 83525 ASSAY OF INSULIN TOTAL $62.25 $83.00 $35.60–$70.55 — 25%
Iron blood test (serum iron) CPT 83540 ASSAY OF IRON $68.25 $91.00 $24.39–$77.35 78% above 25%
Iron blood test (serum iron) inpatient CPT 83540 ASSAY OF IRON $68.25 $91.00 $39.03–$77.35 — 25%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL $105.00 $140.00 $37.52–$119.00 57% above 25%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL $105.00 $140.00 $60.05–$119.00 — 25%
LH (luteinizing hormone) test CPT 83002 GONADOTROPIN (LH) $147.75 $197.00 $52.80–$167.45 37% above 25%
LH (luteinizing hormone) test inpatient CPT 83002 GONADOTROPIN (LH) $147.75 $197.00 $84.49–$167.45 — 25%
Lactate (lactic acid) blood test CPT 83605 ASSAY OF LACTIC ACID $101.25 $135.00 $36.18–$114.75 31% above 25%
Lactate (lactic acid) blood test inpatient CPT 83605 ASSAY OF LACTIC ACID $101.25 $135.00 $57.90–$114.75 — 25%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE (LD) (LDH) ENZYME $66.75 $89.00 $23.85–$75.65 53% above 25%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTATE (LD) (LDH) ENZYME $66.75 $89.00 $38.17–$75.65 — 25%
Lipase blood test (pancreas enzyme) CPT 83690 ASSAY OF LIPASE $61.50 $82.00 $21.98–$69.70 15% above 25%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 ASSAY OF LIPASE $61.50 $82.00 $35.17–$69.70 — 25%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL $127.50 $170.00 $45.56–$144.50 80% above 25%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL $127.50 $170.00 $72.91–$144.50 — 25%
Lyme disease antibody test CPT 86618 LYME DISEASE ANTIBODY $109.50 $146.00 $39.13–$124.10 67% above 25%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE ANTIBODY $109.50 $146.00 $62.62–$124.10 — 25%
Magnesium blood test CPT 83735 MAGNESIUM $90.00 $120.00 $32.16–$102.00 184% above 25%
Magnesium blood test inpatient CPT 83735 MAGNESIUM $90.00 $120.00 $51.47–$102.00 — 25%
Measles (rubeola) antibody test CPT 86765 RUBEOLA ANTIBODY $15.00 $20.00 $5.36–$17.00 74% below 25%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE ANTIBODIES $50.25 $67.00 $17.96–$56.95 14% above 25%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE ANTIBODIES $50.25 $67.00 $28.74–$56.95 — 25%
Mumps immunity blood test CPT 86735 MUMPS $15.00 $20.00 $5.36–$17.00 63% below 25%
PSA (prostate-specific antigen) blood test, total CPT 84153 OCC MED PSA $33.00 $44.00 $11.79–$37.40 66% below 25%
PSA (prostate-specific antigen) blood test, total CPT 84153 LAB PSA SCREENING $86.25 $115.00 $30.82–$97.75 11% below 25%
PSA (prostate-specific antigen) blood test, total CPT 84153 ASSAY OF PSA TOTAL $121.50 $162.00 $43.42–$137.70 26% above 25%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 LAB PSA SCREENING $86.25 $115.00 $49.32–$97.75 — 25%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 ASSAY OF PSA TOTAL $121.50 $162.00 $69.48–$137.70 — 25%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP SCREEN THIN LAYER PREP $90.75 $121.00 $32.43–$102.85 12% below 25%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP DIAGNOSTIC THIN LAYER PREP $90.75 $121.00 $32.43–$102.85 12% below 25%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 PAP SCREEN THIN LAYER PREP $90.75 $121.00 $51.90–$102.85 — 25%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 PAP DIAGNOSTIC THIN LAYER PREP $90.75 $121.00 $51.90–$102.85 — 25%
Parathyroid hormone (PTH) blood test CPT 83970 LAB PTH IMMUNOCH PART 1 $281.25 $375.00 $100.50–$318.75 35% above 25%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 LAB PTH IMMUNOCH PART 1 $281.25 $375.00 $160.84–$318.75 — 25%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL $77.25 $103.00 $27.60–$87.55 134% above 25%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME PARTIAL $77.25 $103.00 $44.18–$87.55 — 25%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS $52.50 $70.00 $18.76–$59.50 56% above 25%
Phosphorus (phosphate) blood test CPT 84100 ASSAY OF PHOSPHORUS $66.00 $88.00 $23.58–$74.80 96% above 25%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS $52.50 $70.00 $30.02–$59.50 — 25%
Phosphorus (phosphate) blood test inpatient CPT 84100 ASSAY OF PHOSPHORUS $66.00 $88.00 $37.74–$74.80 — 25%
Potassium blood test CPT 84132 POTASSIUM; SERUM, PLASMA OR WHOLE BLOOD $62.25 $83.00 $22.24–$70.55 53% above 25%
Potassium blood test inpatient CPT 84132 POTASSIUM; SERUM, PLASMA OR WHOLE BLOOD $62.25 $83.00 $35.60–$70.55 — 25%
Progesterone blood test CPT 84144 PROGESTERONE $138.75 $185.00 $49.58–$157.25 16% above 25%
Prolactin blood test CPT 84146 PROLACTIN $114.75 $153.00 $41.00–$130.05 14% above 25%
Prolactin blood test inpatient CPT 84146 PROLACTIN $114.75 $153.00 $65.62–$130.05 — 25%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME (PT/INR) $48.75 $65.00 $17.42–$55.25 88% above 25%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME (PT/INR) $48.75 $65.00 $27.88–$55.25 — 25%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA ASSAY W/OPTIC $65.25 $87.00 $23.32–$73.95 22% below 25%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA ASSAY W/OPTIC $65.25 $87.00 $37.31–$73.95 — 25%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A ASSAY W/OPTIC $57.75 $77.00 $20.64–$65.45 27% below 25%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP A ASSAY W/OPTIC $57.75 $77.00 $33.03–$65.45 — 25%
Rh blood typing CPT 86901 BLOOD TYPING RH (D) $54.00 $72.00 $19.30–$61.20 41% above 25%
Rh blood typing inpatient CPT 86901 BLOOD TYPING RH (D) $54.00 $72.00 $30.88–$61.20 — 25%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT $60.75 $81.00 $21.71–$68.85 66% above 25%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QUANT $60.75 $81.00 $34.74–$68.85 — 25%
Rubella antibody test (immunity check) CPT 86762 OCC MED MMR ANTIBODY $61.50 $82.00 $21.98–$69.70 8% below 25%
Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY $69.00 $92.00 $24.66–$78.20 4% above 25%
Rubella antibody test (immunity check) inpatient CPT 86762 OCC MED MMR ANTIBODY $61.50 $82.00 $35.17–$69.70 — 25%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODY $69.00 $92.00 $39.46–$78.20 — 25%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 RBC SED RATE, AUTO $44.25 $59.00 $15.81–$50.15 43% above 25%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 RBC SED RATE, AUTO $44.25 $59.00 $25.31–$50.15 — 25%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 SEMEN ANALYSIS VOLUME COUNT MOTILITY DIFFERENT $96.00 $128.00 $34.30–$108.80 4% below 25%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 SEMEN COMPLETE $140.25 $187.00 $50.12–$158.95 40% above 25%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 SEMEN COMPLETE $140.25 $187.00 $80.20–$158.95 — 25%
Sodium blood test CPT 84295 SODIUM; SERUM, PLASMA OR WHOLE BLOOD $66.75 $89.00 $23.85–$75.65 71% above 25%
Sodium blood test inpatient CPT 84295 SODIUM; SERUM, PLASMA OR WHOLE BLOOD $66.75 $89.00 $38.17–$75.65 — 25%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD FECES $14.25 $19.00 $5.09–$16.15 50% below 25%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD FECES $14.25 $19.00 $8.15–$16.15 — 25%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 SCREEN FECALOCCULT IMMUNOASSAY $84.75 $113.00 $30.28–$96.05 1% above 25%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 DX OCCULT BLOOD IMMUNOASSAY $84.75 $113.00 $30.28–$96.05 1% above 25%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 DX OCCULT BLOOD IMMUNOASSAY $84.75 $113.00 $48.47–$96.05 — 25%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 SCREEN FECALOCCULT IMMUNOASSAY $84.75 $113.00 $48.47–$96.05 — 25%
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM $72.75 $97.00 $26.00–$82.45 70% above 25%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TREPONEMA PALLIDUM $72.75 $97.00 $41.60–$82.45 — 25%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST NON-TREP QUAL $85.50 $114.00 $30.55–$96.90 192% above 25%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST NON-TREP QUAL $85.50 $114.00 $48.89–$96.90 — 25%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 OCC MED QUANTIFERON $44.25 $59.00 $15.81–$50.15 60% below 25%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TUBERCULOSIS TEST, CELL IMMUNITY MEASURE $210.00 $280.00 $75.04–$238.00 91% above 25%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TUBERCULOSIS TEST, CELL IMMUNITY MEASURE $210.00 $280.00 $120.09–$238.00 — 25%
Testosterone blood test, total (not free testosterone) CPT 84403 ASSAY OF TOTAL TESTOSTERONE $124.50 $166.00 $44.49–$141.10 65% above 25%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 ASSAY OF TOTAL TESTOSTERONE $124.50 $166.00 $71.20–$141.10 — 25%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODY $95.25 $127.00 $34.04–$107.95 49% above 25%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODY $95.25 $127.00 $54.47–$107.95 — 25%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 ASSAY THYROID STIM HORMONE $160.50 $214.00 $57.35–$181.90 56% above 25%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 ASSAY THYROID STIM HORMONE $160.50 $214.00 $91.78–$181.90 — 25%
Total cholesterol blood test CPT 82465 ASSAY BLD/SERUM CHOLESTEROL $46.50 $62.00 $16.62–$52.70 38% above 25%
Total cholesterol blood test inpatient CPT 82465 ASSAY BLD/SERUM CHOLESTEROL $46.50 $62.00 $26.59–$52.70 — 25%
Transferrin blood test CPT 84466 ASSAY OF TRANSFERRIN $83.25 $111.00 $29.75–$94.35 11% above 25%
Transferrin blood test inpatient CPT 84466 ASSAY OF TRANSFERRIN $83.25 $111.00 $47.61–$94.35 — 25%
Trichomonas test (NAAT) CPT 87661 IADNA TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECH $34.50 $46.00 $12.33–$39.10 66% below 25%
Trichomonas test (NAAT) inpatient CPT 87661 IADNA TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECH $34.50 $46.00 $19.73–$39.10 — 25%
Triglycerides blood test CPT 84478 ASSAY OF TRIGLYCERIDES $60.75 $81.00 $21.71–$68.85 42% above 25%
Triglycerides blood test inpatient CPT 84478 ASSAY OF TRIGLYCERIDES $60.75 $81.00 $34.74–$68.85 — 25%
Troponin test, quantitative CPT 84484 TROPONIN, QUANTITATIVE $144.75 $193.00 $51.72–$164.05 81% above 25%
Troponin test, quantitative inpatient CPT 84484 TROPONIN, QUANTITATIVE $144.75 $193.00 $82.78–$164.05 — 25%
Uric acid blood test CPT 84550 URIC ACID; BLOOD $55.50 $74.00 $19.83–$62.90 38% above 25%
Uric acid blood test inpatient CPT 84550 URIC ACID; BLOOD $55.50 $74.00 $31.74–$62.90 — 25%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS, AUTO, W/SCOPE $39.75 $53.00 $14.20–$45.05 11% above 25%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS, AUTO, W/SCOPE $39.75 $53.00 $22.73–$45.05 — 25%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS, AUTO W/O SCOPE $39.75 $53.00 $14.20–$45.05 123% above 25%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS, AUTO W/O SCOPE $39.75 $53.00 $22.73–$45.05 — 25%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS NONAUTO W/O SCOPE $21.00 $28.00 $7.50–$23.80 at median 25%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS NONAUTO W/O SCOPE $21.00 $28.00 $12.01–$23.80 — 25%
Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE/COLONY COUNT $65.25 $87.00 $23.32–$73.95 8% above 25%
Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CULTURE/COLONY COUNT $65.25 $87.00 $37.31–$73.95 — 25%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN QUANTITATIVE $79.50 $106.00 $28.41–$90.10 96% above 25%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN QUANTITATIVE $79.50 $106.00 $45.46–$90.10 — 25%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B-12 $108.00 $144.00 $38.59–$122.40 12% above 25%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B-12 $108.00 $144.00 $61.76–$122.40 — 25%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D, 25 HYDROXY $195.00 $260.00 $69.68–$221.00 17% above 25%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D, 25 HYDROXY $195.00 $260.00 $111.51–$221.00 — 25%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VIT D 1 25-DIHYDROXY $43.50 $58.00 $15.54–$49.30 66% below 25%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VIT D 1 25-DIHYDROXY $43.50 $58.00 $24.88–$49.30 — 25%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPINC, CHORIONIC (HCG), QUANT $108.00 $144.00 $38.59–$122.40 36% above 25%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 GONADOTROPINC, CHORIONIC (HCG), QUANT $108.00 $144.00 $61.76–$122.40 — 25%

Surgery and procedures

ProcedureCash priceList priceInsurers payvs North DakotaOff list
Botox injections for chronic migraine CPT 64615 CHEMODENERV MUSC MIGRAINE $268.50 $358.00 $95.94–$304.30 30% below 25%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 BX BREAST 1ST LESION STRTCTC $2,394.75 $3,193.00 $855.72–$2,714.05 at median 25%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLOSED RX DIST FIBULA FX $410.25 $547.00 $146.60–$464.95 3% above 25%
Cardiac catheterization with coronary angiogram CPT 93458 L HRT ARTERY/VENTRICLE ANGIO $9,371.25 $12,495.00 $3,348.66–$10,620.75 4% below 25%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 L HRT ARTERY/VENTRICLE ANGIO $9,371.25 $12,495.00 $5,359.11–$10,620.75 — 25%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION, ELECTIVE;EXTERN $1,362.75 $1,817.00 $486.96–$1,544.45 34% above 25%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION, ELECTIVE;EXTERN $1,362.75 $1,817.00 $779.31–$1,544.45 — 25%
Carpal tunnel release, open surgery CPT 64721 REVISE MEDIAN N/CARPAL TUNNEL SURG $1,905.00 $2,540.00 $680.72–$2,159.00 49% below 25%
Carpal tunnel release, open surgery inpatient CPT 64721 REVISE MEDIAN N/CARPAL TUNNEL SURG $1,905.00 $2,540.00 $1,089.41–$2,159.00 — 25%
Catheter ablation for atrial fibrillation CPT 93656 TX ATRIAL FIB PULM VEIN ISOL $24,019.50 $32,026.00 $8,582.97–$27,222.10 3% above 25%
Catheter ablation for atrial fibrillation inpatient CPT 93656 TX ATRIAL FIB PULM VEIN ISOL $24,019.50 $32,026.00 $13,735.95–$27,222.10 — 25%
Cervical biopsy CPT 57500 BIOPSY/EXCIS CERVICAL LESN $783.75 $1,045.00 $280.06–$888.25 12% below 25%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION,CLAMP,NEWBORN $255.00 $340.00 $145.83–$289.00 — 25%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLOSED RX DIST RAD/ULNA FX $339.00 $452.00 $121.14–$384.20 24% below 25%
Colonoscopy with polyp removal CPT 45385 COLONOSCOPY,REMV LESN,SNARE $2,506.50 $3,342.00 $895.66–$2,840.70 24% above 25%
Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY,REMV LESN,SNARE $2,506.50 $3,342.00 $1,433.38–$2,840.70 — 25%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY,BIOPSY $2,298.00 $3,064.00 $821.15–$2,604.40 24% above 25%
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY,BIOPSY $2,298.00 $3,064.00 $1,314.15–$2,604.40 — 25%
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY,FLEX,DIAGNOSTIC $2,120.25 $2,827.00 $757.64–$2,402.95 15% above 25%
Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY,FLEX,DIAGNOSTIC $2,120.25 $2,827.00 $1,212.50–$2,402.95 — 25%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 COLPOSCOPY,BX CERVIX/ENDOCERV CURR $290.25 $387.00 $103.72–$328.95 7% below 25%
Coronary stent placement, one artery CPT 92928 PRQ CARD STENT W/ANGIO 1 VSL $13,602.75 $18,137.00 $4,860.72–$15,416.45 3% above 25%
Coronary stent placement, one artery inpatient CPT 92928 PRQ CARD STENT W/ANGIO 1 VSL $13,602.75 $18,137.00 $7,778.96–$15,416.45 — 25%
Cystoscopy with ureteral stent placement CPT 52332 CYSTOSCOPY,INSERT URETERAL STENT $3,482.25 $4,643.00 $1,244.32–$3,946.55 2% below 25%
Cystoscopy with ureteral stent placement inpatient CPT 52332 CYSTOSCOPY,INSERT URETERAL STENT $3,482.25 $4,643.00 $1,991.38–$3,946.55 — 25%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY $1,473.00 $1,964.00 $526.35–$1,669.40 69% above 25%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUC BENIGN/PREMAL,1ST LESION $205.50 $274.00 $73.43–$232.90 4% above 25%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUC BENIGN/PREMAL,1ST LESION $205.50 $274.00 $117.52–$232.90 — 25%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 CREATE EARDRUM OPENING,LOCAL ANESTH $588.00 $784.00 $210.11–$666.40 41% below 25%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT $79.50 $106.00 $28.41–$90.10 31% above 25%
Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX $185.25 $247.00 $66.20–$209.95 61% above 25%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 BIOPSY OF UTERUS LINING $135.00 $180.00 $48.24–$153.00 53% below 25%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJ CERV/THORAC WITH IMAGE GUIDANCE $1,543.50 $2,058.00 $551.54–$1,749.30 42% above 25%
Eye injection into the vitreous (intravitreal injection) CPT 67028 INJECT INTRAVITREAL PHARMCOLOGIC $366.75 $489.00 $131.05–$415.65 15% below 25%
Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028 INJECT INTRAVITREAL PHARMCOLOGIC $366.75 $489.00 $209.73–$415.65 — 25%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ PARAVERT F JNT L/S1 LEV(T) $1,397.25 $1,863.00 $499.28–$1,583.55 4% above 25%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY,SCREEN PREV $1,103.25 $1,471.00 $394.23–$1,250.35 at median 25%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY,DIAGNOSTIC $1,438.50 $1,918.00 $514.02–$1,630.30 30% above 25%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOIDOSCOPY,SCREEN PREV $1,103.25 $1,471.00 $630.91–$1,250.35 — 25%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOIDOSCOPY,DIAGNOSTIC $1,438.50 $1,918.00 $822.63–$1,630.30 — 25%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATH/INJ HYSTEROSALPINGOGRM(T) $486.75 $649.00 $173.93–$551.65 55% above 25%
IUD insertion (the device itself billed separately) CPT 58300 INSERT INTRAUTERINE DEVICE $89.25 $119.00 $31.89–$101.15 29% below 25%
Incision and drainage of a simple or single skin abscess CPT 10060 DRAIN SKIN ABSCESS SIMPLE(T) $292.50 $390.00 $104.52–$331.50 4% below 25%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 DRAIN SKIN ABSCESS SIMPLE(T) $292.50 $390.00 $167.27–$331.50 — 25%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 REPAIR ING HERNIA,5+Y/O,REDUCIBL $3,578.25 $4,771.00 $1,278.63–$4,055.35 39% below 25%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 REPAIR ING HERNIA,5+Y/O,REDUCIBL $3,578.25 $4,771.00 $2,046.28–$4,055.35 — 25%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON/LIGAMENT/CYST $403.50 $538.00 $144.18–$457.30 29% above 25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ LARGE JOINT/BURSA(T) $324.75 $433.00 $116.04–$368.05 7% above 25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 DRAIN/INJ LARGE JOINT/BURSA(T) $324.75 $433.00 $185.71–$368.05 — 25%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/IN MEDIUM JOINT/BURSA(T) $309.75 $413.00 $110.68–$351.05 10% below 25%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 DRAIN/IN MEDIUM JOINT/BURSA(T) $309.75 $413.00 $177.14–$351.05 — 25%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJ SMALL JOINT/BURSA(T) $351.00 $468.00 $125.42–$397.80 23% above 25%
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 DISCISSION,2ND CATARACT,LASER $765.00 $1,020.00 $273.36–$867.00 2% above 25%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYR CLOS WND TRUNK,ARM,LEG <2.5CM $671.25 $895.00 $239.86–$760.75 30% above 25%
Left heart catheterization, diagnostic one side CPT 93452 LEFT HEART CATH W/VENTRCLGRPHY $8,103.00 $10,804.00 $2,895.47–$9,183.40 9% below 25%
Left heart catheterization, diagnostic inpatient one side CPT 93452 LEFT HEART CATH W/VENTRCLGRPHY $8,103.00 $10,804.00 $4,633.84–$9,183.40 — 25%
Lower-back epidural injection, with imaging guidance CPT 62323 INJ LUMBAR/SACRAL WITH IMAGE GUIDANCE $1,418.25 $1,891.00 $506.79–$1,607.35 28% above 25%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJ LUMBAR/SACRAL WITH IMAGE GUIDANCE $1,418.25 $1,891.00 $811.05–$1,607.35 — 25%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJ LUMBAR/SACRAL W/O IMAGE GUIDANCE $1,298.25 $1,731.00 $742.43–$1,471.35 — 25%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ,FORAMEN,L/S,1 LEVEL(T) $1,448.25 $1,931.00 $517.51–$1,641.35 14% above 25%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJ,FORAMEN,L/S,1 LEVEL(T) $1,448.25 $1,931.00 $828.21–$1,641.35 — 25%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC BENIG .1-.5CM TRUNK,ARM,LE $513.75 $685.00 $183.58–$582.25 2% below 25%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC BENIG .1-.5CM TRUNK,ARM,LE $513.75 $685.00 $293.80–$582.25 — 25%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC SKIN BENIG <5MM FACE,FACIAL $499.50 $666.00 $178.49–$566.10 11% below 25%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC SKIN BENIG <5MM FACE,FACIAL $499.50 $666.00 $285.65–$566.10 — 25%
Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL PLATE $294.00 $392.00 $105.06–$333.20 5% above 25%
Occipital nerve block (injection for headaches) CPT 64405 INJ NERV BLCK,GREAT OCCIPTL(T) $665.25 $887.00 $237.72–$753.95 85% above 25%
Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ NERV BLCK,GREAT OCCIPTL(T) $665.25 $887.00 $380.43–$753.95 — 25%
Pacemaker implant (dual chamber) CPT 33208 INSER HART PACER XVENOUS ATR/VENTR $17,981.25 $23,975.00 $6,425.30–$20,378.75 at median 25%
Pacemaker implant (dual chamber) inpatient CPT 33208 INSER HART PACER XVENOUS ATR/VENTR $17,981.25 $23,975.00 $10,282.88–$20,378.75 — 25%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING(T) $1,191.00 $1,588.00 $425.58–$1,349.80 24% above 25%
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W/IMAGING(T) $1,191.00 $1,588.00 $681.09–$1,349.80 — 25%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED $704.25 $939.00 $251.65–$798.15 25% above 25%
Prostate biopsy CPT 55700 BX OF PROSTATE,NEEDLE/PUNCH(T) $1,968.75 $2,625.00 $703.50–$2,231.25 28% below 25%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTROY LUMB/SAC FACET JNT $2,598.00 $3,464.00 $928.35–$2,944.40 at median 25%
Removal of a foreign object under the skin, simple CPT 10120 REMOVE FOREIGN BODY SIMPLE $622.50 $830.00 $222.44–$705.50 46% above 25%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLONOSCOPY,SCREEN PREV $1,682.25 $2,243.00 $601.12–$1,906.55 3% below 25%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 COLONOSCOPY,SCREEN PREV $1,682.25 $2,243.00 $962.02–$1,906.55 — 25%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLONOSCOPY,FLEX,SCREEN $2,151.00 $2,868.00 $768.62–$2,437.80 23% above 25%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 COLONOSCOPY,FLEX,SCREEN $2,151.00 $2,868.00 $1,230.09–$2,437.80 — 25%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 FRAGMENTING OF KIDNEY STONE $3,337.50 $4,450.00 $1,192.60–$3,782.50 50% below 25%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 FRAGMENTING OF KIDNEY STONE $3,337.50 $4,450.00 $1,908.60–$3,782.50 — 25%
Short arm cast (elbow to hand) CPT 29075 APPLY FOREARM CAST $267.00 $356.00 $95.41–$302.60 14% below 25%
Short arm splint (forearm and hand) CPT 29125 APPLY FOREARM SPLINT,STATIC $230.25 $307.00 $82.28–$260.95 19% above 25%
Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST $342.00 $456.00 $122.21–$387.60 3% below 25%
Short leg cast (below the knee) inpatient CPT 29405 APPLY SHORT LEG CAST $342.00 $456.00 $195.58–$387.60 — 25%
Short leg splint (calf to foot) CPT 29515 APPLY LOWER LEG SPLINT $247.50 $330.00 $88.44–$280.50 11% above 25%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 REPR SUPERF WND BODY <2.5CM $315.75 $421.00 $112.83–$357.85 3% above 25%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 REPR SUPERF WND BODY <2.5CM $315.75 $421.00 $180.57–$357.85 — 25%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN (INCLUDING SIMPLE CLOSURE, WHEN PERFORMED); SINGLE LESION $348.00 $464.00 $124.35–$394.40 3% above 25%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS $204.75 $273.00 $73.16–$232.05 11% below 25%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE,LUMBAR,DX(T) $867.00 $1,156.00 $309.81–$982.60 at median 25%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE,LUMBAR,DX(T) $867.00 $1,156.00 $495.81–$982.60 — 25%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 REPR SUP NPTERF WND BODY 2.6-7.5 $366.75 $489.00 $131.05–$415.65 23% above 25%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 REPR SUP NPTERF WND BODY 2.6-7.5 $366.75 $489.00 $209.73–$415.65 — 25%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 REPR SUPERF WND FACE <2.5CM $341.25 $455.00 $121.94–$386.75 17% above 25%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 REPR SUPERF WND FACE <2.5CM $341.25 $455.00 $195.15–$386.75 — 25%
TURP (transurethral resection of the prostate) CPT 52601 TRANSURETHRAL ELEC-SURG PROSTATECTOM $4,022.25 $5,363.00 $1,437.28–$4,558.55 6% above 25%
TURP (transurethral resection of the prostate) inpatient CPT 52601 TRANSURETHRAL ELEC-SURG PROSTATECTOM $4,022.25 $5,363.00 $2,300.19–$4,558.55 — 25%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY OF SKIN (EG, SHAVE, SCOOP, SAUCERIZE, CURETTE); SINGLE LESION $199.50 $266.00 $71.29–$226.10 26% below 25%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN (EG, SHAVE, SCOOP, SAUCERIZE, CURETTE); SINGLE LESION $199.50 $266.00 $114.09–$226.10 — 25%
Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/ IMAGING $1,311.75 $1,749.00 $468.73–$1,486.65 65% above 25%
Thoracentesis with imaging guidance inpatient CPT 32555 ASPIRATE PLEURA W/ IMAGING $1,311.75 $1,749.00 $750.15–$1,486.65 — 25%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT, 1 OR 2(T) $362.25 $483.00 $129.44–$410.55 1% below 25%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BX BREAST 1ST LESION US IMAG $1,716.75 $2,289.00 $613.45–$1,945.65 19% below 25%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BX BREAST 1ST LESION US IMAG $1,716.75 $2,289.00 $981.75–$1,945.65 — 25%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 UP GI ENDOSCOPY,BALL DIL,30MM $2,779.50 $3,706.00 $993.21–$3,150.10 4% below 25%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 UP GI ENDOSCOPY,BALL DIL,30MM $2,779.50 $3,706.00 $1,589.50–$3,150.10 — 25%
Upper endoscopy (EGD) with biopsy CPT 43239 UPPER GI ENDOSCOPY,BIOPSY $2,322.00 $3,096.00 $829.73–$2,631.60 49% above 25%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 UPPER GI ENDOSCOPY,BIOPSY $2,322.00 $3,096.00 $1,327.87–$2,631.60 — 25%
Upper endoscopy (EGD) with injection into the lining CPT 43236 UPPR GI SCOPE W/SUBMUC INJ $1,815.75 $2,421.00 $648.83–$2,057.85 9% above 25%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 UPPR GI SCOPE W/SUBMUC INJ $1,815.75 $2,421.00 $1,038.37–$2,057.85 — 25%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 UP GI ENDOSCOPY,REMV TUMOR,SNARE $2,652.75 $3,537.00 $947.92–$3,006.45 11% below 25%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 UP GI ENDOSCOPY,REMV TUMOR,SNARE $2,652.75 $3,537.00 $1,517.02–$3,006.45 — 25%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 UP GI ENDOSCOPY,DILATN W GUIDE $2,010.75 $2,681.00 $718.51–$2,278.85 20% above 25%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 UP GI ENDOSCOPY,DILATN W GUIDE $2,010.75 $2,681.00 $1,149.88–$2,278.85 — 25%
Upper endoscopy (EGD), diagnostic CPT 43235 UPPER GI ENDOSCOPY,DIAGNOSIS $1,761.75 $2,349.00 $629.53–$1,996.65 14% above 25%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 UPPER GI ENDOSCOPY,DIAGNOSIS $1,761.75 $2,349.00 $1,007.49–$1,996.65 — 25%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 CYSTO/URETERO W/LITHOTRIPSY $4,470.00 $5,960.00 $1,597.28–$5,066.00 13% below 25%
Ureteroscopy with laser stone breaking and stent placement inpatient CPT 52356 CYSTO/URETERO W/LITHOTRIPSY $4,470.00 $5,960.00 $2,556.24–$5,066.00 — 25%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 REMOVAL OF SPERM DUCT(S) $1,874.25 $2,499.00 $669.73–$2,124.15 8% below 25%
Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 REMOVAL OF SPERM DUCT(S) $1,874.25 $2,499.00 $1,071.82–$2,124.15 — 25%
Vein ablation, radiofrequency, first vein CPT 36475 ENDOVENOUS ABLATION INCOMPETENT VEIN, RADIOFREQ. EXTREMITY,1ST VEIN TREATED $2,922.00 $3,896.00 $1,044.13–$3,311.60 44% below 25%
Vein ablation, radiofrequency, first vein inpatient CPT 36475 ENDOVENOUS ABLATION INCOMPETENT VEIN, RADIOFREQ. EXTREMITY,1ST VEIN TREATED $2,922.00 $3,896.00 $1,670.99–$3,311.60 — 25%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SKIN/TISSUE $477.75 $637.00 $170.72–$541.45 12% above 25%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE SKIN/TISSUE $477.75 $637.00 $273.21–$541.45 — 25%

Doctor visits and therapy

ProcedureCash priceList priceInsurers payvs North DakotaOff list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION SERVICE $658.50 $878.00 $235.30–$746.30 7% below 25%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION SERVICE $658.50 $878.00 $376.57–$746.30 — 25%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY INHALATION TREATMENT $156.75 $209.00 $56.01–$177.65 50% above 25%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 METERED DOSE INHALER TX $160.50 $214.00 $57.35–$181.90 54% above 25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY INHALATION TREATMENT $156.75 $209.00 $89.64–$177.65 — 25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 METERED DOSE INHALER TX $160.50 $214.00 $91.78–$181.90 — 25%
Chemotherapy IV infusion, first hour CPT 96413 CHEMOTHERAPY, IV INFUSION, 1 HOUR $582.00 $776.00 $207.97–$659.60 15% below 25%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMOTHERAPY, IV INFUSION, 1 HOUR $582.00 $776.00 $332.83–$659.60 — 25%
Critical care, first 30 to 74 minutes CPT 99291 FACILITY CRITICAL CARE, E/M 30-74 MINUTES $1,936.50 $2,582.00 $691.98–$2,194.70 at median 25%
Critical care, first 30 to 74 minutes inpatient CPT 99291 FACILITY CRITICAL CARE, E/M 30-74 MINUTES $1,936.50 $2,582.00 $1,107.42–$2,194.70 — 25%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE/DROWSY TC $804.75 $1,073.00 $287.56–$912.05 26% above 25%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG AWAKE/DROWSY TC $804.75 $1,073.00 $460.21–$912.05 — 25%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 COMMUNITY PARAMEDIC ECG 12 LEAD, TRACING $198.75 $265.00 $71.02–$225.25 76% above 25%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG 12 LEAD, TRACING ONLY $198.75 $265.00 $71.02–$225.25 76% above 25%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG 12 LEAD, TRACING $198.75 $265.00 $71.02–$225.25 76% above 25%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 COMMUNITY PARAMEDIC ECG 12 LEAD, TRACING $198.75 $265.00 $113.66–$225.25 — 25%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ECG 12 LEAD, TRACING ONLY $198.75 $265.00 $113.66–$225.25 — 25%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ECG 12 LEAD, TRACING $198.75 $265.00 $113.66–$225.25 — 25%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 FACILITY EMERGENCY LEVEL 1 VISIT $244.50 $326.00 $87.37–$277.10 38% above 25%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 FACILITY EMERGENCY LEVEL 1 VISIT $244.50 $326.00 $139.82–$277.10 — 25%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 FACILITY EMERGENCY LEVEL II VISIT $340.50 $454.00 $121.67–$385.90 14% above 25%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 FACILITY EMERGENCY LEVEL II VISIT $340.50 $454.00 $194.72–$385.90 — 25%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 FACILITY EMERGENCY LEVEL III VISIT $600.00 $800.00 $214.40–$680.00 22% above 25%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 FACILITY EMERGENCY LEVEL III VISIT $600.00 $800.00 $343.12–$680.00 — 25%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 FACILITY EMERGENCY LEVEL IV VISIT $1,003.50 $1,338.00 $358.58–$1,137.30 23% above 25%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 FACILITY EMERGENCY LEVEL IV VISIT $1,003.50 $1,338.00 $573.87–$1,137.30 — 25%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 FACILITY EMERGENCY LEVEL V VISIT $1,397.25 $1,863.00 $499.28–$1,583.55 13% above 25%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 FACILITY EMERGENCY LEVEL V VISIT $1,397.25 $1,863.00 $799.04–$1,583.55 — 25%
Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIAC STRESS TST,TRACING ONLY $522.75 $697.00 $186.80–$592.45 63% above 25%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CARDIAC STRESS TST,TRACING ONLY $522.75 $697.00 $298.94–$592.45 — 25%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 FIRST HOUR IV HYDRATION <1 HOUR $351.00 $468.00 $125.42–$397.80 5% above 25%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 FIRST HOUR IV HYDRATION <1 HOUR $351.00 $468.00 $200.73–$397.80 — 25%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION THERAPY, 1 HOUR $381.75 $509.00 $136.41–$432.65 1% below 25%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION THERAPY, 1 HOUR $381.75 $509.00 $218.31–$432.65 — 25%
IV push of a medicine, first drug CPT 96374 IV PUSH, SINGLE/1ST DRUG $209.25 $279.00 $74.77–$237.15 30% below 25%
IV push of a medicine, first drug inpatient CPT 96374 IV PUSH, SINGLE/1ST DRUG $209.25 $279.00 $119.66–$237.15 — 25%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION, SUBQ/IM $87.75 $117.00 $31.36–$99.45 4% above 25%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION, SUBQ/IM $87.75 $117.00 $50.18–$99.45 — 25%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION $260.25 $347.00 $93.00–$294.95 6% below 25%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION $260.25 $347.00 $148.83–$294.95 — 25%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR RE-EDUCATION $73.50 $98.00 $26.26–$83.30 35% below 25%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR RE-EDUCATION $73.50 $98.00 $42.03–$83.30 — 25%
New patient office visit, about 30 minutes CPT 99203 OFFICE/OUTPT VISIT,NEW,LEVL III $105.00 $140.00 $37.52–$119.00 54% below 25%
New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE/OUTPT VISIT,NEW,LEVL III $105.00 $140.00 $60.05–$119.00 — 25%
New patient office visit, about 45 minutes CPT 99204 OFFICE/OUTPT VISIT,NEW,LEVL IV $143.25 $191.00 $51.19–$162.35 56% below 25%
New patient office visit, about 45 minutes inpatient CPT 99204 OFFICE/OUTPT VISIT,NEW,LEVL IV $143.25 $191.00 $81.92–$162.35 — 25%
New patient office visit, about 60 minutes CPT 99205 OFFICE/OUTPT VISIT,NEW,LEVL V $202.50 $270.00 $72.36–$229.50 48% below 25%
New patient office visit, about 60 minutes inpatient CPT 99205 OFFICE/OUTPT VISIT,NEW,LEVL V $202.50 $270.00 $115.80–$229.50 — 25%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE/OUTPT VISIT,NEW,LEVL II $69.75 $93.00 $24.92–$79.05 56% below 25%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 NUTRITION EDUCATION $51.75 $69.00 $18.49–$58.65 48% below 25%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 NUTRITION EDUCATION $51.75 $69.00 $29.59–$58.65 — 25%
Occupational therapy evaluation, low complexity CPT 97165 OCCUPATIONAL THERAPY EVAL LOW COMPLEX $171.75 $229.00 $61.37–$194.65 35% below 25%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OCCUPATIONAL THERAPY EVAL LOW COMPLEX $171.75 $229.00 $98.22–$194.65 — 25%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PHYSICAL THERAPY EVALUATION HIGH COMPLEX $203.25 $271.00 $116.23–$230.35 — 25%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PHYSICAL THERAPY EVALUATION LOW COMPLEX $171.00 $228.00 $61.10–$193.80 36% below 25%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PHYSICAL THERAPY EVALUATION LOW COMPLEX $171.00 $228.00 $97.79–$193.80 — 25%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PHYSICAL THERAPY EVALUATION MOD COMPLEX $186.75 $249.00 $66.73–$211.65 35% below 25%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PHYSICAL THERAPY EVALUATION MOD COMPLEX $186.75 $249.00 $106.80–$211.65 — 25%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THER TECH,1+REGIONS,EA 15 MIN $78.75 $105.00 $28.14–$89.25 26% below 25%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES $102.75 $137.00 $36.72–$116.45 6% below 25%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES $102.75 $137.00 $58.76–$116.45 — 25%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMKING CESS 4-10 MIN $31.50 $42.00 $11.26–$35.70 12% below 25%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE CONSULTATION,LEVEL V $156.00 $208.00 $55.74–$176.80 55% below 25%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE/OUTPT VISIT,EST,LEVL V $159.75 $213.00 $57.08–$181.05 54% below 25%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFFICE/OUTPT VISIT,EST,LEVL V $159.75 $213.00 $91.36–$181.05 — 25%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE/OUTPT VISIT,EST,LEVL III $78.00 $104.00 $27.87–$88.40 58% below 25%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE CONSULTATION,LEVEL III $138.00 $184.00 $49.31–$156.40 25% below 25%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE/OUTPT VISIT,EST,LEVL III $78.00 $104.00 $44.61–$88.40 — 25%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE/OUTPT VISIT,EST,LEVL IV $110.25 $147.00 $39.40–$124.95 56% below 25%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFFICE/OUTPT VISIT,EST,LEVL IV $110.25 $147.00 $63.05–$124.95 — 25%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE/OUTPT VISIT,EST,LEVL II $47.25 $63.00 $16.88–$53.55 46% below 25%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE CONSULTATION,LEVEL II $109.50 $146.00 $39.13–$124.10 26% above 25%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE/OUTPT VISIT,EST,LEVL II $47.25 $63.00 $27.02–$53.55 — 25%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE CONSULTATION,LEVEL II $109.50 $146.00 $62.62–$124.10 — 25%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFFICE/OUTP CONSULT,LEVEL IV, MODERATE MDM >= 40 MINUTES $148.50 $198.00 $53.06–$168.30 54% below 25%
Speech and language evaluation CPT 92523 SPEECH SOUND LANG COMPREHEN $384.00 $512.00 $137.22–$435.20 33% below 25%
Speech and language evaluation inpatient CPT 92523 SPEECH SOUND LANG COMPREHEN $384.00 $512.00 $219.60–$435.20 — 25%
Speech therapy session, individual CPT 92507 SPEECH/HEARING THERAPY $213.00 $284.00 $76.11–$241.40 22% below 25%
Speech therapy session, individual inpatient CPT 92507 SPEECH/HEARING THERAPY $213.00 $284.00 $121.81–$241.40 — 25%
Spirometry (breathing test) CPT 94010 SPIROMETRY INCL GRAPH REC TC $189.00 $252.00 $67.54–$214.20 36% above 25%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY $181.50 $242.00 $103.79–$205.70 — 25%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY INCL GRAPH REC TC $189.00 $252.00 $108.08–$214.20 — 25%
Spirometry before and after a bronchodilator CPT 94060 BRONCHO RESPONSE PRE & POST TC $125.25 $167.00 $44.76–$141.95 51% below 25%
Spirometry before and after a bronchodilator CPT 94060 BRONCH EVAL B/A BRONCH $292.50 $390.00 $104.52–$331.50 14% above 25%
Spirometry before and after a bronchodilator inpatient CPT 94060 BRONCH EVAL B/A BRONCH $292.50 $390.00 $167.27–$331.50 — 25%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES $75.00 $100.00 $26.80–$85.00 36% below 25%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITIES $75.00 $100.00 $42.89–$85.00 — 25%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY $219.00 $292.00 $78.26–$248.20 13% below 25%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY $219.00 $292.00 $125.24–$248.20 — 25%

Vaccines

ProcedureCash priceList priceInsurers payvs North DakotaOff list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 INFLUENZA IIV ADJUVANTED VACCINE FOR INTRAMUSCULAR USE $153.44 $204.58 $54.83–$173.89 110% above 25%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 INFLUENZA VACCINE ADJ (65+ YRS) 0.5 ML SUSPENSION PREFILLED SYRINGE $155.25 $207.00 $55.48–$175.95 113% above 25%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 INFLUENZA IIV ADJUVANTED VACCINE FOR INTRAMUSCULAR USE $153.44 $204.58 $87.74–$173.89 — 25%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 INFLUENZA VACCINE ADJ (65+ YRS) 0.5 ML SUSPENSION PREFILLED SYRINGE $155.25 $207.00 $88.78–$175.95 — 25%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 COVID-19 VACCINE (PFIZER 12YR+) 30 MCG/0.3ML SUSPENSION PREFILLED SYRINGE $196.80 $262.40 $70.32–$223.04 7% below 25%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 SARSCOV2 VACC 30MCG/0.3ML TRIS-SUCROSE IM USE $196.80 $262.40 $70.32–$223.04 7% below 25%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 SARSCOV2 VACC 30MCG/0.3ML TRIS-SUCROSE IM USE $196.80 $262.40 $112.54–$223.04 — 25%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 COVID-19 VACCINE (PFIZER 12YR+) 30 MCG/0.3ML SUSPENSION PREFILLED SYRINGE $196.80 $262.40 $112.54–$223.04 — 25%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPHTHERIA-ACELLULAR PERTUSSIS-TETANUS 25-58-10 LF-MCG/0.5 SUSPENSION $53.62 $71.50 $19.16–$60.78 3% above 25%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 DTAP-HEPATITIS B RECOMB-IPV SUSPENSION PREFILLED SYRINGE $175.12 $233.50 $100.15–$198.48 — 25%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HPV 9-VALENT RECOMB VACCINE SUSPENSION PREFILLED SYRINGE $553.88 $738.50 $197.92–$627.72 57% above 25%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEPA/HEPB VACCINE ADULT IM $147.75 $197.00 $52.80–$167.45 15% below 25%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VACCINE,ADULT,IM $127.46 $169.94 $45.54–$144.45 26% above 25%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B RECOMB VACCINE 10 MCG/0.5ML SUSPENSION PREFILLED SYRINGE $52.88 $70.50 $18.89–$59.92 32% above 25%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B RECOMB VACCINE 10 MCG/0.5ML SUSPENSION PREFILLED SYRINGE $52.88 $70.50 $30.24–$59.92 — 25%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HAEMOPHILUS B POLYSAC CONJ VAC 7.5 MCG/0.5 ML SUSPENSION $56.22 $74.96 $32.15–$63.72 — 25%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES, MUMPS & RUBELLA VACCINE RECON SOLN $173.22 $230.96 $99.06–$196.32 — 25%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL A C Y&W-135 OLIG (POWDER) RECON SOLN $227.25 $303.00 $81.20–$257.55 28% above 25%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL A C Y&W-135 OLIG (POWDER) RECON SOLN $227.25 $303.00 $129.96–$257.55 — 25%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL RECOM, VACCINE, SEROGROUP B, 2 DOSE, VFC $362.71 $483.61 $129.61–$411.07 8% above 25%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL RECOM, VACCINE, SEROGROUP B, 2 DOSE $362.71 $483.61 $129.61–$411.07 8% above 25%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL RECOM, VACCINE, SEROGROUP B, 2 DOSE, VFC $362.71 $483.61 $207.42–$411.07 — 25%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL RECOM, VACCINE, SEROGROUP B, 2 DOSE $362.71 $483.61 $207.42–$411.07 — 25%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL CONJUGATE VACCINE, 20 VALENT (PCV20), FOR INTRAMUSCULAR USE $457.12 $609.50 $163.35–$518.07 21% above 25%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VAL CONJ VACC 0.5 ML SUSPENSION PREFILLED SYRINGE $457.12 $609.50 $163.35–$518.07 21% above 25%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL CONJUGATE VACCINE, 20 VALENT (PCV20), FOR INTRAMUSCULAR USE $457.12 $609.50 $261.41–$518.07 — 25%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VAL CONJ VACC 0.5 ML SUSPENSION PREFILLED SYRINGE $457.12 $609.50 $261.41–$518.07 — 25%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 NIRSEVIMAB-ALIP 50 MG/0.5ML SOLUTION PREFILLED SYRINGE $1,001.25 $1,335.00 $572.58–$1,134.75 — 25%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 RSV PRE-FUSION F A&B VAC RCMB 120 MCG/0.5ML RECON SOLN $517.88 $690.50 $296.16–$586.92 — 25%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE, RABAVERT, IM $750.57 $1,000.76 $268.20–$850.65 18% above 25%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE, PCEC RECON SUSP $752.62 $1,003.50 $268.94–$852.98 18% above 25%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE, RABAVERT, IM $750.57 $1,000.76 $429.23–$850.65 — 25%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE, PCEC RECON SUSP $750.57 $1,000.76 $429.23–$850.65 — 25%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS-DIPHTHERIA TOXOIDS 5-2 LFU INJECTABLE $73.31 $97.75 $26.20–$83.09 47% above 25%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS-DIPHTHERIA TOXOIDS 5-2 LFU INJECTABLE $72.75 $97.00 $41.60–$82.45 — 25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TETANUS-DIPHTH-ACELL PERTUSSIS 5-2.5-18.5 LF-MCG/0.5 SUSPENSION $82.50 $110.00 $29.48–$93.50 19% above 25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP, TETANUS, DIPHTHERIA, PERTUSSIS 7+ YRS, BOOSTRIX $87.74 $116.99 $31.35–$99.44 26% above 25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TETANUS-DIPHTH-ACELL PERTUSSIS 5-2.5-18.5 LF-MCG/0.5 SUSPENSION PREFILLED SYRINGE $87.74 $116.99 $31.35–$99.44 26% above 25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP, TETANUS, DIPHTHERIA, PERTUSSIS 7+ YRS, BOOSTRIX $87.74 $116.99 $50.18–$99.44 — 25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TETANUS-DIPHTH-ACELL PERTUSSIS 5-2.5-18.5 LF-MCG/0.5 SUSPENSION PREFILLED SYRINGE $87.74 $116.99 $50.18–$99.44 — 25%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUN ADMIN;INITIAL-ND VFC $16.50 $22.00 $5.90–$18.70 66% below 25%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN - INFLUENZA $52.50 $70.00 $18.76–$59.50 9% above 25%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION; ONE VACCINE (SINGLE OR COMBINATION VACCINE/TO* $52.50 $70.00 $18.76–$59.50 9% above 25%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION; ONE VACCINE (SINGLE OR COMBINATION VACCINE/TOXOID) $58.50 $78.00 $20.90–$66.30 22% above 25%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUN ADMIN;INITIAL-ND VFC $16.50 $22.00 $9.44–$18.70 — 25%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION; ONE VACCINE (SINGLE OR COMBINATION VACCINE/TO* $52.50 $70.00 $30.02–$59.50 — 25%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN - INFLUENZA $52.50 $70.00 $30.02–$59.50 — 25%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION; ONE VACCINE (SINGLE OR COMBINATION VACCINE/TOXOID) $58.50 $78.00 $33.45–$66.30 — 25%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMINISTRATION; EACH ADD'L VACCINE (SINGLE OR COMBO VACCINE/T* $29.25 $39.00 $10.45–$33.15 at median 25%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMINISTRATION; EACH ADD'L VACCINE (SINGLE OR COMBO VACCINE/T* $29.25 $39.00 $16.73–$33.15 — 25%
Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More
Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More
List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More
Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More
Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.
Off list How much lower the cash price is than the list price.
No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More
At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More
Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.

Source file: https://www.essentiahealth.org/standard-charges/2026/261175213_Essentia-Fargo_standardcharges.csv