Sanford Westbrook Hospital — price list
← Hospital overviewVerified from Sanford Westbrook Hospital’s published price file
Includes cash prices, list prices, insurance-negotiated rates. Open any row for plan-level negotiated rates. This is public hospital price transparency data, not a guaranteed estimate of your bill.
Showing the first 1,500 prices from a large file. Search a procedure or code below to narrow the list.
How to read these columns
- List
- The hospital’s full undiscounted (gross) charge — rarely what anyone actually pays.
- Cash
- The discounted self-pay price for paying directly, without insurance.
- Negotiated
- Rates agreed with insurers; open a row for plan-level detail. Your share depends on your benefits.
These are the hospital’s published reference prices, not a personalized estimate of your bill.
1,500 prices shown.
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| ,Insulin Aspart Soln Pen-injector 100 Unit/ML,Insulin Aspart Soln Cartridge 100 Unit/ML Outpatient | 0250 RC | $58.30 | $46.64 | $14.11 – $54.80 | — | |
| 5 hiaa (5 hydroxy) random urine 83497.901 Outpatient | 83497 CPT | $59.00 | $47.20 | $14.28 – $55.46 | — | |
| A & p repair Outpatient | 0360 RC | $10,766 | $8,613 | $2,606 – $10,120 | — | |
| Abd hysterectomy Outpatient | 0360 RC | $14,724 | $11,779 | $3,565 – $13,841 | — | |
| Abd hysterectomy bso Outpatient | 0360 RC | $12,456 | $9,965 | $3,016 – $11,709 | — | |
| Acetaminophen Chew Tab 160 MG Outpatient | 0250 RC | $1.50 | $1.20 | $0.36 – $1.41 | — | |
| Acetaminophen IV Soln 10 MG/ML Outpatient | J0134 HCPCS | $166 | $133 | $40.18 – $156 | — | |
| Acetaminophen IV Soln 10 MG/ML Outpatient | J0131 HCPCS | $164 | $132 | $39.82 – $155 | — | |
| Acetaminophen Suppos 120 MG Outpatient | 0250 RC | $1.50 | $1.20 | $0.36 – $1.41 | — | |
| Acetaminophen Suppos 325 MG Outpatient | 0250 RC | $6.15 | $4.92 | $1.49 – $5.78 | — | |
| Acetaminophen Suppos 650 MG Outpatient | 0250 RC | $1.50 | $1.20 | $0.36 – $1.41 | — | |
| Acetaminophen Suppos 80 MG Outpatient | 0250 RC | $6.29 | $5.04 | $1.52 – $5.91 | — | |
| Acetaminophen Susp 160 MG/5ML Outpatient | 0250 RC | $9.83 | $7.87 | $2.38 – $9.24 | — | |
| Acetaminophen Tab 325 MG Outpatient | J3490 HCPCS | $2.75 | $2.20 | $0.67 – $2.59 | — | |
| Acetaminophen Tab 500 MG Outpatient | J3490 HCPCS | $2.75 | $2.20 | $0.67 – $2.59 | — | |
| Acetaminophen Tab ER 650 MG Outpatient | 0250 RC | $1.50 | $1.20 | $0.36 – $1.41 | — | |
| Acetaminophen w/ Codeine Soln 120-12 MG/5ML Outpatient | 0250 RC | $4.95 | $3.96 | $1.20 – $4.65 | — | |
| Acetaminophen w/ Codeine Tab 300-30 MG Outpatient | 0250 RC | $1.50 | $1.20 | $0.36 – $1.41 | — | |
| Acetic Acid Otic Soln 2% Outpatient | 0250 RC | $45.20 | $36.16 | $10.94 – $42.49 | — | |
| Acetylcysteine Inhal Soln 20% Outpatient | 0250 RC | $22.14 | $17.72 | $5.36 – $20.81 | — | |
| Acetylcysteine Inhal Soln 20% Outpatient | J7608 HCPCS | $30.53 | $24.43 | $7.39 – $28.70 | — | |
| Acetylcysteine Inj 200 MG/ML Outpatient | J0132 HCPCS | $98.01 | $78.41 | $23.73 – $92.13 | — | |
| Activated protein c apc resistance assay 85307 Outpatient | 85307 CPT | $304 | $243 | $73.60 – $286 | — | |
| Acute hepatitis panel 80074 Outpatient | 80074 CPT | $432 | $346 | $105 – $406 | — | |
| Acyclovir Tab 400 MG Outpatient | 0250 RC | $1.50 | $1.20 | $0.36 – $1.41 | — | |
| Acylcarnitines quant each spec so 82017.900 Outpatient | 82017 CPT | $62.00 | $49.60 | $15.01 – $58.28 | — | |
| Adenoidectomy Outpatient | 0360 RC | $4,879 | $3,903 | $1,181 – $4,586 | — | |
| Adenoidectomy wtubes Outpatient | 0360 RC | $5,157 | $4,126 | $1,249 – $4,848 | — | |
| Adenosine IV Soln 12 MG/4ML Outpatient | J0153 HCPCS | $84.56 | $67.65 | $20.47 – $79.49 | — | |
| Adenovirus 87260 Outpatient | 87260 CPT | $196 | $157 | $47.45 – $184 | — |