▸ Hospital · ND · CCN 351336
Chi St Alexius Health Dickinson
2500 FAIRWAY STREET, DICKINSON, ND, 58601
25 bedsCritical Access Hospitals1
Compliance grade
A
97/100
Procedures tracked
117
of 209 target codes
Payers
6
with negotiated rates
Rates published
4,546
last crawl 2026-05-23
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychotherapy 30 minutes | CPT | 90832 | 6 | $610 | $384.3 | $256.2 | $481.9 | $591.7 |
| Psychotherapy 45 minutes | CPT | 90834 | 6 | $755 | $475.65 | $317.1 | $596.45 | $732.35 |
| Psychotherapy 60 minutes | CPT | 90837 | 6 | $770 | $485.1 | $323.4 | $608.3 | $746.9 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 6 | $285 | $179.55 | $29.4 | $66.5 | $276.45 |
| ED visit level 2 | CPT | 99282 | 6 | $391 | $246.33 | $57.54 | $130.15 | $379.27 |
| ED visit level 3 | CPT | 99283 | 6 | $569 | $358.47 | $85.68 | $193.8 | $551.93 |
| ED visit level 4 | CPT | 99284 | 6 | $1,030 | $648.9 | $162.12 | $370.56 | $999.1 |
| ED visit level 5 | CPT | 99285 | 6 | $1,777 | $1,119.51 | $238.98 | $540.55 | $1,723.69 |
| Critical care, first hour | CPT | 99291 | 6 | $2,301 | $1,449.63 | $286.02 | $652.5 | $2,231.97 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 6 | $2,051 | $1,292.13 | $861.42 | $1,620.29 | $1,989.47 |
| CT head with contrast | CPT | 70460 | 6 | $2,051 | $1,292.13 | $861.42 | $1,620.29 | $1,989.47 |
| CT head with and without contrast | CPT | 70470 | 6 | $2,892 | $1,821.96 | $1,214.64 | $2,284.68 | $2,805.24 |
| CT neck with contrast | CPT | 70491 | 6 | $1,833 | $1,154.79 | $769.86 | $1,448.07 | $1,778.01 |
| MRI brain without contrast | CPT | 70551 | 6 | $3,107 | $1,957.41 | $1,304.94 | $2,454.53 | $3,013.79 |
| MRI brain with contrast | CPT | 70552 | 6 | $3,107 | $1,957.41 | $1,304.94 | $2,454.53 | $3,013.79 |
| MRI brain with and without contrast | CPT | 70553 | 6 | $4,502 | $2,836.26 | $1,890.84 | $3,556.58 | $4,366.94 |
| Chest X-ray single view | CPT | 71045 | 6 | $246 | $154.98 | $103.32 | $194.34 | $238.62 |
| Chest X-ray 2 views | CPT | 71046 | 6 | $386 | $243.18 | $131.88 | $271.69 | $374.42 |
| Chest X-ray 3 views | CPT | 71047 | 6 | $342 | $215.46 | $143.64 | $270.18 | $331.74 |
| CT chest without contrast | CPT | 71250 | 6 | $1,942 | $1,223.46 | $815.64 | $1,534.18 | $1,883.74 |
| CT chest with contrast | CPT | 71260 | 6 | $1,942 | $1,223.46 | $815.64 | $1,534.18 | $1,883.74 |
| CT chest with and without contrast | CPT | 71270 | 6 | $3,048 | $1,920.24 | $1,280.16 | $2,407.92 | $2,956.56 |
| MRI chest without contrast | CPT | 71550 | 6 | $2,268 | $1,428.84 | $952.56 | $1,791.72 | $2,199.96 |
| MRI chest with contrast | CPT | 71551 | 6 | $2,266 | $1,427.58 | $951.72 | $1,790.14 | $2,198.02 |
| MRI chest with and without contrast | CPT | 71552 | 6 | $3,623 | $2,282.49 | $1,521.66 | $2,862.17 | $3,514.31 |
| Lumbosacral spine X-ray | CPT | 72100 | 6 | $506 | $318.78 | $212.52 | $399.74 | $490.82 |
| CT cervical spine without contrast | CPT | 72125 | 6 | $2,184 | $1,375.92 | $917.28 | $1,725.36 | $2,118.48 |
| CT thoracic spine without contrast | CPT | 72128 | 6 | $2,184 | $1,375.92 | $917.28 | $1,725.36 | $2,118.48 |
| CT lumbar spine without contrast | CPT | 72131 | 6 | $2,060 | $1,297.8 | $865.2 | $1,627.4 | $1,998.2 |
| MRI cervical spine without contrast | CPT | 72141 | 6 | $3,165 | $1,993.95 | $1,329.3 | $2,500.35 | $3,070.05 |
| MRI thoracic spine without contrast | CPT | 72146 | 6 | $3,165 | $1,993.95 | $1,329.3 | $2,500.35 | $3,070.05 |
| MRI lumbar spine without contrast | CPT | 72148 | 6 | $3,098 | $1,951.74 | $1,301.16 | $2,447.42 | $3,005.06 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 6 | $3,098 | $1,951.74 | $1,301.16 | $2,447.42 | $3,005.06 |
| MRI cervical spine with and without contrast | CPT | 72156 | 6 | $5,348 | $3,369.24 | $2,246.16 | $4,224.92 | $5,187.56 |
| MRI lumbar spine with contrast | CPT | 72158 | 6 | $5,235 | $3,298.05 | $2,198.7 | $4,135.65 | $5,077.95 |
| CT pelvis without contrast | CPT | 72192 | 6 | $2,167 | $1,365.21 | $910.14 | $1,711.93 | $2,101.99 |
| CT pelvis with contrast | CPT | 72193 | 6 | $2,167 | $1,365.21 | $910.14 | $1,711.93 | $2,101.99 |
| CT abdomen without contrast | CPT | 74150 | 6 | $1,864 | $1,174.32 | $782.88 | $1,472.56 | $1,808.08 |
| CT abdomen with contrast | CPT | 74160 | 6 | $1,864 | $1,174.32 | $782.88 | $1,472.56 | $1,808.08 |
| CT abdomen with and without contrast | CPT | 74170 | 6 | $2,610 | $1,644.3 | $1,096.2 | $2,061.9 | $2,531.7 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 6 | $3,766 | $2,372.58 | $1,581.72 | $2,975.14 | $3,653.02 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 6 | $3,766 | $2,372.58 | $1,581.72 | $2,975.14 | $3,653.02 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 6 | $4,595 | $2,894.85 | $1,929.9 | $3,630.05 | $4,457.15 |
| MRI abdomen without contrast | CPT | 74181 | 6 | $2,646 | $1,666.98 | $1,111.32 | $2,090.34 | $2,566.62 |
| MRI abdomen with and without contrast | CPT | 74183 | 6 | $4,900 | $3,087 | $1,934.52 | $3,754.87 | $4,753 |
| Abdominal ultrasound complete | CPT | 76700 | 6 | $813 | $512.19 | $341.46 | $642.27 | $788.61 |
| Abdominal ultrasound limited | CPT | 76705 | 6 | $656 | $413.28 | $275.52 | $518.24 | $636.32 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 6 | $651 | $410.13 | $273.42 | $514.29 | $631.47 |
| Obstetric ultrasound first trimester | CPT | 76801 | 6 | $474 | $298.62 | $34.86 | $139.8 | $459.78 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 6 | $687 | $432.81 | $288.54 | $542.73 | $666.39 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 6 | $793 | $499.59 | $333.06 | $626.47 | $769.21 |
| Transvaginal ultrasound | CPT | 76830 | 6 | $657 | $413.91 | $275.94 | $519.03 | $637.29 |
| Pelvic ultrasound complete | CPT | 76856 | 6 | $538 | $338.94 | $225.96 | $425.02 | $521.86 |
| Scrotal ultrasound | CPT | 76870 | 6 | $612 | $385.56 | $257.04 | $483.48 | $593.64 |
| Diagnostic mammography bilateral | CPT | 77066 | 6 | $778 | $490.14 | $326.76 | $614.62 | $754.66 |
| Screening mammography bilateral | CPT | 77067 | 6 | $1,120 | $705.6 | $89.44 | $884.8 | $1,086.4 |
| EKG complete | CPT | 93000 | 6 | $40 | $25.2 | $16.8 | $31.6 | $38.8 |
| EKG tracing only | CPT | 93005 | 6 | $304 | $191.52 | $7.56 | $72.57 | $294.88 |
| EKG interpretation only | CPT | 93010 | 6 | $36 | $22.68 | $9.24 | $21.34 | $34.92 |
| Transthoracic echocardiogram complete | CPT | 93306 | 6 | $1,381 | $870.03 | $580.02 | $1,090.99 | $1,339.57 |
| Transthoracic echocardiogram | CPT | 93307 | 6 | $1,237 | $779.31 | $519.54 | $977.23 | $1,199.89 |
| inpatient | ||||||||
| Initial hospital care, low complexity | CPT | 99221 | 6 | $402 | $253.26 | $95.34 | $215.65 | $389.94 |
| Initial hospital care, moderate complexity | CPT | 99222 | 6 | $545 | $343.35 | $151.62 | $332.25 | $528.65 |
| Initial hospital care, high complexity | CPT | 99223 | 6 | $802 | $505.26 | $202.02 | $456.95 | $777.94 |
| Hospital discharge, <30 min | CPT | 99238 | 6 | $226 | $142.38 | $94.92 | $178.54 | $219.22 |
| Hospital discharge, >30 min | CPT | 99239 | 6 | $322 | $202.86 | $134.4 | $253.59 | $312.34 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 6 | $243 | $153.09 | $8.46 | $87.3 | $235.71 |
| General health panel | CPT | 80050 | 6 | $54 | $34.02 | $22.68 | $42.66 | $52.38 |
| Electrolyte panel | CPT | 80051 | 6 | $147 | $92.61 | $7.01 | $116.13 | $142.59 |
| Comprehensive metabolic panel | CPT | 80053 | 6 | $280 | $176.4 | $10.56 | $114.46 | $271.6 |
| Lipid panel | CPT | 80061 | 6 | $192 | $120.96 | $13.39 | $113.05 | $186.24 |
| Renal function panel | CPT | 80069 | 6 | $274 | $172.62 | $8.68 | $216.46 | $265.78 |
| Hepatic function panel | CPT | 80076 | 6 | $243 | $153.09 | $8.17 | $191.97 | $235.71 |
| Urinalysis non-automated | CPT | 81002 | 6 | $40 | $25.2 | $3.48 | $31.6 | $38.8 |
| Urinalysis automated | CPT | 81003 | 6 | $72 | $45.36 | $2.25 | $37.92 | $69.84 |
| Glucose quantitative | CPT | 82947 | 6 | $90 | $56.7 | $3.93 | $28.13 | $87.3 |
| Hemoglobin A1c | CPT | 83036 | 6 | $118 | $74.34 | $9.71 | $93.22 | $114.46 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 6 | $205 | $129.15 | $16.8 | $48.89 | $198.85 |
| Complete blood count with automated differential | CPT | 85025 | 6 | $206 | $129.78 | $7.77 | $89.24 | $199.82 |
| Complete blood count without differential | CPT | 85027 | 6 | $142 | $89.46 | $6.47 | $73.72 | $137.74 |
| Urine culture bacterial | CPT | 87086 | 6 | $133 | $83.79 | $8.07 | $98.31 | $129.01 |
| Urine culture identification | CPT | 87088 | 6 | $99 | $62.37 | $8.09 | $78.21 | $96.03 |
| Tissue exam by pathologist level IV | CPT | 88305 | 6 | $345 | $217.35 | $65.06 | $149.03 | $334.65 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 6 | $356 | $224.28 | $14.28 | $96.6 | $345.32 |
| Vaginal delivery only | CPT | 59409 | 6 | $4,810 | $3,030.3 | $892.08 | $2,318.78 | $4,665.7 |
| Vaginal delivery with postpartum | CPT | 59410 | 6 | $2,875 | $1,811.25 | $1,207.5 | $2,271.25 | $2,788.75 |
| C-section delivery only | CPT | 59514 | 6 | $2,385 | $1,502.55 | $1,001.7 | $1,884.15 | $2,313.45 |
| C-section with postpartum | CPT | 59515 | 6 | $3,544 | $2,232.72 | $1,488.48 | $2,799.76 | $3,437.68 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 6 | $204 | $128.52 | $21.42 | $104.55 | $197.88 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 6 | $316 | $199.08 | $33.18 | $161.95 | $306.52 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 6 | $473 | $297.99 | $49.56 | $242.5 | $458.81 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 6 | $624 | $393.12 | $65.52 | $319.8 | $605.28 |
| Office visit, established patient, 5 min | CPT | 99211 | 6 | $206 | $129.78 | $6.72 | $49.47 | $199.82 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 6 | $205 | $129.15 | $16.8 | $82.6 | $198.85 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 6 | $260 | $163.8 | $27.3 | $80.24 | $252.2 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 6 | $365 | $229.95 | $38.22 | $107.5 | $354.05 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 6 | $511 | $321.93 | $50.82 | $142.24 | $495.67 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 6 | $777 | $489.51 | $326.34 | $613.83 | $753.69 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 6 | $1,053 | $663.39 | $442.26 | $831.87 | $1,021.41 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 6 | $1,408 | $887.04 | $89.04 | $527.31 | $1,365.76 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 6 | $806 | $507.78 | $338.52 | $636.74 | $781.82 |
| Colonoscopy diagnostic | CPT | 45378 | 6 | $957 | $602.91 | $401.52 | $755.64 | $928.29 |
| Colonoscopy with biopsy | CPT | 45380 | 6 | $1,215 | $765.45 | $510.3 | $959.85 | $1,178.55 |
| Colonoscopy with polyp removal | CPT | 45385 | 6 | $1,271 | $800.73 | $533.82 | $1,004.09 | $1,232.87 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 6 | — | — | $42 | $74.5 | $19,532 |
| Total hip replacement | CPT | 27130 | 6 | — | — | $42 | $74.5 | $17,556 |
| Total knee replacement | CPT | 27447 | 6 | — | — | $42 | $74.5 | $17,556 |
| Open appendectomy | CPT | 44950 | 6 | $1,742 | $1,097.46 | $731.64 | $1,376.18 | $1,689.74 |
| Laparoscopic appendectomy | CPT | 44970 | 6 | $1,647 | $1,037.61 | $691.74 | $1,301.13 | $1,597.59 |
| Laparoscopic cholecystectomy | CPT | 47562 | 6 | $1,802 | $1,135.26 | $756.84 | $1,423.58 | $1,747.94 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 6 | $1,958 | $1,233.54 | $822.36 | $1,546.82 | $1,899.26 |
| Lap inguinal hernia repair | CPT | 49650 | 6 | $1,195 | $752.85 | $501.9 | $944.05 | $1,159.15 |
| Total abdominal hysterectomy | CPT | 58150 | 6 | $2,808 | $1,769.04 | $1,179.36 | $2,218.32 | $2,723.76 |
| Vaginal hysterectomy | CPT | 58260 | 6 | $2,345 | $1,477.35 | $984.9 | $1,852.55 | $2,274.65 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 6 | $2,433 | $1,532.79 | $1,021.86 | $1,922.07 | $2,360.01 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 6 | $2,704 | $1,703.52 | $1,135.68 | $2,136.16 | $2,622.88 |
| Lap salpingo-oophorectomy | CPT | 58661 | 6 | $1,794 | $1,130.22 | $753.48 | $1,417.26 | $1,740.18 |
Payer mix (top 6)
| Payer | Codes covered | Median rate |
|---|---|---|
| Blue Cross Blue Shield | 117 | $216.07 |
| health partners | 117 | $371.45 |
| medica | 117 | $308.85 |
| Multiplan | 117 | $379.27 |
| sanford health plan | 117 | $308.89 |
| UnitedHealthcare | 117 | $249.2 |