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 |
|---|---|---|---|---|
| Strapping of ankle and/or ft 29540 CPT 29540 | not published | not published | $165.68 – $165.68 | 1 |
| Strapping of chest CPT 29200 | not published | not published | $165.68 – $165.68 | 1 |
| Strapping of elbow or wrist 29260 CPT 29260 | not published | not published | $62.37 – $62.37 | 1 |
| Strapping of hand or finger CPT 29280 | not published | not published | $62.37 – $62.37 | 1 |
| Strapping of hip CPT 29520 | not published | not published | $135.35 – $135.35 | 1 |
| Strapping of knee CPT 29530 | not published | not published | $135.35 – $135.35 | 1 |
| Strapping of toes 29550 CPT 29550 | not published | not published | $62.37 – $62.37 | 1 |
| Stress test pulmonary CPT 94618 | not published | not published | $135.35 – $135.35 | 1 |
| Stress tte complete CPT 93351 | not published | not published | $575.70 – $575.70 | 1 |
| Subdural tap fontanelle/sutur infant init 61000 CPT 61000 | not published | not published | $727.15 – $727.15 | 1 |
| Subq njx filling matrl 1cc/< CPT 11950 | not published | not published | $208.64 – $208.64 | 1 |
| Subq njx fil matrl 5.1-10cc CPT 11952 | not published | not published | $642.74 – $642.74 | 1 |
| Subtalar arthro w/deb CPT 29906 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Subtalar arthro w/exc CPT 29905 | not published | not published | $7,500.92 – $7,500.92 | 1 |
| Subtalar arthro w/fb rmvl CPT 29904 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Subtalar arthro w/fusion CPT 29907 | not published | not published | $13,510.16 – $13,510.16 | 1 |
| Succinylcholine chloride 20 mg/ml injection solution (wrapper) HCPCS J0330 | $71.60 | $89.50 | $21.67 – $80.55 | 16 |
| Suction lipectomy head&neck CPT 15876 | not published | not published | $3,844.02 – $3,844.02 | 1 |
| Suction lipectomy lwr extrem CPT 15879 | not published | not published | $3,844.02 – $3,844.02 | 1 |
| Suction lipectomy trunk CPT 15877 | not published | not published | $3,844.02 – $3,844.02 | 1 |
| Suction lipectomy upr extrem CPT 15878 | not published | not published | $1,920.69 – $1,920.69 | 1 |
| Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 | $64.83 | $81.03 | $19.06 – $70.85 | 16 |
| Sup of prep of antigen # of vials 95144 CPT 95144 | not published | not published | $48.45 – $48.45 | 1 |
| Support clav 29.6-40.5in med HCPCS L3650 | $31.20 | $39.00 | $7.99 – $29.70 | 16 |
| Surg dx exam anorectal CPT 45990 | not published | not published | $2,879.51 – $2,879.51 | 1 |
| Surgery for urethra pouch CPT 53240 | not published | not published | $3,621.42 – $3,621.42 | 1 |
| Surgery to stop leg growth CPT 27475 | not published | not published | $7,500.92 – $7,500.92 | 1 |
| Surgery to stop leg growth CPT 27477 | not published | not published | $7,500.92 – $7,500.92 | 1 |
| Surgery to stop leg growth CPT 27479 | not published | not published | $7,500.92 – $7,500.92 | 1 |
| Surgery to stop leg growth CPT 27485 | not published | not published | $7,500.92 – $7,500.92 | 1 |
| Surgical exposure prostate 55860 CPT 55860 | not published | not published | $5,337.80 – $5,337.80 | 1 |
| Surgical opening of stomach CPT 43510 | not published | not published | $984.44 – $984.44 | 1 |
| Surgical opening of throat CPT 42955 | not published | not published | $1,555.34 – $1,555.34 | 1 |
| Surgical pathology level 1 gross examination only CPT 88300 | $64.00 | $80.00 | $19.37 – $72.00 | 16 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $136.00 | $170.00 | $41.16 – $153.00 | 16 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $140.00 | $175.00 | $42.37 – $157.50 | 16 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $145.60 | $182.00 | $77.90 – $163.80 | 16 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $679.20 | $849.00 | $205.54 – $764.10 | 16 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $1,002.40 | $1,253.00 | $303.35 – $1,127.70 | 16 |
| Surg tx anal fistula 2nd stage 46285 CPT 46285 | not published | not published | $2,879.51 – $2,879.51 | 1 |
| Susceptibility agar dilution per agent CPT 87181 | $117.60 | $147.00 | $16.46 – $61.20 | 16 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $162.40 | $203.00 | $49.15 – $182.70 | 16 |
| Susceptibility mic per plate CPT 87186 | $191.20 | $239.00 | $15.74 – $58.50 | 16 |
| Suspension of testis CPT 54620 | not published | not published | $3,621.42 – $3,621.42 | 1 |
| Svc venogram s&i CPT 75827 | not published | not published | $1,631.11 – $1,631.11 | 1 |
| Swallowing Evaluation (Bedside) CPT 92610 | $410.40 | $513.00 | $124.20 – $461.70 | 16 |
| Swallowing Therapy Session CPT 92526 | $312.80 | $391.00 | $94.66 – $351.90 | 16 |
| Sympathectomy cervical CPT 64802 | not published | not published | $2,050.41 – $2,050.41 | 1 |
| Sympathectomy digital artery CPT 64820 | not published | not published | $2,050.41 – $2,050.41 | 1 |
| Sympathectomy supfc palmar CPT 64823 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Synthetic sentence id test CPT 92576 | not published | not published | $41.21 – $41.21 | 1 |
| Synvisc or synvisc-one HCPCS J7325 | $395.25 | $494.06 | $119.61 – $444.65 | 16 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $48.80 | $61.00 | $14.77 – $54.90 | 16 |
| T3 (triiodothyronine) free CPT 84481 | $147.20 | $184.00 | $44.55 – $165.60 | 16 |
| T3 (triiodothyronine) total CPT 84480 | $92.00 | $115.00 | $27.84 – $103.50 | 16 |
| T4 (thyroxine) free CPT 84439 | $160.80 | $201.00 | $28.08 – $104.40 | 16 |
| T4 (thyroxine) total CPT 84436 | $103.20 | $129.00 | $31.23 – $116.10 | 16 |
| Tacrolimus therapeutic drug level CPT 80197 | $196.00 | $245.00 | $59.31 – $220.50 | 16 |
| Tailbone (Sacrum and Coccyx) X-ray CPT 72220 | $442.40 | $553.00 | $92.45 – $497.70 | 16 |
| Tattooing/intraderm 6.1-20.0 sq cm 11921 CPT 11921 | not published | not published | $642.74 – $642.74 | 1 |
| Tbs techl calculation only CPT 77091 | not published | not published | $92.45 – $92.45 | 1 |
| Tbs techl prep&transmis data CPT 77090 | not published | not published | $92.45 – $92.45 | 1 |
| Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells CPT 86481 | $279.20 | $349.00 | $84.49 – $314.10 | 16 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $542.40 | $678.00 | $54.23 – $201.60 | 16 |
| Tc-99m labeled rbc HCPCS A9560 | $428.00 | $535.00 | $129.52 – $481.50 | 16 |
| Tc-99m mebrofenin HCPCS A9537 | $178.40 | $223.00 | $53.99 – $200.70 | 16 |
| Tc-99m medronate HCPCS A9503 | $133.60 | $167.00 | $40.43 – $150.30 | 16 |
| Tc-99m mertiatide HCPCS A9562 | $756.00 | $945.00 | $228.78 – $850.50 | 16 |
| Tc-99m oxidronate HCPCS A9561 | $168.00 | $210.00 | $50.84 – $189.00 | 16 |
| Tc-99m sestamibi p study dose HCPCS A9500 | $352.00 | $440.00 | $106.52 – $396.00 | 16 |
| Tc-99m sulfur colloid HCPCS A9541 | $308.00 | $385.00 | $93.21 – $346.50 | 16 |
| Tcd emboli detect w/inj CPT 93893 | not published | not published | $111.66 – $111.66 | 1 |
| Tcd emboli detect without inj CPT 93892 | not published | not published | $111.66 – $111.66 | 1 |
| T-cell depletion of harvest CPT 38210 | not published | not published | $459.04 – $459.04 | 1 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $184.00 | $230.00 | $55.68 – $207.00 | 16 |
| T cells total count CPT 86359 | $160.80 | $201.00 | $48.66 – $180.90 | 16 |
| Tcranial magn stim tx deli CPT 90868 | not published | not published | $326.96 – $326.96 | 1 |
| Tcranial magn stim tx plan CPT 90867 | not published | not published | $326.96 – $326.96 | 1 |
| Tcran magn stim redetemine CPT 90869 | not published | not published | $326.96 – $326.96 | 1 |
| Tee w or without fol w/cont,cong HCPCS C8926 | not published | not published | $829.56 – $829.56 | 1 |
| Tee w or without fol w/cont, mon HCPCS C8927 | not published | not published | $829.56 – $829.56 | 1 |
| Telavancin injection HCPCS J3095 | $693.60 | $867.00 | $209.90 – $780.30 | 16 |
| Telehealth original site facility fee HCPCS Q3014 | $69.60 | $87.00 | $21.06 – $78.30 | 16 |
| Telethx isodose plan cplx CPT 77307 | not published | not published | $384.37 – $384.37 | 1 |
| Telethx isodose plan simple CPT 77306 | not published | not published | $384.37 – $384.37 | 1 |
| Temperature gradient studies CPT 93740 | not published | not published | $164.28 – $164.28 | 1 |
| Tendon lengthening CPT 26476 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Tendon lngth upr a/e ea tdn CPT 24305 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Tendon shortening CPT 26477 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Tendon transfer with graft CPT 26492 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) HCPCS J3101 | $8,113.89 | $10,142.36 | $2,455.47 – $9,128.12 | 16 |
| Tenodesis biceps tdn at elbw CPT 24340 | not published | not published | $7,500.92 – $7,500.92 | 1 |
| Tenolysis extensor tendon hand/finger each CPT 26445 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Tenolysis triceps CPT 24332 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Tenoplasty elbow to sho 1 CPT 24320 | not published | not published | $7,500.92 – $7,500.92 | 1 |
| Tenosynovectomy radic 26145 CPT 26145 | not published | not published | $1,680.43 – $1,680.43 | 1 |
| Tenotomy length/rls abductor hallucis musc 28240 CPT 28240 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Tenotomy open tndn flxr toe sgl tndn spx CPT 28232 | not published | not published | $1,680.43 – $1,680.43 | 1 |
| Terbutaline 1 mg/ml subcutaneous solution HCPCS J3105 | $61.20 | $76.49 | $18.45 – $68.57 | 16 |
| Testicular imaging w/vasc flow CPT 78761 | 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.