Monument Health Spearfish Hospital — price list
← Hospital overviewVerified from Monument Health Spearfish Hospital’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.
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.
137 prices shown.
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| ACTIVATED CHARCOAL-SORBITOL 25 GRAM/120 ML ORAL SUSPENSION Inpatient | RX-124812 CDM | $81.92 | $81.92 | $50.79 – $79.46 | — | |
| ACTIVATED CHARCOAL-SORBITOL 25 GRAM/120 ML ORAL SUSPENSION Outpatient | RX-124812 CDM | $81.92 | $81.92 | $33.59 – $79.46 | — | |
| ALOGLIPTIN 25 MG TABLET Inpatient | RX-119801 CDM | $52.35 | $52.35 | $32.46 – $50.78 | — | |
| ALOGLIPTIN 25 MG TABLET Outpatient | RX-119801 CDM | $52.35 | $52.35 | $21.46 – $50.78 | — | |
| ALOGLIPTIN 6.25 MG TABLET Inpatient | RX-119799 CDM | $53.47 | $53.47 | $33.15 – $51.87 | — | |
| ALOGLIPTIN 6.25 MG TABLET Outpatient | RX-119799 CDM | $53.47 | $53.47 | $21.92 – $51.87 | — | |
| AMMONIUM LACTATE 12 % LOTION Inpatient | RX-10380 CDM | $58.84 | $58.84 | $36.48 – $57.07 | — | |
| AMMONIUM LACTATE 12 % LOTION Outpatient | RX-10380 CDM | $58.84 | $58.84 | $24.12 – $57.07 | — | |
| APIXABAN 5 MG TABLET Inpatient | RX-119614 CDM | $62.16 | $62.16 | $38.54 – $60.30 | — | |
| APIXABAN 5 MG TABLET Outpatient | RX-119614 CDM | $62.16 | $62.16 | $25.49 – $60.30 | — | |
| BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINTMENT IN PACKET Inpatient | RX-123706 CDM | $70.95 | $70.95 | $43.99 – $68.82 | — | |
| BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINTMENT IN PACKET Outpatient | RX-123706 CDM | $70.95 | $70.95 | $29.09 – $68.82 | — | |
| CUPRIC CHLORIDE 0.4 MG/ML INTRAVENOUS SOLUTION Inpatient | RX-121256 CDM | $297 | $297 | $184 – $289 | — | |
| CUPRIC CHLORIDE 0.4 MG/ML INTRAVENOUS SOLUTION Outpatient | RX-121256 CDM | $297 | $297 | $122 – $289 | — | |
| DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 730 MG/100 ML SOLN Inpatient | RX-124768 CDM | $455 | $455 | $282 – $442 | — | |
| DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 730 MG/100 ML SOLN Outpatient | RX-124768 CDM | $455 | $455 | $187 – $442 | — | |
| DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE Inpatient | RX-123367 CDM | $282 | $282 | $175 – $274 | — | |
| DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE Outpatient | RX-123367 CDM | $282 | $282 | $116 – $274 | — | |
| FERRIC SUBSULFATE 0.2 GRAM TO 0.22 GRAM/ML TOPICAL SOLN AND APPLICATOR Inpatient | RX-119255 CDM | $93.83 | $93.83 | $58.17 – $91.02 | — | |
| FERRIC SUBSULFATE 0.2 GRAM TO 0.22 GRAM/ML TOPICAL SOLN AND APPLICATOR Outpatient | RX-119255 CDM | $93.83 | $93.83 | $38.47 – $91.02 | — | |
| FINASTERIDE 5 MG TABLET Inpatient | RX-10037 CDM | $27.02 | $27.02 | $0.00 – $26.21 | — | |
| FINASTERIDE 5 MG TABLET Outpatient | RX-10037 CDM | $27.02 | $27.02 | $0.00 – $26.21 | — | |
| FLUCONAZOLE 100 MG TABLET Inpatient | RX-10044 CDM | $38.36 | $38.36 | $23.78 – $37.21 | — | |
| FLUCONAZOLE 100 MG TABLET Outpatient | RX-10044 CDM | $38.36 | $38.36 | $15.73 – $37.21 | — | |
| FLUORESCEIN 500 MG/5 ML (10 %) INTRAVENOUS SOLUTION Inpatient | RX-10059 CDM | $440 | $440 | $273 – $427 | — | |
| FLUORESCEIN 500 MG/5 ML (10 %) INTRAVENOUS SOLUTION Outpatient | RX-10059 CDM | $440 | $440 | $180 – $427 | — | |
| FLURBIPROFEN 0.03 % EYE DROPS Inpatient | RX-10080 CDM | $186 | $186 | $115 – $180 | — | |
| FLURBIPROFEN 0.03 % EYE DROPS Outpatient | RX-10080 CDM | $186 | $186 | $76.16 – $180 | — | |
| GLIPIZIDE 5 MG TABLET Inpatient | RX-10117 CDM | $15.63 | $15.63 | $0.00 – $0.00 | — | |
| GLIPIZIDE 5 MG TABLET Outpatient | RX-10117 CDM | $15.63 | $15.63 | $0.00 – $0.00 | — |