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 |
|---|---|---|---|---|
| Phenytoin total therapeutic drug level CPT 80185 | $186.40 | $233.00 | $53.75 – $199.80 | 16 |
| Phlebotomy therapeutic CPT 99195 | $249.60 | $312.00 | $75.54 – $280.80 | 16 |
| Phleb veins 1 extrm 10-20 stab CPT 37765 | not published | not published | $3,304.88 – $3,304.88 | 1 |
| Phleb veins 1 extrm >20 stab CPT 37766 | not published | not published | $3,304.88 – $3,304.88 | 1 |
| Phosphorus CPT 84100 | $72.00 | $90.00 | $21.79 – $81.00 | 16 |
| Phosphorus 24 hour urine CPT 84105 | $62.40 | $78.00 | $9.44 – $35.10 | 16 |
| Photchmtx tar&uvb/ptrltm&uvb CPT 96910 | not published | not published | $62.37 – $62.37 | 1 |
| Photochemotherapy puva CPT 96912 | not published | not published | $62.37 – $62.37 | 1 |
| Photochemotherapy uv-a or b CPT 96913 | not published | not published | $419.51 – $419.51 | 1 |
| Photo patch test CPT 95052 | not published | not published | $62.37 – $62.37 | 1 |
| Photopheresis CPT 36522 | not published | not published | $4,919.43 – $4,919.43 | 1 |
| Photosensitivity tests CPT 95056 | not published | not published | $135.35 – $135.35 | 1 |
| Physical Therapy Evaluation (high complexity) CPT 97163 | $352.80 | $441.00 | $106.77 – $396.90 | 16 |
| Physical Therapy Evaluation (low complexity) CPT 97161 | $262.40 | $328.00 | $115.50 – $295.20 | 16 |
| Physical Therapy Evaluation (moderate complexity) CPT 97162 | $308.00 | $385.00 | $93.21 – $346.50 | 16 |
| Physical Therapy Re-Evaluation CPT 97164 | $244.00 | $305.00 | $73.84 – $274.50 | 16 |
| Phytonadione (vitamin k1) 10 mg/ml injection solution HCPCS J3430 | $92.30 | $115.37 | $22.87 – $85.02 | 16 |
| Pinch graft 1/mlt c> sm ulcer tip/oth area 2cm 15050 CPT 15050 | not published | not published | $642.74 – $642.74 | 1 |
| Pin finger dislocation CPT 26776 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Pin finger fracture each CPT 26756 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Pin hand dislocation CPT 26676 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Pin knuckle dislocation CPT 26706 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Pinworm exam CPT 87172 | $82.40 | $103.00 | $24.94 – $92.70 | 16 |
| Piperacillin-tazobactam 3.375 gram intravenous solution HCPCS J2543 | $63.89 | $79.86 | $18.63 – $69.25 | 16 |
| Place breast rad tube/caths CPT 19298 | not published | not published | $6,847.53 – $6,847.53 | 1 |
| Place cecostomy tube perc CPT 49442 | not published | not published | $1,238.03 – $1,238.03 | 1 |
| Place duod/jej tube perc CPT 49441 | not published | not published | $1,991.84 – $1,991.84 | 1 |
| Place endorectal app HCPCS C9725 | not published | not published | $957.30 – $957.30 | 1 |
| Place gastrostomy tube perc CPT 49440 | $2,951.20 | $3,689.00 | $893.11 – $3,320.10 | 16 |
| Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides) CPT 19281 | not published | not published | $1,701.25 – $1,701.25 | 1 |
| Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides) CPT 19285 | not published | not published | $738.77 – $738.77 | 1 |
| Placement nephrostomy catheter (both sides) CPT 50432 | not published | not published | $2,150.94 – $2,150.94 | 1 |
| Placement of seton CPT 46020 | not published | not published | $2,879.51 – $2,879.51 | 1 |
| Placement stent(s) intravascular transcatheter artery initial CPT 37236 | not published | not published | $11,907.60 – $11,907.60 | 1 |
| Place ndl musc/tis for right CPT 20555 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Place needles h&n for right CPT 41019 | not published | not published | $6,211.44 – $6,211.44 | 1 |
| Place needles pelvic for right CPT 55920 | not published | not published | $5,183.27 – $5,183.27 | 1 |
| Place non-slctv cath thoracic arta CPT 36221 | not published | not published | $3,304.88 – $3,304.88 | 1 |
| Place po breast cath for rad CPT 19296 | not published | not published | $10,047.49 – $10,047.49 | 1 |
| Place right device/marker pros CPT 55876 | not published | not published | $1,436.67 – $1,436.67 | 1 |
| Place slctv cath carotd art uni CPT 36224 | not published | not published | $5,675.99 – $5,675.99 | 1 |
| Place slctv cath carotid/inom art excrn uni CPT 36222 | not published | not published | $3,304.88 – $3,304.88 | 1 |
| Place slctv cath carotid/inom art intcrn uni CPT 36223 | not published | not published | $5,675.99 – $5,675.99 | 1 |
| Place slctv cath subclavian art CPT 36225 | not published | not published | $3,304.88 – $3,304.88 | 1 |
| Place slctv cath vertebral art uni CPT 36226 | not published | not published | $5,675.99 – $5,675.99 | 1 |
| Plasma volume multiple CPT 78111 | not published | not published | $1,370.75 – $1,370.75 | 1 |
| Plasma volume single CPT 78110 | not published | not published | $1,370.75 – $1,370.75 | 1 |
| Platelet aggregation each agent teg CPT 85576 | $203.20 | $254.00 | $61.49 – $228.60 | 16 |
| Platelet automated CPT 85049 | $56.00 | $70.00 | $16.95 – $63.00 | 16 |
| Platelet deplete of harvest CPT 38213 | not published | not published | $459.04 – $459.04 | 1 |
| Platelet pheresis irr ea HCPCS P9036 | $704.00 | $880.00 | $213.05 – $792.00 | 16 |
| Platelets each unit HCPCS P9019 | $599.20 | $749.00 | $181.33 – $674.10 | 16 |
| Platelet survival CPT 78191 | not published | not published | $421.92 – $421.92 | 1 |
| Plcmnt biliary drainage cath w/img ext CPT 47533 | not published | not published | $3,705.51 – $3,705.51 | 1 |
| Plcmnt ureteral stent pq w/img exstng trct CPT 50693 | not published | not published | $3,621.42 – $3,621.42 | 1 |
| Plcmnt ureteral stent pq w/img new w/cath CPT 50695 | not published | not published | $3,621.42 – $3,621.42 | 1 |
| Plcmt sft tiss loc pq w/img 1st lsn CPT 10035 | not published | not published | $738.77 – $738.77 | 1 |
| Plethysmography lung volumes/airway resistance CPT 94726 | not published | not published | $326.96 – $326.96 | 1 |
| Plmt access bil tree sm bwl CPT 47541 | not published | not published | $6,551.74 – $6,551.74 | 1 |
| Plmt biliary drainage cath CPT 47534 | not published | not published | $3,705.51 – $3,705.51 | 1 |
| Plmt nephroureteral catheter CPT 50433 | not published | not published | $3,621.42 – $3,621.42 | 1 |
| Plmt ureteral stent prq CPT 50694 | not published | not published | $3,621.42 – $3,621.42 | 1 |
| Pm device progr eval dual CPT 93280 | not published | not published | $39.15 – $39.15 | 1 |
| Pm device progr eval multi CPT 93281 | not published | not published | $39.15 – $39.15 | 1 |
| Pm phone r-strip device eval CPT 93293 | not published | not published | $39.15 – $39.15 | 1 |
| Pneumothrx tx-intraplrl inj ai CPT 32960 | not published | not published | $649.17 – $649.17 | 1 |
| Poct blood gases ph pco2 po2 arterial calculated o2 CPT 82803 | $320.80 | $401.00 | $97.08 – $360.90 | 16 |
| Polysom <6 yrs cpap/bilvl CPT 95783 | not published | not published | $1,068.26 – $1,068.26 | 1 |
| Polysom any age 1-3> param CPT 95808 | not published | not published | $1,068.26 – $1,068.26 | 1 |
| Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap CPT 95811 | $4,949.60 | $6,187.00 | $785.86 – $2,921.40 | 16 |
| Positional change of finger CPT 26555 | not published | not published | $7,500.92 – $7,500.92 | 1 |
| Post op service lvrs min 6 HCPCS G0305 | not published | not published | $557.13 – $557.13 | 1 |
| Potassium 24 hour urine CPT 84133 | $72.80 | $91.00 | $9.44 – $35.10 | 16 |
| Potassium chloride 10 meq/100ml in sterile water intravenous piggyback HCPCS J3480 | $134.14 | $167.67 | $18.34 – $68.18 | 16 |
| Potassium serum/plasma/whole blood CPT 84132 | $76.00 | $95.00 | $23.00 – $85.50 | 16 |
| Pq kyphplsty 1 bdy lumb w/img CPT 22514 | not published | not published | $7,500.92 – $7,500.92 | 1 |
| Pq thr inj ext pse CPT 36002 | not published | not published | $649.17 – $649.17 | 1 |
| Pq vrtbrplst 1 bdy inj crv-thr w/img ini CPT 22510 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Pq vrtbrplst 1 bdy inj lmb-scr w/img ini CPT 22511 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Pralidoxime 1 gram solution for injection HCPCS J2730 | $190.77 | $238.46 | $57.73 – $214.61 | 16 |
| Pr amput fgr/thumb prim/sec any joint/phal sgl incl neurectomies w dir clsr CPT 26951 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Pr application of long arm splint CPT 29105 | $315.20 | $394.00 | $95.39 – $354.60 | 16 |
| Pr application splint static short arm CPT 29125 | $277.60 | $347.00 | $84.01 – $312.30 | 16 |
| Pr assessment emotional/behavioral per instrument brief CPT 96127 | not published | not published | $41.21 – $41.21 | 1 |
| Pr biopsy skin punch single lesion CPT 11104 | $600.80 | $751.00 | $181.82 – $675.90 | 16 |
| Pr correction hallux valgus (bunionectomy) with sesamoidectomy when performed with first metatarsal and cuneiform joint arthrodesis any method CPT 28297 | not published | not published | $13,510.16 – $13,510.16 | 1 |
| Pr correction hammertoe CPT 28285 | $4,127.20 | $5,159.00 | $1,248.99 – $4,643.10 | 16 |
| Pr counseling smoke/tobacco intermediate greater 3 - 10 minutes CPT 99406 | not published | not published | $31.28 – $31.28 | 1 |
| Pr cystourethroscopy with insertion indwelling ureteral stent CPT 52332 | not published | not published | $3,621.42 – $3,621.42 | 1 |
| Prealbumin CPT 84134 | $94.40 | $118.00 | $28.57 – $106.20 | 16 |
| Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution HCPCS J7510 | $14.63 | $18.28 | $1.20 – $4.46 | 16 |
| Pr egd flexible transoral w/placement percutaneous gastrostomy tube CPT 43246 | not published | not published | $1,991.84 – $1,991.84 | 1 |
| Pregnancy Ultrasound (complete, after first trimester) CPT 76805 | $1,038.40 | $1,298.00 | $111.66 – $1,168.20 | 16 |
| Pregnancy Ultrasound (first trimester) CPT 76801 | $955.20 | $1,194.00 | $111.66 – $1,074.60 | 16 |
| Pregnancy Ultrasound (limited) CPT 76815 | $604.80 | $756.00 | $111.66 – $680.40 | 16 |
| Pre-op service lvrs 10-15dos HCPCS G0303 | not published | not published | $326.96 – $326.96 | 1 |
| Pre-op service lvrs 1-9 dos HCPCS G0304 | not published | not published | $557.13 – $557.13 | 1 |
| Pre-op service lvrs complete HCPCS G0302 | not published | not published | $557.13 – $557.13 | 1 |
| Preparation palate mold CPT 42280 | not published | not published | $534.71 – $534.71 | 1 |
| Prepj skn cll ssp agrft 1st CPT 15013 | not published | not published | $7,613.03 – $7,613.03 | 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.