healthcosts.net
New Patient Office Visit (level 4) at Sanford Sheldon Medical Center
118 N 7th Ave, Sheldon, IA · Sanford Health · · NPI 1841200623
$244.00
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.
$305.00
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.
$86.93 with Sanford Health Plan Align vs $274.50 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 | $86.93 | ↓ -64% |
| Ucare | Medicare Replacement | $93.33 | ↓ -62% |
| Aetna | Medicare Replacement | $94.25 | ↓ -61% |
| Blue Cross Blue Shield of North Dakota | Medicare Replacement | $94.25 | ↓ -61% |
| Great Plains Medicare Advantage | Medicare Replacement | $94.25 | ↓ -61% |
| Health Partners | Medicare Replacement | $94.25 | ↓ -61% |
| United Healthcare | Medicare Replacement | $94.25 | ↓ -61% |
| Primewest | Medicare Replacement | $96.08 | ↓ -61% |
| Wellmark | HMO | $152.50 | ↓ -38% |
| Wellmark | PPO | $158.60 | ↓ -35% |
| Sanford Health Plan | Group Health/True | $163.42 | ↓ -33% |
| Sanford Health Plan | SD Exchange True | $163.42 | ↓ -33% |
| Security Health Plan | Commercial | $167.75 | ↓ -31% |
| Sanford Health Plan | Commercial/ND Pers | $192.24 | ↓ -21% |
| Sanford Health Plan | SD Exchange Commercial | $192.24 | ↓ -21% |
| Health Partners | State Employees | $201.30 | ↓ -18% |
| Health Partners | Commercial | $228.75 | ↓ -6% |
| Medica | Choice | $251.63 | ↑ +3% |
| United Healthcare | Commercial + Top 20 | $254.68 | ↑ +4% |
| Aetna | Commercial | $265.05 | ↑ +9% |
| Ucare | Commercial | $267.97 | ↑ +10% |
| Medica | Elect | $269.01 | ↑ +10% |
| First Choice Health Network | Commercial | $274.50 | ↑ +13% |
| Healthez | Commercial | $274.50 | ↑ +13% |
| Multiplan | Commercial | $274.50 | ↑ +13% |
Visitor-reported prices
Comments
New Patient Office Visit (level 4) at other Iowa hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UnityPoint Health - Iowa Lutheran Hospital | Des Moines | $289.60 | $121.61 – $251.15 |
| UnityPoint Health - Allen Hospital | Waterloo | $289.60 | $121.61 – $251.15 |
| MercyOne Genesis Davenport West Medical Center | Davenport | $206.40 | not published |
| MercyOne New Hampton Medical Center | New Hampton | $507.65 | $74.55 – $386.00 |
| MercyOne Dyersville Medical Center | Dyersville | $250.90 | $121.61 – $434.48 |
| MercyOne Clinton Medical Center | Clinton | $307.00 | $74.55 – $307.00 |
| MercyOne Oelwein Medical Center | Oelwein | $250.90 | $121.61 – $386.00 |
| MercyOne Cedar Falls Medical Center | Cedar Falls | $307.00 | $74.55 – $285.00 |