Exc/pilonidal cyst/sinus/simple 11770 at Sanford Sheldon Medical Center
118 N 7th Ave, Sheldon, IA · Sanford Health · · NPI 1841200623
$6,529.60
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.
$8,162.00
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.
$2,326.17 with Sanford Health Plan Align vs $7,345.80 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 | $2,326.17 | ↓ -64% |
| Ucare | Medicare Replacement | $2,497.57 | ↓ -62% |
| Great Plains Medicare Advantage | Medicare Replacement | $2,522.06 | ↓ -61% |
| Aetna | Medicare Replacement | $2,522.06 | ↓ -61% |
| Blue Cross Blue Shield of North Dakota | Medicare Replacement | $2,522.06 | ↓ -61% |
| Health Partners | Medicare Replacement | $2,522.06 | ↓ -61% |
| United Healthcare | Medicare Replacement | $2,522.06 | ↓ -61% |
| Primewest | Medicare Replacement | $2,571.03 | ↓ -61% |
| Wellmark | HMO | $4,081.00 | ↓ -38% |
| Wellmark | PPO | $4,244.24 | ↓ -35% |
| Sanford Health Plan | Group Health/True | $4,373.20 | ↓ -33% |
| Sanford Health Plan | SD Exchange True | $4,373.20 | ↓ -33% |
| Security Health Plan | Commercial | $4,489.10 | ↓ -31% |
| Sanford Health Plan | Commercial/ND Pers | $5,144.51 | ↓ -21% |
| Sanford Health Plan | SD Exchange Commercial | $5,144.51 | ↓ -21% |
| Health Partners | State Employees | $5,386.92 | ↓ -18% |
| Health Partners | Commercial | $6,121.50 | ↓ -6% |
| Medica | Choice | $6,733.65 | ↑ +3% |
| United Healthcare | Commercial + Top 20 | $6,815.27 | ↑ +4% |
| Aetna | Commercial | $7,092.78 | ↑ +9% |
| Ucare | Commercial | $7,171.13 | ↑ +10% |
| Medica | Elect | $7,198.88 | ↑ +10% |
| Healthez | Commercial | $7,345.80 | ↑ +13% |
| First Choice Health Network | Commercial | $7,345.80 | ↑ +13% |
| Multiplan | Commercial | $7,345.80 | ↑ +13% |
Visitor-reported prices
Comments
Exc/pilonidal cyst/sinus/simple 11770 at other Iowa hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| MercyOne Genesis Davenport West Medical Center | Davenport | $487.80 | not published |
| MercyOne Clinton Medical Center | Clinton | $17,642.26 | $9.09 – $6,215.96 |
| MercyOne Des Moines Medical Center | Des Moines | $602.00 | $40.77 – $536.94 |
| MercyOne Centerville Medical Center | Centerville | $602.00 | $40.77 – $529.97 |
| MercyOne Genesis Davenport Medical Center | Davenport | $512.40 | not published |
| MercyOne Genesis DeWitt Medical Center | DeWitt | $512.40 | $623.42 – $2,679.00 |
| MercyOne Waterloo Medical Center | Waterloo | $30,668.93 | $0.96 – $5,612.77 |
| UnityPoint Health - Allen Hospital | Waterloo | $758.40 | $164.02 – $2,372.28 |