Sanford Westbrook Hospital — Infusion prices
← 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.
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.
10 prices shown.
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| ED 96360 IV infus therapy hydration fluids initial 31 min-1hr Outpatient | 96360 CPT | $746 | $597 | $181 – $701 | — | |
| ED 96365 IV infus ther proph diag initial up to 1hr Outpatient | 96365 CPT | $689 | $551 | $151 – $648 | — | |
| ED 96366 IV infus ther proph diag each addl hr Outpatient | 96366 CPT | $305 | $244 | $48.45 – $287 | — | |
| Infus tx px dx 1 hr 2v m59 Outpatient | 96365 CPT | $689 | $551 | $151 – $648 | — | |
| Infus tx px dx addl hr 2v m59 Outpatient | 96366 CPT | $305 | $244 | $48.45 – $287 | — | |
| Infusion tx prop dx 1hr 1v Outpatient | 96365 CPT | $689 | $551 | $151 – $648 | — | |
| IV hydrat initial 31-60mins Outpatient | 96360 CPT | $746 | $597 | $181 – $701 | — | |
| IV hydrat initial31-60min2vm59 Outpatient | 96360 CPT | $746 | $597 | $181 – $701 | — | |
| IV infusion each add hr Outpatient | 96366 CPT | $305 | $244 | $48.45 – $287 | — | |
| IV infusion tx proph dx init to 1hr Outpatient | 96365 CPT | $689 | $551 | $151 – $648 | — |