Home › Hospitals › Sanford Canby Medical Center Posts prices for 33 of the 66 common shoppable procedures we track. Price file retrieved 2026-09-01.
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Procedure Cash price Gross charge × Medicare
CT head/brain without contrast (70450) $1,952.80
$2,441
18.1×
MRI brain without contrast (70551) $3,083.20
$3,854
12.5×
MRI brain with contrast (70552) $3,189.60
$3,987
8.9×
MRI brain without and with contrast (70553) $4,214.40
$5,268
11.7×
X-ray lower spine, 4+ views (72110) $551.20
$689
5.1×
MRI lumbar spine without contrast (72148) $3,237.60
$4,047
13.1×
CT pelvis with contrast (72193) $2,271.20
$2,839
12.5×
MRI lower-extremity joint without contrast (73721) $3,237.60
$4,047
13.1×
CT abdomen and pelvis with contrast (74177) $4,086.40
$5,108
11.3×
Ultrasound, abdomen complete (76700) $1,004
$1,255
9.3×
Ultrasound, pregnant uterus (≥14 weeks) (76805) $920.80
$1,151
8.5×
Ultrasound, transvaginal (76830) $742.40
$928
6.9×
Mammography, one breast (diagnostic) (77065) $272.80
$341
3.2×
Mammography, both breasts (diagnostic) (77066) $424
$530
3.8×
Mammography, screening (bilateral) (77067) $454.80
$568.50
5.0×
Basic metabolic panel (80048) $120.80
$151
14.3×
Comprehensive metabolic panel (80053) $180.80
$226
17.1×
Obstetric panel (80055) $184
$230
3.8×
Lipid panel (80061) $100
$125
7.5×
Renal function panel (80069) $137.60
$172
15.9×
Hepatic function panel (80076) $114.40
$143
14.0×
PSA, total (84153) $89.60
$112
4.9×
Thyroid stimulating hormone (TSH) (84443) $133.60
$167
8.0×
CBC with automated differential (85025) $119.20
$149
15.3×
CBC, automated (85027) $84
$105
13.0×
Prothrombin time (PT) (85610) $83.20
$104
19.4×
Partial thromboplastin time (PTT) (85730) $88
$110
14.6×
Sleep study (attended polysomnography) (95810) $4,175.20
$5,219
4.7×
Physical therapy, therapeutic exercise (per 15 min) (97110) $126.40
$158
4.3×
Office visit, new patient (low complexity, ~30 min) (99203) $195.20
$244
1.4×
Office visit, new patient (moderate complexity, ~45 min) (99204) $244.80
$306
1.8×
Office visit, new patient (high complexity, ~60 min) (99205) $312
$390
2.3×
Office consultation (low complexity, ~30 min) (99243) $178.40
$223
1.3×
As a Critical Access Hospital, Medicare pays this facility about 101% of its own costs. The × Medicare column compares the cash price against that cost-based benchmark, not a standard rate.
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