Sanford Medical Center Mayville — price list
← Hospital overviewVerified from Sanford Medical Center Mayville’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) | |
|---|---|---|---|---|---|---|
| ,Insulin Aspart Soln Pen-injector 100 Unit/ML,Insulin Aspart Soln Cartridge 100 Unit/ML Inpatient | 0250 RC | $39.26 | $31.41 | $21.59 – $36.46 | — | |
| 17 hydroxypregnenolone 84143.900 Inpatient | 84143 CPT | $87.00 | $69.60 | $47.85 – $80.80 | — | |
| 5 hiaa (5 hydroxy) random urine 83497.901 Inpatient | 83497 CPT | $57.00 | $45.60 | $31.35 – $52.94 | — | |
| Abatacept For IV Soln 250 MG Inpatient | J0129 HCPCS | $1,847 | $1,477 | $1,016 – $1,715 | — | |
| Acetaminophen IV Soln 10 MG/ML Inpatient | J0134 HCPCS | $114 | $90.88 | $62.48 – $106 | — | |
| Acetaminophen IV Soln 10 MG/ML Inpatient | J0131 HCPCS | $19.00 | $15.20 | $10.45 – $17.65 | — | |
| Acetaminophen Liquid 167 MG/5ML Inpatient | 0250 RC | $4.25 | $3.40 | $2.34 – $3.95 | — | |
| Acetaminophen Suppos 120 MG Inpatient | 0250 RC | $4.25 | $3.40 | $2.34 – $3.95 | — | |
| Acetaminophen Suppos 325 MG Inpatient | 0250 RC | $4.25 | $3.40 | $2.34 – $3.95 | — | |
| Acetaminophen Suppos 650 MG Inpatient | 0250 RC | $4.25 | $3.40 | $2.34 – $3.95 | — | |
| Acetaminophen Tab 500 MG Inpatient | J3490 HCPCS | $4.25 | $3.40 | $2.34 – $3.95 | — | |
| Acetaminophen Tab ER 650 MG Inpatient | 0250 RC | $4.25 | $3.40 | $2.34 – $3.95 | — | |
| Acetaminophen w/ Codeine Soln 120-12 MG/5ML Inpatient | 0250 RC | $5.65 | $4.52 | $3.11 – $5.25 | — | |
| Acetaminophen w/ Codeine Tab 300-30 MG Inpatient | 0250 RC | $4.25 | $3.40 | $2.34 – $3.95 | — | |
| Acetazolamide Cap ER 12HR 500 MG Inpatient | 0250 RC | $7.17 | $5.74 | $3.94 – $6.66 | — | |
| Acetic Acid Irrigation Soln 0.25% Inpatient | 0250 RC | $21.00 | $16.80 | $11.55 – $19.50 | — | |
| Acetylcholine Chloride Intraocular For Soln 20 MG (1:100) Inpatient | 0250 RC | $120 | $95.99 | $65.99 – $111 | — | |
| Acetylcysteine Cap 600 MG Inpatient | 0250 RC | $4.25 | $3.40 | $2.34 – $3.95 | — | |
| Acetylcysteine Inhal Soln 20% Inpatient | 0250 RC | $8.72 | $6.98 | $4.80 – $8.10 | — | |
| Acetylcysteine Inhal Soln 20% Inpatient | J7608 HCPCS | $8.72 | $6.98 | $4.80 – $8.10 | — | |
| Acitretin Cap 17.5 MG Inpatient | 0250 RC | $26.57 | $21.26 | $14.61 – $24.68 | — | |
| Activated protein c apc resistance assay 85307 Inpatient | 85307 CPT | $114 | $91.20 | $62.70 – $106 | — | |
| Activity therapy Inpatient | G0176 HCPCS | $670 | $536 | $369 – $622 | — | |
| Acute hepatitis panel 80074 Inpatient | 80074 CPT | $272 | $218 | $150 – $253 | — | |
| Acyclovir Sodium IV Soln 50 MG/ML Inpatient | J0133 HCPCS | $18.43 | $14.75 | $10.14 – $17.12 | — | |
| Acyclovir Tab 400 MG Inpatient | 0250 RC | $4.25 | $3.40 | $2.34 – $3.95 | — | |
| Acyclovir Tab 800 MG Inpatient | 0250 RC | $17.20 | $13.76 | $9.46 – $15.97 | — | |
| Acylcarnitines quant each spec so 82017.900 Inpatient | 82017 CPT | $62.00 | $49.60 | $34.10 – $57.58 | — | |
| Adenosine IV Soln 6 MG/2ML Inpatient | J0153 HCPCS | $34.85 | $27.88 | $19.17 – $32.37 | — | |
| Admin hepatitis b vaccine Inpatient | 90471 CPT | $78.00 | $62.40 | $42.90 – $72.44 | — |