Home › Hospitals › Sanford Westbrook Medical Center Posts prices for 30 of the 66 common shoppable procedures we track. Price file retrieved 2026-09-01.
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Procedure Cash price Gross charge × Medicare
CT head/brain without contrast (70450) $2,126.40
$2,658
19.7×
MRI brain without contrast (70551) $3,062.40
$3,828
12.4×
MRI brain without and with contrast (70553) $4,155.20
$5,194
11.5×
X-ray lower spine, 4+ views (72110) $710.40
$888
6.6×
MRI lumbar spine without contrast (72148) $3,189.60
$3,987
13.0×
CT pelvis with contrast (72193) $2,544
$3,180
14.1×
MRI lower-extremity joint without contrast (73721) $2,818.40
$3,523
11.4×
CT abdomen and pelvis with contrast (74177) $4,656
$5,820
12.9×
Ultrasound, abdomen complete (76700) $1,108
$1,385
10.3×
Ultrasound, pregnant uterus (≥14 weeks) (76805) $1,038.40
$1,298
9.6×
Ultrasound, transvaginal (76830) $903.20
$1,129
8.4×
Mammography, one breast (diagnostic) (77065) $444
$555
5.2×
Mammography, both breasts (diagnostic) (77066) $487.20
$609
4.4×
Mammography, screening (bilateral) (77067) $435.20
$544
4.8×
Basic metabolic panel (80048) $155.20
$194
18.3×
Comprehensive metabolic panel (80053) $196.80
$246
18.6×
Obstetric panel (80055) $238.40
$298
5.0×
Lipid panel (80061) $145.60
$182
10.9×
Renal function panel (80069) $116
$145
13.4×
Hepatic function panel (80076) $175.20
$219
21.4×
Urinalysis, non-automated, without microscopy (81002) $41.60
$52
12.0×
PSA, total (84153) $89.60
$112
4.9×
Thyroid stimulating hormone (TSH) (84443) $141.60
$177
8.4×
CBC with automated differential (85025) $133.60
$167
17.2×
CBC, automated (85027) $85.60
$107
13.2×
Prothrombin time (PT) (85610) $77.60
$97
18.1×
Partial thromboplastin time (PTT) (85730) $114.40
$143
19.0×
Sleep study (attended polysomnography) (95810) $4,226.40
$5,283
4.8×
Physical therapy, therapeutic exercise (per 15 min) (97110) $128.80
$161
4.4×
Office visit, new patient (low complexity, ~30 min) (99203) $176.80
$221
1.3×
As a Critical Access Hospital, Medicare pays this facility about 101% of its own costs. The × Medicare column compares the cash price against that cost-based benchmark, not a standard rate.
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