Fomepizole 1 gram/ml intravenous solution at Sanford Westbrook Hospital

920 Bell Ave, Westbrook, MN · Sanford Health · · NPI 1942253547

Source: hospital's published price file ↗ · Published Mar 4, 2026 · Ingested Aug 12, 2026

$871.20

Cash price

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Discounted cash price

What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge.

Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.

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What you pay up front if you don't use insurance.

$1,089.00

Gross charge

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Gross charge (chargemaster price)

The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this.

Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.

Full explanation →

The hospital's undiscounted list price — almost no one pays this.

$263.65 with Blue Cross Blue Shield of Minnesota vs $1,023.66 with Medica — same scan, same building. Share

Negotiated rates by payer
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Negotiated rate

The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.

Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.

Full explanation →

Payer
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Payer

The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on.

Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509.

Full explanation →
Plan
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Plan

The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates.

Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible.

Full explanation →
Negotiated rate vs. cash
Blue Cross Blue Shield of Minnesota PMAP $263.65 ↓ -70%
Sanford Health Plan Align Medicare Replacement $466.09 ↓ -47%
Ucare Medicare Replacement $499.85 ↓ -43%
Wellmark SD Medicare Replacement $499.85 ↓ -43%
Aetna Medicare Replacement $505.30 ↓ -42%
United Healthcare Medicare Replacement $505.30 ↓ -42%
Health Partners Medicare Replacement $505.30 ↓ -42%
Great Plains Medicare Advantage Medicare Replacement $505.30 ↓ -42%
Primewest Medicare Replacement $514.55 ↓ -41%
Primewest Medicaid Managed Care $551.03 ↓ -37%
Security Health Plan Commercial $598.95 ↓ -31%
Health Partners State Employees $750.32 ↓ -14%
Sanford Health Plan SD Exchange True $859.66 ↓ -1%
Sanford Health Plan Group Health/True $859.66 ↓ -1%
Health Partners Commercial $871.20 ↑ +0%
Blue Cross Blue Shield of Minnesota State Employees $890.80 ↑ +2%
United Healthcare Commercial + Top 20 $909.32 ↑ +4%
Aetna Commercial $946.34 ↑ +9%
Ucare Commercial $956.80 ↑ +10%
Medica Choice $957.23 ↑ +10%
Healthez Commercial $980.10 ↑ +13%
Cigna Commercial $980.10 ↑ +13%
Multiplan Commercial $980.10 ↑ +13%
First Choice Health Network Commercial $980.10 ↑ +13%
Blue Cross Blue Shield of Minnesota Commercial/Federal $1,007.54 ↑ +16%
Sanford Health Plan SD Exchange Commercial $1,011.35 ↑ +16%
Sanford Health Plan Commercial/ND Pers $1,011.35 ↑ +16%
Medica Elect $1,023.66 ↑ +18%
Ucare Medicaid Managed Care not published by hospital —

Visitor-reported prices

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Fomepizole 1 gram/ml intravenous solution at other Minnesota hospitals

Hospital City Cash price Negotiated range
Sanford Luverne Medical Center Luverne $974.40 $268.00 – $996.30
Sanford Bemidji Medical Center Bemidji $1,658.51 $5.96 – $660.38
Sanford Worthington Medical Center Worthington $1,526.40 $5.96 – $745.20
Sanford Tracy Hospital Tracy $804.56 $243.48 – $905.13
Sanford Thief River Falls Medical Center Thief River Falls $1,594.03 $655.06 – $1,716.33
Sanford Behavioral Health Thief River Falls Thief River Falls $1,594.03 $655.06 – $1,716.33
United Hospital MN | 1175 Nininger Road. Hastings $1,503.13 $6.11 – $20.92
Owatonna Hospital Owatonna $1,924.23 $6.11 – $1,295.08

All Minnesota hospitals for this procedure →