Visits & medical services prices at Sanford Westbrook Medical Center

Westbrook, MN · every code in this section with a posted price and a Medicare benchmark.

141 codes. Prices are the hospital's own posted facility charges.

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ProcedurePosted cashPosted gross× Medicare
Admn Sarscov2 Vacc 1 Dose (90480) $71.20 $89 1.7×
Airway Inhalation Treatment (94640)
range across 3 matching MRF lines
$172.80–$204 $216–$255 varies
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $112.80 $141 7.9×
Behavral qualit analys voice (92524) $390.40 $488 3.6×
Breath hydrogen/methane test (91065) $475.20 $594 2.1×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $663.20 $829 1.7×
Canalith repositioning proc (95992) $164 $205 4.0×
Cardiac Stress Tst,Tracing Only (93017) $1,112.80 $1,391 5.0×
Cardiopulmonary resuscitation (92950) $1,293.60 $1,617 5.8×
Cardioversion (92960) $1,760.80 $2,201 2.6×
Caregiver Training Strategies&Tq Ea Addl 15 Min (97551) $64.80 $81 2.5×
Chemo Anti-Neopl Sq/Im (96401) $287.20 $359 3.9×
Chemo Hormon Antineopl Sq/Im (96402) $261.60 $327 3.5×
Chemo IV infusion addl hr (96415) $288.80 $361 3.9×
Chemo IV push addl drug (96411) $355.20 $444 4.8×
Chemother Prolong Infuse W/Pump (96416) $881.60 $1,102 2.6×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $383.20 $479 5.2×
Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) $859.20 $1,074 2.5×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $571.20 $714 1.7×
Chest Wall Manipulation (94668) $164 $205 1.2×
Color/duplex Doppler, complete (93975) $1,596 $1,995 6.5×
Color/duplex Doppler, limited (93976) $1,561.60 $1,952 14.5×
Community/Work Reintegration Trainj Ea 15 Min (97537) $143.20 $179 4.5×
Continuous Pulse Ox (94762) $351.20 $439 2.6×
Cpap Ventilation Cpap Initiation&Mgmt (94660)
range across 3 matching MRF lines
$416.80–$922.40 $521–$1,153 varies
Cpt initial (94667) $213.60 $267 1.6×
Critical care first hour (99291) $2,927.20 $3,659 3.4×
Debridement Open Wound 20 Sq Cm< (97597) $403.20 $504 1.9×
Dup-scan aorta ivc iliac vascl/bpgs complete (93978) $1,040.80 $1,301 4.2×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $866.40 $1,083 8.0×
Dup-scan lxtr art/artl bpgs compl bi study (93925) $1,357.60 $1,697 5.5×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $918.40 $1,148 8.5×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $1,336.80 $1,671 5.4×
Dup-scan xtr veins unilateral/limited study (93971) $1,030.40 $1,288 9.5×
Duplex Scan Artl Infl&Ven O/F Hemo Compl Bi Std (93985) $918.40 $1,148 3.7×
Duplex Scan Hemodialysis Access (93990) $720 $900 6.7×
Duplex up extrem art bilat (93930) $1,354.40 $1,693 5.5×
Duplex up extrem art unilat/ltd (93931) $856 $1,070 7.9×
Echo Congenital Complete (93303) $2,436.80 $3,046 4.3×
Echo Heart Xthoracic,Limited (93308) $966.40 $1,208 3.9×
Echo transesophageal (93312) $3,103.20 $3,879 5.5×
Eeg 41-60 Minutes (95812) $1,295.20 $1,619 5.8×
EEG awake and asleep (95819) $1,242.40 $1,553 5.6×
EEG awake drowsy (95816) $1,184.80 $1,481 5.3×
Electrical Stimulation Ea 15 Min (97032) $111.20 $139 7.6×
Electrocardiogram Tracing (93005) $278.40 $348 4.6×
Emergency Dept Visit Level 2 (99282) $464 $580 2.9×
Emergency Dept Visit Level 3 (99283) $704.80 $881 2.5×
Emergency Dept Visit Level 4 (99284) $1,292.80 $1,616 3.0×
Er level 1 (99281) $323.20 $404 3.7×
Er level v (99285) $1,752.80 $2,191 2.9×
Evaluate pt use of inhaler (94664) $204 $255 0.9×
Evaluate Speech Production (92522) $376.80 $471 3.4×
Evaluate Swallowing Function (92610) $410.40 $513 4.8×
Evaluation of speech fluency (92521) $400.80 $501 3.0×
External ECG rec>48hr<7d recording (93242) $190.40 $238 4.9×
External ECG rec>7d<15d recording (93246) $239.20 $299 6.2×
External ECG rec>7d<15d scanning alys w/report (93247) $386.40 $483 2.8×
External Ecg Scanning Analysis Report (93226) $676.80 $846 11.1×
Extracranial Bilat Study (93880) $1,245.60 $1,557 5.1×
Extracranial Uni/Ltd Study (93882) $874.40 $1,093 8.1×
F-up/limited tthrc echo congenital car anomaly (93304) $1,518.40 $1,898 2.7×
Group Therapeutic Procedures (97150) $120.80 $151 6.7×
Holter monitor recording (93225) $536.80 $671 3.9×
Im Adm Intransl/Oral 1 Vaccine (90473) $32 $40 0.4×
Immunization administration (90471)
range across 11 matching MRF lines
$15.75–$64 $19.68–$80 varies
Intracranial Complete Study (93886) $1,917.60 $2,397 7.8×
Iontophoresis 15 min (97033) $124 $155 6.5×
Irrig Drug Delivery Device (96523) $237.60 $297 3.9×
IV infusion hydration each additional hour (96361) $179.20 $224 3.7×
IV infusion hydration initial 31 min-1 hour (96360) $596.80 $746 2.7×
IV infusion ther proph addl sequential to 1 hr (96367) $384 $480 5.2×
IV infusion therapy prophylaxis/dx ea hour (96366) $244 $305 5.0×
IV push initial (96374)
range across 3 matching MRF lines
$344–$374.40 $430–$468 varies
Lwr Xtr Vasc Stdy Bilat (93924) $1,016.80 $1,271 4.6×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $64 $80 2.0×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $70.40 $88 1.9×
Methacholine challenge (94070) $1,084 $1,355 2.8×
Multiple Sleep Latency Test (95805)
range across 2 matching MRF lines
$2,872–$3,167.20 $3,590–$3,959 varies
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $389.60 $487 1.9×
Nerve Conduction Studies 1-2 Studies (95907) $557.60 $697 2.5×
Nerve Conduction Studies 11-12 Studies (95912) $2,134.40 $2,668 5.5×
Nerve conduction studies 13 or more studies (95913) $2,475.20 $3,094 6.4×
Nerve Conduction Studies 3-4 Studies (95908) $902.40 $1,128 4.0×
Nerve conduction studies 5-6 studies (95909) $1,105.60 $1,382 5.0×
Nerve conduction studies 7-8 studies (95910) $1,236.80 $1,546 3.2×
Nerve Conduction Studies 9-10 Studies (95911) $1,797.60 $2,247 4.7×
Neuromuscular Reeducation (97112) $130.40 $163 4.0×
Oral Function Therapy (92526) $312.80 $391 3.7×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $178.40 $223 3.9×
Ot Contrast Bath Ea 15 Min (97034) $110.40 $138 7.9×
Ot eval high complexity (97167) $386.40 $483 3.8×
Ot Eval Low Complex (97165) $280 $350 2.8×
Ot Eval Moderate Complexity (97166) $322.40 $403 3.2×
Ot manual therapy 15 min (97140) $128 $160 4.6×
Ot paraffin bath (97018) $108 $135 18.0×
Ot Re-Eval Est Plan Care (97168) $263.20 $329 3.8×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $281.60 $352 2.1×
Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) $248.80 $311 1.9×
Peripheral arterial disease rehab per session (93668) $179.20 $224 2.9×
Phlebotomy therapeutic (99195) $249.60 $312 1.8×
Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) $224 $280 3.7×
Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) $224 $280 3.7×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811)
range across 4 matching MRF lines
$2,596.80–$4,949.60 $3,246–$6,187 varies
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $48.80 $61 1.0×
Prof svcs allg immntx x w/prv allgic xtrcs njxs (95117) $68.80 $86 1.4×
Pt Eval High Complex (97163) $352.80 $441 3.6×
Pt eval low complex 20 min (97161) $262.40 $328 2.7×
Pt Eval Mod Complex (97162) $308 $385 3.1×
Pt gait training 15 min (97116) $118.40 $148 4.1×
Pt group caregiver training (97552) $54.40 $68 2.5×
Pt mechanical traction (97012) $123.20 $154 8.6×
Pt Re-Eval Est Plan Care (97164) $244 $305 3.6×
Pulm function test by gas (94727) $296.80 $371 1.3×
Refill/Maint Portable Pump (96521) $514.40 $643 2.3×
Remote 30 Day Ecg Rev/Report (93270) $409.60 $512 10.6×
Rhythm Ecg 1-3 Leads Tracing Only W/O I&R (93041) $164 $205 2.7×
Self Care Mngment Training (97535) $132 $165 4.1×
Slp caregiver training 1st 30 min (97550) $129.60 $162 2.5×
Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800) $608 $760 2.7×
Speech sound lang comprehen (92523) $490.40 $613 2.2×
Spirometry (94010) $277.60 $347 1.2×
Stress Tte Only (93350) $2,185.60 $2,732 3.9×
Subcutaneous Infusion Each Additional Hour (96370) $157.60 $197 3.3×
Subcutaneous infusion initial 1 hr w/pump set-up (96369) $193.60 $242 0.9×
Subq Infusion Additional Pump Infusion Site (96371) $174.40 $218 2.3×
Temp transcutaneous pacing (92953) $815.20 $1,019 1.2×
Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) $134.40 $168 6.0×
Ther Ivntj Ea Addl 15 Min (97130) $116.80 $146 5.6×
Ther Px 1/> Areas Each 15 Minutes Massage (97124) $110.40 $138 3.7×
Ther/Proph/Diag Inj Ia (96373) $226.40 $283 1.0×
Ther/Proph/Diag Inj Sc/Im (96372)
range across 4 matching MRF lines
$20–$176.80 $25–$221 varies
Ther/Proph/Diag Iv Inf Init (96365) $551.20 $689 2.5×
Therapeutic Activities (97530) $133.60 $167 3.8×
Tte w/doppler, complete (93306) $2,535.20 $3,169 4.5×
Tte W/O Doppler Complete (93307) $1,782.40 $2,228 7.2×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $324 $405 4.3×
Tx/Pro/Dx Inj New Drug Addon (96375)
range across 2 matching MRF lines
$208–$240.80 $260–$301 varies
Upr/L Xtremity Art 2 Levels (93922)
range across 3 matching MRF lines
$705.60–$771.20 $882–$964 varies
Upr/Lxtr Art Stdy 3+ Lvls (93923) $1,136.80 $1,421 5.1×
Wheelchair Mgmt Ea 15 Min (97542) $133.60 $167 4.3×

A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.