Sanford Sheldon Medical Center
118 N 7th Ave, Sheldon, IA · Sanford Health · · NPI 1841200623
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| 17-hydroxypregnenolone CPT 84143 | $69.60 | $87.00 | $24.80 – $78.30 | 15 |
| 24 hr ambulatory b/p monitor CPT 93786 | $349.60 | $437.00 | $124.55 – $393.30 | 15 |
| 3d recon without postprocess indpndt CPT 76376 | $891.20 | $1,114.00 | $317.49 – $1,002.60 | 15 |
| 5% dextrose and 0.45% saline HCPCS S5010 | $40.00 | $50.00 | $14.25 – $45.00 | 15 |
| 88334 ap bill cytologic exam each additional site CPT 88334 | $118.40 | $148.00 | $42.18 – $133.20 | 15 |
| Abatacept (with maltose) 250 mg intravenous solution HCPCS J0129 | $2,091.11 | $2,613.88 | $44.25 – $2,352.49 | 15 |
| Abdominal and Pelvic Blood Vessel Ultrasound (complete) CPT 93975 | $1,216.80 | $1,521.00 | $433.49 – $1,368.90 | 15 |
| Abdominal and Pelvic Blood Vessel Ultrasound (limited) CPT 93976 | $850.40 | $1,063.00 | $302.96 – $956.70 | 15 |
| Abdominal CT scan (with and without contrast) CPT 74170 | $2,880.80 | $3,601.00 | $1,026.29 – $3,240.90 | 15 |
| Abdominal CT scan (with contrast) CPT 74160 | $2,761.60 | $3,452.00 | $983.82 – $3,106.80 | 15 |
| Abdominal CT scan (without contrast) CPT 74150 | $2,223.20 | $2,779.00 | $792.02 – $2,501.10 | 15 |
| Abdominal MRI (with and without contrast) CPT 74183 | $4,155.20 | $5,194.00 | $1,480.29 – $4,674.60 | 15 |
| Abdominal MRI (with contrast) CPT 74182 | $3,222.40 | $4,028.00 | $1,147.98 – $3,625.20 | 15 |
| Abdominal MRI (without contrast) CPT 74181 | $2,896.80 | $3,621.00 | $1,031.99 – $3,258.90 | 15 |
| Abdominal paracentesis w/image guidance CPT 49083 | $1,884.00 | $2,355.00 | $671.18 – $2,119.50 | 15 |
| Abdominal Ultrasound (complete) CPT 76700 | $983.20 | $1,229.00 | $350.27 – $1,106.10 | 15 |
| Abdominal Ultrasound (limited) CPT 76705 | $756.00 | $945.00 | $269.33 – $850.50 | 15 |
| Abdominal X-ray (2 views) CPT 74019 | $376.80 | $471.00 | $134.24 – $423.90 | 15 |
| Abdominal X-ray Series (acute, with chest view) CPT 74022 | $520.80 | $651.00 | $185.54 – $585.90 | 15 |
| Abdominal X-ray (single view) CPT 74018 | $313.60 | $392.00 | $111.72 – $352.80 | 15 |
| Abd paracentesis/w/o image guide 49082 CPT 49082 | $1,176.00 | $1,470.00 | $418.95 – $1,323.00 | 15 |
| Ablation cryo thigh/knee CPT 27599 | $4,309.60 | $5,387.00 | $1,535.30 – $4,848.30 | 15 |
| Ablation of upper extremity nerves rf CPT 64999 | $526.40 | $658.00 | $187.53 – $592.20 | 15 |
| Acetaminophen 10 mg/ml soln 100 ml glass cont HCPCS J0131 | $137.75 | $172.18 | $22.37 – $70.65 | 15 |
| Acetaminophen level CPT 80143 | $62.40 | $78.00 | $22.23 – $70.20 | 15 |
| Acetazolamide 500 mg solution for injection HCPCS J1120 | $78.58 | $98.22 | $27.75 – $87.63 | 15 |
| Acetone qualitative CPT 82009 | $39.20 | $49.00 | $13.97 – $44.10 | 15 |
| Acetylcysteine 200 mg/ml (20 %) intravenous solution HCPCS J0132 | $368.16 | $460.20 | $26.99 – $85.24 | 15 |
| Acetylcysteine non-comp unit HCPCS J7608 | $24.16 | $30.19 | $4.17 – $13.18 | 15 |
| Aco cont gluc mnt phys/qhp eqp 95250aco CPT 95250 | $451.20 | $564.00 | $160.74 – $507.60 | 15 |
| Aco med nutria tx/group, ea 30 min 97804aco CPT 97804 | $53.60 | $67.00 | $19.10 – $60.30 | 15 |
| Acute hepatitis panel CPT 80074 | $382.40 | $478.00 | $136.23 – $430.20 | 15 |
| Acyclovir 400 mg tablet HCPCS J8499 | $417.63 | $522.03 | $0.43 – $1.35 | 15 |
| Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr HCPCS J0133 | $63.05 | $78.81 | $21.97 – $69.38 | 15 |
| #acylcarnitineprfl CPT 82017 | $51.20 | $64.00 | $18.24 – $57.60 | 15 |
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | $64.61 | $80.76 | $21.83 – $68.94 | 15 |
| Adh-sendout CPT 84588 | $174.40 | $218.00 | $62.13 – $196.20 | 15 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $91.80 | $114.74 | $14.02 – $44.27 | 15 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $328.80 | $411.00 | $67.20 – $369.90 | 15 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | $362.40 | $453.00 | $129.11 – $407.70 | 15 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $858.40 | $1,073.00 | $305.81 – $965.70 | 15 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | $550.40 | $688.00 | $196.08 – $619.20 | 15 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | $254.40 | $318.00 | $85.60 – $286.20 | 15 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $298.40 | $373.00 | $106.31 – $335.70 | 15 |
| Administration immunization each additional vaccine CPT 90472 | $86.40 | $108.00 | $30.78 – $97.20 | 15 |
| Administration immunization intranasal/oral route 1 vaccine CPT 90473 | $58.40 | $73.00 | $20.81 – $65.70 | 15 |
| Administration immunization intranasal/oral route each additional vaccine CPT 90474 | $54.40 | $68.00 | $19.38 – $61.20 | 15 |
| _afb id by dna probe rflx ast CPT 87149 | $109.60 | $137.00 | $39.05 – $123.30 | 15 |
| Agalsidase beta 35 mg intravenous solution HCPCS J0180 | not published | not published | $227.74 – $227.74 | 1 |
| Airway resistance by impulse oscillometry 94728 CPT 94728 | $458.40 | $573.00 | $163.31 – $515.70 | 15 |
| Albumin body fluid quantitative each specimen CPT 82042 | $42.40 | $53.00 | $10.26 – $32.40 | 15 |
| Albumin (human), 25%, 50ml HCPCS P9047 | $146.20 | $182.75 | $26.46 – $83.55 | 15 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $67.20 | $84.00 | $23.94 – $75.60 | 15 |
| Albumin serum plasma or whole blood CPT 82040 | $28.80 | $36.00 | $10.26 – $32.40 | 15 |
| Albuterol ipratrop non-comp HCPCS J7620 | $5.62 | $7.02 | $1.71 – $5.40 | 15 |
| Albuterol non-comp con HCPCS J7611 | $4.80 | $6.00 | $1.71 – $5.40 | 15 |
| Albuterol non-comp unit HCPCS J7613 | $4.80 | $6.00 | $1.71 – $5.40 | 15 |
| Alcohol (ethanol) any specimen except urine/breath CPT 82077 | $100.80 | $126.00 | $35.91 – $113.40 | 15 |
| Alemtuzumab 12 mg/1.2 ml intravenous solution HCPCS J0202 | not published | not published | $2,381.81 – $2,381.81 | 1 |
| Alkaline phosphatase CPT 84075 | $29.60 | $37.00 | $10.26 – $32.40 | 15 |
| Allergen egg white ige CPT 86003 | $36.00 | $45.00 | $12.83 – $40.50 | 15 |
| Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution HCPCS J0256 | not published | not published | $5.03 – $5.03 | 1 |
| Alpha-fetoprotein tumor marker CPT 82105 | $136.00 | $170.00 | $48.45 – $153.00 | 15 |
| Alprostadil for injection HCPCS J0270 | $90.76 | $113.44 | $32.33 – $102.10 | 15 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | $12,850.08 | $16,062.60 | $91.13 – $287.77 | 15 |
| Alt/sgpt CPT 84460 | $39.20 | $49.00 | $13.97 – $44.10 | 15 |
| Ambl bp mntr w/sw a/r CPT 93788 | $376.00 | $470.00 | $133.95 – $423.00 | 15 |
| Amikacin 4 mg/ml intravitreal injection - cnr HCPCS J0278 | $63.37 | $79.21 | $22.40 – $70.72 | 15 |
| Aminophylline 25 mg/ml intravenous solution (wrapper) HCPCS J0280 | $60.35 | $75.43 | $21.50 – $67.89 | 15 |
| Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV HCPCS J0283 | $123.03 | $153.78 | $42.89 – $135.43 | 15 |
| Amiodarone 50 mg/ml intravenous solution HCPCS J0282 | $60.83 | $76.03 | $21.56 – $68.09 | 15 |
| Ammonia CPT 82140 | $116.80 | $146.00 | $41.61 – $131.40 | 15 |
| Amniocentesisdiagnostic 59000 CPT 59000 | $1,204.80 | $1,506.00 | $429.21 – $1,355.40 | 15 |
| Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J0289 | $398.40 | $498.00 | $141.93 – $448.20 | 15 |
| Ampicillin 1 gram solution for injection HCPCS J0290 | $74.12 | $92.65 | $21.54 – $68.03 | 15 |
| Ampicillin-sulbactam 1.5 gram solution for injection HCPCS J0295 | $67.06 | $83.82 | $21.76 – $68.71 | 15 |
| Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis CPT 81515 | $496.00 | $620.00 | $176.70 – $558.00 | 15 |
| Amylase CPT 82150 | $79.20 | $99.00 | $28.22 – $89.10 | 15 |
| Ana ds-dna CPT 86226 | $128.00 | $160.00 | $45.60 – $144.00 | 15 |
| Analysis gene f2 20210g>a variant CPT 81240 | $345.60 | $432.00 | $68.40 – $216.00 | 15 |
| Analysis gene f5 leiden variant CPT 81241 | $331.20 | $414.00 | $68.40 – $216.00 | 15 |
| Anastrozole 1 mg HCPCS S0170 | $4.44 | $5.54 | $0.43 – $1.35 | 15 |
| Anca screen with reflex to titer -quest CPT 86021 | $176.00 | $220.00 | $62.70 – $198.00 | 15 |
| An cholangiogram percutaneous compl CPT 47531 | $2,060.00 | $2,575.00 | $733.88 – $2,317.50 | 15 |
| An fluoro guide for cvp CPT 77001 | $716.00 | $895.00 | $255.08 – $805.50 | 15 |
| Angiotensin ii 0.5 mg/ml soln 1 ml vial HCPCS J3490 | $202.21 | $252.76 | $0.43 – $1.35 | 15 |
| Ankle X-ray CPT 73610 | $353.60 | $442.00 | $125.97 – $397.80 | 15 |
| Ankle X-ray (2 views, both ankles) CPT 73600 | $302.40 | $378.00 | $107.73 – $340.20 | 15 |
| Anora (draw only) CPT 99001 | $43.20 | $54.00 | $15.39 – $48.60 | 15 |
| Anoscopy remove fb 46608 CPT 46608 | $1,424.80 | $1,781.00 | $507.59 – $1,602.90 | 15 |
| Antibody bacterium, not elsewhere specified CPT 86609 | $31.20 | $39.00 | $11.12 – $35.10 | 15 |
| Antibody elution rbc reference CPT 86860 | $164.80 | $206.00 | $58.71 – $185.40 | 15 |
| Antibody id rbc panel CPT 86870 | $341.60 | $427.00 | $121.70 – $384.30 | 15 |
| Antibody screen rbc CPT 86850 | $86.40 | $108.00 | $30.78 – $97.20 | 15 |
| Antibody tetanus CPT 86774 | $134.40 | $168.00 | $47.88 – $151.20 | 15 |
| Antinuclear antibodies CPT 86038 | $96.80 | $121.00 | $34.49 – $108.90 | 15 |
| Antinuclear antibodies titer CPT 86039 | $86.40 | $108.00 | $30.78 – $97.20 | 15 |
| Antistreptolysin o titer CPT 86060 | $67.20 | $84.00 | $23.94 – $75.60 | 15 |
| Antithrombin iii activity CPT 85300 | $187.20 | $234.00 | $66.69 – $210.60 | 15 |
| Aortic Aneurysm Screening Ultrasound CPT 76706 | $482.40 | $603.00 | $171.86 – $542.70 | 15 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.