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SANFORD WESTBROOK HOSPITAL

Hospital

920 BELL AVENUE PO BOX 188

WESTBROOK, MN, 56183

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Procedure Prices at SANFORD WESTBROOK HOSPITAL

Blood Draw From Vein Using Needle

CPT 36415

$5.4

Mechanical Traction

CPT 97012

$66.1

Therapeutic Exercises

CPT 97110

$73.74

Therapeutic Activities

CPT 97530

$76.2

Lab Test - Complete Blood Cell Count With White Blood Cell Percentage

CPT 85025

$92.26

EKG Tracing

CPT 93005

$101.95

Screening Mammogram (bilateral)

CPT 77067

$132.78

Lab Test - Comprehensive Metabolic Panel

CPT 80053

$132.84

Outpatient Clinic Visit Established Patient Level III

CPT 99213

$139.35

Chest X-Ray (1 view)

CPT 71045

$196.08

Chest X-Ray (2 views)

CPT 71046

$251.94

Thoracic Spine X-Ray

CPT 72072

$402.59

Abdominal Ultrasound — Limited

CPT 76705

$415.93

ER Visit — Low-Moderate Complexity

CPT 99283

$552.98

Retroperitoneal Ultrasound

CPT 76770

$561.75

ER Visit — Moderate Complexity

CPT 99284

$615.13

ER Visit — High Complexity

CPT 99285

$1,020.71

Abdominal Ultrasound

CPT 76700

$1,109.7

CT Chest

CPT 71250

$1,150.6

MRI Joint of Lower Extremity

CPT 73721

$1,588.09

Echocardiogram w/ Doppler

CPT 93306

$1,595.32

MRI Brain w/o Contrast

CPT 70551

$1,726.01

CT Abdomen & Pelvis

CPT 74177

$2,281.57

MRI Brain w/ Contrast

CPT 70553

$2,456.02

Colonoscopy

CPT 45378

$2,922.61

Colonoscopy w/ Biopsy

CPT 45380

$3,504.49

Upper GI Endoscopy w/ Biopsy

CPT 43239

$4,194.16

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Prices sourced from federally mandated hospital price transparency files. Cash prices reflect self-pay discounted rates. Negotiated rates vary by insurance plan. Data may not reflect current pricing — always confirm with the hospital before scheduling.