▸ Hospital · MN · CCN 241370

St Gabriels Hospital

815 SE 2ND STREET, LITTLE FALLS, MN, 56345

25 bedsCritical Access Hospitals2

Compliance grade

100/100

Procedures tracked

194

of 209 target codes

Payers

with negotiated rates

Rates published

24,859

last crawl 2026-05-24

▸ Compare with other hospitals All MN hospitals JSON Full cost report on HCRIS.io →

Source MRF: https://www.chihealth.com/content/dam/chihealthcom/documents/patients-and-visitors/financial-assistance/price-transparency-2025/umw/410721642_chi-st-gabriels-health_standardcharges.csv?adobe_mc=MCMID=47305907076111227494616949278145012020 · CSV

Procedures & rates

Procedure	Type	Code	Payers	Gross	Cash	Neg min	Neg median	Neg max
behavioral
Psychoses	MS-DRG	885	7	—	—	$2,344	$3,838	$13,941
Psychiatric eval with medical services	CPT	90792	13	$417	$241.86	$36.42	$132.05	$396.15
Psychotherapy 30 minutes	CPT	90832	8	$255	$147.9	$17.4	$84.15	$242.25
Psychotherapy 45 minutes	CPT	90834	13	$340	$197.2	$18.39	$99.87	$323
Psychotherapy 60 minutes	CPT	90837	13	$499	$289.42	$28.64	$147.77	$474.05
Crisis psychotherapy 60 minutes	CPT	90839	13	$331	$191.98	$33	$104.5	$314.45
emergency
ED visit level 1	CPT	99281	13	$324	$187.92	$23.8	$151	$2,046
ED visit level 2	CPT	99282	13	$578	$335.24	$46.04	$160.55	$2,046
ED visit level 3	CPT	99283	13	$947	$549.26	$77.8	$247	$2,046
ED visit level 4	CPT	99284	13	$1,524	$883.92	$132.18	$548.64	$2,046
ED visit level 5	CPT	99285	13	$2,309	$1,339.22	$191.95	$653.6	$2,193.55
Critical care, first hour	CPT	99291	13	$3,446	$1,998.68	$237.73	$950	$3,273.7
imaging
CT head without contrast	CPT	70450	13	$2,102	$1,219.16	$84.07	$1,187.63	$1,996.9
CT head with contrast	CPT	70460	13	$2,102	$1,219.16	$122.07	$1,187.63	$1,996.9
CT head with and without contrast	CPT	70470	13	$3,153	$1,828.74	$147.01	$1,425.5	$2,995.35
CT neck with contrast	CPT	70491	13	$2,145	$1,244.1	$154.93	$1,211.93	$2,037.75
MRI brain without contrast	CPT	70551	13	$3,680	$2,134.4	$167.73	$1,833	$3,496
MRI brain with contrast	CPT	70552	13	$3,680	$2,134.4	$248.49	$1,833	$3,496
MRI brain with and without contrast	CPT	70553	13	$5,483	$3,180.14	$282.93	$2,152.09	$5,208.85
Chest X-ray single view	CPT	71045	13	$173	$100.34	$19.14	$100.64	$168.28
Chest X-ray 2 views	CPT	71046	13	$333	$193.14	$26.26	$198.07	$316.35
Chest X-ray 3 views	CPT	71047	13	$492	$285.36	$33.39	$280.44	$467.4
CT chest without contrast	CPT	71250	13	$2,244	$1,301.52	$105.04	$1,267.86	$2,131.8
CT chest with contrast	CPT	71260	13	$2,244	$1,301.52	$144.24	$1,267.86	$2,131.8
CT chest with and without contrast	CPT	71270	13	$3,366	$1,952.28	$178.68	$1,425.5	$3,197.7
MRI chest without contrast	CPT	71550	13	$3,748	$2,173.84	$366.87	$1,833	$3,560.6
MRI chest with contrast	CPT	71551	13	$3,748	$2,173.84	$397.23	$1,833	$3,560.6
MRI chest with and without contrast	CPT	71552	13	$5,622	$3,260.76	$500.55	$2,206.64	$5,340.9
Lumbosacral spine X-ray	CPT	72100	13	$231	$133.98	$18.39	$108.44	$226.66
CT cervical spine without contrast	CPT	72125	13	$2,493	$1,445.94	$106.23	$1,386.04	$2,368.35
CT thoracic spine without contrast	CPT	72128	13	$2,424	$1,405.92	$105.84	$1,366.72	$2,302.8
CT lumbar spine without contrast	CPT	72131	13	$2,477	$1,436.66	$105.45	$1,381.56	$2,353.15
MRI cervical spine without contrast	CPT	72141	13	$3,369	$1,926.18	$162.05	$1,814.38	$3,200.55
MRI thoracic spine without contrast	CPT	72146	13	$3,661	$2,123.38	$162.05	$1,833	$3,477.95
MRI lumbar spine without contrast	CPT	72148	13	$3,661	$2,123.38	$162.44	$1,833	$3,477.95
MRI lumbar spine with and without contrast	CPT	72149	13	$3,661	$2,123.38	$250.87	$1,833	$3,477.95
MRI cervical spine with and without contrast	CPT	72156	13	$5,054	$2,888.98	$286.9	$1,962.14	$4,801.3
MRI lumbar spine with contrast	CPT	72158	13	$5,492	$3,185.36	$286.1	$2,155.62	$5,217.4
CT pelvis without contrast	CPT	72192	13	$2,272	$1,317.76	$105.04	$1,283.68	$2,158.4
CT pelvis with contrast	CPT	72193	13	$2,272	$1,317.76	$223.03	$1,283.68	$2,158.4
Shoulder X-ray	CPT	73030	9	$165	$82.5	$18.03	$53.39	$168.28
Humerus X-ray	CPT	73060	9	$207	$103.5	$21.57	$59.54	$196.65
Hand X-ray 3 views	CPT	73130	9	$158	$79	$17.33	$51.21	$168.28
MRI upper extremity joint without contrast	CPT	73221	9	$3,369	$1,684.5	$183.18	$1,246.53	$3,200.55
MRI upper extremity joint with and without contrast	CPT	73223	9	$5,054	$2,527	$391.41	$1,786.59	$4,801.3
Knee X-ray 1-2 views	CPT	73560	9	$139	$69.5	$15.21	$45	$168.28
Ankle X-ray 3 views	CPT	73610	9	$161	$80.5	$17.68	$52.21	$168.28
MRI lower extremity joint without contrast	CPT	73721	9	$3,369	$1,684.5	$182.77	$1,246.53	$3,200.55
MRI lower extremity joint with and without contrast	CPT	73723	9	$5,054	$2,527	$390.22	$1,786.59	$4,801.3
CT abdomen without contrast	CPT	74150	13	$2,335	$1,354.3	$103.86	$1,319.28	$2,218.25
CT abdomen with contrast	CPT	74160	13	$2,335	$1,354.3	$222.23	$1,319.28	$2,218.25
CT abdomen with and without contrast	CPT	74170	13	$3,484	$2,020.72	$251.66	$1,446.5	$3,309.8
CT abdomen and pelvis without contrast	CPT	74176	13	$4,028	$2,336.24	$129.99	$1,581	$3,826.6
CT abdomen and pelvis with contrast	CPT	74177	13	$4,028	$2,336.24	$282.54	$1,581	$3,826.6
CT abdomen and pelvis with and without contrast	CPT	74178	13	$6,042	$3,504.36	$319.36	$2,371.49	$5,739.9
MRI abdomen without contrast	CPT	74181	13	$3,680	$2,134.4	$171.95	$1,769	$3,496
MRI abdomen with and without contrast	CPT	74183	13	$5,493	$3,185.94	$319.36	$2,156.01	$5,218.35
Abdominal ultrasound complete	CPT	76700	13	$1,041	$603.78	$95.94	$588.17	$988.95
Abdominal ultrasound limited	CPT	76705	13	$713	$413.54	$72.18	$402.85	$677.35
Retroperitoneal ultrasound complete	CPT	76770	13	$950	$551	$89.21	$541.5	$902.5
Obstetric ultrasound first trimester	CPT	76801	13	$509	$295.22	$40.66	$226.66	$483.55
Obstetric ultrasound after first trimester	CPT	76805	13	$666	$386.28	$52.68	$271.07	$632.7
Transvaginal ultrasound	CPT	76830	13	$476	$276.08	$39.6	$226.66	$452.2
Pelvic ultrasound complete	CPT	76856	13	$675	$391.5	$56.21	$274.73	$641.25
Scrotal ultrasound	CPT	76870	13	$876	$508.08	$85.65	$499.32	$832.2
Diagnostic mammography unilateral	CPT	77065	13	$512	$296.96	$103.47	$291.84	$486.4
Diagnostic mammography bilateral	CPT	77066	13	$651	$377.58	$132.36	$371.07	$618.45
Screening mammography bilateral	CPT	77067	13	$547	$317.26	$91.61	$325.47	$519.65
EKG tracing only	CPT	93005	13	$297	$148.5	$5.4	$14.4	$282.15
EKG interpretation only	CPT	93010	12	$31	$15.5	$6.9	$13.11	$29.45
Transthoracic echocardiogram complete	CPT	93306	13	$2,152	$1,248.16	$69.29	$672.77	$2,044.4
Transthoracic echocardiogram	CPT	93307	8	$1,310	$759.8	$34.5	$393	$1,244.5
Stress echocardiogram	CPT	93350	13	$1,767	$1,024.86	$77.42	$501.6	$1,678.65
inpatient
Intracranial hemorrhage/CVA w MCC	MS-DRG	064	7	—	—	$2,344	$3,838	$21,346
Intracranial hemorrhage/CVA w CC	MS-DRG	065	7	—	—	$2,344	$3,838	$11,361
Intracranial hemorrhage/CVA w/o CC/MCC	MS-DRG	066	7	—	—	$2,344	$3,838	$7,932.44
Respiratory infections & inflammations w MCC	MS-DRG	177	7	—	—	$2,344	$3,838	$20,590
COPD w MCC	MS-DRG	190	7	—	—	$2,344	$3,838	$12,541
COPD w CC	MS-DRG	191	7	—	—	$2,344	$3,838	$9,853.89
COPD w/o CC/MCC	MS-DRG	192	7	—	—	$2,344	$3,838	$7,753.9
Simple pneumonia & pleurisy w CC	MS-DRG	194	7	—	—	$2,344	$3,838	$9,629.61
Simple pneumonia & pleurisy w/o CC/MCC	MS-DRG	195	7	—	—	$2,344	$3,838	$7,420.27
AMI discharged alive w MCC	MS-DRG	280	7	—	—	$2,344	$3,838	$18,146
AMI discharged alive w CC	MS-DRG	281	7	—	—	$2,344	$3,838	$10,401
AMI discharged alive w/o CC/MCC	MS-DRG	282	7	—	—	$2,344	$3,838	$8,095.35
Heart failure & shock w MCC	MS-DRG	291	7	—	—	$2,344	$3,838	$14,962
Heart failure & shock w CC	MS-DRG	292	7	—	—	$2,344	$3,838	$9,987.79
Heart failure & shock w/o CC/MCC	MS-DRG	293	7	—	—	$2,344	$3,838	$7,281.91
Cardiac arrhythmia w MCC	MS-DRG	308	7	—	—	$2,344	$3,838	$13,382
Cardiac arrhythmia w CC	MS-DRG	309	7	—	—	$2,344	$3,838	$8,362.03
Cardiac arrhythmia w/o CC/MCC	MS-DRG	310	7	—	—	$2,344	$3,838	$6,230.79
GI hemorrhage w CC	MS-DRG	378	7	—	—	$2,344	$3,838	$11,082
GI hemorrhage w/o CC/MCC	MS-DRG	379	7	—	—	$2,344	$3,838	$7,108.95
Esophagitis/gastroenteritis w/o MCC	MS-DRG	392	7	—	—	$2,344	$3,838	$8,529.4
Fractures of femur w/o MCC	MS-DRG	533	7	—	—	$2,344	$3,838	$16,645
Kidney/UTI w MCC	MS-DRG	689	7	—	—	$2,344	$3,838	$12,400
Kidney/UTI w/o MCC	MS-DRG	690	7	—	—	$2,344	$3,838	$8,839.61
Septicemia or severe sepsis w MV 96+ hrs	MS-DRG	871	7	—	—	$2,344	$3,838	$20,846
Septicemia or severe sepsis w/o MV 96+ hrs	MS-DRG	872	7	—	—	$2,344	$3,838	$11,399
Initial hospital care, low complexity	CPT	99221	8	$231	$133.98	$69.3	$131.67	$219.45
Initial hospital care, moderate complexity	CPT	99222	8	$366	$212.28	$109.8	$208.62	$347.7
Initial hospital care, high complexity	CPT	99223	8	$489	$283.62	$146.7	$278.73	$464.55
Hospital discharge, <30 min	CPT	99238	12	$245	$132.82	$68.7	$133.97	$232.75
Hospital discharge, >30 min	CPT	99239	8	$324	$187.92	$97.2	$184.68	$307.8
lab
Basic metabolic panel (BMP)	CPT	80048	13	$302	$175.16	$8.46	$165.41	$286.9
General health panel	CPT	80050	12	$595	$345.1	$82.96	$339.15	$565.25
Electrolyte panel	CPT	80051	13	$125	$72.5	$7.01	$70.63	$118.75
Comprehensive metabolic panel	CPT	80053	13	$347	$201.26	$10.56	$190.2	$329.65
Lipid panel	CPT	80061	13	$83	$48.14	$13.39	$50.04	$95.18
Renal function panel	CPT	80069	13	$321	$186.18	$8.68	$181.37	$304.95
Hepatic function panel	CPT	80076	13	$321	$186.18	$8.17	$181.37	$304.95
Urinalysis non-automated	CPT	81002	13	$30	$15	$3.48	$11.97	$28.5
Urinalysis automated	CPT	81003	13	$64	$37.12	$2.25	$36.16	$60.8
Glucose quantitative	CPT	82947	13	$45	$26.1	$3.93	$24.7	$42.75
Hemoglobin A1c	CPT	83036	13	$71	$41.18	$9.71	$39.48	$78.39
Thyroid stimulating hormone (TSH)	CPT	84443	13	$130	$75.4	$16.8	$68.63	$123.5
Complete blood count with automated differential	CPT	85025	13	$162	$93.96	$7.77	$87.71	$153.9
Complete blood count without differential	CPT	85027	13	$102	$59.16	$6.47	$57.63	$96.9
Urine culture bacterial	CPT	87086	13	$81	$46.98	$8.07	$44.79	$76.95
Tissue exam by pathologist level IV	CPT	88305	13	$72	$41.76	$18.39	$43.2	$162.37
maternity
Fetal non-stress test	CPT	59025	13	$185	$107.3	$17.7	$67.53	$780
Routine obstetric care including vaginal delivery	CPT	59400	4	—	—	$2,523.53	$2,523.53	$4,058.38
Vaginal delivery only	CPT	59409	13	$2,694	$1,347	$644.1	$1,256	$5,456.34
Vaginal delivery with postpartum	CPT	59410	4	—	—	$1,106.26	$1,106.26	$1,986.62
Routine obstetric care with C-section	CPT	59510	4	—	—	$2,764.72	$2,764.72	$4,470.26
C-section delivery only	CPT	59514	4	—	—	$938.08	$938.08	$1,735.56
C-section with postpartum	CPT	59515	4	—	—	$1,352.27	$1,352.27	$2,402.87
office
Office visit, new patient, 15-29 min	CPT	99202	13	$308	$178.64	$15.3	$92.4	$292.6
Office visit, new patient, 30-44 minutes	CPT	99203	13	$436	$218	$24	$115.2	$414.2
Office visit, new patient, 45-59 min	CPT	99204	13	$591	$295.5	$35.7	$163.91	$561.45
Office visit, new patient, 60-74 min	CPT	99205	13	$732	$366	$47.1	$208.23	$695.4
Office visit, established patient, 5 min	CPT	99211	13	$67	$38.86	$9.95	$30.6	$63.65
Office visit, established patient, 10-19 min	CPT	99212	13	$205	$102.5	$12	$53.79	$194.75
Office visit, established patient, 20-29 minutes	CPT	99213	13	$262	$151.96	$19.45	$80.18	$248.9
Office visit, established patient, 30-39 minutes	CPT	99214	13	$379	$214.02	$27.6	$118.43	$360.05
Office visit, established patient, 40-54 min	CPT	99215	13	$527	$299.86	$38.7	$161.01	$500.65
preventive
Upper GI endoscopy diagnostic	CPT	43235	13	$996	$498	$133.82	$595.68	$2,311.27
Upper GI endoscopy with biopsy	CPT	43239	13	$1,151	$613.64	$151.22	$755.42	$2,311.27
Sigmoidoscopy diagnostic	CPT	45330	13	$534	$309.72	$60.87	$304.38	$1,650.82
Sigmoidoscopy with biopsy	CPT	45331	13	$809	$469.22	$78.55	$457.09	$1,650.82
Colonoscopy diagnostic	CPT	45378	13	$963	$558.54	$201.54	$602.92	$2,791.66
Colonoscopy with biopsy	CPT	45380	13	$1,577	$788.5	$218.95	$892.06	$2,425.49
Colonoscopy with polyp removal	CPT	45385	13	$1,780	$890	$277.08	$934.4	$2,425.49
surgery
Total shoulder arthroplasty	CPT	23472	13	$5,059	$2,529.5	$1,212.3	$2,363.99	$12,243
PCI w drug-eluting stent w MCC	MS-DRG	246	2	—	—	$28,009	$31,443	$34,878
PCI w drug-eluting stent w/o MCC	MS-DRG	247	2	—	—	$17,816	$20,001	$22,185
Hip hemiarthroplasty	CPT	27125	5	—	—	$1,227.49	$1,227.49	$7,460
Total hip replacement	CPT	27130	13	$5,435	$2,717.5	$1,077.3	$2,100.74	$25,615
Total knee replacement	CPT	27447	13	$5,871	$2,935.5	$1,075.8	$2,151.6	$25,615
Knee revision arthroplasty single component	CPT	27486	13	$5,320	$2,660	$1,179.6	$2,300.22	$12,243
Knee revision arthroplasty all components	CPT	27487	6	—	—	$1,892.73	$2,676.84	$12,243
Shoulder arthroscopy with decompression	CPT	29826	13	$2,667	$1,333.5	$141.6	$313.34	$2,533.65
Shoulder arthroscopy with rotator cuff repair	CPT	29827	13	$4,353	$2,176.5	$902.7	$1,760.27	$13,031
Knee arthroscopy with meniscectomy	CPT	29881	13	$4,744	$2,372	$595.57	$1,767	$5,887.31
ACL reconstruction	CPT	29888	13	$3,217	$1,608.5	$823.2	$1,605.24	$13,031
Major small/large bowel procedures w MCC	MS-DRG	329	7	—	—	$2,344	$3,838	$54,121
Major small/large bowel procedures w CC	MS-DRG	330	7	—	—	$2,344	$3,838	$28,331
Major small/large bowel procedures w/o CC/MCC	MS-DRG	331	7	—	—	$2,344	$3,838	$19,082
CABG single arterial graft	CPT	33533	4	—	—	$1,949.08	$1,949.08	$3,592.65
CABG 2 arterial grafts	CPT	33534	4	—	—	$2,286.97	$2,286.97	$4,221.39
CABG 3 arterial grafts	CPT	33535	4	—	—	$2,545.79	$2,545.79	$4,706.76
CABG 4+ arterial grafts	CPT	33536	4	—	—	$2,739.68	$2,739.68	$5,058.97
Laparoscopic cholecystectomy w/o CDE w MCC	MS-DRG	418	7	—	—	$2,344	$3,838	$18,836
Laparoscopic cholecystectomy w/o CDE w CC	MS-DRG	419	7	—	—	$2,344	$3,838	$14,675
Laparoscopic cholecystectomy w/o CDE w/o CC/MCC	MS-DRG	420	7	—	—	$2,344	$3,838	$39,211
Open appendectomy	CPT	44950	13	$2,064	$1,032	$529.2	$1,031.94	$6,621.58
Laparoscopic appendectomy	CPT	44970	13	$1,896	$966.86	$500.1	$975.2	$10,526
Spinal fusion (non-cervical) w MCC	MS-DRG	459	7	—	—	$2,344	$3,838	$75,115
Spinal fusion (non-cervical) w/o MCC	MS-DRG	460	7	—	—	$2,344	$3,838	$43,882
Major joint replacement w MCC	MS-DRG	469	7	—	—	$2,344	$3,838	$34,417
Major joint replacement w/o MCC	MS-DRG	470	7	—	—	$2,344	$3,838	$21,200
Laparoscopic cholecystectomy	CPT	47562	13	$2,362	$1,181	$547.2	$1,067.04	$10,526
Lap cholecystectomy with cholangiography	CPT	47563	13	$2,156	$1,148.98	$594.3	$1,158.89	$10,526
Hip & femur procedures except major joint w MCC	MS-DRG	480	7	—	—	$2,344	$3,838	$33,748
Hip & femur procedures except major joint w CC	MS-DRG	481	7	—	—	$2,344	$3,838	$23,382
Hip & femur procedures except major joint w/o CC/MCC	MS-DRG	482	7	—	—	$2,344	$3,838	$18,375
Open umbilical hernia repair	CPT	49560	9	$2,364	$1,182	$785.8	$1,516.75	$6,621.58
Umbilical hernia repair age 5+	CPT	49585	9	$1,394	$697	$480.96	$894.4	$6,621.58
Lap inguinal hernia repair	CPT	49650	13	$1,362	$700.64	$362.4	$706.68	$10,526
Lap incisional hernia repair	CPT	49652	9	$2,417	$1,208.5	$792.57	$1,550.75	$10,526
Total abdominal hysterectomy	CPT	58150	5	—	—	$1,098.82	$1,098.82	$3,804
Vaginal hysterectomy	CPT	58260	13	$2,796	$1,398	$702.6	$1,370.07	$9,171.96
Lap-assisted vaginal hysterectomy	CPT	58550	13	$2,607	$1,429.12	$739.2	$1,441.44	$10,526
Lap-assisted vaginal hysterectomy >250g	CPT	58552	13	$3,105	$1,588.04	$821.4	$1,601.73	$18,528
Lap salpingo-oophorectomy	CPT	58661	13	$2,191	$1,095.5	$545.1	$1,062.95	$10,526
OR procedure for obesity w MCC	MS-DRG	619	7	—	—	$2,344	$3,838	$34,157
OR procedure for obesity w CC	MS-DRG	620	7	—	—	$2,344	$3,838	$19,651
OR procedure for obesity w/o CC/MCC	MS-DRG	621	7	—	—	$2,344	$3,838	$17,813
Complex cataract surgery	CPT	66982	6	—	—	$827.65	$1,935.33	$4,324.7
Cataract surgery with lens implant	CPT	66984	6	—	—	$604.53	$1,823.77	$4,324.7
Intravitreal injection	CPT	67028	6	—	—	$101.74	$225.87	$780
Vitrectomy mechanical	CPT	67042	6	—	—	$1,266.53	$2,154.77	$8,149
Uterine & adnexa procedures w CC/MCC	MS-DRG	743	7	—	—	$2,344	$3,838	$12,635
Uterine & adnexa procedures w/o CC/MCC	MS-DRG	744	7	—	—	$2,344	$3,838	$20,018

Rate history available after the next quarterly refresh. We re-crawl all hospital MRFs each quarter to track rate changes over time.

Payer mix (top 13)

Payer	Codes covered	Median rate
Humana	192	$222.63
Blue Cross Blue Shield	192	$238.75
commercial \| health partners \| all plans	188	$756.58
commercial \| medica \| all plans	175	$1,621
medica	171	$800.07
health partners	164	$351.5
ucare	164	$469.92
Medicare	140	$153.08
UnitedHealthcare	131	$393.6
Multiplan	131	$474.05
Medicaid	125	$159.47
commercial \| sanford health plan \| all plans	125	$409.45
sanford health plan	119	$504.45