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 |
|---|---|---|---|---|
| Laser surgery of prostate CPT 52647 | not published | not published | $5,337.80 – $5,337.80 | 1 |
| Laser surgery of prostate CPT 52648 | not published | not published | $5,337.80 – $5,337.80 | 1 |
| Laser surg penis lesion(s) CPT 54057 | not published | not published | $1,920.69 – $1,920.69 | 1 |
| Laser treatment of retina CPT 67039 | not published | not published | $4,224.00 – $4,224.00 | 1 |
| Laser treatment of retina CPT 67040 | not published | not published | $4,224.00 – $4,224.00 | 1 |
| Lateral canthopexy CPT 21282 | not published | not published | $3,405.22 – $3,405.22 | 1 |
| Lat retinacular release open CPT 27425 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Lavage cannulation maxillary sinus CPT 31000 | not published | not published | $243.83 – $243.83 | 1 |
| Lavh >250 gms 58553 CPT 58553 | not published | not published | $10,931.77 – $10,931.77 | 1 |
| Lb with mastopexy 15839 CPT 15839 | not published | not published | $3,005.15 – $3,005.15 | 1 |
| Lead capillary CPT 83655 | $128.80 | $161.00 | $7.99 – $29.70 | 16 |
| Lefort i-1 piece without graft CPT 21141 | not published | not published | $6,211.44 – $6,211.44 | 1 |
| Lefort i-2 piece without graft CPT 21142 | not published | not published | $6,211.44 – $6,211.44 | 1 |
| Lefort i-3/> piece without graft CPT 21143 | not published | not published | $6,211.44 – $6,211.44 | 1 |
| Lefort ii anterior intrusion CPT 21150 | not published | not published | $6,211.44 – $6,211.44 | 1 |
| Leg Artery Ultrasound (complete, both legs) CPT 93925 | $1,357.60 | $1,697.00 | $253.81 – $1,527.30 | 16 |
| Leg CT Scan (with contrast, both legs) CPT 73701 | $2,652.80 | $3,316.00 | $186.92 – $2,984.40 | 16 |
| Leg CT Scan (without contrast, both legs) CPT 73700 | $2,307.20 | $2,884.00 | $111.66 – $2,595.60 | 16 |
| Leg vein fusion 34530 CPT 34530 | not published | not published | $3,304.88 – $3,304.88 | 1 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $1,336.80 | $1,671.00 | $253.81 – $1,503.90 | 16 |
| Lengthening of hand tendon CPT 26478 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Lengthening of palate CPT 42227 | not published | not published | $6,211.44 – $6,211.44 | 1 |
| Lengthening of palate+pharyngeal flap 42226 CPT 42226 | not published | not published | $6,211.44 – $6,211.44 | 1 |
| Lengthening of thigh tendon CPT 27393 | not published | not published | $7,500.92 – $7,500.92 | 1 |
| Lengthening of thigh tendons CPT 27394 | not published | not published | $7,500.92 – $7,500.92 | 1 |
| Lengthening of thigh tendons CPT 27395 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Lengthen metacarpal/finger CPT 26568 | not published | not published | $7,500.92 – $7,500.92 | 1 |
| Lengthen radius or ulna CPT 25391 | not published | not published | $13,510.16 – $13,510.16 | 1 |
| Lengthen radius & ulna CPT 25393 | not published | not published | $7,500.92 – $7,500.92 | 1 |
| Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 | $73.72 | $92.15 | $19.37 – $72.01 | 16 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | $4,396.20 | $5,495.25 | $158.84 – $590.49 | 16 |
| Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 | $2,037.62 | $2,547.02 | $616.63 – $2,292.32 | 16 |
| Lev 1 hosp type b ed visit HCPCS G0380 | not published | not published | $88.27 – $88.27 | 1 |
| Lev 2 hosp type b ed visit HCPCS G0381 | not published | not published | $116.19 – $116.19 | 1 |
| Lev 3 hosp type b ed visit HCPCS G0382 | not published | not published | $195.92 – $195.92 | 1 |
| Lev 4 hosp type b ed visit HCPCS G0383 | not published | not published | $299.83 – $299.83 | 1 |
| Lev 5 hosp type b ed visit HCPCS G0384 | not published | not published | $424.08 – $424.08 | 1 |
| Levalbuterol non-comp unit HCPCS J7614 | $6.20 | $7.75 | $1.88 – $6.98 | 16 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $60.98 | $76.22 | $18.45 – $68.60 | 16 |
| Levetiracetam therapeutic drug level CPT 80177 | $160.00 | $200.00 | $48.42 – $180.00 | 16 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $107.46 | $134.32 | $32.52 – $120.89 | 16 |
| L hrt cath chd nm/abn nt cnj CPT 93595 | not published | not published | $3,377.23 – $3,377.23 | 1 |
| Lidocaine (pf) 10 mg/ml (1 %) injection solution HCPCS J2003 | $60.25 | $75.31 | $6.40 – $23.81 | 16 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | $108.18 | $135.22 | $32.74 – $121.70 | 16 |
| Ligate leg veins open CPT 37761 | not published | not published | $3,304.88 – $3,304.88 | 1 |
| Ligate leg veins radical 37760 CPT 37760 | $6,402.40 | $8,003.00 | $1,937.53 – $7,202.70 | 16 |
| Ligate/strip long leg vein CPT 37722 | not published | not published | $3,304.88 – $3,304.88 | 1 |
| Ligate/strip short leg vein CPT 37718 | not published | not published | $3,304.88 – $3,304.88 | 1 |
| Ligate/transect fallopian tubes 58600 CPT 58600 | not published | not published | $3,338.51 – $3,338.51 | 1 |
| Ligation/biopsy of temporal artery 37609 CPT 37609 | not published | not published | $1,701.25 – $1,701.25 | 1 |
| Ligation/divis of long saph vein 37700 CPT 37700 | $6,522.40 | $8,153.00 | $1,973.84 – $7,337.70 | 16 |
| Ligation external carotid artery 37600 CPT 37600 | not published | not published | $3,304.88 – $3,304.88 | 1 |
| Ligation internal/common carotid artery 37605 CPT 37605 | not published | not published | $3,304.88 – $3,304.88 | 1 |
| Ligation internal jugular vein 37565 CPT 37565 | not published | not published | $3,304.88 – $3,304.88 | 1 |
| Ligation major artery neck CPT 37615 | not published | not published | $3,304.88 – $3,304.88 | 1 |
| Ligation nasal sinus artery CPT 30915 | not published | not published | $3,304.88 – $3,304.88 | 1 |
| Ligation of femoral vein CPT 37650 | not published | not published | $3,304.88 – $3,304.88 | 1 |
| Ligation of inf vena cava CPT 37619 | not published | not published | $5,675.99 – $5,675.99 | 1 |
| Ligation of neck artery CPT 37606 | not published | not published | $3,304.88 – $3,304.88 | 1 |
| Ligation of salivary duct CPT 42665 | not published | not published | $3,405.22 – $3,405.22 | 1 |
| Ligation upper jaw artery CPT 30920 | not published | not published | $3,304.88 – $3,304.88 | 1 |
| Ligation vericose vein cluster(s) 1 leg CPT 37785 | $5,698.40 | $7,123.00 | $1,724.48 – $6,410.70 | 16 |
| Lig/band angioaccess av fistula CPT 37607 | not published | not published | $3,304.88 – $3,304.88 | 1 |
| Lig&div&compl strpg saph vn CPT 37735 | not published | not published | $3,304.88 – $3,304.88 | 1 |
| Limb exercise test CPT 95875 | not published | not published | $164.28 – $164.28 | 1 |
| Limited visual field xm CPT 92081 | not published | not published | $62.37 – $62.37 | 1 |
| Lincomycin injection HCPCS J2010 | $69.15 | $86.43 | $20.92 – $77.79 | 16 |
| Lipase CPT 83690 | $208.00 | $260.00 | $62.95 – $234.00 | 16 |
| Lip exc/transverse wedge/w closure 40510 CPT 40510 | not published | not published | $3,405.22 – $3,405.22 | 1 |
| Lipoprotein direct measurement hdl CPT 83718 | $85.60 | $107.00 | $25.90 – $96.30 | 16 |
| Lipoprotein direct measurement ldl CPT 83721 | $112.00 | $140.00 | $33.89 – $126.00 | 16 |
| Lip surgery procedure CPT 40799 | not published | not published | $243.83 – $243.83 | 1 |
| Lithium therapeutic drug level CPT 80178 | $84.80 | $106.00 | $25.66 – $95.40 | 16 |
| Liver elastography 91200 CPT 91200 | not published | not published | $164.28 – $164.28 | 1 |
| Liver Function Test CPT 80076 | $175.20 | $219.00 | $53.02 – $197.10 | 16 |
| Liver imaging CPT 78201 | $1,852.80 | $2,316.00 | $560.70 – $2,084.40 | 16 |
| Liver imag w/vasclr flow CPT 78202 | $1,864.80 | $2,331.00 | $564.34 – $2,097.90 | 16 |
| Liver/spleen imag static only CPT 78215 | $1,676.00 | $2,095.00 | $421.92 – $1,885.50 | 16 |
| Liver/spleen imag w/vasclr flow CPT 78216 | $1,992.80 | $2,491.00 | $421.92 – $2,241.90 | 16 |
| Lmtd oph exam general anes CPT 92019 | not published | not published | $2,449.61 – $2,449.61 | 1 |
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $20.00 | $25.00 | $6.05 – $22.50 | 16 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $61.44 | $76.79 | $18.37 – $68.29 | 16 |
| Loudness balance test CPT 92562 | not published | not published | $326.96 – $326.96 | 1 |
| Low back disk surgery CPT 63030 | not published | not published | $7,500.92 – $7,500.92 | 1 |
| Low-Dose Lung Cancer Screening CT Scan CPT 71271 | not published | not published | $111.66 – $111.66 | 1 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | not published | not published | $186.92 – $446.60 | 2 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $2,769.60 | $3,462.00 | $374.99 – $3,115.80 | 16 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $2,592.00 | $3,240.00 | $111.66 – $2,916.00 | 16 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $4,399.20 | $5,499.00 | $374.99 – $4,949.10 | 16 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $3,508.00 | $4,385.00 | $374.99 – $3,946.50 | 16 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $3,189.60 | $3,987.00 | $253.81 – $3,588.30 | 16 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $501.60 | $627.00 | $111.66 – $564.30 | 16 |
| Lower Back (Lumbar Spine) X-ray (4 or more views) CPT 72110 | $710.40 | $888.00 | $111.66 – $799.20 | 16 |
| Lower Back (Lumbar Spine) X-ray (with bending views) CPT 72114 | $756.00 | $945.00 | $111.66 – $850.50 | 16 |
| Lower jaw bone graft CPT 21215 | not published | not published | $6,211.44 – $6,211.44 | 1 |
| Lower Leg (Shin) X-ray (both sides) CPT 73590 | $456.00 | $570.00 | $92.45 – $513.00 | 16 |
| Lsh uterus 250 g or less CPT 58541 | not published | not published | $10,931.77 – $10,931.77 | 1 |
| Lsh uterus above 250 g CPT 58543 | not published | not published | $10,931.77 – $10,931.77 | 1 |
| Lsh w/t/o ut 250 g or less CPT 58542 | not published | not published | $10,931.77 – $10,931.77 | 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.