Sanford Luverne Medical Center — price list
← Hospital overviewVerified from Sanford Luverne Medical Center’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.
1,500 prices shown.
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| Abatacept For IV Soln 250 MG Inpatient | J0129 HCPCS | $3,153 | $2,522 | $1,689 – $2,983 | — | |
| Abd hysterectomy bso Inpatient | 0360 RC | $6,635 | $5,308 | $3,555 – $6,277 | — | |
| Abiraterone Acetate Tab 250 MG Inpatient | J8999 HCPCS | $6.75 | $5.40 | $3.62 – $6.39 | — | |
| Acebutolol HCl Cap 200 MG Inpatient | 0250 RC | $6.38 | $5.11 | $3.42 – $6.04 | — | |
| Acetaminophen IV Soln 10 MG/ML Inpatient | J0134 HCPCS | $193 | $154 | $103 – $182 | — | |
| Acetaminophen IV Soln 10 MG/ML Inpatient | J0131 HCPCS | $194 | $155 | $104 – $183 | — | |
| Acetaminophen IV Soln 10 MG/ML Inpatient | J0136 HCPCS | $161 | $128 | $86.00 – $152 | — | |
| Acetaminophen Suppos 120 MG Inpatient | 0250 RC | $1.50 | $1.20 | $0.80 – $1.42 | — | |
| Acetaminophen Suppos 325 MG Inpatient | 0250 RC | $1.50 | $1.20 | $0.80 – $1.42 | — | |
| Acetaminophen Suppos 650 MG Inpatient | 0250 RC | $1.50 | $1.20 | $0.80 – $1.42 | — | |
| Acetaminophen Susp 160 MG/5ML Inpatient | 0250 RC | $4.97 | $3.98 | $2.66 – $4.70 | — | |
| Acetaminophen Tab 325 MG Inpatient | J3490 HCPCS | $3.25 | $2.60 | $1.74 – $3.07 | — | |
| Acetaminophen Tab 500 MG Inpatient | J3490 HCPCS | $3.25 | $2.60 | $1.74 – $3.07 | — | |
| Acetaminophen Tab ER 650 MG Inpatient | 0250 RC | $1.50 | $1.20 | $0.80 – $1.42 | — | |
| Acetaminophen w/ Codeine Tab 300-30 MG Inpatient | 0250 RC | $1.50 | $1.20 | $0.80 – $1.42 | — | |
| Acetazolamide Sodium For Inj 500 MG Inpatient | J1120 HCPCS | $99.83 | $79.87 | $53.49 – $94.44 | — | |
| Acetazolamide Tab 125 MG Inpatient | 0250 RC | $6.02 | $4.82 | $3.23 – $5.69 | — | |
| Acetic Acid Soln 3% Inpatient | 0250 RC | $39.37 | $31.50 | $21.09 – $37.24 | — | |
| Acetylcysteine Cap 600 MG Inpatient | 0250 RC | $1.50 | $1.20 | $0.80 – $1.42 | — | |
| Acetylcysteine Inhal Soln 20% Inpatient | 0250 RC | $31.17 | $24.94 | $16.70 – $29.49 | — | |
| Acetylcysteine Inhal Soln 20% Inpatient | J7608 HCPCS | $31.17 | $24.94 | $16.70 – $29.49 | — | |
| Acetylcysteine Inj 200 MG/ML Inpatient | J0132 HCPCS | $114 | $91.35 | $61.18 – $108 | — | |
| Acute hepatitis panel 80074 Inpatient | 80074 CPT | $344 | $275 | $184 – $325 | — | |
| Acyclovir Cap 200 MG Inpatient | 0250 RC | $1.50 | $1.20 | $0.80 – $1.42 | — | |
| Acyclovir Sodium IV Soln 50 MG/ML Inpatient | J0133 HCPCS | $77.28 | $61.83 | $41.41 – $73.11 | — | |
| Acyclovir Tab 400 MG Inpatient | 0250 RC | $1.50 | $1.20 | $0.80 – $1.42 | — | |
| Adenosine IV Soln 12 MG/4ML Inpatient | J0153 HCPCS | $77.01 | $61.61 | $41.26 – $72.85 | — | |
| Adenosine IV Soln 6 MG/2ML Inpatient | J0153 HCPCS | $76.77 | $61.42 | $41.13 – $72.62 | — | |
| Adolescent clinic Inpatient | 0510 RC | $126 | $101 | $67.51 – $119 | — | |
| Adrenocorticotropic hormone acth so 82024.900 Inpatient | 82024 CPT | $141 | $113 | $75.55 – $133 | — |