Essentia Health-Sandstone — price list
← Hospital overviewVerified from Essentia Health-Sandstone’s published price file
Includes cash prices, list prices, insurance-negotiated rates. Open any row for plan-level negotiated rates. This is public hospital price transparency data, not a guaranteed estimate of your bill.
Showing the first 1,500 prices from a large file. Search a procedure or code below to narrow the list.
How to read these columns
- List
- The hospital’s full undiscounted (gross) charge — rarely what anyone actually pays.
- Cash
- The discounted self-pay price for paying directly, without insurance.
- Negotiated
- Rates agreed with insurers; open a row for plan-level detail. Your share depends on your benefits.
These are the hospital’s published reference prices, not a personalized estimate of your bill.
37 prices shown (filtered).
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| Acetylcholine chloride 20 mg recon soln Outpatient | 25000000 CDM | $294 | $217 | $113 – $294 | — | |
| Alprazolam 2 mg tablet Outpatient | 25000000 CDM | $3.00 | $2.22 | $1.15 – $3.00 | — | |
| Ammonia inhaler Outpatient | 25000000 CDM | $1.50 | $1.11 | $0.58 – $1.50 | — | |
| Bacitracin 500 unit/gm ointment 28.4 g tube Outpatient | 25000000 CDM | $3.50 | $2.59 | $1.34 – $3.50 | — | |
| Bacitracin-polymyxin b 500-10000 unit/gm ointment 28.4 g tube Outpatient | 25000000 CDM | $9.00 | $6.65 | $3.46 – $9.00 | — | |
| Bacitracin-polymyxin b 500-10000 unit/gm ointment 3.5 g tube Outpatient | 25000000 CDM | $87.50 | $64.66 | $33.59 – $87.50 | — | |
| Benzocaine 20 % aerosol Outpatient | 25000000 CDM | $0.50 | $0.37 | $0.19 – $0.50 | — | |
| Bupivacaine 0.25 % 30 ml in 0.9 % sodium chloride 30 ml Outpatient | 25000000 CDM | $55.50 | $41.01 | $21.31 – $55.50 | — | |
| Bupivacaine 0.5% (pf) & lidocaine 2% withepi equal parts 5 ml syringe Outpatient | 25000000 CDM | $12.50 | $9.24 | $4.80 – $12.50 | — | |
| Bupivacaine-epinephrine pf 0.25%-1:200,000 + lidocaine 1% in 0.9% sodium chloride 160 ml bag Outpatient | 25000000 CDM | $11.08 | $8.19 | $4.25 – $11.08 | — | |
| Erythromycin 5 mg/gm ointment 1 g tube Outpatient | 25000000 CDM | $29.00 | $21.43 | $11.13 – $29.00 | — | |
| Erythromycin 5 mg/gm ointment 3.5 g tube Outpatient | 25000000 CDM | $60.00 | $44.34 | $23.03 – $60.00 | — | |
| Eye tray (for charging only) Outpatient | 25000000 CDM | $38.50 | $28.45 | $14.78 – $38.50 | — | |
| Fluorescein sodium 0.6 mg strip 300 each box Outpatient | 25000000 CDM | $3.00 | $2.22 | $1.15 – $3.00 | — | |
| Fluorescein sodium 1 mg strip Outpatient | 25000000 CDM | $2.80 | $2.07 | $1.07 – $2.80 | — | |
| Gelatin adsorbable 100 misc Outpatient | 25000000 CDM | $185 | $137 | $71.02 – $185 | — | |
| Lamotrigine XR 50 mg tablet extended release 24 hour Outpatient | 25000000 CDM | $5.40 | $3.99 | $2.07 – $5.40 | — | |
| Lidocaine 2% 5 ml + bupivacaine 0.75% 5 ml + vitrase 200 units/ml 0.5 ml Outpatient | 25000000 CDM | $319 | $236 | $122 – $319 | — | |
| Lidocaine 2% 5 ml-bupivacaine 0.75 % 5 ml-amphadase 75 units Outpatient | 25000000 CDM | $156 | $115 | $59.89 – $156 | — | |
| Lidocaine 3.5 % gel 1 ml tube Outpatient | 25000000 CDM | $93.50 | $69.10 | $35.89 – $93.50 | — | |
| Lidocaine jelly 2% 5 ml -gelfoam 50 misc Outpatient | 25000000 CDM | $103 | $75.87 | $39.42 – $103 | — | |
| Lidocaine urethral/mucosal 2 % gel Outpatient | 25000000 CDM | $28.00 | $20.69 | $10.75 – $28.00 | — | |
| Lidocaine urethral/mucosal 2 % gel 5 ml tube Outpatient | 25000000 CDM | $28.00 | $20.69 | $10.75 – $28.00 | — | |
| Lidocaine-bupivacaine-hyaluronidase pf 2 %-0.375 %-15 unit/ml 8 ml syringe Outpatient | 25000000 CDM | $67.50 | $49.88 | $25.91 – $67.50 | — | |
| Lidocaine-epinephrine-hyaluronidase pf 3%-1:400,000-15 unit/ml 5 ml syringe Outpatient | 25000000 CDM | $30.00 | $22.17 | $11.52 – $30.00 | — | |
| Mercaptopurine 50 mg tablet Outpatient | 25000000 CDM | $7.00 | $5.17 | $2.69 – $7.00 | — | |
| Mupirocin calcium 2 % cream 15 g tube Outpatient | 25000000 CDM | $300 | $222 | $115 – $300 | — | |
| Neomycin-bacitracin-polymyxin 3.5-400-5000 ointment 14.2 g tube Outpatient | 25000000 CDM | $3.50 | $2.59 | $1.34 – $3.50 | — | |
| Neomycin-bacitracin-polymyxin 3.5-400-5000 ointment 28 g tube Outpatient | 25000000 CDM | $4.50 | $3.33 | $1.73 – $4.50 | — | |
| Neomycin-bacitracin-polymyxin 3.5-400-5000 ointment 28.35 g tube Outpatient | 25000000 CDM | $9.00 | $6.65 | $3.46 – $9.00 | — |