Sanford Luverne Medical Center Prices (2025)

Treatment Room - Negative Pressure Wound Therapy, Surface Area Less Than Or Equal To 50 Square Centimeters, Per Session (1002928) $241.00

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Treatment Room - Negative Pressure Wound Therapy, Surface Area Greater Than 50 Square Centimeters, Per Session (1002929) $307.00

N/A

Treatment Room - Established Patient Office Or Other Outpatient Visit, Typically 5 Minutes (1028030) $226.00

N/A

Treatment Room - Established Patient Office Or Other Outpatient Visit, Typically 5 Minutes (1004719) $128.00

N/A

Treatment Room - Application Of Vein Wound Compression System Lower Leg Below Knee Including Ankle And Foot (1010224) $301.00

N/A

Trauma Response - Full Trauma Activation (1027810) $235.00

N/A

Therapeutic Services - Therapeutic Removal Of Whole Blood To Correct Blood Level Imbalance (1004588) $249.00

N/A

Therapeutic Services - Irrigation Of Implanted Venous Access Drug Delivery Device (1004718) $154.00

N/A

Telemedicine - Fee For Remote Healthcare Service (1009851) $42.00

N/A

Speech Therapy - Treatment Of Swallowing Or Oral Feeding Function (1002861) $268.00

N/A

Speech Therapy - Treatment Of Speech, Language, Voice, Communication, Or Hearing Processing Disorder, Individual (1002858) $260.00

N/A

Speech Therapy - Standardized Thought Processing Testing With Interpretation And Report, Per Hour Of Qualified Professional Time (1006830) $340.00

N/A

Speech Therapy - Fluoroscopic And Video Recorded Motion Evaluation Of Swallowing Function (1002872) $268.00

N/A

Speech Therapy - Evaluation Of Swallowing Function (1002860) $260.00

N/A

Speech Therapy - Evaluation Of Speech Sound Production (1021037) $285.00

N/A

Room & Board - Private (1000439) $1,670.00

N/A

Room & Board - Private (1004313) $777.00

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Room & Board - Post Icu Intensive Care (1000440) $1,815.00

N/A

Room & Board - Other (1008187) $564.00

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Room & Board - Other (1004310) $454.00

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Room & Board - Nursery (1004623) $1,128.00

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Room & Board - Nursery (1004622) $1,128.00

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Room & Board - Nursery (1004624) $978.00

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Room & Board - Nursery (1000438) $978.00

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Room & Board - Intensive Care (1000441) $2,486.00

N/A

Respiratory Services - Ventilation Management In Hospital - Initial Day (1003236) $1,159.00

N/A

Respiratory Services - Test For Exercise-Induced Lung Stress (1027651) $312.00

N/A

Respiratory Services - Suction Removal Of Secretions From The Nose And Throat (1008256) $111.00

N/A

Respiratory Services - Resuscitation In Delivery Or Birthing Room (1021613) $785.00

N/A

Respiratory Services - Respiratory Inhaled Pressure Or Nonpressure Treatment To Relieve Airway Obstruction Or For Sputum Specimen (1009222) $110.00

N/A

Respiratory Services - Respiratory Inhaled Pressure Or Nonpressure Treatment To Relieve Airway Obstruction Or For Sputum Specimen (1006731) $110.00

N/A

Respiratory Services - Respiratory Inhaled Pressure Or Nonpressure Treatment To Relieve Airway Obstruction Or For Sputum Specimen (1009221) $110.00

N/A

Respiratory Services - Respiratory Inhaled Pressure Or Nonpressure Treatment To Relieve Airway Obstruction Or For Sputum Specimen (1004474) $79.00

N/A

Respiratory Services - Respiratory Inhaled Pressure Or Nonpressure Treatment To Relieve Airway Obstruction Or For Sputum Specimen (1006717) $79.00

N/A

Respiratory Services - Procedure To Improve Lung Function, Each 15 Minutes (1007537) $96.00

N/A

Respiratory Services - Physician Attendance At Delivery And Stabilization Of Newborn (1021614) $368.00

N/A

Respiratory Services - Overnight Measurement Of Oxygen Saturation In Blood Using Ear Or Finger Device (1002093) $296.00

N/A

Respiratory Services - Multiple Measurements Of Oxygen Saturation In Blood Using Ear Or Finger Device (1003249) $28.00

N/A

Respiratory Services - Measurement Of Oxygen Saturation In Blood Using Ear Or Finger Device (1003265) $19.00

N/A

Respiratory Services - Measurement And Graphic Recording Of Total And Timed Exhaled Air Capacity (1003239) $215.00

N/A

Respiratory Services - Measurement And Graphic Recording Of The Amount And Speed Of Breathed Air, Before And Following Medication Administration (1001533) $338.00

N/A

Respiratory Services - Manual Maneuvers To Chest Wall To Assist Movement Of Lung Secretions (1003254) $118.00

N/A

Respiratory Services - Initiation And Management Of Continuous Positive Airway Pressure (Cpap) Assistance By Mask Or Breathing Tube (1004468) $198.00

N/A

Respiratory Services - Initiation And Management Of Continuous Positive Airway Pressure (Cpap) Assistance By Mask Or Breathing Tube (1003262) $198.00

N/A

Respiratory Services - Inhaled Pneumonia Treatment (1004609) $179.00

N/A

Respiratory Services - Exercise Test For Spasm Of Lung Airways (1027650) $290.00

N/A

Respiratory Services - Demonstration Or Evaluation Of Manual Maneuvers To Chest Wall To Assist Movement Of Lung Secretions (1003278) $154.00

N/A

Respiratory Services - Application Of Electrical Stimulation To 1 Or More Areas, Each 15 Minutes (1004481) $58.00

N/A

Recovery Room Additional (1004671) $131.00

N/A

Recovery Room (1004670) $1,241.00

N/A

Recovery - Post Anesthesia Services (1001874) $27.00

N/A

Radiopharmaceuticals - Technetium Sulfur Colloid (Radioactive Imaging Agent) (1003542) $339.00

N/A

Radiopharmaceuticals - Technetium Sestamibi (Radioactive Imaging Agent) (1003575) $338.00

N/A

Radiopharmaceuticals - Technetium Pentetate (Radioactive Imaging Agent) (1010432) $296.00

N/A

Radiopharmaceuticals - Technetium Mertiatide (Radioactive Imaging Agent) (1005454) $741.00

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Radiopharmaceuticals - Technetium Medronate (Radioactive Imaging Agent) (1009453) $188.00

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Radiopharmaceuticals - Technetium Mebrofenin (Radioactive Imaging Agent) (1005436) $273.00

N/A

Radiopharmaceuticals - Technetium Macroaggregated Albumin (Radioactive Imaging Agent) (1005439) $311.00

N/A

Radiopharmaceuticals - Fluorodeoxyglucose F-18 (Radioactive Imaging Agent) (1005446) $2,098.00

N/A

Pulmonary Rehabilitation - Pulmonary Rehabilitation Sesstion Including Exercise (1010220) $341.00

N/A

Professional Services - Vaginal Removal Of Uterus (1003057) $82.00

N/A

Professional Services - Urinary System Procedure (1003044) $82.00

N/A

Professional Services - Upper Arm Bone And Shoulder Joint Procedure (1003101) $82.00

N/A

Professional Services - Upper Arm And Elbow Procedure (1003109) $82.00

N/A

Professional Services - Upper And Lower Gastrointestinal Procedure (1027675) $82.00

N/A

Professional Services - Upper Abdominal Procedure (1003017) $82.00

N/A

Professional Services - Upper Abdominal Hernia Repair (1003012) $82.00

N/A

Professional Services - Subsequent Hospital Inpatient Care, Typically 15 Minutes Per Day (1010862) $113.00

N/A

Professional Services - Skin Of Arms, Legs Or Trunk Procedure (1002978) $82.00

N/A

Professional Services - Repair Or Removal Of Vagina And Urethral Procedure (1003056) $82.00

N/A

Professional Services - Repair Of Incisional Hernia Or Wound Opening (1003013) $82.00

N/A

Professional Services - Removal Of Uterus (1003031) $82.00

N/A

Professional Services - Relocation Of Undescended Testicle Into Scrotum (1003052) $82.00

N/A

Professional Services - Nerve, Muscle Or Tendon Procedure Of Forearm, Wrist, And Hand (1003115) $82.00

N/A

Professional Services - Middle Or Incisional Abdominal Hernia Repair (1003026) $82.00

N/A

Professional Services - Male Genitalia Procedure (1003048) $82.00

N/A

Professional Services - Lower Abdominal Hernia Repair (1003025) $82.00

N/A

Professional Services - Lower Abdominal Cavity Procedure (1003029) $82.00

N/A

Professional Services - Lens Surgery (1002955) $82.00

N/A

Professional Services - Large Intestine Procedure (1027673) $82.00

N/A

Professional Services - Labor During Planned Vaginal Delivery (1003134) $82.00

N/A

Professional Services - Insertion Of Needle Into Vein, Patient 3 Years Or Older (1008501) $82.00

N/A

Professional Services - Insertion Of Needle Into Upper Leg Or Neck Vein, Patient Younger Than 3 Years (1007824) $82.00

N/A

Professional Services - Injection Of Substance Into Spinal Canal Of Lower Back Or Sacrum Using Imaging Guidance (1026832) $82.00

N/A

Professional Services - Head And Neck Procedure (1002973) $82.00

N/A

Professional Services - Exam Of Uterus With Endoscope (1003059) $82.00

N/A

Professional Services - Emergent Insertion Of Breathing Tube Into Windpipe (1002947) $82.00

N/A

Professional Services - Division Of Fallopian Tubes (1003032) $82.00

N/A

Professional Services - Diagnostic Exam Of Upper Gastrointestinal System (1027669) $82.00

N/A

Professional Services - Diagnostic Exam Of Large Intestine (1027674) $82.00

N/A

Professional Services - Continuous Spinal Drug Administration (1004387) $82.00

N/A

Professional Services - Closed Lower Leg, Ankle Or Foot Procedure (1003088) $82.00

N/A

Professional Services - Cesarean Delivery Following Labor (1004385) $82.00

N/A

Professional Services - Cesarean Delivery (1003132) $82.00

N/A

Professional Services - Central Venous Access (1002992) $82.00

N/A

Professional Services - Bone Procedure Of Lower Leg, Ankle And Foot (1003092) $82.00

N/A

Professional Services - Bone Procedure Of Forearm, Wrist, Or Hand (1003117) $82.00

N/A

Professional Services - Bone Procedure Of Forearm, Wrist, Or Hand (1003116) $82.00

N/A

Professional Services - Biopsy Of Female Genitalia (1003055) $82.00

N/A

Professional Services - Anal And Rectal Procedure (1003041) $82.00

N/A

Professional Services - Abdominal Wall Procedure (1003009) $82.00

N/A

Preventive Services - Administration Of Vaccine By Injection, Each Additional Vaccine (1008507) $32.00

N/A

Preventive Services - Administration Of Vaccine By Injection, Each Additional Vaccine (1007693) $32.00

N/A

Preventive Services - Administration Of Vaccine By Injection, 1 Vaccine (1004368) $62.00

N/A

Preventive Services - Administration Of Vaccine By Injection, 1 Vaccine (1007692) $62.00

N/A

Preventive Services - Administration Of Vaccine By Injection, 1 Vaccine (1011896) $61.00

N/A

Physical Therapy - Water Pool Therapy With Therapeutic Exercises To 1 Or More Areas, Each 15 Minutes (1002903) $120.00

N/A

Physical Therapy - Walking Training To 1 Or More Areas, Each 15 Minutes (1002904) $99.00

N/A

Physical Therapy - Training In Use Of Prosthesis For Arms Or Legs, Per 15 Minutes (1002911) $107.00

N/A

Physical Therapy - Therapeutic Procedure To Re-Educate Brain-To-Nerve-To-Muscle Function, Each 15 Minutes (1002902) $111.00

N/A

Physical Therapy - Repositioning Maneuvers For Treatment Of Vertigo, Per Day (1009796) $130.00

N/A

Physical Therapy - Re-Evaluation Of Physical Therapy, Typically 20 Minutes (1026788) $148.00

N/A

Physical Therapy - Evaluation Of Physical Therapy, Typically 30 Minutes (1026786) $204.00

N/A

Physical Therapy - Evaluation Of Physical Therapy, Typically 20 Minutes (1026785) $204.00

N/A

Physical Therapy - Application Of Ultrasound To 1 Or More Areas, Each 15 Minutes (1002900) $53.00

N/A

Physical Therapy - Application Of Medication Through Skin Using Electrical Current, Each 15 Minutes (1002897) $64.00

N/A

Physical Therapy - Application Of Mechanical Traction To 1 Or More Areas (1002885) $62.00

N/A

Physical Therapy - Application Of Electrical Stimulation To 1 Or More Areas, Unattended By Physical Therapist (1002886) $45.00

N/A

Pathology - Special Stained Specimen Slides To Examine Tissue Including Interpretation And Report (Group I For Microorganisms) (1006359) $375.00

N/A

Pathology - Special Stained Specimen Slides To Examine Tissue (Initial Single Slide Or Stain) (1006381) $263.00

N/A

Pathology - Special Stained Specimen Slides To Examine Tissue (Each Additional Slide Or Stain) (1024653) $224.00

N/A

Pathology - Preparation Of Tissue For Exam By Removing Any Calcium Present (1006358) $132.00

N/A

Pathology - Pap Smear (Thin Layer Prep With Automated Screening And Manual Rescreening) (1006967) $113.00

N/A

Pathology - Microscopic Genetic Analysis Of Tumor Specimen (Manual Tumor Immunohistochemistry) (1010667) $461.00

N/A

Pathology - Level Vi Pathology Exam Of Tissue Using Visual Inspection And Microscopic Examination (Specimen Specific Or High Complexity) (1006357) $1,796.00

N/A

Pathology - Level V Pathology Exam Of Tissue Using Visual Inspection And Microscopic Examination (Specimen Specific Or Moderately High Complexity) (1006356) $1,150.00

N/A

Pathology - Level Iv Pathology Exam Of Tissue Using Visual Inspection And Microscopic Examination (Specimen Specific Or Intermediate Complexity) (1006355) $294.00

N/A

Pathology - Level Iii Pathology Exam Of Tissue Using Visual Inspection And Microscopic Examination (Specimen Specific Or Moderatley Low Complexity) (1006354) $175.00

N/A

Pathology - Level Ii Pathology Exam Of Tissue Using Visual Inspection And Microscopic Examination (Specimen Specific Or Low Complexity) (1006353) $126.00

N/A

Pathology - Flow Cytometry For Dna Or Cell Analysis (Technical Component, First Marker) (1006317) $281.00

N/A

Pathology - Flow Cytometry For Dna Or Cell Analysis (Technical Component, Each Additional Marker) (1006323) $177.00

N/A

Pathology - Chromosome Analysis For Genetic Defects (Interphase Ish, Analyze 100 To 300 Cells) (1006348) $237.00

N/A

Pathology - Chromosome Analysis For Genetic Defects (Each Dna Probe) (1006341) $127.00

N/A

Pathology - Cellular Exam Of Specimen Using Concentration Technique (Smears) (1006417) $277.00

N/A

Pathology - Cellular Exam Of Non-Gynecologic Specimen Using Cellular Enhancement Technique (1009034) $274.00

N/A

Pathology - Cellular Exam Of Fine Needle Aspirate (Physician Interpretation And Report) (1006424) $572.00

N/A

Operating Room - Umbilical Hernia (1002407) $3,108.00

N/A

Operating Room - Tying Of Fallopian Tubes Using Endoscope (1001520) $4,311.00

N/A

Operating Room - Tying Of Fallopian Tubes (1002380) $3,350.00

N/A

Operating Room - Suspension Of Vaginal Tissue Using Tape (1005121) $2,626.00

N/A

Operating Room - Skin Lesion (1002086) $1,639.00

N/A

Operating Room - Scraping Of Uterine Tissue Using Endoscope (1020856) $4,910.00

N/A

Operating Room - Repair Of Hernia Using Endoscope (1001515) $6,089.00

N/A

Operating Room - Removal Of Uterus, Ovaries And Fallopian Tubes (1000464) $4,853.00

N/A

Operating Room - Removal Of Uterus Using Endoscope (1001508) $7,519.00

N/A

Operating Room - Removal Of Uterus Through Vagina (1002447) $4,372.00

N/A

Operating Room - Removal Of Tissue (1001019) $2,670.00

N/A

Operating Room - Removal Of Recurring Cataracts Using Laser (1004380) $1,161.00

N/A

Operating Room - Removal Of Ovaries Using Endoscope (1006752) $3,133.00

N/A

Operating Room - Removal Of Large Intestine Using Endoscope (1001502) $7,013.00

N/A

Operating Room - Removal Of Growth From Breast (1000719) $2,411.00

N/A

Operating Room - Removal Of Gallbladder Using Endoscope (1001514) $5,884.00

N/A

Operating Room - Removal Of Foreskin (1000880) $2,763.00

N/A

Operating Room - Removal Of Fluid From Abdominal Cavity With Imaging Guidance (1007763) $851.00

N/A

Operating Room - Removal Of Cataracts Using Fragmentation And Aspiration (1005017) $4,257.00

N/A

Operating Room - Removal Of Appendix Using Endoscope (1001513) $4,436.00

N/A

Operating Room - Removal Of Abnormal Growth (1001590) $2,660.00

N/A

Operating Room - Rectal Procedure (1001343) $2,944.00

N/A

Operating Room - Pain Clinic Procedure (1007581) $870.00

N/A

Operating Room - Open Exploration Of Abdominal Cavity (1001521) $4,053.00

N/A

Operating Room - Minor Amputation (1007759) $2,519.00

N/A

Operating Room - Manipulation Of Broken Bone Or Dislocated Joint Without Incision (1000887) $1,810.00

N/A

Operating Room - Introduction Of Saline Or X-Ray Contrast Material For Imaging Of The Uterus And Tubes (1001373) $525.00

N/A

Operating Room - Insertion Of Catheter Into Central Vein (1006826) $1,301.00

N/A

Operating Room - Insertion Of Catheter In Central Vein, Access Via Arm, Leg, Or Neck Vein, 5+ Years (1004760) $1,019.00

N/A

Operating Room - Insertion Of Access Site Into Vein (1002469) $2,070.00

N/A

Operating Room - Incision Into Bladder (1001004) $2,189.00

N/A

Operating Room - Groin Hernia (1001412) $4,040.00

N/A

Operating Room - Fluid Collection In Scrotum (1001371) $3,093.00

N/A

Operating Room - Exam With Anesthesia (1005043) $1,551.00

N/A

Operating Room - Drainage Or Aspiration Of Chest Cavity (1010488) $1,030.00

N/A

Operating Room - Dilation And Scraping Of Uterus (1001009) $3,588.00

N/A

Operating Room - Diagnostic Exam Of Uterus (1001374) $2,643.00

N/A

Operating Room - Diagnostic Exam Of Bladder Using Flexible Endoscope (1004739) $2,427.00

N/A

Operating Room - Diagnostic Exam Of Abdominal Cavity Using Endoscope (1001517) $3,152.00

N/A

Operating Room - Cesarean Delivery With Tying Of Fallopian Tubes (1007070) $6,174.00

N/A

Operating Room - Cesarean Delivery (1004275) $5,583.00

N/A

Operating Room - Bladder Instillation Of Cancer Preventive, Inhibiting, Or Suppressive Agent (1006737) $775.00

N/A

Operating Room - Biopsy Of Prostate With Trus (1002378) $1,700.00

N/A

Operating Room - Aspiration Or Injection Of Large Joint Or Joint Capsule (1001416) $508.00

N/A

Operating Room - Additional Urinary Procedure Using Endoscope (1000997) $3,471.00

N/A

Operating Room - Additional Minutes (1005000) $16.00

N/A

Operating Room - Abdominal Wall Hernia (1002476) $3,591.00

N/A

Occupational Therapy - Therapeutic Exercise To Develop Strength, Endurance, Range Of Motion, And Flexibility, Each 15 Minutes (1002901) $111.00

N/A

Occupational Therapy - Therapeutic Activities To Improve Function With One-On-One Contact Between Patient And Provider, Each 15 Minutes (1002912) $109.00

N/A

Occupational Therapy - Sensory Technique To Enhance Processing And Adaptation To Environmental Demands, Each 15 Minutes (1002914) $109.00

N/A

Occupational Therapy - Self-Care Or Home Management Training, Each 15 Minutes (1002915) $111.00

N/A

Occupational Therapy - Re-Evaluation Of Occupational Therapy Established Plan Of Care, Typically 30 Minutes (1026792) $167.00

N/A

Occupational Therapy - Physical Medicine Service Or Procedure (1004482) $93.00

N/A

Occupational Therapy - One-On-One Therapeutic Interventions Focused On Thought Processing And Strategies To Manage Activities (1027626) $101.00

N/A

Occupational Therapy - Manual Therapy Techniques To 1 Or More Regions, Each 15 Minutes (1002908) $107.00

N/A

Occupational Therapy - Management And/or Training In Use Of Orthotics For Arms Legs And/or Trunk Per 15 Minutes (1027627) $62.00

N/A

Occupational Therapy - Evaluation Of Occupational Therapy, Typically 45 Minutes (1026790) $235.00

N/A

Occupational Therapy - Evaluation Of Occupational Therapy, Typically 30 Minutes (1026789) $235.00

N/A

Occupational Therapy - Application Of Ultrasound To 1 Or More Areas, Each 15 Minutes (1002899) $53.00

N/A

Occupational Therapy - Application Of Hot Wax Bath To 1 Or More Areas (1002890) $15.00

N/A

Observation - Hospital Observation Care - Each Hour Of Service (1000442) $59.00

N/A

Observation - Hospital Observation Care - Each Hour Of Service (1004317) $59.00

N/A

Nuclear Medicine - Diagnostic Tomographic (Spect) Scan Of Heart, Multiple Studies (1003505) $2,644.00

N/A

Nuclear Medicine - Diagnostic Tomographic (Spect) Scan Of Bones Or Joints (1003518) $1,199.00

N/A

Sanford Luverne Medical Center Prices (2025)

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