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.
469 prices shown (filtered).
| 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 | — | |
| Acetaminophen Chew Tab 160 MG Outpatient | 0250 RC | $1.50 | $1.20 | $0.36 – $1.41 | — | |
| 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 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 | — | |
| Acyclovir Tab 400 MG Outpatient | 0250 RC | $1.50 | $1.20 | $0.36 – $1.41 | — | |
| Albuterol Sulfate Inhal Aero 108 MCG/ACT (90MCG Base Equiv) Outpatient | 0250 RC | $65.21 | $52.17 | $15.79 – $61.30 | — | |
| Albuterol Sulfate Syrup 2 MG/5ML Outpatient | 0250 RC | $4.95 | $3.96 | $1.20 – $4.65 | — | |
| Allopurinol Tab 100 MG Outpatient | 0250 RC | $1.50 | $1.20 | $0.36 – $1.41 | — | |
| Allopurinol Tab 300 MG Outpatient | 0250 RC | $1.50 | $1.20 | $0.36 – $1.41 | — | |
| Alprazolam Tab 0.25 MG Outpatient | 0250 RC | $1.50 | $1.20 | $0.36 – $1.41 | — | |
| Alprazolam Tab 0.5 MG Outpatient | 0250 RC | $1.50 | $1.20 | $0.36 – $1.41 | — | |
| Alprazolam Tab 1 MG Outpatient | 0250 RC | $1.50 | $1.20 | $0.36 – $1.41 | — | |
| Alum & Mag Hydroxide-Simethicone Susp 200-200-20 MG/5ML Outpatient | 0250 RC | $9.54 | $7.64 | $2.31 – $8.97 | — | |
| Amiodarone HCl Tab 200 MG Outpatient | 0250 RC | $1.50 | $1.20 | $0.36 – $1.41 | — | |
| Amitriptyline HCl Tab 10 MG Outpatient | 0250 RC | $1.50 | $1.20 | $0.36 – $1.41 | — | |
| Amitriptyline HCl Tab 25 MG Outpatient | 0250 RC | $1.50 | $1.20 | $0.36 – $1.41 | — | |
| Amlodipine Besylate Tab 2.5 MG (Base Equivalent) Outpatient | 0250 RC | $1.50 | $1.20 | $0.36 – $1.41 | — | |
| Amlodipine Besylate Tab 5 MG (Base Equivalent) Outpatient | 0250 RC | $1.50 | $1.20 | $0.36 – $1.41 | — | |
| Amoxicillin (Trihydrate) Cap 250 MG Outpatient | 0250 RC | $1.50 | $1.20 | $0.36 – $1.41 | — | |
| Amoxicillin (Trihydrate) Cap 500 MG Outpatient | 0250 RC | $1.50 | $1.20 | $0.36 – $1.41 | — | |
| Amoxicillin (Trihydrate) For Susp 125 MG/5ML Outpatient | 0250 RC | $23.65 | $18.92 | $5.73 – $22.23 | — | |
| Amoxicillin (Trihydrate) For Susp 250 MG/5ML Outpatient | 0250 RC | $23.65 | $18.92 | $5.73 – $22.23 | — |