Sanford Worthington Medical Center — price list
← Hospital overviewVerified from Sanford Worthington 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) | |
|---|---|---|---|---|---|---|
| ,Insulin Aspart Soln Pen-injector 100 Unit/ML,Insulin Aspart Soln Cartridge 100 Unit/ML Inpatient | 0250 RC | $69.90 | $55.92 | $27.10 – $66.75 | — | |
| 3-d sim therapy rad Inpatient | 77295 CPT | $9,284 | $7,427 | $3,599 – $8,866 | — | |
| A-v shunt fistula Inpatient | 0360 RC | $4,722 | $3,778 | $1,831 – $4,510 | — | |
| Abatacept For IV Soln 250 MG Inpatient | J0129 HCPCS | $2,927 | $2,341 | $1,135 – $2,795 | — | |
| Abd hysterectomy Inpatient | 0360 RC | $5,971 | $4,777 | $2,315 – $5,702 | — | |
| Acetaminophen IV Soln 10 MG/ML Inpatient | J0134 HCPCS | $163 | $131 | $63.24 – $156 | — | |
| Acetaminophen IV Soln 10 MG/ML Inpatient | J0136 HCPCS | $163 | $130 | $63.22 – $156 | — | |
| Acetaminophen Soln 160 MG/5ML Inpatient | 0250 RC | $6.62 | $5.30 | $2.57 – $6.32 | — | |
| Acetaminophen Suppos 120 MG Inpatient | 0250 RC | $1.50 | $1.20 | $0.58 – $1.43 | — | |
| Acetaminophen Suppos 325 MG Inpatient | 0250 RC | $5.65 | $4.52 | $2.19 – $5.40 | — | |
| Acetaminophen Suppos 650 MG Inpatient | 0250 RC | $1.50 | $1.20 | $0.58 – $1.43 | — | |
| Acetaminophen Susp 160 MG/5ML Inpatient | 0250 RC | $4.86 | $3.89 | $1.88 – $4.64 | — | |
| Acetaminophen Tab 325 MG Inpatient | J3490 HCPCS | $1.50 | $1.20 | $0.58 – $1.43 | — | |
| Acetaminophen Tab 500 MG Inpatient | J3490 HCPCS | $1.50 | $1.20 | $0.58 – $1.43 | — | |
| Acetaminophen Tab ER 650 MG Inpatient | 0250 RC | $1.50 | $1.20 | $0.58 – $1.43 | — | |
| Acetaminophen w/ Codeine Tab 300-30 MG Inpatient | 0250 RC | $1.50 | $1.20 | $0.58 – $1.43 | — | |
| Acetazolamide Sodium For Inj 500 MG Inpatient | J1120 HCPCS | $102 | $81.71 | $39.60 – $97.53 | — | |
| Acetazolamide Tab 250 MG Inpatient | 0250 RC | $5.76 | $4.61 | $2.23 – $5.50 | — | |
| Acetic Acid Irrigation Soln 0.25% Inpatient | 0250 RC | $28.40 | $22.72 | $11.01 – $27.12 | — | |
| Acetic Acid Otic Soln 2% Inpatient | 0250 RC | $68.81 | $55.05 | $26.68 – $65.71 | — | |
| Acetic Acid Soln 3% Inpatient | 0250 RC | $47.60 | $38.08 | $18.45 – $45.46 | — | |
| Acetic Acid Soln 5% Inpatient | 0250 RC | $26.95 | $21.56 | $10.45 – $25.74 | — | |
| Acetylcysteine Inhal Soln 20% Inpatient | J7608 HCPCS | $13.98 | $11.19 | $5.42 – $13.35 | — | |
| Acetylcysteine Inhal Soln 20% Inpatient | 0250 RC | $13.98 | $11.19 | $5.42 – $13.35 | — | |
| Acetylcysteine Inj 200 MG/ML Inpatient | J0132 HCPCS | $114 | $91.20 | $44.20 – $109 | — | |
| Acyclovir Oint 5% Inpatient | 0250 RC | $43.67 | $34.94 | $16.93 – $41.70 | — | |
| Acyclovir Sodium IV Soln 50 MG/ML Inpatient | J0133 HCPCS | $77.24 | $61.80 | $29.95 – $73.76 | — | |
| Acyclovir Tab 400 MG Inpatient | 0250 RC | $1.50 | $1.20 | $0.58 – $1.43 | — | |
| Adenoidectomy Inpatient | 0360 RC | $5,080 | $4,064 | $1,970 – $4,851 | — | |
| Adenosine IV Soln 12 MG/4ML Inpatient | J0153 HCPCS | $76.98 | $61.59 | $29.85 – $73.52 | — |