Breast punct aspir cyst, bil at Sanford Sheldon Medical Center
118 N 7th Ave, Sheldon, IA · Sanford Health · · NPI 1841200623
$1,110.40
Cash price Discounted cash price What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge. Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.
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What you pay up front if you don't use insurance.
$1,388.00
Gross charge Gross charge (chargemaster price) The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this. Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.
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The hospital's undiscounted list price — almost no one pays this.
$395.58 with Sanford Health Plan Align vs $1,249.20 with Multiplan — same scan, same building. Share
Negotiated rates by payer
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →Payer ?Payer The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on. Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509. Full explanation → |
Plan ?Plan The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates. Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible. Full explanation → |
Negotiated rate | vs. cash |
|---|---|---|---|
| Sanford Health Plan Align | Medicare Replacement | $395.58 | ↓ -64% |
| Ucare | Medicare Replacement | $424.73 | ↓ -62% |
| Great Plains Medicare Advantage | Medicare Replacement | $428.89 | ↓ -61% |
| Aetna | Medicare Replacement | $428.89 | ↓ -61% |
| Blue Cross Blue Shield of North Dakota | Medicare Replacement | $428.89 | ↓ -61% |
| Health Partners | Medicare Replacement | $428.89 | ↓ -61% |
| United Healthcare | Medicare Replacement | $428.89 | ↓ -61% |
| Primewest | Medicare Replacement | $437.22 | ↓ -61% |
| Wellmark | HMO | $694.00 | ↓ -38% |
| Wellmark | PPO | $721.76 | ↓ -35% |
| Sanford Health Plan | Group Health/True | $743.69 | ↓ -33% |
| Sanford Health Plan | SD Exchange True | $743.69 | ↓ -33% |
| Security Health Plan | Commercial | $763.40 | ↓ -31% |
| Sanford Health Plan | Commercial/ND Pers | $874.86 | ↓ -21% |
| Sanford Health Plan | SD Exchange Commercial | $874.86 | ↓ -21% |
| Health Partners | State Employees | $916.08 | ↓ -18% |
| Health Partners | Commercial | $1,041.00 | ↓ -6% |
| Medica | Choice | $1,145.10 | ↑ +3% |
| United Healthcare | Commercial + Top 20 | $1,158.98 | ↑ +4% |
| Aetna | Commercial | $1,206.17 | ↑ +9% |
| Ucare | Commercial | $1,219.50 | ↑ +10% |
| Medica | Elect | $1,224.22 | ↑ +10% |
| Healthez | Commercial | $1,249.20 | ↑ +13% |
| First Choice Health Network | Commercial | $1,249.20 | ↑ +13% |
| Multiplan | Commercial | $1,249.20 | ↑ +13% |
Visitor-reported prices
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Breast punct aspir cyst, bil at other Iowa hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| MercyOne Genesis Davenport West Medical Center | Davenport | $714.60 | $516.10 – $673.49 |
| MercyOne Dubuque Medical Center | Dubuque | $682.50 | $38.10 – $1,414.91 |
| MercyOne West Des Moines Medical Center | West Des Moines | $795.00 | $38.10 – $1,374.78 |
| MercyOne Des Moines Medical Center | Des Moines | $516.75 | $11.05 – $795.00 |
| MercyOne North Iowa Medical Center | Mason City | $1,442.35 | $38.10 – $2,219.00 |
| MercyOne Genesis Davenport Medical Center | Davenport | $825.60 | $596.05 – $673.49 |
| MercyOne Genesis DeWitt Medical Center | DeWitt | $825.60 | $254.77 – $296.82 |
| MercyOne Waterloo Medical Center | Waterloo | $1,212.90 | $38.10 – $3,576.15 |