Sanford Wheaton Medical Center Prices { open = false; }, 3000);" x-ref="trigger"> Prices have been verified using third-party online ordering systems.
Claim Business Form
Items
-
Treatment Room - Simple Procedure (1026071)
$157.00
-
Treatment Room - Established Patient Office Or Other Outpatient Visit, Typically 5 Minutes (1009264)
$160.00
-
Treatment Room - Established Patient Office Or Other Outpatient Visit, Typically 5 Minutes (1028030)
$92.00
-
Trauma Response - Hospital Critical Care Service (1027813)
$1,276.00
-
Trauma Response - Full Trauma Activation (1027810)
$1,147.00
-
Therapeutic Services - Irrigation Of Implanted Venous Access Drug Delivery Device (1004718)
$98.00
-
Telemedicine - Fee For Remote Healthcare Service (1009851)
$47.00
-
Speech Therapy - Treatment Of Swallowing Or Oral Feeding Function (1002861)
$240.00
-
Speech Therapy - Treatment Of Speech, Language, Voice, Communication, Or Hearing Processing Disorder, Individual (1002858)
$215.00
-
Speech Therapy - Evaluation Of Swallowing Function (1002860)
$295.00
-
Speech Therapy - Evaluation Of Speech Sound Production With Evaluation Of Language Comprehension And Expression (1021038)
$275.00
-
Speech Therapy - Evaluation Of Speech Sound Production (1021037)
$145.00
-
Speech Therapy - Behavioral And Qualitative Analysis Of Voice And Resonance (1021039)
$165.00
-
Room & Board - Semi-Private (1009460)
$1,457.00
-
Room & Board - Private (1000439)
$1,248.00
-
Room & Board - Private (1004313)
$482.00
-
Room & Board - Other (1008186)
$343.00
-
Respiratory Services - Respiratory Inhaled Pressure Or Nonpressure Treatment To Relieve Airway Obstruction Or For Sputum Specimen (1006730)
$90.00
-
Recovery Room (1004670)
$536.00
-
Recovery - Second Hour (1011668)
$144.00
-
Recovery - Each Additional Hour Up To 24 Hours (1011669)
$24.00
-
Recovery - 25-48 Hours (1011670)
$49.00
-
Preventive Services - Administration Of Vaccine By Injection, 1 Vaccine (1004368)
$59.00
-
Preventive Services - Administration Of Vaccine By Injection, 1 Vaccine (1011895)
$55.00
-
Physical Therapy - Walking Training To 1 Or More Areas, Each 15 Minutes (1002904)
$87.00
-
Physical Therapy - Therapeutic Procedure To Re-Educate Brain-To-Nerve-To-Muscle Function, Each 15 Minutes (1002902)
$98.00
-
Physical Therapy - Physical Medicine Or Rehabilitation Service Or Procedure (1008125)
$109.00
-
Physical Therapy - Evaluation Of Physical Therapy, Typically 45 Minutes (1026787)
$199.00
-
Physical Therapy - Evaluation Of Physical Therapy, Typically 30 Minutes (1026786)
$175.00
-
Physical Therapy - Evaluation Of Physical Therapy, Typically 20 Minutes (1026785)
$155.00
-
Physical Therapy - Application Of Medication Through Skin Using Electrical Current, Each 15 Minutes (1002897)
$96.00
-
Physical Therapy - Application Of Mechanical Traction To 1 Or More Areas (1002885)
$95.00
-
Physical Therapy - Application Of Electrical Stimulation To 1 Or More Areas, Unattended By Physical Therapist (1002886)
$92.00
-
Pathology - Special Stained Specimen Slides To Examine Tissue Including Interpretation And Report (Group Ii For All Other Excluding Microorganisms) (1006361)
$49.00
-
Pathology - Special Stained Specimen Slides To Examine Tissue (Initial Single Slide Or Stain) (1006381)
$151.00
-
Pathology - Special Stained Specimen Slides To Examine Tissue (Each Additional Slide Or Stain) (1024653)
$151.00
-
Pathology - Pap Smear (Thin Layer Prep With Manual Screening) (1006966)
$70.00
-
Pathology - Level Iv Pathology Exam Of Tissue Using Visual Inspection And Microscopic Examination (Specimen Specific Or Intermediate Complexity) (1006355)
$179.00
-
Pathology - Level Iii Pathology Exam Of Tissue Using Visual Inspection And Microscopic Examination (Specimen Specific Or Moderatley Low Complexity) (1006354)
$117.00
-
Pathology - Level Ii Pathology Exam Of Tissue Using Visual Inspection And Microscopic Examination (Specimen Specific Or Low Complexity) (1006353)
$93.00
-
Pathology - Level I Pathology Exam Of Tissue Using Visual Inspection (1006352)
$65.00
-
Pathology - Gene Identification And Typing (Hla Class Ii, Each Locus, Low Resolution) (1022104)
$17.00
-
Operating Room - Tying Of Vas Deferens (1004727)
$572.00
-
Operating Room - Removal Of Gallbladder Using Endoscope (1001514)
$10,326.00
-
Operating Room - Release Of Wrist Nerve (Carpal Tunnel Surgery) (1000764)
$692.00
-
Operating Room - Level 3 Per Hour (1011662)
$1,994.00
-
Operating Room - Level 1 Per Hour (1011660)
$1,524.00
-
Operating Room - Intermediate Procedure (1011663)
$321.00
-
Operating Room - Hernia Repair (1004381)
$4,185.00
-
Operating Room - Diagnostic Exam Of Upper Gastrointestinal Tract Using Endoscope, Level 2 (1011659)
$1,753.00
-
Operating Room - Diagnostic Exam Of Upper Gastrointestinal Tract Using Endoscope (1010166)
$1,467.00
-
Operating Room - Diagnostic Exam Of Large Intestine Using Endoscope, Level 2 (1011674)
$1,858.00
-
Occupational Therapy - Training In Use Of Orthotics For Arms, Legs, Or Trunk, Per 15 Minutes (1002910)
$115.00
-
Occupational Therapy - Therapeutic Exercise To Develop Strength, Endurance, Range Of Motion, And Flexibility, Each 15 Minutes (1002901)
$95.00
-
Occupational Therapy - Therapeutic Activities To Improve Function With One-On-One Contact Between Patient And Provider, Each 15 Minutes (1002912)
$90.00
-
Occupational Therapy - Self-Care Or Home Management Training, Each 15 Minutes (1002915)
$75.00
-
Occupational Therapy - Manual Therapy Techniques To 1 Or More Regions, Each 15 Minutes (1002908)
$95.00
-
Occupational Therapy - Evaluation Of Occupational Therapy, Typically 45 Minutes (1026790)
$175.00
-
Occupational Therapy - Evaluation Of Occupational Therapy, Typically 30 Minutes (1026789)
$155.00
-
Occupational Therapy - Evaluation Of Occupational Therapy Established Plan Of Care, Typically 60 Minutes (1026791)
$199.00
-
Occupational Therapy - Application Of Ultrasound To 1 Or More Areas, Each 15 Minutes (1002899)
$83.00
-
Occupational Therapy - Application Of Hot Wax Bath To 1 Or More Areas (1002890)
$80.00
-
Occupational Therapy - Application Of Electrical Stimulation To 1 Or More Areas, Each 15 Minutes (1002894)
$78.00
-
Observation - Hospital Observation Care - Each Hour Of Service (1011653)
$470.00
-
Observation - Hospital Observation Care - Each Hour Of Service (1011650)
$368.00
-
Observation - Hospital Observation Care - Each Hour Of Service (1011655)
$77.00
-
Observation - Hospital Observation Care - Each Hour Of Service (1011652)
$56.00
-
Observation - Hospital Observation Care - Each Hour Of Service (1011654)
$53.00
-
Observation - Hospital Observation Care - Each Hour Of Service (1011651)
$41.00
-
Nuclear Medicine - Diagnostic Tomographic (Spect) Scan Of Heart, Multiple Studies (1003505)
$3,348.00
-
Nuclear Medicine - Diagnostic Scan Of Bones Or Joints, Whole Body (1003461)
$1,462.00
-
Lab - Zinc Level (1005871)
$58.00
-
Lab - Withdrawal Of Arterial Blood For Diagnosis (1004304)
$52.00
-
Lab - White Blood Cell Count (Automated) (1004492)
$42.00
-
Lab - White Blood Cell Antibodies Identification (1006075)
$103.00
-
Lab - White Blood Cell Antibodies Identification (1006073)
$103.00
-
Lab - West Nile Antibody Analysis (Igm) (1007766)
$60.00
-
Lab - Vitamin K Level (1005868)
$67.00
-
Lab - Vitamin E Level (1005854)
$87.00
-
Lab - Vitamin D-3 Level (1010913)
$161.00
-
Lab - Vitamin B-6 Level (1004830)
$240.00
-
Lab - Vitamin B-12 Level (Cyanocobalamin Level) (1004564)
$103.00
-
Lab - Vitamin B-1 Level (1005846)
$73.00
-
Lab - Vitamin A Level (1005867)
$89.00
-
Lab - Varicella-Zoster Antibody Analysis (1006207)
$66.00
-
Lab - Vancomycin Level (1008950)
$87.00
-
Lab - Valproic Acid Level (Total) (1005480)
$118.00
-
Lab - Urine Volume Measurement (1018839)
$14.00
-
Lab - Urine Pregnancy Test (1004532)
$70.00
-
Lab - Urine Concentration Measurement (1026155)
$49.00
-
Lab - Uric Acid Level In Specimen Other Than Blood (1026162)
$13.00
-
Lab - Uric Acid Level In Blood (1004521)
$53.00
-
Lab - Urea Nitrogen Level In Urine (Bun Only) (1026164)
$9.00
-
Lab - Urea Nitrogen Level In Blood (Quantitative) (1004506)
$53.00
-
Lab - Tuberculosis Antigen Analysis (Gamma Interferon Secretion Test) (1009874)
$142.00
-
Lab - Troponin Protein Level (1004528)
$137.00
-
Lab - Total Protein Level In Urine (1005822)
$44.00
-
Lab - Total Protein Level In Blood (1004592)
$52.00
-
Lab - Total Cell Count For Natural Killer Cells (1006120)
$120.00
-
Lab - Total Cell Count For B Cells (1006119)
$120.00
-
Lab - Topiramate Level (1005514)
$85.00
-
Lab - Thyroxine Level (Total) (1004527)
$41.00
-
Lab - Thyroxine Level (Free) (1004576)
$94.00
-
Lab - Thyroid Stimulating Hormone Level (1004529)
$120.00
-
Lab - Thyroid Hormone Level (T3 Free) (1005858)
$142.00
-
Lab - Thyroglobulin Hormone Level (1005848)
$73.00
-
Lab - Thyroglobulin Antibody Measurement (1006213)
$73.00
-
Lab - Thyroglobulin Antibody Measurement (1006211)
$63.00
-
Lab - Testosterone Level (Total) (1010016)
$125.00
-
Lab - Testosterone Level (Total) (1005845)
$125.00
-
Lab - Testosterone Level (Total) (1005843)
$123.00
-
Lab - Testosterone Level (Free) (1024367)
$90.00
-
Lab - Testosterone Level (Free) (1005842)
$90.00
-
Lab - Testosterone Level (Free) (1019739)
$90.00
-
Lab - Testosterone Level (Bioavailable) (1023956)
$122.00
-
Lab - Tacrolimus Level (1004580)
$212.00
-
Lab - Syphilis Antibody Identification (1004658)
$63.00
-
Lab - Susceptibility Study Of Specific Antimicrobial Agent (Mic Or Breakpoint, Per Plate, Each Multi-Antimicrobial Agent) (1004561)
$79.00
-
Lab - Susceptibility Study Of Specific Antimicrobial Agent (Agar Dilution Method, Per Drug) (1018258)
$39.00
-
Lab - Sulfate Level In Urine (1026161)
$7.00
-
Lab - Stool Specimen Analysis For Helicobacter Pylori Bacteria (Immunoassay Technique) (1006282)
$168.00
-
Lab - Stone Analysis By Infrared Absorption (1004767)
$98.00
-
Lab - Steroid Hormone Level (Dehydroepiandrosterone-Sulfate) (1005626)
$77.00
-
Lab - Specimen Analysis Using Light Refraction (1007969)
$124.00
-
Lab - Specimen Analysis For Strep Group A Bacteria (Immunoassay With Direct Optical Observation) (1004535)
$66.00
-
Lab - Specimen Analysis For Hiv-1 And Hiv-2 (Immunoassay Technique) (1023235)
$69.00
-
Lab - Specimen Analysis For Hepatitis C Virus Genotype (1006295)
$318.00
-
Lab - Specimen Analysis For Hepatitis B Surface Antigen (Immunoassay Technique) (1004851)
$46.00
-
Lab - Specimen Analysis For Giardia Parasite (Immunoassay Technique) (1019195)
$48.00
-
Lab - Specimen Analysis For Cryptosporidium Parasite (Immunoassay Technique) (1009617)
$51.00
-
Lab - Somatomedin Growth Factor Level (1005838)
$114.00
-
Lab - Sodium Level In Urine (1026160)
$18.00
-
Lab - Sodium Level In Blood (1004519)
$53.00
-
Lab - Smear With Wet Mount For Infectious Agents (1004554)
$55.00
-
Lab - Smear With Special Stain For Microorganisms (Gram Or Giemsa Stain) (1004546)
$42.00
-
Lab - Serum Protein Level (Haptoglobin, Quantitative) (1005663)
$55.00
-
Lab - Semen Analysis For Presence And Motility Of Sperm (1004598)
$50.00
-
Lab - Selenium Essential Mineral Level (1005831)
$90.00
-
Lab - Screening Psa Lab Test (1004758)
$120.00
-
Lab - Rubeola Antibody Analysis (1006201)
$122.00
-
Lab - Rubella Antibody Analysis (1004796)
$64.00
-
Lab - Rheumatoid Factor Measurement (1021318)
$49.00
-
Lab - Rheumatoid Arthritis Antibody Measurement (Cyclic Citrullinated Peptide Antibody) (1006092)
$81.00
-
Lab - Renin Enzyme Level (1005830)
$98.00
-
Lab - Red Blood Cell Volume Count (Electronic Hematocrit) (1004486)
$18.00
-
Lab - Red Blood Cell Sedimentation Rate (Non-Automated) (1006500)
$45.00
-
Lab - Red Blood Cell Antibody Screen (1004494)
$96.00
-
Lab - Puncture Of Skin For Collection Of Blood Sample (1004544)
$28.00
-
Lab - Proteins In Blood Analysis (Serum Immunofixation Electrophoresis) (1006116)
$89.00
-
Lab - Protein Tumor Marker Level (Carcinoembryonic Antigen) (1004568)
$129.00
-
Lab - Protein Level In Blood (1004792)
$58.00
-
Lab - Prostate Specific Antigen Level (Psa, Total) (1004526)
$120.00
-
Lab - Prolactin Hormone Level (1005820)
$89.00
-
Lab - Progesterone Reproductive Hormone Level (1005819)
$83.00
-
Lab - Pregnancy Hormone Level (Hcg Quantitative) (1001981)
$114.00
-
Lab - Potassium Level In Urine (1026159)
$13.00
-
Lab - Potassium Level In Blood (1004517)
$53.00
-
Lab - Platelet Count (Automated) (1004805)
$45.00
-
Lab - Pituitarty Hormone Level (Adrenocorticotropic) (1004785)
$159.00
-
Lab - Phosphate Level In Urine (1026158)
$11.00
-
Lab - Phosphate Level In Blood (1004516)
$58.00
-
Lab - Phenytoin Level (Total) (1004572)
$115.00
-
Lab - Phenobarbital Level (1004606)
$109.00
-
Lab - Ph Measurement Using Body Fluid (1026157)
$9.00
-
Lab - Parathyroid Hormone Level (1005798)
$85.00
-
Lab - Oxalate Level (1026156)
$28.00
-
Lab - Other Tumor Antigen Measurement (1006112)
$81.00
-
Lab - Organic Acid Level (1005793)
$153.00
-
Lab - Noninfectious Agent Antibody Analysis (1006074)
$118.00
-
Lab - Noninfectious Agent Antibody Analysis (1006777)
$27.00
-
Lab - Non-Infectious Substance Measurement (By Radioimmunoassay) (1006612)
$689.00
-
Lab - Non-Infectious Substance Analysis (Immunoassay Multiple Step Method) (1005694)
$81.00
-
Lab - Non-Infectious Substance Analysis (Immunoassay Multiple Step Method) (1012314)
$80.00
-
Lab - Non-Infectious Substance Analysis (Immunoassay Multiple Step Method) (1027108)
$74.00
-
Lab - Non-Infectious Substance Analysis (Immunoassay Multiple Step Method) (1028107)
$40.00
-
Lab - Non-Infectious Substance Analysis (Immunoassay Multiple Step Method) (1027987)
$40.00
-
Lab - Natriuretic Peptide Protein Level (1004593)
$142.00
-
Lab - Mycoplasma Antibody Analysis (1004660)
$63.00
-
Lab - Mumps Antibody Analysis (1004789)
$77.00
-
Lab - Mononucleosis Antibody Identification (1004531)
$64.00
-
Lab - Miscellaneous Therapeutic Drug Level (1005519)
$92.00
-
Lab - Microsomal Antibodies Measurement (1006127)
$73.00
-
Lab - Metanephrines Level (1005740)
$217.00
-
Lab - Magnesium Level (1004523)
$63.00
-
Lab - Magnesium Level (1026154)
$31.00
-
Lab - Lyme Disease Antibody Analysis (1006151)
$61.00
-
Lab - Luteinizing Hormone Level (Gonadotropin Lh) (1004780)
$82.00
-
Lab - Lupus Anticoagulants Identification (Hexagonal Phospholipid Neutralization) (1026528)
$86.00
-
Lab - Liver Function Panel (1004538)
$131.00
-
Lab - Liver Enzyme Level (Ast, Sgot) (1004502)
$59.00
-
Lab - Liver Enzyme Level (Alt, Sgpt) (1004500)
$59.00
-
Lab - Lithium Level (1004783)
$70.00
-
Lab - Lipid Panel (1004539)
$118.00
-
Lab - Lipase Enzyme Level (1004578)
$85.00
-
Lab - Light Emission Measurement From Chemical Reaction (Chemiluminescent Assay) (1009064)
$84.00
-
Lab - Light Emission Measurement From Chemical Reaction (Chemiluminescent Assay) (1010022)
$24.00
-
Lab - Levetiracetam Level (1021058)
$54.00
-
Lab - Lead Level (1006677)
$79.00
-
Lab - Ldl Cholesterol Level (1005730)
$68.00
-
Lab - Lamotrigine Level (1021057)
$69.00