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 |
|---|---|---|---|---|
| Mayo immunoassay c1 esterase inhibitor antibody quantitative CPT 83520 | $436.00 | $545.00 | $12.11 – $45.00 | 16 |
| Mayo immunoassay infectious agent antibody quantitative diptheria igg CPT 86317 | $52.80 | $66.00 | $15.98 – $59.40 | 16 |
| Mayo immunoassay tumor antigen quantitative ca 27.29 CPT 86300 | $101.60 | $127.00 | $30.75 – $114.30 | 16 |
| Mayo immunoassay tumor antigen quantitative chromogranin a CPT 86316 | $52.80 | $66.00 | $15.98 – $59.40 | 16 |
| Mayo infectious agent antigen immunoassay direct optical observation cryptococcus CPT 87899 | $188.00 | $235.00 | $31.47 – $117.00 | 16 |
| Mayo infectious agent antigen immunoassay ql/sq multi step aspergillus bal CPT 87305 | $40.80 | $51.00 | $12.35 – $45.90 | 16 |
| Mayo infectious agent nucleic acid amplified probe mycoplasma genitalium urine CPT 87563 | $143.20 | $179.00 | $43.34 – $161.10 | 16 |
| Mayo infectious agent nucleic acid quantification cytomegalovirus CPT 87497 | $104.80 | $131.00 | $31.72 – $117.90 | 16 |
| Mayo inhab inhibin a CPT 86336 | $56.80 | $71.00 | $17.19 – $63.90 | 16 |
| Mayo iodine CPT 83789 | $240.00 | $300.00 | $65.12 – $242.10 | 16 |
| Mayo itraconazole therapeutic drug level CPT 80189 | $71.20 | $89.00 | $21.55 – $80.10 | 16 |
| Mayo lamotrigine therapeutic drug level CPT 80175 | $37.60 | $47.00 | $11.38 – $42.30 | 16 |
| Mayo ld_i lactate dehydrogenase isoenzymes CPT 83625 | $216.00 | $270.00 | $65.37 – $243.00 | 16 |
| Mayo legionella antibody CPT 86713 | $244.00 | $305.00 | $47.45 – $176.40 | 16 |
| Mayo lywb borrelia burgdorferi (lyme disease) antibody igg confirmatory CPT 86617 | $52.80 | $66.00 | $15.98 – $59.40 | 16 |
| Mayo metanephrines plasma CPT 83835 | $46.40 | $58.00 | $14.04 – $52.20 | 16 |
| Mayo mgle voltage-gated calcium channel antibody each CPT 86596 | $54.40 | $68.00 | $16.46 – $61.20 | 16 |
| Mayo mgrm acetylcholine receptor binding antibody CPT 86041 | $108.00 | $135.00 | $32.68 – $121.50 | 16 |
| Mayo microsomal antibody liver-kidney CPT 86376 | $100.00 | $125.00 | $15.98 – $59.40 | 16 |
| Mayo mitotane (lysodren) therapeutic drug level CPT 80299 | $232.80 | $291.00 | $16.46 – $61.20 | 16 |
| Mayo molecular pathology procedure level 2 apoe genotype CPT 81401 | $447.20 | $559.00 | $100.23 – $372.60 | 16 |
| Mayo muscle-specific kinase (musk) antibody CPT 86366 | $596.80 | $746.00 | $180.61 – $671.40 | 16 |
| Mayo mycophenolic acid therapeutic drug level CPT 80180 | $71.20 | $89.00 | $21.55 – $80.10 | 16 |
| Mayo myoglobin CPT 83874 | $302.40 | $378.00 | $65.85 – $244.80 | 16 |
| Mayo opatu opiates definitive assay >=1 CPT 80361 | $80.80 | $101.00 | $24.45 – $90.90 | 16 |
| Mayo opatu oxycodone definitive assay CPT 80365 | $167.20 | $209.00 | $29.54 – $109.80 | 16 |
| Mayo organic acid methylmalonic single quantitative CPT 83921 | $52.00 | $65.00 | $15.25 – $56.70 | 16 |
| Mayo oxalate 24 hour urine CPT 83945 | $57.60 | $72.00 | $17.43 – $64.80 | 16 |
| Mayo parvs parvovirus b19 antibody igg CPT 86747 | $56.80 | $71.00 | $17.19 – $63.90 | 16 |
| Mayo paval fluorescent antibody screen agna type 1 CPT 86255 | $164.80 | $206.00 | $15.98 – $59.40 | 16 |
| Mayo pborb infectious agent nucleic acid amplified probe borrelia burgdorferi (lyme) CPT 87476 | $200.80 | $251.00 | $60.77 – $225.90 | 16 |
| Mayo phospholipid neutralization hexagonal lupus anticoagulant CPT 85598 | $164.00 | $205.00 | $49.63 – $184.50 | 16 |
| Mayo pntft phenytoin free therapeutic drug level CPT 80186 | $71.20 | $89.00 | $21.55 – $80.10 | 16 |
| Mayo pregnenolone CPT 84140 | $49.60 | $62.00 | $15.01 – $55.80 | 16 |
| Mayo prmb primidone therapeutic drug level CPT 80188 | $71.20 | $89.00 | $21.55 – $80.10 | 16 |
| Mayo proinsulin CPT 84206 | $61.60 | $77.00 | $18.64 – $69.30 | 16 |
| Mayo psaft prostate specific antigen free CPT 84154 | $271.20 | $339.00 | $27.12 – $100.80 | 16 |
| Mayo radioimmunoassay procollagen i intact n-terminal antibody quantitative CPT 83519 | $323.20 | $404.00 | $15.74 – $58.50 | 16 |
| Mayo renin CPT 84244 | $51.20 | $64.00 | $9.68 – $36.00 | 16 |
| Mayo repu protein electrophoresis urine CPT 84166 | $145.60 | $182.00 | $44.06 – $163.80 | 16 |
| Mayo selenium CPT 84255 | $61.60 | $77.00 | $18.64 – $69.30 | 16 |
| Mayo semb semen analysis volume/count/motility/differential strict morphologic criteria CPT 89322 | $216.80 | $271.00 | $65.61 – $243.90 | 16 |
| Mayo serotonin CPT 84260 | $103.20 | $129.00 | $31.23 – $116.10 | 16 |
| Mayo sfgp rickettsia rickettsii antibody igg CPT 86757 | $56.80 | $71.00 | $17.19 – $63.90 | 16 |
| Mayo sirolimus therapeutic drug level CPT 80195 | $115.20 | $144.00 | $34.86 – $129.60 | 16 |
| Mayo streptococcus pneumoniae antibody igg 23 serotypes multiplex immunoassay quantitative CPT 86581 | $55.20 | $69.00 | $16.70 – $62.10 | 16 |
| Mayo syphilis test non-treponemal antibody qualitative vdrl CPT 86592 | $84.00 | $105.00 | $25.42 – $94.50 | 16 |
| Mayo tau phosphorylated 217 each CPT 84393 | $500.00 | $625.00 | $151.31 – $562.50 | 16 |
| Mayo tgrp testosterone free CPT 84402 | $60.00 | $75.00 | $18.16 – $67.50 | 16 |
| Mayo tgrp testosterone total CPT 84403 | $262.40 | $328.00 | $18.40 – $68.40 | 16 |
| Mayo thiopurine s-methyltransferase CPT 84433 | $150.40 | $188.00 | $45.51 – $169.20 | 16 |
| Mayo thyroglobulin CPT 84432 | $228.00 | $285.00 | $13.80 – $51.30 | 16 |
| Mayo ticks anaplasma phagocytophilum antibody igg CPT 86666 | $56.80 | $71.00 | $16.46 – $61.20 | 16 |
| Mayo ticks babesia microti antibody igg CPT 86753 | $54.40 | $68.00 | $16.46 – $61.20 | 16 |
| Mayo tramadol definitive assay w metabolite quantitative urine CPT 80373 | $104.80 | $131.00 | $31.72 – $117.90 | 16 |
| Mayo ttfb testosterone bioavailable direct CPT 84410 | $124.80 | $156.00 | $36.32 – $135.00 | 16 |
| Mayo tulab francisella tularensis antibody igg CPT 86668 | $210.40 | $263.00 | $63.67 – $236.70 | 16 |
| Mayo valpg valproic acid free therapeutic drug level CPT 80165 | $132.00 | $165.00 | $11.38 – $42.30 | 16 |
| Mayo vitamin b-2 (riboflavin) CPT 84252 | $57.60 | $72.00 | $17.43 – $64.80 | 16 |
| Mayo vitamin k CPT 84597 | $76.00 | $95.00 | $23.00 – $85.50 | 16 |
| Mayo zonisamide therapeutic drug level CPT 80203 | $71.20 | $89.00 | $21.55 – $80.10 | 16 |
| Mcp joint arthroscopy dx CPT 29900 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Mcp joint arthroscopy surg CPT 29901 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Mcp joint arthroscopysurg 29902 CPT 29902 | not published | not published | $1,680.43 – $1,680.43 | 1 |
| Mdfc flap w/prsrv vasc pedcl CPT 15730 | not published | not published | $3,844.02 – $3,844.02 | 1 |
| Meas lung vol thru 2 yrs CPT 94013 | not published | not published | $557.13 – $557.13 | 1 |
| Measure kidney pressure CPT 50396 | not published | not published | $700.84 – $700.84 | 1 |
| Measurement post void urine by ultrasound CPT 51798 | $190.40 | $238.00 | $57.62 – $214.20 | 16 |
| Measure ureter pressure CPT 50686 | not published | not published | $164.28 – $164.28 | 1 |
| #mec-opiates CPT 80356 | $77.60 | $97.00 | $23.48 – $87.30 | 16 |
| Medial canthopexy CPT 21280 | not published | not published | $3,405.22 – $3,405.22 | 1 |
| Mediastinoscpy w/lmph nod bx CPT 39402 | not published | not published | $6,126.08 – $6,126.08 | 1 |
| Mediastinoscpy w/medstnl bx 39401 CPT 39401 | not published | not published | $6,126.08 – $6,126.08 | 1 |
| Med physic dos eval rad exps CPT 76145 | not published | not published | $557.13 – $557.13 | 1 |
| Medroxyprogesterone 150 mg/ml im injection (wrapper) HCPCS J1050 | $97.76 | $122.19 | $21.37 – $79.44 | 16 |
| Meg evoked single CPT 95966 | not published | not published | $1,068.26 – $1,068.26 | 1 |
| Meg spontaneous CPT 95965 | not published | not published | $1,068.26 – $1,068.26 | 1 |
| Meniscal trnspl knee w/scpe CPT 29868 | not published | not published | $7,500.92 – $7,500.92 | 1 |
| Mepolizumab 100 mg/ml subcutaneous auto-injector HCPCS J2182 | $4,121.44 | $5,151.80 | $31.01 – $4,636.62 | 16 |
| Meropenem 1 gram intravenous solution HCPCS J2185 | $64.51 | $80.63 | $19.37 – $72.01 | 16 |
| Mesna 100 mg/ml intravenous solution HCPCS J9209 | $68.54 | $85.67 | $20.74 – $77.10 | 16 |
| Metabolic Blood Panel (Basic) CPT 80048 | $155.20 | $194.00 | $57.75 – $174.60 | 16 |
| Metabolic Blood Panel (Comprehensive) CPT 80053 | $196.80 | $246.00 | $74.25 – $221.40 | 16 |
| Metabolic panel ionized ca CPT 80047 | $155.20 | $194.00 | $46.97 – $174.60 | 16 |
| Methylene blue (antidote) 5 mg/ml intravenous solution HCPCS Q9968 | $66.01 | $82.51 | $8.24 – $74.26 | 16 |
| Methylprednisolone acetate 40 mg/ml suspension for injection HCPCS J1010 | $65.15 | $81.43 | $19.71 – $73.29 | 16 |
| Methylprednisolone sodium succinate 1,000 mg intravenous solution HCPCS J2919 | $91.09 | $113.86 | $18.84 – $70.05 | 16 |
| Metoclopramide in d5w IV syringe 0.2 mg/ml (neo/ped) - cnr HCPCS J2765 | $60.94 | $76.17 | $18.29 – $68.00 | 16 |
| Metoprolol tartrate 5 mg/5 ml intravenous (wrapper) HCPCS J0616 | $60.57 | $75.71 | $18.24 – $67.81 | 16 |
| Metronidazole 500 mg/100 ml in sodium chlor(iso) intravenous piggyback HCPCS J1836 | $106.82 | $133.52 | $32.25 – $119.90 | 16 |
| Micafungin 100 mg intravenous solution HCPCS J2248 | $108.96 | $136.19 | $32.97 – $122.57 | 16 |
| Microalbumin urine screen CPT 82044 | $122.40 | $153.00 | $37.04 – $137.70 | 16 |
| Microvolt t-wave assess CPT 93025 | not published | not published | $164.28 – $164.28 | 1 |
| Microwave bronch, 3d, ebus HCPCS C9751 | not published | not published | $3,938.03 – $3,938.03 | 1 |
| Mid and Lower Back (Thoracolumbar Spine) X-ray CPT 72080 | $442.40 | $553.00 | $92.45 – $497.70 | 16 |
| Midazolam 1 mg/ml injection solution HCPCS J2250 | $60.70 | $75.87 | $1.52 – $5.66 | 16 |
| Middle cerebral artery echo CPT 76821 | not published | not published | $111.66 – $111.66 | 1 |
| Mitomycin 40 mg intravenous solution HCPCS J9280 | $613.62 | $767.02 | $185.70 – $690.32 | 16 |
| Mlt osteot rlgnm imed rd hum CPT 24410 | not published | not published | $13,510.16 – $13,510.16 | 1 |
| Mnl appl strs jt radiography CPT 77071 | not published | not published | $92.45 – $92.45 | 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.