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 |
|---|---|---|---|---|
| Frenulotomy of penis CPT 54164 | not published | not published | $2,150.94 – $2,150.94 | 1 |
| Fresh frozen plasma frozen within 8 hours of collection each unit HCPCS P9017 | $313.60 | $392.00 | $94.90 – $352.80 | 16 |
| Fructosamine glycated protein CPT 82985 | $56.00 | $70.00 | $16.95 – $63.00 | 16 |
| Full mouth x-ray of teeth CPT 70320 | not published | not published | $253.81 – $253.81 | 1 |
| Full Spine X-ray (Scoliosis Survey) CPT 72082 | $520.80 | $651.00 | $111.66 – $585.90 | 16 |
| Full thick gft/nose/ear/lid/lip/20sqcm or< 15260 CPT 15260 | not published | not published | $1,920.69 – $1,920.69 | 1 |
| Full thick gft/scalp/arm/leg/20sqcm or< 15220 CPT 15220 | not published | not published | $1,920.69 – $1,920.69 | 1 |
| Full thick gft w/close donor fccmnaghf <=20sqcm 15240 CPT 15240 | not published | not published | $1,920.69 – $1,920.69 | 1 |
| Fundus photography with i&r 92250 CPT 92250 | not published | not published | $135.35 – $135.35 | 1 |
| Furosemide 10 mg/ml injection solution HCPCS J1938 | $60.78 | $75.97 | $0.73 – $2.70 | 16 |
| Fusion/graft of finger joint CPT 26862 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Fusion/graft of hand joint CPT 26844 | not published | not published | $7,500.92 – $7,500.92 | 1 |
| Fusion of ankle joint open CPT 27870 | not published | not published | $13,510.16 – $13,510.16 | 1 |
| Fusion of big toe joint CPT 28750 | $8,581.60 | $10,727.00 | $2,597.01 – $9,654.30 | 16 |
| Fusion of big toe joint CPT 28755 | not published | not published | $7,500.92 – $7,500.92 | 1 |
| Fusion of finger joint CPT 26860 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Fusion of finger tendons CPT 26471 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Fusion of finger tendons CPT 26474 | not published | not published | $1,680.43 – $1,680.43 | 1 |
| Fusion of foot bones CPT 28730 | not published | not published | $13,510.16 – $13,510.16 | 1 |
| Fusion of foot bones CPT 28735 | not published | not published | $13,510.16 – $13,510.16 | 1 |
| Fusion of foot bones CPT 28740 | not published | not published | $7,500.92 – $7,500.92 | 1 |
| Fusion of hand joint CPT 26843 | not published | not published | $7,500.92 – $7,500.92 | 1 |
| Fusion of knuckle CPT 26850 | not published | not published | $7,500.92 – $7,500.92 | 1 |
| Fusion of knuckle joint CPT 26516 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Fusion of knuckle joints CPT 26517 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Fusion of knuckle joints CPT 26518 | not published | not published | $7,500.92 – $7,500.92 | 1 |
| Fusion of knuckle with graft CPT 26852 | not published | not published | $7,500.92 – $7,500.92 | 1 |
| Fusion of spermatic ducts CPT 54900 | not published | not published | $2,150.94 – $2,150.94 | 1 |
| Fusion of spermatic ducts CPT 54901 | not published | not published | $3,621.42 – $3,621.42 | 1 |
| Fusion of tendons at wrist CPT 25300 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Fusion of tendons at wrist CPT 25301 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Fusion of thumb CPT 26841 | not published | not published | $7,500.92 – $7,500.92 | 1 |
| Fusion of tibiofibular joint CPT 27871 | not published | not published | $13,510.16 – $13,510.16 | 1 |
| Fusion of toes CPT 28280 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Gadobutrol 1 mmol/ml intravenous solution (wrapper) HCPCS A9585 | $102.00 | $127.50 | $30.87 – $114.75 | 16 |
| Gallbladder and Bile Duct Scan (HIDA Scan) CPT 78226 | $1,925.60 | $2,407.00 | $421.92 – $2,166.30 | 16 |
| Gallbladder Function Scan (HIDA with Medication) CPT 78227 | $2,131.20 | $2,664.00 | $565.18 – $2,397.60 | 16 |
| Gallbladder Removal (Laparoscopic) CPT 47562 | not published | not published | $6,126.08 – $6,126.08 | 1 |
| Galsulfase injection HCPCS J1458 | not published | not published | $493.88 – $493.88 | 1 |
| Gamma globulin > 10 cc inj HCPCS J1560 | not published | not published | $507.94 – $507.94 | 1 |
| Gamma globulin 1 cc inj HCPCS J1460 | not published | not published | $50.78 – $50.78 | 1 |
| Gammaglobulin iga CPT 82784 | $91.20 | $114.00 | $8.72 – $32.40 | 16 |
| Gammaglobulin ige CPT 82785 | $188.00 | $235.00 | $55.93 – $207.90 | 16 |
| Gamma glutamyltransferase CPT 82977 | $74.40 | $93.00 | $22.52 – $83.70 | 16 |
| Gammaplex injection HCPCS J1557 | not published | not published | $59.03 – $59.03 | 1 |
| Gamunex-c/gammaked HCPCS J1561 | not published | not published | $49.73 – $49.73 | 1 |
| Gastric emptying imag study CPT 78265 | not published | not published | $421.92 – $421.92 | 1 |
| Gastric emptying imag study CPT 78266 | not published | not published | $565.18 – $565.18 | 1 |
| Gastric motility studies CPT 91020 | not published | not published | $557.13 – $557.13 | 1 |
| Gastric mucosa imaging CPT 78261 | not published | not published | $421.92 – $421.92 | 1 |
| Gastroesophageal reflux study CPT 78262 | not published | not published | $421.92 – $421.92 | 1 |
| Gastroesophageal reflux test CPT 91034 | not published | not published | $557.13 – $557.13 | 1 |
| Gastrostomy open neonatal CPT 43831 | not published | not published | $984.44 – $984.44 | 1 |
| Gated heart multiple CPT 78473 | not published | not published | $421.92 – $421.92 | 1 |
| General health panel CPT 80050 | $333.60 | $417.00 | $100.96 – $375.30 | 16 |
| Genioplasty augmentation CPT 21120 | not published | not published | $6,211.44 – $6,211.44 | 1 |
| Geniop sldg augmentation CPT 21123 | not published | not published | $3,405.22 – $3,405.22 | 1 |
| Geniop sldg osteot 1 CPT 21121 | not published | not published | $3,405.22 – $3,405.22 | 1 |
| Geniop sldg osteot 2/> CPT 21122 | not published | not published | $6,211.44 – $6,211.44 | 1 |
| Gentamicin 10 mg/ml liquid compound - enteral use only HCPCS J1580 | $63.08 | $78.84 | $18.56 – $68.99 | 16 |
| Gentamicin peak therapeutic drug level CPT 80170 | $172.00 | $215.00 | $52.05 – $193.50 | 16 |
| G-esoph reflx tst w/electrod CPT 91035 | not published | not published | $557.13 – $557.13 | 1 |
| Ghs abscess perianal iandd CPT 46050 | $1,628.00 | $2,035.00 | $492.67 – $1,831.50 | 16 |
| Ghs abscess postoperative iandd complex CPT 10180 | not published | not published | $3,005.15 – $3,005.15 | 1 |
| Ghs analysis neurostim without reprogramming CPT 95970 | not published | not published | $135.35 – $135.35 | 1 |
| Ghs antibodies (torch) igm CPT 86694 | $352.00 | $440.00 | $106.52 – $396.00 | 16 |
| Ghs aspiration bladder - needle CPT 51100 | not published | not published | $255.37 – $255.37 | 1 |
| Ghs bladder cath - complex-foley CPT 51703 | $340.00 | $425.00 | $102.89 – $382.50 | 16 |
| Ghs block ilioinguinal/gentitofemoral CPT 64425 | not published | not published | $727.15 – $727.15 | 1 |
| Ghs central line insert < age 5, failed CPT 36555 | not published | not published | $3,304.88 – $3,304.88 | 1 |
| Ghs change cysto/gastrost CPT 43762 | not published | not published | $255.37 – $255.37 | 1 |
| Ghs chemo >8 hrs CPT 96416 | $881.60 | $1,102.00 | $266.79 – $991.80 | 16 |
| Ghs chemo infusion >8 hrs CPT 96425 | not published | not published | $348.27 – $407.20 | 2 |
| Ghs chemo IV push, ea addtl CPT 96411 | $355.20 | $444.00 | $74.73 – $399.60 | 16 |
| Ghs closd tx interphalang jt disloc w/ma CPT 26770 | $496.00 | $620.00 | $150.10 – $558.00 | 16 |
| Ghs closed reduction ankle dislocation CPT 27840 | $560.80 | $701.00 | $169.71 – $630.90 | 16 |
| Ghs closed tx bimalleolar fracture w/manip CPT 27810 | $1,122.40 | $1,403.00 | $339.67 – $1,262.70 | 16 |
| Ghs closed tx radiocarpal disloc w manip CPT 25660 | not published | not published | $251.87 – $251.87 | 1 |
| Ghs closed tx tibial fracture w/manip CPT 27752 | $1,490.40 | $1,863.00 | $451.03 – $1,676.70 | 16 |
| Ghs closure surg wound/dehiscence-13160 CPT 13160 | not published | not published | $1,920.69 – $1,920.69 | 1 |
| Ghs clsd red med malleolus fx without manip CPT 27760 | $453.60 | $567.00 | $137.27 – $510.30 | 16 |
| Ghs clsd red med malleolus fx w manip CPT 27762 | not published | not published | $1,680.43 – $1,680.43 | 1 |
| Ghs clsd tx frac distal tibia w/manipulation CPT 27825 | $2,496.00 | $3,120.00 | $755.35 – $2,808.00 | 16 |
| Ghs cl tx knee disl; wo anesth CPT 27550 | $592.80 | $741.00 | $179.40 – $666.90 | 16 |
| Ghs cl tx metacarpophal disloc without anes CPT 26700 | $500.00 | $625.00 | $151.31 – $562.50 | 16 |
| Ghs community re-entry 15 minutes CPT 97537 | $143.20 | $179.00 | $43.34 – $161.10 | 16 |
| Ghs conjunctiva foreign body-embed bil CPT 65210 | not published | not published | $418.99 – $418.99 | 1 |
| Ghs conjunctiva foreign body-superf bil CPT 65205 | $186.40 | $233.00 | $56.41 – $209.70 | 16 |
| Ghs corneal fb without slit lamp bilat CPT 65220 | $399.20 | $499.00 | $120.81 – $449.10 | 16 |
| Ghs corneal fb with slit lamp bilat CPT 65222 | $344.00 | $430.00 | $104.10 – $387.00 | 16 |
| Ghs cricothyroidotomy CPT 31605 | not published | not published | $243.83 – $243.83 | 1 |
| Ghs cutdown placement age 1 and over CPT 36425 | not published | not published | $418.99 – $418.99 | 1 |
| Ghs cutdown placement under 1 yr CPT 36420 | not published | not published | $135.35 – $135.35 | 1 |
| Ghs dislocation elbow closed treatment CPT 24600 | $583.20 | $729.00 | $176.49 – $656.10 | 16 |
| Ghs ed peritoneal lavage w guidance if performed CPT 49084 | not published | not published | $984.44 – $984.44 | 1 |
| Ghs ed rmvl or bivalving cast CPT 29700 | not published | not published | $278.86 – $278.86 | 1 |
| Ghs ed therapeutic lp, drain csf w fluoro CPT 62329 | not published | not published | $727.15 – $727.15 | 1 |
| Ghs eeg cont rec w/video by tec min 8 chnls CPT 95700 | not published | not published | $164.28 – $164.28 | 1 |
| Ghs electrostagmgraphy CPT 92537 | not published | not published | $164.28 – $164.28 | 1 |
| Ghs elect torsion swing CPT 92546 | not published | not published | $164.28 – $164.28 | 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.