Fairmont 56031-4575
1 known revision on file.
| Revision date | Added | Payer-specific rates |
|---|---|---|
| Mar 31, 2026 | Oct 24, 2026 | Yes |
Search by billing code or procedure name (CPT, HCPCS, MS-DRG and more) to see Mayo Clinic Health System’s price for it.
The codes Mayo Clinic Health System has the most pricing samples for.
| Procedure | |||||||
|---|---|---|---|---|---|---|---|
| Iodixanol contrast injection, 320 mg/mLHCPCS Q9967 | $40 | $59 | $44 | 76% | 43,269–43,278 | $0 | $199 |
| Blood draw from a veinCPT 36415 | $34 | $33 | $10 | 31% | 4,352–4,568 | $7 | $235 |
| Human albumin 25% injectionHCPCS P9047 | $234 | $226 | $31 | 14% | 2,000 | $51 | $247 |
| Complete blood count with automated differentialCPT 85025 | $67 | $65 | $11 | 17% | 1,020–1,119 | $7 | $71 |
| Comprehensive metabolic blood panelCPT 80053 | $101 | $97 | $17 | 17% | 995–1,103 | $9 | $106 |
| Sodium chloride (saline) IV solutionHCPCS J7050 | $76 | $74 | $10 | 13% | 1,000 | $1 | $82 |
| Pembrolizumab injection, per 1 mgHCPCS J9271 | $16.3k | $15.3k | $3.5k | 23% | 856 | $60 | $16.7k |
| Hemoglobin A1c blood testCPT 83036 | $29 | $49 | $23 | 47% | 602–728 | $6 | $76 |
| Additional IV push of new drugCPT 96375 | $129 | $122 | $23 | 19% | 606–642 | $11 | $136 |
| Observation care, per hourHCPCS G0378 | $83 | $90 | $12 | 13% | 525–705 | $18 | $106 |
EIN: 410760836
Last updated: Mar 31, 2026
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Hospital ID: 129d9e7bd2a26a73952718cecf3c0777b224906d76ef0b4fa5c71fbd2a432c03