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 |
|---|---|---|---|---|
| Ghs st - eval for alt comm CPT 92567 | not published | not published | $41.21 – $41.21 | 1 |
| Ghs strapping shoulder - 29240 CPT 29240 | not published | not published | $135.35 – $135.35 | 1 |
| Ghs subcutaneous infus, for therapy ea. add. hr CPT 96370 | $157.60 | $197.00 | $38.40 – $177.30 | 16 |
| Ghs subcutaneous infus. for therapy init 1 hr CPT 96369 | $193.60 | $242.00 | $58.59 – $217.80 | 16 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $1,568.80 | $1,961.00 | $474.76 – $1,764.90 | 16 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | not published | not published | $419.51 – $419.51 | 1 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | $2,568.80 | $3,211.00 | $777.38 – $2,889.90 | 16 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $524.80 | $656.00 | $158.82 – $590.40 | 16 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | not published | not published | $251.87 – $251.87 | 1 |
| Ghs urine, porphyrins quant CPT 84120 | $50.40 | $63.00 | $15.25 – $56.70 | 16 |
| Ghs vaginal delivery only CPT 59409 | $3,528.00 | $4,410.00 | $1,067.66 – $3,969.00 | 16 |
| Ghs veeg 12-26 hr intmt mont CPT 95715 | not published | not published | $557.13 – $557.13 | 1 |
| Ghs windowing of cast CPT 29730 | not published | not published | $165.68 – $165.68 | 1 |
| Giardia lamblia antibody CPT 86674 | $260.00 | $325.00 | $78.68 – $292.50 | 16 |
| Gi endoscopic ultrasound CPT 76975 | not published | not published | $253.81 – $253.81 | 1 |
| Gi inhouse confirmation CPT 87045 | $54.40 | $68.00 | $15.98 – $59.40 | 16 |
| Gingivoplasty each quadrant CPT 41872 | not published | not published | $3,405.22 – $3,405.22 | 1 |
| Gi protein loss CPT 78282 | not published | not published | $421.92 – $421.92 | 1 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | not published | not published | $984.44 – $984.44 | 1 |
| Gi trc img intral colon i&r CPT 91113 | not published | not published | $957.30 – $957.30 | 1 |
| Gi trc img intral esophagus CPT 91111 | not published | not published | $984.44 – $984.44 | 1 |
| Glassia injection HCPCS J0257 | not published | not published | $5.66 – $5.66 | 1 |
| Glaucoma scrn hgh risk direc HCPCS G0117 | not published | not published | $25.71 – $25.71 | 1 |
| Glaucoma scrn hgh risk direc HCPCS G0118 | not published | not published | $41.21 – $41.21 | 1 |
| Glaucoma surgery CPT 66150 | not published | not published | $4,224.00 – $4,224.00 | 1 |
| Glaucoma surgery CPT 66155 | not published | not published | $4,224.00 – $4,224.00 | 1 |
| Glaucoma surgery CPT 66160 | not published | not published | $2,394.77 – $2,394.77 | 1 |
| Glaucoma surgery CPT 66170 | not published | not published | $2,394.77 – $2,394.77 | 1 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $517.27 | $646.58 | $95.87 – $356.40 | 16 |
| Glucagon plasma - sendout CPT 82943 | $48.80 | $61.00 | $14.77 – $54.90 | 16 |
| Glucose 1 hr post dose CPT 82950 | $101.60 | $127.00 | $30.75 – $114.30 | 16 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $28.80 | $36.00 | $8.72 – $32.40 | 16 |
| Glucose blood quantitative CPT 82947 | $52.80 | $66.00 | $15.98 – $59.40 | 16 |
| Glucose body fluid CPT 82945 | $80.80 | $101.00 | $24.45 – $90.90 | 16 |
| Glucose monitoring continual min 72hr pt CPT 95249 | not published | not published | $62.37 – $62.37 | 1 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $232.00 | $290.00 | $70.21 – $261.00 | 16 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $50.40 | $63.00 | $15.25 – $56.70 | 16 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | $60.95 | $76.18 | $18.26 – $67.88 | 16 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | not published | not published | $11.33 – $11.33 | 1 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $247.20 | $309.00 | $16.46 – $61.20 | 16 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $243.20 | $304.00 | $17.67 – $65.70 | 16 |
| Gonioscopy CPT 92020 | not published | not published | $135.35 – $135.35 | 1 |
| Goniotomy CPT 65820 | not published | not published | $4,224.00 – $4,224.00 | 1 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | $3,109.20 | $3,886.50 | $370.55 – $1,377.51 | 16 |
| Graft axiofill 1000mg HCPCS J3590 | $2,933.93 | $3,667.41 | $887.88 – $3,300.67 | 16 |
| Graft hand or finger tendon CPT 26416 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $1,171.20 | $1,464.00 | $27.84 – $103.50 | 16 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $344.00 | $430.00 | $82.31 – $306.00 | 16 |
| Great toe with reduction 28495 CPT 28495 | $520.00 | $650.00 | $157.37 – $585.00 | 16 |
| Grfg autol fat lipo 25 cc/< CPT 15773 | not published | not published | $1,920.69 – $1,920.69 | 1 |
| Grfg autol fat lipo 50 cc/< CPT 15771 | not published | not published | $3,844.02 – $3,844.02 | 1 |
| Grfg autol soft tiss dir exc CPT 15769 | not published | not published | $3,844.02 – $3,844.02 | 1 |
| Group train without patient HCPCS G0543 | $54.40 | $68.00 | $16.46 – $61.20 | 16 |
| Gstrst open wo constj tube CPT 43830 | not published | not published | $1,991.84 – $1,991.84 | 1 |
| G-tube reposition CPT 43761 | not published | not published | $255.37 – $255.37 | 1 |
| Gu dilat ureter/urethra s&i CPT 74485 | not published | not published | $2,150.94 – $2,150.94 | 1 |
| Guided cath fluid drainage 10030 CPT 10030 | not published | not published | $738.77 – $738.77 | 1 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $612.80 | $766.00 | $27.12 – $100.80 | 16 |
| Gum graft CPT 41870 | not published | not published | $1,555.34 – $1,555.34 | 1 |
| Gw stiffened micro access kit HCPCS C1894 | $104.80 | $131.00 | $21.55 – $80.10 | 16 |
| Gynecomastia (males) 19300 CPT 19300 | not published | not published | $4,020.74 – $4,020.74 | 1 |
| Hair removal by electrolysis 17380 CPT 17380 | not published | not published | $642.74 – $642.74 | 1 |
| Hair trnspl 1-15 punch grfts CPT 15775 | not published | not published | $419.51 – $419.51 | 1 |
| Hair trnspl >15 punch grafts CPT 15776 | not published | not published | $419.51 – $419.51 | 1 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $63.72 | $79.64 | $18.30 – $68.01 | 16 |
| Hands-On Manual Therapy (each 15 minutes) CPT 97140 | $128.00 | $160.00 | $63.25 – $144.00 | 16 |
| Hand tendon/muscle transfer CPT 26494 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Hand tendon reconstruction CPT 26500 | not published | not published | $7,500.92 – $7,500.92 | 1 |
| Hand tendon reconstruction CPT 26502 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Hand X-ray CPT 73130 | $429.60 | $537.00 | $92.45 – $483.30 | 16 |
| Hand X-ray (2 views, both hands) CPT 73120 | $368.00 | $460.00 | $111.37 – $414.00 | 16 |
| Haptoglobin quantitative CPT 83010 | $143.20 | $179.00 | $43.34 – $161.10 | 16 |
| Harvest auto stem cells CPT 38206 | not published | not published | $1,721.24 – $1,721.24 | 1 |
| Harvest cultured skin graft 15040 CPT 15040 | not published | not published | $1,920.69 – $1,920.69 | 1 |
| Harvest eye tissue alograft CPT 68371 | not published | not published | $2,449.61 – $2,449.61 | 1 |
| Harvest stem cell concentrte CPT 38215 | not published | not published | $459.04 – $459.04 | 1 |
| Hast w/i&r phys/qhp CPT 94452 | not published | not published | $135.35 – $135.35 | 1 |
| Hast w/oxygen titrate CPT 94453 | not published | not published | $135.35 – $135.35 | 1 |
| Hbot, full body chamber, 30m HCPCS G0277 | not published | not published | $144.80 – $144.80 | 1 |
| Hc fl sm bowel enteroclss tube w kub double contrast CPT 74251 | not published | not published | $186.92 – $186.92 | 1 |
| Hcg qualitative CPT 84703 | $85.60 | $107.00 | $25.90 – $96.30 | 16 |
| Hcg quantitative CPT 84702 | $191.20 | $239.00 | $57.86 – $215.10 | 16 |
| Hc metata joint dislocation anes CPT 28635 | not published | not published | $1,680.43 – $1,680.43 | 1 |
| Hc mohs micrographic h/n/h/f/g 1st stage 5 blocks CPT 17311 | not published | not published | $642.74 – $642.74 | 1 |
| Hc mohs trunk/arm/leg 1st stage 5 blocks CPT 17313 | not published | not published | $642.74 – $642.74 | 1 |
| Hc nm cardiac blood pool planar 1 stdy wal motn eject fract CPT 78481 | not published | not published | $565.18 – $565.18 | 1 |
| Hc nm fusion spect CT unlisted CPT 78999 | not published | not published | $421.92 – $421.92 | 1 |
| Hc nm kidney imaging with flow CPT 78701 | not published | not published | $421.92 – $421.92 | 1 |
| Hc nm myocard infarct avid plnr tomo spect w/wo quant CPT 78469 | not published | not published | $565.18 – $565.18 | 1 |
| Hc pet myocardial imaging metabolic eval single study CPT 78459 | not published | not published | $1,370.75 – $1,370.75 | 1 |
| Hdr rdncl ntrstl/icav brchtx CPT 77770 | not published | not published | $728.50 – $728.50 | 1 |
| Hdr rdncl ntrstl/icav brchtx CPT 77771 | not published | not published | $728.50 – $728.50 | 1 |
| Hdr rdncl ntrstl/icav brchtx CPT 77772 | not published | not published | $728.50 – $728.50 | 1 |
| Hdr rdncl skn surf brachytx CPT 77767 | not published | not published | $276.13 – $276.13 | 1 |
| Hdr rdncl skn surf brachytx CPT 77768 | not published | not published | $276.13 – $276.13 | 1 |
| Head CT scan (with and without contrast) CPT 70470 | $2,852.00 | $3,565.00 | $186.92 – $3,208.50 | 16 |
| Head CT scan (with contrast) CPT 70460 | $2,716.80 | $3,396.00 | $186.92 – $3,056.40 | 16 |
| Head CT scan (without contrast) CPT 70450 | $2,126.40 | $2,658.00 | $111.66 – $2,392.20 | 16 |
| Heart first pass multiple CPT 78483 | not published | not published | $565.18 – $565.18 | 1 |
| Heart image spect CPT 78494 | not published | not published | $421.92 – $421.92 | 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.