Does Jacobson Memorial Hospital Care Center publish its standard charges and chargemaster?

Yes. Jacobson Memorial Hospital Care Center publishes a machine-readable file with 1,944 standard-charge rows — gross charges, cash prices, and payer-negotiated rates, earning a CMS price transparency compliance grade of A. Browse the negotiated rates by procedure and payer on this page.

How much does Jacobson Memorial Hospital Care Center charge for procedures?

Jacobson Memorial Hospital Care Center (Elgin, ND) publishes a separately negotiated rate for each insurance payer, plus a discounted cash price and a gross (list) charge, for every procedure in its price transparency file. This page compares each procedure's negotiated median against the national median so you can see whether a price is above or below market.

▸ Hospital · ND · CCN 351314

Jacobson Memorial Hospital Care Center

Elgin, ND, 58533-

25 bedsCritical Access Hospitals2

Compliance grade

100/100

Rates published

1,944

last crawl 2026-05-23

Procedures tracked

of 209 target codes

Payers

with negotiated rates

Procedures tracked

...

Payers

...

▸ Compare with other hospitals All ND hospitalsJSON

The report bundles all published codes × every payer rate + compliance grade as a downloadable PDF + CSV with a data-version manifest.

Source MRF: https://www.jacobsonhospital.org/jacobson_memorial_hospital_standard_charges_new.json · JSON

Procedures & rates

vs nat'l shows this hospital's negotiated median against the national median for that code (green = at/below market, amber = 1–1.5×, red = >1.5× the national median).

Procedure	Type	Code	Payers	Gross	Cash	Neg min	Neg median	vs nat'l	Neg max
emergency
ED visit level 1	CPT	99281	15	$264.15	$198.11	$158.49	$237.73	1.7×	$369.81
ED visit level 2	CPT	99282	15	$475.08	$356.31	$285.05	$427.57	1.8×	$665.11
ED visit level 3	CPT	99283	15	$830.67	$623	$498.4	$747.6	1.8×	$1,162.94
ED visit level 4	CPT	99284	15	$1,277.46	$958.1	$766.48	$1,149.71	1.7×	$1,788.44
ED visit level 5	CPT	99285	15	$1,839.3	$1,379.48	$1,103.58	$1,655.37	1.6×	$2,575.02
Critical care, first hour	CPT	99291	15	$2,527.83	$1,895.87	$1,516.7	$2,275.05	2.1×	$3,538.96
imaging
CT head without contrast	CPT	70450	15	$1,059.15	$794.36	$635.49	$953.23	4.6×	$1,482.81
CT head with contrast	CPT	70460	15	$1,124	$843	$674.4	$1,011.6	4.3×	$1,573.6
CT head with and without contrast	CPT	70470	15	$1,400	$1,050	$840	$1,260	4.7×	$1,960
CT neck with contrast	CPT	70491	15	$1,517	$1,137.75	$910.2	$1,365.3	5.0×	$2,123.8
MRI brain without contrast	CPT	70551	15	$1,492	$1,119	$895.2	$1,342.8	3.3×	$2,088.8
MRI brain with and without contrast	CPT	70553	15	$3,842.15	$2,881.61	$2,305.29	$3,457.93	5.9×	$5,379.01
Chest X-ray single view	CPT	71045	15	$104.65	$78.49	$62.79	$94.18	1.00×	$146.51
Chest X-ray 2 views	CPT	71046	15	$144.9	$108.67	$86.94	$130.41	1.3×	$202.86
CT chest without contrast	CPT	71250	15	$1,359.3	$1,019.47	$815.58	$1,223.37	5.7×	$1,903.02
CT chest with contrast	CPT	71260	15	$1,756.05	$1,317.04	$1,053.63	$1,580.44	5.6×	$2,458.47
CT chest with and without contrast	CPT	71270	15	$1,881	$1,410.75	$1,128.6	$1,692.9	5.8×	$2,633.4
MRI chest without contrast	CPT	71550	15	$3,309	$2,481.75	$1,985.4	$2,978.1	6.9×	$4,632.6
MRI chest with and without contrast	CPT	71552	15	$4,512	$3,384	$2,707.2	$4,060.8	6.8×	$6,316.8
Lumbosacral spine X-ray	CPT	72100	15	$155	$116.25	$93	$139.5	1.3×	$217
CT cervical spine without contrast	CPT	72125	15	$1,491.55	$1,118.66	$894.93	$1,342.39	6.7×	$2,088.17
CT thoracic spine without contrast	CPT	72128	15	$1,293	$969.75	$775.8	$1,163.7	5.8×	$1,810.2
CT lumbar spine without contrast	CPT	72131	15	$1,480.05	$1,110.04	$888.03	$1,332.05	6.6×	$2,072.07
MRI cervical spine without contrast	CPT	72141	15	$2,281.6	$1,711.2	$1,368.96	$2,053.44	5.2×	$3,194.24
MRI thoracic spine without contrast	CPT	72146	15	$2,117	$1,587.75	$1,270.2	$1,905.3	5.1×	$2,963.8
MRI lumbar spine without contrast	CPT	72148	15	$2,434.55	$1,825.91	$1,460.73	$2,191.09	5.8×	$3,408.37
MRI cervical spine with and without contrast	CPT	72156	15	$3,282	$2,461.5	$1,969.2	$2,953.8	5.5×	$4,594.8
MRI lumbar spine with contrast	CPT	72158	15	$3,277	$2,457.75	$1,966.2	$2,949.3	5.4×	$4,587.8
CT pelvis without contrast	CPT	72192	15	$1,143	$857.25	$685.8	$1,028.7	5.1×	$1,600.2
CT pelvis with contrast	CPT	72193	15	$1,979	$1,484.25	$1,187.4	$1,781.1	6.3×	$2,770.6
Shoulder X-ray	CPT	73030	15	$136	$102	$81.6	$122.4	1.3×	$190.4
Humerus X-ray	CPT	73060	15	$130	$97.5	$78	$117	1.3×	$182
Hand X-ray 3 views	CPT	73130	15	$151	$113.25	$90.6	$135.9	1.5×	$211.4
MRI upper extremity joint without contrast	CPT	73221	15	$2,461	$1,845.75	$1,476.6	$2,214.9	5.3×	$3,445.4
MRI upper extremity joint with and without contrast	CPT	73223	15	$3,473	$2,604.75	$2,083.8	$3,125.7	5.1×	$4,862.2
Knee X-ray 1-2 views	CPT	73560	15	$142	$106.5	$85.2	$127.8	1.4×	$198.8
Ankle X-ray 3 views	CPT	73610	15	$152	$114	$91.2	$136.8	1.5×	$212.8
MRI lower extremity joint without contrast	CPT	73721	15	$2,523.1	$1,892.32	$1,513.86	$2,270.79	4.9×	$3,532.34
MRI lower extremity joint with and without contrast	CPT	73723	15	$3,511	$2,633.25	$2,106.6	$3,159.9	5.0×	$4,915.4
CT abdomen without contrast	CPT	74150	15	$1,107	$830.25	$664.2	$996.3	5.3×	$1,549.8
CT abdomen with contrast	CPT	74160	15	$1,971	$1,478.25	$1,182.6	$1,773.9	6.2×	$2,759.4
CT abdomen with and without contrast	CPT	74170	15	$2,234	$1,675.5	$1,340.4	$2,010.6	6.0×	$3,127.6
CT abdomen and pelvis without contrast	CPT	74176	15	$1,328.25	$996.19	$796.95	$1,195.42	3.3×	$1,859.55
CT abdomen and pelvis with contrast	CPT	74177	15	$2,885.35	$2,164.01	$1,731.21	$2,596.82	4.7×	$4,039.49
CT abdomen and pelvis with and without contrast	CPT	74178	15	$3,261.4	$2,446.05	$1,956.84	$2,935.26	5.1×	$4,565.96
MRI abdomen without contrast	CPT	74181	15	$1,527	$1,145.25	$916.2	$1,374.3	3.5×	$2,137.8
Abdominal ultrasound complete	CPT	76700	15	$493	$369.75	$295.8	$443.7	3.0×	$690.2
Abdominal ultrasound limited	CPT	76705	15	$379	$284.25	$227.4	$341.1	2.3×	$530.6
Retroperitoneal ultrasound complete	CPT	76770	15	$483	$362.25	$289.8	$434.7	3.0×	$676.2
Obstetric ultrasound first trimester	CPT	76801	15	$400	$300	$240	$360	2.5×	$560
Obstetric ultrasound after first trimester	CPT	76805	15	$505	$378.75	$303	$454.5	3.0×	$707
Transvaginal ultrasound	CPT	76830	15	$492	$369	$295.2	$442.8	3.0×	$688.8
Pelvic ultrasound complete	CPT	76856	15	$444	$333	$266.4	$399.6	2.8×	$621.6
Scrotal ultrasound	CPT	76870	15	$449	$336.75	$269.4	$404.1	3.1×	$628.6
Diagnostic mammography unilateral	CPT	77065	15	$499	$374.25	$299.4	$449.1	3.0×	$698.6
Diagnostic mammography bilateral	CPT	77066	15	$638	$478.5	$382.8	$574.2	3.0×	$893.2
Screening mammography bilateral	CPT	77067	15	$527	$395.25	$316.2	$474.3	3.0×	$737.8
EKG tracing only	CPT	93005	15	$74.25	$55.69	$44.55	$66.83	0.57×	$103.95
Transthoracic echocardiogram complete	CPT	93306	15	$829.15	$621.86	$497.49	$746.24	1.2×	$1,160.81
lab
Basic metabolic panel (BMP)	CPT	80048	15	$84.6	$63.45	$50.76	$76.14	2.4×	$118.44
General health panel	CPT	80050	15	$224	$168	$134.4	$201.6	1.9×	$313.6
Electrolyte panel	CPT	80051	15	$49	$36.75	$29.4	$44.1	1.9×	$68.6
Comprehensive metabolic panel	CPT	80053	15	$105.6	$79.2	$63.36	$95.04	2.1×	$147.84
Lipid panel	CPT	80061	15	$133.9	$100.43	$80.34	$120.51	3.2×	$187.46
Renal function panel	CPT	80069	15	$62	$46.5	$37.2	$55.8	2.0×	$86.8
Hepatic function panel	CPT	80076	15	$58	$43.5	$34.8	$52.2	2.0×	$81.2
Urinalysis non-automated	CPT	81002	15	$23	$17.25	$13.8	$20.7	3.0×	$32.2
Urinalysis automated	CPT	81003	15	$21	$15.75	$10.2	$17	1.2×	$29.4
Glucose quantitative	CPT	82947	15	$29	$21.75	$17.4	$26.1	1.5×	$40.6
Hemoglobin A1c	CPT	83036	15	$97.1	$72.83	$58.26	$87.39	3.2×	$135.94
Thyroid stimulating hormone (TSH)	CPT	84443	15	$168	$126	$100.8	$151.2	3.2×	$235.2
Complete blood count with automated differential	CPT	85025	15	$77.7	$58.27	$46.62	$69.93	2.6×	$108.78
Complete blood count without differential	CPT	85027	15	$45	$33.75	$27	$40.5	1.9×	$63
Urine culture bacterial	CPT	87086	15	$80.7	$60.53	$48.42	$72.63	3.1×	$112.98
Urine culture identification	CPT	87088	15	$58	$43.5	$34.8	$52.2	2.3×	$81.2
Tissue exam by pathologist level IV	CPT	88305	15	$217	$162.75	$130.2	$195.3	1.9×	$303.8
maternity
Vaginal delivery only	CPT	59409	15	$5,361	$4,020.75	$3,216.6	$4,824.9	2.2×	$7,505.4
office
Office visit, established patient, 5 min	CPT	99211	15	$49	$36.75	$29.4	$44.1	0.68×	$68.6

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 15)

Payer	Codes covered	Median rate
Aetna	78	$497.95
Blue Cross Blue Shield	78	$702.8
Cigna	78	$474.3
healthpartners	78	$474.3
Humana	78	$527
medica	78	$421.6
Medicaid	78	$377.33
Medicare	78	$619.2
Medicare Advantage	78	$474.3
Multiplan	78	$474.3
nextblue	78	$527
sanford health plan	78	$527
tlc advantage	78	$421.6
TRICARE	78	$395.25
UnitedHealthcare	78	$502

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