Home › Hospitals › Sanford Luverne Medical Center Posts prices for 32 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) $1,883.20
$2,354
17.5×
MRI brain without contrast (70551) $2,939.20
$3,674
11.9×
MRI brain with contrast (70552) $3,168
$3,960
8.8×
MRI brain without and with contrast (70553) $4,024
$5,030
11.2×
X-ray lower spine, 4+ views (72110) $320.80
$401
3.0×
MRI lumbar spine without contrast (72148) $2,875.20
$3,594
11.7×
CT pelvis with contrast (72193) $2,607.20
$3,259
14.4×
MRI lower-extremity joint without contrast (73721) $2,682.40
$3,353
10.9×
CT abdomen and pelvis with contrast (74177) $4,336
$5,420
12.0×
Ultrasound, abdomen complete (76700) $803.20
$1,004
7.4×
Ultrasound, pregnant uterus (≥14 weeks) (76805) $852.80
$1,066
7.9×
Ultrasound, transvaginal (76830) $761.60
$952
7.1×
Mammography, one breast (diagnostic) (77065) $460.80
$576
5.3×
Mammography, both breasts (diagnostic) (77066) $550.40
$688
5.0×
Mammography, screening (bilateral) (77067) $470.40
$588
5.2×
Basic metabolic panel (80048) $60.80
$76
7.2×
Comprehensive metabolic panel (80053) $72
$90
6.8×
Obstetric panel (80055) $243.20
$304
5.1×
Lipid panel (80061) $77.60
$97
5.8×
Renal function panel (80069) $56
$70
6.5×
Hepatic function panel (80076) $48
$60
5.9×
Urinalysis, non-automated, with microscopy (81000) $38.40
$48
9.6×
Urinalysis, non-automated, without microscopy (81002) $14.40
$18
4.1×
PSA, total (84153) $89.60
$112
4.9×
Thyroid stimulating hormone (TSH) (84443) $90.40
$113
5.4×
CBC with automated differential (85025) $49.60
$62
6.4×
CBC, automated (85027) $31.20
$39
4.8×
Prothrombin time (PT) (85610) $29.60
$37
6.9×
Partial thromboplastin time (PTT) (85730) $34.40
$43
5.7×
Group psychotherapy (90853) $151.20
$189
1.4×
Sleep study (attended polysomnography) (95810) $4,214.40
$5,268
4.8×
Physical therapy, therapeutic exercise (per 15 min) (97110) $110.40
$138
3.8×
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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