healthcosts.net
Lower Back (Lumbar Spine) MRI (with and without contrast) at Sanford Sheldon Medical Center
118 N 7th Ave, Sheldon, IA · Sanford Health · · NPI 1841200623
$4,326.40
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.
?
What you pay up front if you don't use insurance.
$5,408.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$1,541.28 with Sanford Health Plan Align vs $4,867.20 with Multiplan — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $1,541.28 | ↓ -64% |
| Ucare | Medicare Replacement | $1,654.85 | ↓ -62% |
| Aetna | Medicare Replacement | $1,671.07 | ↓ -61% |
| Blue Cross Blue Shield of North Dakota | Medicare Replacement | $1,671.07 | ↓ -61% |
| Great Plains Medicare Advantage | Medicare Replacement | $1,671.07 | ↓ -61% |
| Health Partners | Medicare Replacement | $1,671.07 | ↓ -61% |
| United Healthcare | Medicare Replacement | $1,671.07 | ↓ -61% |
| Primewest | Medicare Replacement | $1,703.52 | ↓ -61% |
| Wellmark | HMO | $2,704.00 | ↓ -38% |
| Wellmark | PPO | $2,812.16 | ↓ -35% |
| Sanford Health Plan | Group Health/True | $2,897.61 | ↓ -33% |
| Sanford Health Plan | SD Exchange True | $2,897.61 | ↓ -33% |
| Security Health Plan | Commercial | $2,974.40 | ↓ -31% |
| Sanford Health Plan | Commercial/ND Pers | $3,408.66 | ↓ -21% |
| Sanford Health Plan | SD Exchange Commercial | $3,408.66 | ↓ -21% |
| Health Partners | State Employees | $3,569.28 | ↓ -18% |
| Health Partners | Commercial | $4,056.00 | ↓ -6% |
| Medica | Choice | $4,461.60 | ↑ +3% |
| United Healthcare | Commercial + Top 20 | $4,515.68 | ↑ +4% |
| Aetna | Commercial | $4,699.55 | ↑ +9% |
| Ucare | Commercial | $4,751.47 | ↑ +10% |
| Medica | Elect | $4,769.86 | ↑ +10% |
| First Choice Health Network | Commercial | $4,867.20 | ↑ +13% |
| Healthez | Commercial | $4,867.20 | ↑ +13% |
| Multiplan | Commercial | $4,867.20 | ↑ +13% |
Visitor-reported prices
Comments
Lower Back (Lumbar Spine) MRI (with and without contrast) at other Iowa hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UnityPoint Health - Iowa Lutheran Hospital | Des Moines | $5,340.27 | $100.51 – $1,962.55 |
| UnityPoint Health - Allen Hospital | Waterloo | $2,525.67 | $100.51 – $1,663.78 |
| MercyOne Genesis Davenport West Medical Center | Davenport | $2,162.40 | $341.85 – $478.59 |
| MercyOne Dubuque Medical Center | Dubuque | $4,841.20 | $312.99 – $7,448.00 |
| MercyOne New Hampton Medical Center | New Hampton | $3,803.15 | $2,316.41 – $5,851.00 |
| MercyOne Clinton Medical Center | Clinton | $4,882.80 | $321.26 – $7,512.00 |
| MercyOne Oelwein Medical Center | Oelwein | $3,803.15 | $2,236.25 – $5,851.00 |
| MercyOne Cedar Falls Medical Center | Cedar Falls | $3,307.20 | $328.68 – $5,088.00 |