SANFORD MEDICAL CENTER FARGO

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
J3399	Onasemnogene Abeparvovec-xioi 7x8.3 ML Susp Kit	$2,704,250	$2,163,400	—	—	2
Q2056	CILTACABTAGENE AUTOLEUCEL	$2,013,978	$1,611,182	—	—	2
Q2054	LISOCABTAGENE MARALEUCEL	$1,964,500	$1,571,600	—	—	2
Q2041	AXICABTAGENE CILOLEUCEL	$1,932,746	$1,546,197	—	—	2
Q2055	IDECABTAGENE VICLEUCEL	$1,916,063	$1,532,850	—	—	2
Q2042	TISAGENLECLEUCEL CAR POS T LYMPHOMA ADULTS	$1,842,084	$1,473,667	—	—	2
Q2053	BREXUCABTAGENE AUTOLEUCEL	$1,773,169	$1,418,535	—	—	2
C9482	Sotalol HCl Inj 150 MG/10ML (15 MG/ML)	$143,374	$114,699	—	—	2
J9226	Histrelin Acetate (CPP) Implant Kit 50 MG	$90,810	$72,648	—	—	2
0811	LIVE DONOR KIDNEY ACQUIS	$73,966	$59,173	—	—	2
0812	KIDNEY STANDARD ACQUIS	$73,966	$59,173	—	—	2
C1827	IPG VNS VIVISTIM	$70,800	$56,640	—	—	2
33264	RMVL & REPLC DEFIB GEN MULT LEADS	$69,554	$55,643	—	—	2
L8614	COCHLEAR NUCLEUS CI512	$66,360	$53,088	—	—	2
0408T	INSJ/RPLC CAR MODULJ SYS PLS GEN TRANSVNS ELTRD	$65,304	$52,243	—	—	2
C1820	STIM DBS ACTIVA RC RECHG	$60,000	$48,000	—	—	2
J3316	Triptorelin Pamoate For IM ER Susp 22.5 MG (Base Equiv)	$59,200	$47,360	—	—	2
J9118	Calaspargase Pegol-mknl IV Soln 3750 Unit/5ML (750 Unit/ML)	$58,363	$46,690	—	—	2
C9293	Glucarpidase For IV Inj 1000 UNIT	$57,715	$46,172	—	—	2
33231	INSERT DEFIB GENERATOR W EXIST MULT LEADS	$57,038	$45,630	—	—	2
C2624	KT PA CARDIOMEM SENSOR DEL SYS	$54,000	$43,200	—	—	2
C1822	SYS STIM SPNL SENZA IPG	$52,114	$41,691	—	—	2
J2326	Nusinersen Intrathecal Soln 12 MG/5ML (2.4 MG/ML)	$52,083	$41,667	—	—	2
J9266	Pegaspargase Inj 750 Unit/ML	$51,332	$41,065	—	—	2
J9229	Inotuzumab Ozogamicin For IV Soln 0.9 MG	$50,880	$40,704	—	—	2
33263	RMVL & REPLC DEFIB GEN DUAL LEADS	$48,400	$38,720	—	—	2
J2502	Pasireotide Pamoate For IM ER Susp 20 MG (Base Equiv)	$48,316	$38,653	—	—	2
C1826	STIM NEURO GENRTR INCEPTIV SCS	$48,000	$38,400	—	—	2
C2616	Y90 BRACYTX NONSTRANDED PER SOURCE	$46,759	$37,407	—	—	2
33262	RMVL & REPLC DEFIB GEN SNGLE LEAD	$46,603	$37,282	—	—	2
J9348	Naxitamab-gqgk IV Soln 40 MG/10ML (4 MG/ML)	$44,097	$35,278	—	—	2
0571T	INSJ/RPLCMT ICDS W/SUBSTERNAL ELECTRODE	$43,924	$35,139	—	—	2
C1735	CATH RDN SYMPLICITY SPYRAL 4FR	$43,700	$34,960	—	—	2
C9767	REVASC LITHOTRIP-STENT-ATHER	$43,460	$34,768	—	—	2
37294	SURG 37294 REVSC EVASC TPVT ST ATHRC UNI CPLX LES 1ST VSL	$42,821	$34,257	—	—	2
37277	SURG 37277 REVSC EVASC FPVT ST ATHRC UNI CPLX LES 1ST VSL	$42,577	$34,062	—	—	2
93653	COMPRE EP EVAL ABLTJ 3D MAPG TX SVT	$40,064	$32,051	—	—	2
33240	INSERT DEFIB GENERATOR W EXIST SNGLE LEAD	$39,927	$31,942	—	—	2
37292	SURG 37292 REVSC EVASC TPVT ST ATHRC UNI SF LES 1ST VSL	$39,821	$31,857	—	—	2
C1882	CRT-D UNIFY ASSURA DF4	$39,615	$31,692	—	—	2
37275	SURG 37275 REVSC EVASC FPVT ST ATHRC UNI SF LES 1ST VSL	$39,577	$31,662	—	—	2
93654	COMPRE EP EVAL ABLTJ 3D MAPG TX VT	$38,838	$31,070	—	—	2
33230	INSERT DEFIB GENERATOR W EXIST DUAL LEADS	$38,797	$31,038	—	—	2
93656	COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION	$37,967	$30,374	—	—	2
37290	SURG 37290 REVSC EVASC TPVT ATHRC UNI CPLX LES 1ST VSL	$35,150	$28,120	—	—	2
C9797	VASC EMB OR OCC W PRS CATH INCL IMAGING	$34,417	$27,534	—	—	2
0569T	SURG 0569T TRANSCATH TRICUSPID VALVE RPR PERQ INIT PROSTH	$33,990	$27,192	—	—	2
34843	SURG 34843 ENDOVASC VISCER AORTA REPAIR FENEST 3 ENDOGRAFT	$33,876	$27,101	—	—	2
C9765	REVASC INTRA LITHOTRIP-STENT	$33,649	$26,919	—	—	2
C9766	REVASC INTRA LITHOTRIP-ATHER	$33,557	$26,846	—	—	2

Showing top 50 of 4,798 priced procedures, sorted by gross charge.

Data straight from this hospital's federally-mandated machine-readable file (45 CFR § 180). The compliance grade reflects how completely the hospital published the six required data elements, not the quality of care.