SAKAKAWEA MEDICAL CENTER - CAH

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
Blood Infection with major complications	Blood Infection with major complications	$27,837	$27,837	—	—	1
Major small & large bowel procedures without com	Major small & large bowel procedures without complications	$20,709	$20,709	—	—	1
4903651	HC RPR AA HERNIA RECR 3-10 CM NCRC8/STRANGULATED	$18,170	$18,170	—	—	1
4903392	HC REPAIR HERNIA W/ENDOSCOPE	$18,170	$18,170	—	—	1
4903621	HC RPR AA HERNIA 1ST < 3 CM NCRC8/STRANGULATED	$18,170	$18,170	—	—	2
4903623	HC RPR AA HERNIA 1ST 3-10 CM NCRC8/STRANGULATED	$18,170	$18,170	—	—	2
4902031	HC LAPAROSCOPY,FUNDOPLASTY	$18,170	$18,170	—	—	4
4902403	HC LAP PARAESOPHAG HERN REPAIR	$18,170	$18,170	—	—	4
4903620	HC RPR AA HERNIA 1ST < 3 CM REDUCIBLE	$18,170	$18,170	—	—	4
4903622	HC RPR AA HERNIA 1ST 3-10 CM REDUCIBLE	$18,170	$18,170	—	—	2
Head trauma w coma >1 hr or hemorrhage [Moderate	Head trauma w coma >1 hr or hemorrhage [Moderate Severity]	$16,827	$16,827	—	—	1
4902570	HC TLH W/T/O UTERUS 250G OR <	$16,788	$16,788	—	—	3
4902492	HC TLH UTERUS 250G OR LESS	$16,788	$16,788	—	—	1
28530	Tenecteplase For IV Soln Kit 50 MG	$16,237	$16,237	—	—	5
600949	Tenecteplase For IV Soln Kit 50 MG	$16,237	$16,237	—	—	5
600948	Tenecteplase For IV Soln Kit 50 MG	$14,093	$14,093	—	—	10
4905040	HC VAG HYST > 250 GM RMVL TUBE&/OVARY W/RPR ENTRCLE	$12,805	$12,805	—	—	1
Pneumonia with major complications	Pneumonia with major complications	$12,323	$12,323	—	—	1
Respiratory infections and inflammations with ma	Respiratory infections and inflammations with major complications	$12,015	$12,015	—	—	1
Kidney failure with major complications	Kidney failure with major complications	$11,680	$11,680	—	—	1
Osteomyelitis with complications	Osteomyelitis with complications	$11,473	$11,473	—	—	1
4902106	HC LAPAROSCOPY/APPENDECTOMY	$10,322	$10,322	—	—	2
4902216	HC LAPAROSCOPIC CHOLECYSTECTOMY	$10,322	$10,322	—	—	6
4902242	HC LAPARO PROC,ABD/PER/OMENT	$10,322	$10,322	—	—	1
4902217	HC LAPARO CHOLECYSTECTOMY/GRAPH	$10,322	$10,322	—	—	3
4902237	HC DIAG LAPARO SEPARATE PROC	$10,322	$10,322	—	—	2
4902239	HC LAPAROSCOPY W/ASPIRATION	$10,322	$10,322	—	—	1
4901577	HC LAPAROSCOPY,REMOVE ADNEXA	$9,537	$9,537	—	—	2
4901569	HC LAPAROSCOPIC MYOMECTOMY	$9,537	$9,537	—	—	1
4901578	HC LAPAROSCOPY,EXCISE LESIONS	$9,537	$9,537	—	—	2
4901579	HC LAPAROSCOPY,TUBAL CAUTERY	$9,537	$9,537	—	—	1
21108	Leuprolide Acetate (4 Month) For Inj Kit 30 MG	$9,415	$9,415	—	—	3
Stomach Disorder without complications	Stomach Disorder without complications	$9,301	$9,301	—	—	1
133089	Pegfilgrastim Soln Prefilled Syringe 6 MG/0.6ML	$8,460	$8,460	—	—	4
4901532	HC REPAIR OF RECTUM/VAGINA	$8,310	$8,310	—	—	2
4901533	HC COMBINED ANT/POST COLPORRHAPHY	$8,310	$8,310	—	—	2
4902651	HC HYSTEROSCOPY RESECT SEPTUM	$8,310	$8,310	—	—	1
4901573	HC HYSTEROSCOPY,REMOVE MYOMA	$8,310	$8,310	—	—	1
4901574	HC HYSTEROSCOPY,ABLATION	$8,310	$8,310	—	—	1
4901531	HC REPAIR BLADDER/VAGINA	$8,310	$8,310	—	—	1
4902446	HC VAG HYST W/T/O & VAG REPAIR	$8,310	$8,310	—	—	1
163825	Pegfilgrastim Soln Prefill Syr/Infusion Dev 6 MG/0.6ML	$8,298	$8,298	—	—	4
133082	Rituximab IV Soln 500 MG/50ML	$7,753	$7,753	—	—	1
21045	Leuprolide Acetate (3 Month) For Inj Kit 22.5 MG	$7,062	$7,062	—	—	3
153134	Tezepelumab-ekko Subcutaneous Soln Pref Syr 210 MG/1.91ML	$6,867	$6,867	—	—	1
4902263	HC RPR INITIAL HERNIA >5 YRS REDUC	$6,494	$6,494	—	—	6
4902265	HC RPR INGUINAL HERNIA,REDUCE	$6,494	$6,494	—	—	1
4902226	HC PLMT PORTA CATH >5 YR OLD	$6,155	$6,155	—	—	1
4900274	HC REMOVE BREAST LESION	$5,951	$5,951	—	—	2
4901322	HC BX/REMV,LYMPH NODE,DEEP CERV	$5,811	$5,811	—	—	1

Showing top 50 of 1,222 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.