Devils Lake, ND, 58301
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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 |
|---|---|---|---|---|---|---|---|---|---|
| imaging | |||||||||
| CT head without contrast | CPT | 70450 | 5 | $1,689 | $709.38 | $641.82 | $1,232.97 | 6.0× | $1,604.55 |
| CT head with contrast | CPT | 70460 | 5 | $2,280 | $957.6 | $866.4 | $1,664.4 | 7.1× | $2,166 |
| CT head with and without contrast | CPT | 70470 | 5 | $2,533 | $1,063.86 | $962.54 | $1,849.09 | 6.9× | $2,406.35 |
| CT neck with contrast | CPT | 70491 | 5 | $2,455 | $1,031.1 | $932.9 | $1,792.15 | 6.6× | $2,332.25 |
| MRI brain without contrast | CPT | 70551 | 5 | $3,358 | $1,410.36 | $1,276.04 | $2,451.34 | 6.1× | $3,190.1 |
| MRI brain with contrast | CPT | 70552 | 5 | $4,185 | $1,757.7 | $1,590.3 | $3,055.05 | 6.4× | $3,975.75 |
| MRI brain with and without contrast | CPT | 70553 | 5 | $4,866 | $2,043.72 | $1,849.08 | $3,552.18 | 6.0× | $4,622.7 |
| Chest X-ray single view | CPT | 71045 | 5 | $167 | $70.14 | $63.46 | $121.91 | 1.3× | $158.65 |
| Chest X-ray 2 views | CPT | 71046 | 5 | $216 | $90.72 | $82.08 | $157.68 | 1.6× | $205.2 |
| Chest X-ray 3 views | CPT | 71047 | 5 | $268 | $112.56 | $101.84 | $195.64 | 2.0× | $254.6 |
| CT chest without contrast | CPT | 71250 | 5 | $2,089 | $877.38 | $793.82 | $1,524.97 | 7.1× | $1,984.55 |
| CT chest with contrast | CPT | 71260 | 5 | $2,785 | $1,169.7 | $1,058.3 | $2,033.05 | 7.2× | $2,645.75 |
| CT chest with and without contrast | CPT | 71270 | 5 | $3,397 | $1,426.74 | $1,290.86 | $2,479.81 | 8.5× | $3,227.15 |
| MRI chest without contrast | CPT | 71550 | 5 | $3,586 | $1,506.12 | $1,362.68 | $2,617.78 | 6.1× | $3,406.7 |
| MRI chest with contrast | CPT | 71551 | 5 | $3,932 | $1,651.44 | $1,494.16 | $2,870.36 | 3.5× | $3,735.4 |
| MRI chest with and without contrast | CPT | 71552 | 5 | $4,986 | $2,094.12 | $1,894.68 | $3,639.78 | 6.1× | $4,736.7 |
| Lumbosacral spine X-ray | CPT | 72100 | 5 | $281 | $118.02 | $106.78 | $205.13 | 2.0× | $266.95 |
| CT cervical spine without contrast | CPT | 72125 | 5 | $2,764 | $1,160.88 | $1,050.32 | $2,017.72 | 10.0× | $2,625.8 |
| CT thoracic spine without contrast | CPT | 72128 | 5 | $2,034 | $854.28 | $772.92 | $1,484.82 | 7.5× | $1,932.3 |
| CT lumbar spine without contrast | CPT | 72131 | 5 | $2,739 | $1,150.38 | $1,040.82 | $1,999.47 | 9.8× | $2,602.05 |
| MRI cervical spine without contrast | CPT | 72141 | 5 | $2,928 | $1,229.76 | $1,112.64 | $2,137.44 | 5.4× | $2,781.6 |
| MRI thoracic spine without contrast | CPT | 72146 | 5 | $3,453 | $1,450.26 | $1,312.14 | $2,520.69 | 6.8× | $3,280.35 |
| MRI lumbar spine without contrast | CPT | 72148 | 5 | $3,294 | $1,383.48 | $1,215.24 | $2,404.62 | 6.4× | $3,129.3 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 5 | $3,486 | $1,464.12 | $1,324.68 | $2,544.78 | 5.6× | $3,311.7 |
| MRI cervical spine with and without contrast | CPT | 72156 | 5 | $4,948 | $2,078.16 | $1,880.24 | $3,612.04 | 6.7× | $4,700.6 |
| MRI lumbar spine with contrast | CPT | 72158 | 5 | $5,884 | $2,471.28 | $2,235.92 | $4,295.32 | 7.8× | $5,589.8 |
| CT pelvis without contrast | CPT | 72192 | 5 | $2,822 | $1,185.24 | $1,072.36 | $2,060.06 | 10.3× | $2,680.9 |
| CT pelvis with contrast | CPT | 72193 | 5 | $3,527 | $1,481.34 | $1,340.26 | $2,574.71 | 9.2× | $3,350.65 |
| MRI upper extremity joint without contrast | CPT | 73221 | 5 | $3,718 | $1,561.56 | $1,261.98 | $2,714.14 | 6.5× | $3,532.1 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 5 | $5,847 | $2,455.74 | $2,221.86 | $4,268.31 | 7.0× | $5,554.65 |
| MRI lower extremity joint without contrast | CPT | 73721 | 5 | $3,917 | $1,645.14 | $1,234.62 | $2,820.24 | 6.0× | $3,721.15 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 5 | $4,554 | $1,912.68 | $1,730.52 | $3,324.42 | 5.2× | $4,326.3 |
| CT abdomen without contrast | CPT | 74150 | 5 | $1,824 | $766.08 | $693.12 | $1,331.52 | 7.1× | $1,732.8 |
| CT abdomen with contrast | CPT | 74160 | 5 | $3,535 | $1,484.7 | $1,343.3 | $2,580.55 | 9.0× | $3,358.25 |
| CT abdomen with and without contrast | CPT | 74170 | 5 | $3,721 | $1,562.82 | $1,413.98 | $2,716.33 | 8.1× | $3,534.95 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 5 | $2,323 | $975.66 | $882.74 | $1,695.79 | 4.7× | $2,206.85 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 5 | $4,645 | $1,950.9 | $1,765.1 | $3,390.85 | 6.2× | $4,412.75 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 5 | $5,296 | $2,224.32 | $2,012.48 | $3,866.08 | 6.7× | $5,031.2 |
| MRI abdomen without contrast | CPT | 74181 | 5 | $2,874 | $1,207.08 | $1,092.12 | $2,098.02 | 5.4× | $2,730.3 |
| MRI abdomen with and without contrast | CPT | 74183 | 5 | $4,421 | $1,856.82 | $1,679.98 | $3,227.33 | 5.7× | $4,199.95 |
| Abdominal ultrasound complete | CPT | 76700 | 5 | $1,046 | $439.32 | $397.48 | $763.58 | 5.1× | $993.7 |
| Abdominal ultrasound limited | CPT | 76705 | 5 | $792 | $332.64 | $159.6 | $392.7 | 2.7× | $752.4 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 5 | $939 | $394.38 | $356.82 | $685.47 | 4.8× | $892.05 |
| Obstetric ultrasound first trimester | CPT | 76801 | 5 | $598 | $251.16 | $227.24 | $436.54 | 3.1× | $568.1 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 5 | $850 | $357 | $323 | $620.5 | 4.1× | $807.5 |
| Transvaginal ultrasound | CPT | 76830 | 5 | $825 | $346.5 | $313.5 | $602.25 | 4.1× | $783.75 |
| Pelvic ultrasound complete | CPT | 76856 | 5 | $930 | $390.6 | $353.4 | $678.9 | 4.7× | $883.5 |
| Scrotal ultrasound | CPT | 76870 | 5 | $697 | $292.74 | $264.86 | $508.81 | 3.9× | $662.15 |
| Diagnostic mammography bilateral | CPT | 77066 | 5 | $1,182 | $496.44 | $449.16 | $862.86 | 4.5× | $1,122.9 |
| Screening mammography bilateral | CPT | 77067 | 5 | $753 | $316.26 | $286.14 | $549.69 | 3.5× | $715.35 |
| EKG tracing only | CPT | 93005 | 5 | $242 | $101.64 | $91.96 | $176.66 | 1.5× | $229.9 |
| Transthoracic echocardiogram complete | CPT | 93306 | 5 | $1,215 | $510.3 | $461.7 | $886.95 | 1.5× | $1,154.25 |
| Transthoracic echocardiogram | CPT | 93307 | 5 | $412 | $173.04 | $156.56 | $300.76 | 1.2× | $391.4 |
| lab | |||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 5 | $141 | $59.22 | $8.46 | $102.93 | 3.2× | $133.95 |
| Electrolyte panel | CPT | 80051 | 5 | $110 | $46.2 | $7.01 | $80.3 | 3.4× | $104.5 |
| Comprehensive metabolic panel | CPT | 80053 | 5 | $173 | $72.66 | $10.56 | $126.29 | 2.8× | $164.35 |
| Lipid panel | CPT | 80061 | 5 | $177 | $74.34 | $13.39 | $57.95 | 1.5× | $168.15 |
| Renal function panel | CPT | 80069 | 5 | $144 | $60.48 | $8.68 | $105.12 | 3.9× | $136.8 |
| Hepatic function panel | CPT | 80076 | 5 | $129 | $54.18 | $8.17 | $94.17 | 3.5× | $122.55 |
| Urinalysis non-automated | CPT | 81002 | 5 | $32 | $13.44 | $3.48 | $23.36 | 3.4× | $30.4 |
| Urinalysis automated | CPT | 81003 | 5 | $30 | $12.6 | $2.25 | $17.77 | 1.3× | $28.5 |
| Glucose quantitative | CPT | 82947 | 5 | $62 | $26.04 | $3.93 | $32.3 | 1.8× | $58.9 |
| Hemoglobin A1c | CPT | 83036 | 5 | $128 | $53.76 | $9.71 | $93.44 | 3.5× | $121.6 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 5 | $232 | $97.44 | $16.8 | $47.88 | 1.0× | $220.4 |
| Complete blood count with automated differential | CPT | 85025 | 5 | $102 | $42.84 | $7.77 | $74.46 | 2.8× | $96.9 |
| Complete blood count without differential | CPT | 85027 | 5 | $92 | $38.64 | $6.47 | $67.16 | 3.1× | $87.4 |
| Urine culture bacterial | CPT | 87086 | 5 | $107 | $44.94 | $8.07 | $78.11 | 3.3× | $101.65 |
| Urine culture identification | CPT | 87088 | 5 | $108 | $45.36 | $8.09 | $81.34 | 3.7× | $102.6 |
| Tissue exam by pathologist level IV | CPT | 88305 | 5 | $218 | $91.56 | $58.86 | $142.5 | 1.4× | $207.1 |
| surgery | |||||||||
| Total shoulder arthroplasty | CPT | 23472 | 5 | — | — | $38 | $73 | 0.02× | $18,267 |
| Total hip replacement | CPT | 27130 | 5 | — | — | $38 | $73 | 0.02× | $18,267 |
| Total knee replacement | CPT | 27447 | 5 | — | — | $38 | $73 | 0.02× | $18,267 |
| Payer | Codes covered | Median rate |
|---|---|---|
| Blue Cross Blue Shield | 72 | $649.31 |
| health partners | 72 | $1,122.9 |
| medica | 72 | $865.14 |
| sanford health plan | 72 | $851.04 |
| UnitedHealthcare | 72 | $886.95 |
