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 |
|---|---|---|---|---|
| Unlisted px neck/thorax CPT 21899 | not published | not published | $243.83 – $243.83 | 1 |
| Unlisted px palate uvula CPT 42299 | not published | not published | $243.83 – $243.83 | 1 |
| Unlisted px pelvis/hip joint CPT 27299 | not published | not published | $251.87 – $251.87 | 1 |
| Unlisted px posterior segmnt CPT 67299 | not published | not published | $2,394.77 – $2,394.77 | 1 |
| Unlisted px salivry glnd/dux CPT 42699 | not published | not published | $243.83 – $243.83 | 1 |
| Unlisted px small intestine CPT 44799 | not published | not published | $984.44 – $984.44 | 1 |
| Unlisted px temporal bone CPT 69979 | not published | not published | $243.83 – $243.83 | 1 |
| Unlisted px ther rad tx plng CPT 77299 | not published | not published | $139.41 – $139.41 | 1 |
| Unlisted px tongue flr mouth CPT 41599 | not published | not published | $243.83 – $243.83 | 1 |
| Unlisted px vestibule mouth CPT 40899 | not published | not published | $243.83 – $243.83 | 1 |
| Unlisted resp px dx nuc med CPT 78599 | not published | not published | $421.92 – $421.92 | 1 |
| Unlisted spec derm svc/px CPT 96999 | not published | not published | $208.64 – $208.64 | 1 |
| Unlisted ultrasound procedure CPT 76999 | $669.60 | $837.00 | $92.45 – $753.30 | 16 |
| Unlisted vasc endoscopy px CPT 37501 | not published | not published | $649.17 – $649.17 | 1 |
| Unlstd hematop ret/endo lymp CPT 78199 | not published | not published | $421.92 – $421.92 | 1 |
| Unlstd laps px mat care&dlvr CPT 59898 | not published | not published | $6,126.08 – $6,126.08 | 1 |
| Unlstd laps px sprmatic cord CPT 55559 | not published | not published | $6,126.08 – $6,126.08 | 1 |
| Unsched dialysis esrd pt hos HCPCS G0257 | not published | not published | $734.71 – $734.71 | 1 |
| Upgrade pm system CPT 33214 | not published | not published | $10,988.60 – $10,988.60 | 1 |
| Upper Arm (Humerus) X-ray (left side) CPT 73060 | $403.20 | $504.00 | $92.45 – $453.60 | 16 |
| Upper Back (Thoracic Spine) CT Scan (with contrast) CPT 72129 | not published | not published | $186.92 – $446.60 | 2 |
| Upper Back (Thoracic Spine) CT Scan (without contrast) CPT 72128 | $2,564.00 | $3,205.00 | $111.66 – $2,884.50 | 16 |
| Upper Back (Thoracic Spine) MRI (with and without contrast) CPT 72157 | $4,322.40 | $5,403.00 | $374.99 – $4,862.70 | 16 |
| Upper Back (Thoracic Spine) MRI (with contrast) CPT 72147 | $3,496.80 | $4,371.00 | $374.99 – $3,933.90 | 16 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | $3,370.40 | $4,213.00 | $253.81 – $3,791.70 | 16 |
| Upper Back (Thoracic Spine) X-ray (2 views) CPT 72070 | $463.20 | $579.00 | $111.66 – $521.10 | 16 |
| Upper Back (Thoracic Spine) X-ray (3 views) CPT 72072 | $580.80 | $726.00 | $111.66 – $653.40 | 16 |
| Upper Endoscopy (EGD, diagnostic) CPT 43235 | not published | not published | $984.44 – $1,135.20 | 2 |
| Upper Endoscopy (EGD, with biopsy) CPT 43239 | not published | not published | $984.44 – $1,135.20 | 2 |
| Upper GI Barium X-ray (barium and gas) CPT 74246 | not published | not published | $186.92 – $186.92 | 1 |
| Upper GI Barium X-ray (barium only) CPT 74240 | not published | not published | $186.92 – $186.92 | 1 |
| Uppr gi scope w/submuc inj CPT 43236 | not published | not published | $984.44 – $984.44 | 1 |
| Urachal cyst/sinus excision 51500 CPT 51500 | not published | not published | $6,126.08 – $6,126.08 | 1 |
| Urea nitrogen CPT 84520 | $85.60 | $107.00 | $25.90 – $96.30 | 16 |
| Urea nitrogen 24 hour urine CPT 84540 | $48.80 | $61.00 | $9.44 – $35.10 | 16 |
| Ureteral reflux study CPT 78740 | not published | not published | $421.92 – $421.92 | 1 |
| Ureter endoscopy CPT 50970 | not published | not published | $3,621.42 – $3,621.42 | 1 |
| Ureter endoscopy & biopsy CPT 50955 | not published | not published | $5,337.80 – $5,337.80 | 1 |
| Ureter endoscopy & biopsy CPT 50974 | not published | not published | $5,337.80 – $5,337.80 | 1 |
| Ureter endoscopy & catheter CPT 50972 | not published | not published | $3,621.42 – $3,621.42 | 1 |
| Ureter endoscopy & treatment CPT 50957 | not published | not published | $5,337.80 – $5,337.80 | 1 |
| Ureter endoscopy & treatment CPT 50961 | not published | not published | $5,337.80 – $5,337.80 | 1 |
| Ureter endoscopy & treatment CPT 50976 | not published | not published | $5,337.80 – $5,337.80 | 1 |
| Ureter endoscopy & treatment CPT 50980 | not published | not published | $5,337.80 – $5,337.80 | 1 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | not published | not published | $253.81 – $253.81 | 1 |
| Urethrlys transvag with scope CPT 53500 | not published | not published | $3,621.42 – $3,621.42 | 1 |
| Urethrocystography void s&i CPT 74455 | not published | not published | $253.81 – $253.81 | 1 |
| Uric acid blood CPT 84550 | $74.40 | $93.00 | $22.52 – $83.70 | 16 |
| Uric acid urine CPT 84560 | $72.00 | $90.00 | $9.44 – $35.10 | 16 |
| Urinalysis microscopic only CPT 81015 | $76.00 | $95.00 | $23.00 – $85.50 | 16 |
| Urinalysis qual/semiquant excpt ia CPT 81005 | $50.40 | $63.00 | $15.25 – $56.70 | 16 |
| Urinalysis (with microscopy) CPT 81001 | $82.40 | $103.00 | $24.94 – $92.70 | 16 |
| Urinalysis (without microscopy) CPT 81003 | $39.20 | $49.00 | $11.62 – $43.20 | 16 |
| Urinary reflex study CPT 51792 | not published | not published | $62.37 – $62.37 | 1 |
| Urine Culture Test CPT 87086 | $114.40 | $143.00 | $34.62 – $128.70 | 16 |
| Urine flow measurement 51736 CPT 51736 | not published | not published | $135.35 – $135.35 | 1 |
| Urine pregnancy test CPT 81025 | $88.80 | $111.00 | $26.87 – $99.90 | 16 |
| Urography, antegrade CPT 74425 | not published | not published | $374.99 – $374.99 | 1 |
| Urography inf drip &/or bolus CPT 74410 | not published | not published | $186.92 – $186.92 | 1 |
| Use 1st target lesion CPT 76982 | not published | not published | $111.66 – $111.66 | 1 |
| Vaccine Administration (one shot) CPT 90471 | $64.00 | $80.00 | $4.76 – $17.71 | 16 |
| Vaccine dtap < 7 years im CPT 90700 | $76.58 | $95.72 | $23.17 – $86.15 | 16 |
| Vaccine dtap-ipv-hib-hepb im CPT 90697 | $247.92 | $309.89 | $75.02 – $278.90 | 16 |
| Vaccine dtap-ipv/hib im CPT 90698 | $109.34 | $136.67 | $33.09 – $123.00 | 16 |
| Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im CPT 90647 | $77.13 | $96.41 | $23.34 – $86.77 | 16 |
| Vaccine hepatitis a (hepa) adult im CPT 90632 | $93.75 | $117.18 | $28.37 – $105.46 | 16 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im CPT 90633 | $79.15 | $98.93 | $23.95 – $89.04 | 16 |
| Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im CPT 90739 | $218.79 | $273.48 | $66.21 – $246.13 | 16 |
| Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 | $68.33 | $85.41 | $20.68 – $76.87 | 16 |
| Vaccine mmr live subcutaneous CPT 90707 | $104.84 | $131.05 | $31.73 – $117.95 | 16 |
| Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im CPT 90732 | $219.46 | $274.32 | $66.41 – $246.89 | 16 |
| Vaccine pneumonococcal conjugate 15 valent (pcv15) im CPT 90671 | $370.80 | $463.49 | $112.21 – $417.14 | 16 |
| Vaccine polio (ipv) subcutaneous/im CPT 90713 | $77.67 | $97.08 | $23.50 – $87.37 | 16 |
| Vaccine rabies im CPT 90675 | $564.60 | $705.74 | $150.38 – $559.03 | 16 |
| Vaccine rotavirus pentavalent (rv5) live 3 dose oral CPT 90680 | $108.43 | $135.53 | $32.81 – $121.98 | 16 |
| Vaccine tdap >=7 years im CPT 90715 | $85.60 | $107.00 | $25.90 – $96.30 | 16 |
| Vaccine td preservative free >= 7 years im CPT 90714 | $75.64 | $94.55 | $22.89 – $85.10 | 16 |
| Vaccine varicella live subcutaneous CPT 90716 | $120.17 | $150.21 | $36.37 – $135.19 | 16 |
| Vag hys/<250g/rmv tube/rpr entero 58263 CPT 58263 | not published | not published | $5,183.27 – $5,183.27 | 1 |
| Vag hyst incl t/o complex CPT 58291 | not published | not published | $5,183.27 – $5,183.27 | 1 |
| Vag hyst including t/o CPT 58262 | not published | not published | $5,183.27 – $5,183.27 | 1 |
| Vag hyst t/o & repair compl CPT 58292 | not published | not published | $7,764.55 – $7,764.55 | 1 |
| Vag hyst w/enterocele compl 58294 CPT 58294 | not published | not published | $5,183.27 – $5,183.27 | 1 |
| Vag hyst w/enterocele repair CPT 58270 | not published | not published | $5,183.27 – $5,183.27 | 1 |
| Vaginal bx CPT 58999 | not published | not published | $211.23 – $211.23 | 1 |
| Vaginal delivery after cesarean delivery 59612 CPT 59612 | not published | not published | $3,338.51 – $3,338.51 | 1 |
| Vaginal hysterectomy CPT 58260 | not published | not published | $5,183.27 – $5,183.27 | 1 |
| Vaginectomy partial w/nodes CPT 57109 | not published | not published | $3,338.51 – $3,338.51 | 1 |
| Valproic acid total therapeutic drug level CPT 80164 | $100.80 | $126.00 | $11.38 – $42.30 | 16 |
| Valvuloplasty aortic CPT 92986 | not published | not published | $5,986.60 – $5,986.60 | 1 |
| Valvuloplasty mitral CPT 92987 | not published | not published | $11,907.60 – $11,907.60 | 1 |
| Valvuloplasty pulmonary CPT 92990 | not published | not published | $11,907.60 – $11,907.60 | 1 |
| Vancomycin 1,000 mg intravenous injection HCPCS J3373 | $73.00 | $91.25 | $18.59 – $69.09 | 16 |
| Vancomycin peak therapeutic drug level CPT 80202 | $168.00 | $210.00 | $50.84 – $189.00 | 16 |
| Varicella zoster antibody igg CPT 86787 | $54.40 | $68.00 | $16.46 – $61.20 | 16 |
| Vasc graft into carpal bone CPT 25430 | not published | not published | $3,406.84 – $3,406.84 | 1 |
| Vasectomy CPT 55250 | $3,714.40 | $4,643.00 | $1,124.07 – $4,178.70 | 16 |
| Vedolizumab 300 mg intravenous solution HCPCS J3380 | not published | not published | $22.69 – $27.58 | 2 |
| Veeg cont 2-12 hrs CPT 95713 | not published | not published | $557.13 – $557.13 | 1 |
| Veeg ea 12-26hr cont mntr CPT 95716 | not published | not published | $1,068.26 – $1,068.26 | 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.