Sanford Westbrook Hospital
920 Bell Ave, Westbrook, MN · Sanford Health · · NPI 1942253547
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Destroy cervthor facet jnt 64633 CPT 64633 | not published | not published | $2,050.41 – $2,050.41 | 1 |
| Destroy internal hemorrhoids destroy 46930 CPT 46930 | not published | not published | $1,238.03 – $1,238.03 | 1 |
| Destroy premlg lesns;1st lesn 17000 CPT 17000 | not published | not published | $208.64 – $208.64 | 1 |
| Destroy vulva lesion extensive 56515 CPT 56515 | not published | not published | $1,920.69 – $1,920.69 | 1 |
| Destroy vulva lesion simple 56501 CPT 56501 | not published | not published | $1,920.69 – $1,920.69 | 1 |
| Destruct ben lesion 15/> 17111 CPT 17111 | not published | not published | $208.64 – $208.64 | 1 |
| Destruct cut vasl lesions 10-50cm 17107 CPT 17107 | not published | not published | $642.74 – $642.74 | 1 |
| Destruct cut vasl lesions <10cm 17106 CPT 17106 | not published | not published | $419.51 – $419.51 | 1 |
| Destruct cut vasl lesions >50cm 17108 CPT 17108 | not published | not published | $1,920.69 – $1,920.69 | 1 |
| Destruction anal lesion(s) CPT 46910 | not published | not published | $1,920.69 – $1,920.69 | 1 |
| Destruction anal lesion(s) CPT 46924 | not published | not published | $2,879.51 – $2,879.51 | 1 |
| Destruction anal lesion(s) smpl chem 46900 CPT 46900 | not published | not published | $419.51 – $419.51 | 1 |
| Destruction benign lesions < 14 lesions CPT 17110 | $248.80 | $311.00 | $75.29 – $279.90 | 16 |
| Destruction by injection tx of nerve 64630 CPT 64630 | not published | not published | $934.80 – $934.80 | 1 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides) CPT 64635 | not published | not published | $2,050.41 – $2,050.41 | 1 |
| Destruction ciliary body CPT 66700 | not published | not published | $2,394.77 – $2,394.77 | 1 |
| Destruction ciliary body CPT 66720 | not published | not published | $2,449.61 – $2,449.61 | 1 |
| Destruction ciliary body CPT 66740 | not published | not published | $2,449.61 – $2,449.61 | 1 |
| Destruction cryosurgery anal lesion(s) simpl 46916 CPT 46916 | not published | not published | $208.64 – $208.64 | 1 |
| Destruction laser surgery anal lesions 46917 CPT 46917 | not published | not published | $2,879.51 – $2,879.51 | 1 |
| Destruction les conjunctiva CPT 68135 | not published | not published | $2,449.61 – $2,449.61 | 1 |
| Destruction mal lsn s/n/h/f/g 2.1-3cm CPT 17273 | not published | not published | $419.51 – $419.51 | 1 |
| Destruction mal lsn s/n/h/f/g 3.1-4cm CPT 17274 | not published | not published | $419.51 – $419.51 | 1 |
| Destruction mal lsn t/a/l 3.1-4cm CPT 17264 | not published | not published | $419.51 – $419.51 | 1 |
| Destruction mal lsn t/a/l >4cm CPT 17266 | not published | not published | $419.51 – $419.51 | 1 |
| Destruction penis lesion(s) chem 54050 CPT 54050 | not published | not published | $419.51 – $419.51 | 1 |
| Destruction penis lesion(s) exten 54065 CPT 54065 | not published | not published | $1,920.69 – $1,920.69 | 1 |
| Destruction premal lesions 15/> 17004 CPT 17004 | not published | not published | $419.51 – $419.51 | 1 |
| Destruction rectal tumor 45190 CPT 45190 | not published | not published | $2,879.51 – $2,879.51 | 1 |
| Destruction vag lesions complex 57065 CPT 57065 | not published | not published | $3,338.51 – $3,338.51 | 1 |
| Destruction vag lesions simple 57061 CPT 57061 | not published | not published | $3,338.51 – $3,338.51 | 1 |
| Destruct penis les/smp/electrodesi 54055 CPT 54055 | not published | not published | $1,920.69 – $1,920.69 | 1 |
| Devel tst phys/qhp 1st hr CPT 96112 | not published | not published | $164.28 – $164.28 | 1 |
| Devlopment test interpt&rep HCPCS G0451 | not published | not published | $97.13 – $97.13 | 1 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | $425.60 | $532.00 | $92.45 – $478.80 | 16 |
| Dexamethasone 4 mg tablet HCPCS J8540 | $57.82 | $72.27 | $1.52 – $5.64 | 16 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $60.80 | $75.99 | $18.18 – $67.58 | 16 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | $80.00 | $100.00 | $24.21 – $90.00 | 16 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | $80.00 | $100.00 | $18.16 – $67.50 | 16 |
| Dextrose 5 % IV bolus HCPCS J7070 | $80.00 | $100.00 | $24.21 – $90.00 | 16 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $254.40 | $318.00 | $16.22 – $60.30 | 16 |
| Diabetes (HbA1c) Test CPT 83036 | $117.60 | $147.00 | $38.50 – $132.30 | 16 |
| Diabetes training group per 30 min g0109 HCPCS G0136 | not published | not published | $31.28 – $31.28 | 1 |
| Diab manage trn ind/group HCPCS G0109 | $63.20 | $79.00 | $19.13 – $71.10 | 16 |
| Diag bronchoscope/catheter CPT 31643 | not published | not published | $1,810.69 – $1,810.69 | 1 |
| Diag laparo separate proc 49320 CPT 49320 | not published | not published | $6,126.08 – $6,126.08 | 1 |
| Diagnostic anoscopy CPT 46601 | not published | not published | $418.99 – $418.99 | 1 |
| Diagnostic anoscopy & biopsy CPT 46607 | not published | not published | $1,238.03 – $1,238.03 | 1 |
| Diagnostic anoscopy spx 46600 CPT 46600 | not published | not published | $135.35 – $135.35 | 1 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | $172.00 | $215.00 | $52.05 – $193.50 | 16 |
| Diagnostic laryngoscopy 31505 CPT 31505 | not published | not published | $203.85 – $203.85 | 1 |
| Diagnostic laryngoscopy 31575 CPT 31575 | not published | not published | $203.85 – $203.85 | 1 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $487.20 | $609.00 | $147.44 – $548.10 | 16 |
| Diagnostic Mammogram (one breast) CPT 77065 | $444.00 | $555.00 | $134.37 – $499.50 | 16 |
| Diagnostic radio unlisted proc CPT 76499 | not published | not published | $92.45 – $92.45 | 1 |
| Dialysis one evaluation CPT 90945 | not published | not published | $447.11 – $447.11 | 1 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $67.04 | $83.79 | $20.29 – $75.41 | 16 |
| Dicyclomine injection HCPCS J0500 | $74.94 | $93.67 | $22.68 – $84.30 | 16 |
| Diffusing capacity CPT 94729 | $336.80 | $421.00 | $101.92 – $378.90 | 16 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $62.34 | $77.92 | $18.72 – $69.58 | 16 |
| Digoxin total therapeutic drug level CPT 80162 | $130.40 | $163.00 | $39.46 – $146.70 | 16 |
| Dilate esophagus CPT 43453 | $3,694.40 | $4,618.00 | $1,118.02 – $4,156.20 | 16 |
| Dilate esophagus 1/mult pass CPT 43450 | not published | not published | $984.44 – $984.44 | 1 |
| Dilate tear duct opening CPT 68801 | not published | not published | $418.99 – $418.99 | 1 |
| Dilate urethra stricture CPT 53600 | not published | not published | $255.37 – $255.37 | 1 |
| Dilate urethra stricture CPT 53601 | not published | not published | $135.35 – $135.35 | 1 |
| Dilate urethra stricture CPT 53605 | not published | not published | $3,621.42 – $3,621.42 | 1 |
| Dilate urethra stricture CPT 53621 | not published | not published | $255.37 – $255.37 | 1 |
| Dilation/female urethra/initial 53660 CPT 53660 | not published | not published | $164.28 – $164.28 | 1 |
| Dilation of anal sphincter CPT 45905 | not published | not published | $1,238.03 – $1,238.03 | 1 |
| Dilation of cervical canal 57800 CPT 57800 | not published | not published | $3,338.51 – $3,338.51 | 1 |
| Dilation of rectal stricture 45910 CPT 45910 | not published | not published | $1,238.03 – $1,238.03 | 1 |
| Dilation of salivary duct CPT 42660 | not published | not published | $534.71 – $534.71 | 1 |
| Dilation of urethra CPT 53661 | not published | not published | $135.35 – $135.35 | 1 |
| Dilation of urethra CPT 53665 | not published | not published | $2,150.94 – $2,150.94 | 1 |
| Dilation of vagina CPT 57400 | not published | not published | $3,338.51 – $3,338.51 | 1 |
| Dilation salivary duct 42650 CPT 42650 | not published | not published | $1,555.34 – $1,555.34 | 1 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | not published | not published | $700.84 – $700.84 | 1 |
| Dilat xst trc ndurlgc px CPT 50436 | not published | not published | $3,621.42 – $3,621.42 | 1 |
| Dilat xst trc new access rcs CPT 50437 | not published | not published | $3,621.42 – $3,621.42 | 1 |
| Diltiazem 5 mg/ml intravenous solution HCPCS J1163 | $60.66 | $75.82 | $18.30 – $68.01 | 16 |
| Diphenhydramine 12.5 mg/5 ml oral elixir HCPCS Q0163 | $5.10 | $6.37 | $0.36 – $1.35 | 16 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $60.76 | $75.94 | $18.34 – $68.19 | 16 |
| Dir nsl mucous membrane test CPT 95065 | not published | not published | $41.21 – $41.21 | 1 |
| Disability dlco CPT 94727 | $296.80 | $371.00 | $89.82 – $333.90 | 16 |
| Disarticulation sho sec clsr CPT 23921 | not published | not published | $1,920.69 – $1,920.69 | 1 |
| Discography cerv/thor spine CPT 72285 | not published | not published | $2,050.41 – $2,050.41 | 1 |
| Dise eval slp do brth flx dx CPT 42975 | not published | not published | $1,810.69 – $1,810.69 | 1 |
| Dist revas ligation hemo CPT 36838 | not published | not published | $5,675.99 – $5,675.99 | 1 |
| Diverticulectomy/hypophar/esoph 43130 CPT 43130 | not published | not published | $6,211.44 – $6,211.44 | 1 |
| Dna antibody native/double stranded CPT 86225 | $158.40 | $198.00 | $47.94 – $178.20 | 16 |
| Dna probe chlamydia CPT 87490 | $151.20 | $189.00 | $45.76 – $170.10 | 16 |
| Dna probe gc CPT 87590 | $140.00 | $175.00 | $42.37 – $157.50 | 16 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $208.25 | $260.31 | $18.73 – $69.64 | 16 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $132.54 | $165.67 | $18.37 – $68.28 | 16 |
| Doppler echo complete CPT 93320 | $787.20 | $984.00 | $238.23 – $885.60 | 16 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $1,136.80 | $1,421.00 | $164.28 – $1,278.90 | 16 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $771.20 | $964.00 | $135.35 – $793.80 | 16 |
| Dostarlimab-gxly 50 mg/ml intravenous solution HCPCS J9272 | not published | not published | $283.24 – $283.24 | 1 |
| Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension HCPCS Q2050 | not published | not published | $114.74 – $114.74 | 1 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.