Oth resp proc, group at Sanford Sheldon Medical Center
118 N 7th Ave, Sheldon, IA · Sanford Health · · NPI 1841200623
$173.60
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.
$217.00
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.
$61.85 with Sanford Health Plan Align vs $195.30 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 | $61.85 | ↓ -64% |
| Ucare | Medicare Replacement | $66.40 | ↓ -62% |
| Great Plains Medicare Advantage | Medicare Replacement | $67.05 | ↓ -61% |
| Aetna | Medicare Replacement | $67.05 | ↓ -61% |
| Blue Cross Blue Shield of North Dakota | Medicare Replacement | $67.05 | ↓ -61% |
| Health Partners | Medicare Replacement | $67.05 | ↓ -61% |
| United Healthcare | Medicare Replacement | $67.05 | ↓ -61% |
| Primewest | Medicare Replacement | $68.36 | ↓ -61% |
| Wellmark | HMO | $108.50 | ↓ -38% |
| Wellmark | PPO | $112.84 | ↓ -35% |
| Sanford Health Plan | Group Health/True | $116.27 | ↓ -33% |
| Sanford Health Plan | SD Exchange True | $116.27 | ↓ -33% |
| Security Health Plan | Commercial | $119.35 | ↓ -31% |
| Sanford Health Plan | Commercial/ND Pers | $136.78 | ↓ -21% |
| Sanford Health Plan | SD Exchange Commercial | $136.78 | ↓ -21% |
| Health Partners | State Employees | $143.22 | ↓ -18% |
| Health Partners | Commercial | $162.75 | ↓ -6% |
| Medica | Choice | $179.03 | ↑ +3% |
| United Healthcare | Commercial + Top 20 | $181.20 | ↑ +4% |
| Aetna | Commercial | $188.57 | ↑ +9% |
| Ucare | Commercial | $190.66 | ↑ +10% |
| Medica | Elect | $191.39 | ↑ +10% |
| Healthez | Commercial | $195.30 | ↑ +13% |
| First Choice Health Network | Commercial | $195.30 | ↑ +13% |
| Multiplan | Commercial | $195.30 | ↑ +13% |
Visitor-reported prices
Comments
Oth resp proc, group at other Iowa hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| MercyOne Genesis Davenport West Medical Center | Davenport | $139.80 | $37.57 – $52.60 |
| MercyOne Dubuque Medical Center | Dubuque | $146.25 | $33.51 – $225.00 |
| MercyOne Des Moines Medical Center | Des Moines | $253.50 | $35.25 – $390.00 |
| MercyOne Genesis Davenport Medical Center | Davenport | $124.20 | $37.57 – $52.60 |
| MercyOne Genesis DeWitt Medical Center | DeWitt | $108.60 | $61.54 – $132.13 |
| UnityPoint Health - Allen Hospital | Waterloo | $228.75 | $11.67 – $150.69 |
| UnityPoint Health - Finley Hospital | Dubuque | $191.87 | $11.67 – $191.86 |
| UnityPoint Health - Grinnell Regional Medical Center | Grinnell | $158.07 | $11.67 – $79.62 |