Sanford Sheldon Medical Center
118 N 7th Ave, Sheldon, IA · Sanford Health · · NPI 1841200623
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Hip X-ray CPT 73502 | $352.00 | $440.00 | $125.40 – $396.00 | 15 |
| Histamine CPT 83088 | $130.40 | $163.00 | $26.79 – $84.60 | 15 |
| Hizentra injection HCPCS J1559 | not published | not published | $13.46 – $13.46 | 1 |
| Home sleep test/type 3 porta HCPCS G0399 | $670.40 | $838.00 | $238.83 – $754.20 | 15 |
| Homocysteine CPT 83090 | $96.00 | $120.00 | $34.20 – $108.00 | 15 |
| Homovanillic acid (hva) CPT 83150 | $68.80 | $86.00 | $24.51 – $77.40 | 15 |
| Hyaluronidase, human recombinant 150 unit/ml injection solution HCPCS J3473 | $89.61 | $112.01 | $31.92 – $100.81 | 15 |
| Hydralazine 20 mg/ml injection solution HCPCS J0360 | $63.64 | $79.55 | $22.28 – $70.35 | 15 |
| Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J1720 | $85.22 | $106.52 | $22.72 – $71.74 | 15 |
| Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper) HCPCS J1171 | $60.37 | $75.46 | $21.47 – $67.79 | 15 |
| Hydromorphone 20-0.9 mg/100ml-% soln 100 ml cartridge HCPCS J7999 | $189.40 | $236.75 | $22.43 – $70.83 | 15 |
| Hydroxyzine hcl 50 mg/ml intramuscular solution HCPCS J3410 | $60.29 | $75.36 | $21.45 – $67.73 | 15 |
| Hyqvia 100mg immuneglobulin HCPCS J1575 | not published | not published | $17.81 – $17.81 | 1 |
| Hysterosalpingography s&i CPT 74740 | $897.60 | $1,122.00 | $319.77 – $1,009.80 | 15 |
| I-123 sod iodide diag per 100 uci HCPCS A9516 | $224.80 | $281.00 | $80.09 – $252.90 | 15 |
| Iaadi respiratory synctial virus CPT 87280 | $68.00 | $85.00 | $24.23 – $76.50 | 15 |
| Icatibant injection HCPCS J1744 | not published | not published | $93.19 – $93.19 | 1 |
| Idursulfase injection HCPCS J1743 | not published | not published | $548.06 – $548.06 | 1 |
| Ihc/icc per specimen each additional single antibody stain CPT 88341 | $280.80 | $351.00 | $100.04 – $315.90 | 15 |
| Ihc/icc per specimen each multiplex antibody stain CPT 88344 | $644.80 | $806.00 | $229.71 – $725.40 | 15 |
| Ihc/icc per specimen initial single antibody stain CPT 88342 | $351.20 | $439.00 | $125.12 – $395.10 | 15 |
| Immobilizer shldr cntor adlt HCPCS L3670 | $81.60 | $102.00 | $18.24 – $57.60 | 15 |
| Immobilizer shldr dlx str 24-36in med HCPCS L1830 | $131.20 | $164.00 | $29.07 – $91.80 | 15 |
| Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution HCPCS J1569 | $3,359.52 | $4,199.40 | $50.63 – $686.16 | 15 |
| Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution HCPCS J1566 | not published | not published | $83.74 – $83.74 | 1 |
| Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution HCPCS J1568 | not published | not published | $49.91 – $49.91 | 1 |
| Immunoassay tumor antigen quantitative ca 125 CPT 86304 | $101.60 | $127.00 | $36.20 – $114.30 | 15 |
| Immunoassay tumor antigen quantitative ca 19-9 CPT 86301 | $101.60 | $127.00 | $36.20 – $114.30 | 15 |
| Immunodiff gel qual ea antigen/ab CPT 86331 | $69.60 | $87.00 | $11.12 – $35.10 | 15 |
| Immunofixation electrophoresis serum CPT 86334 | $166.40 | $208.00 | $59.28 – $187.20 | 15 |
| Imuglucerase injection HCPCS J1786 | not published | not published | $44.44 – $44.44 | 1 |
| In-111 pentetate dtpa / 0.5 mci HCPCS A9548 | $5,174.40 | $6,468.00 | $1,843.38 – $5,821.20 | 15 |
| Incision & drainage hematoma/seroma/fluid collection CPT 10140 | $2,856.80 | $3,571.00 | $1,017.74 – $3,213.90 | 15 |
| Incision of breast lesion CPT 19020 | $2,817.60 | $3,522.00 | $1,003.77 – $3,169.80 | 15 |
| Inf agt nucleic acid human papillomavirus separately reported high-risk types pooled result(s) CPT 87626 | $175.20 | $219.00 | $62.42 – $197.10 | 15 |
| Infect ag eia influenza a or b ea CPT 87400 | $93.60 | $117.00 | $33.35 – $105.30 | 15 |
| Infect ag genotype na hiv-1 revr trn/prt CPT 87901 | $859.20 | $1,074.00 | $306.09 – $966.60 | 15 |
| Infect ag ia optc obs influenza CPT 87804 | $71.20 | $89.00 | $25.37 – $80.10 | 15 |
| Infect ag if influenza a CPT 87276 | $74.40 | $93.00 | $26.51 – $83.70 | 15 |
| Infect ag if influenza b CPT 87275 | $72.00 | $90.00 | $25.65 – $81.00 | 15 |
| Infect ag if nos ea CPT 87299 | $96.80 | $121.00 | $34.49 – $108.90 | 15 |
| Infect ag na hpv high-risk types CPT 87624 | $175.20 | $219.00 | $62.42 – $197.10 | 15 |
| Infect ag na influenza r/amp 1st 2 types CPT 87502 | $248.80 | $311.00 | $88.64 – $279.90 | 15 |
| Infect ag na orthopoxvirus amp prb each CPT 87593 | $145.60 | $182.00 | $51.87 – $163.80 | 15 |
| Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin CPT 87324 | $108.00 | $135.00 | $38.48 – $121.50 | 15 |
| Infectious agent antigen immunoassay ql/sq multi step cryptosporidium CPT 87328 | $94.40 | $118.00 | $33.63 – $106.20 | 15 |
| Infectious agent antigen immunoassay ql/sq multi step giardia CPT 87329 | $97.60 | $122.00 | $34.49 – $108.90 | 15 |
| Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool CPT 87338 | $170.40 | $213.00 | $60.71 – $191.70 | 15 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn CPT 87340 | $70.40 | $88.00 | $25.08 – $79.20 | 15 |
| Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies CPT 87389 | $101.60 | $127.00 | $36.20 – $114.30 | 15 |
| Infectious agent antigen immunoassay ql/sq multi step legionella urine CPT 87449 | $31.20 | $39.00 | $11.12 – $35.10 | 15 |
| Infectious agent antigen immunoassay ql/sq multi step rotavirus CPT 87425 | $129.60 | $162.00 | $46.17 – $145.80 | 15 |
| Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin CPT 87427 | $92.00 | $115.00 | $32.78 – $103.50 | 15 |
| Infectious agent nucleic acid amplified probe CPT 87798 | $177.60 | $222.00 | $30.78 – $97.20 | 15 |
| Infectious agent nucleic acid amplified probe chlamydia trachomatis CPT 87491 | $184.00 | $230.00 | $40.76 – $128.70 | 15 |
| Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s) CPT 87493 | $210.40 | $263.00 | $74.96 – $236.70 | 15 |
| Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets CPT 87483 | $1,355.20 | $1,694.00 | $482.79 – $1,524.60 | 15 |
| Infectious agent nucleic acid amplified probe hsv-1 CPT 87529 | $263.20 | $329.00 | $93.77 – $296.10 | 15 |
| Infectious agent nucleic acid amplified probe neisseria gonorrhoeae CPT 87591 | $182.40 | $228.00 | $30.78 – $97.20 | 15 |
| Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 CPT 87635 | $124.80 | $156.00 | $44.46 – $140.40 | 15 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b CPT 87636 | $349.60 | $437.00 | $124.55 – $393.30 | 15 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv CPT 87637 | $460.80 | $576.00 | $164.16 – $518.40 | 15 |
| Infectious agent nucleic acid amplified probe streptococcus group a CPT 87651 | $105.60 | $132.00 | $37.62 – $118.80 | 15 |
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | $114.40 | $143.00 | $40.76 – $128.70 | 15 |
| Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae CPT 87494 | $366.40 | $458.00 | $71.54 – $225.90 | 15 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | $1,227.20 | $1,534.00 | $437.19 – $1,380.60 | 15 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets CPT 87506 | $757.60 | $947.00 | $269.90 – $852.30 | 15 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | $103.20 | $129.00 | $36.77 – $116.10 | 15 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | $100.00 | $125.00 | $35.63 – $112.50 | 15 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $461.60 | $577.00 | $164.45 – $519.30 | 15 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $443.20 | $554.00 | $157.89 – $498.60 | 15 |
| Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets CPT 87631 | $348.00 | $435.00 | $123.98 – $391.50 | 15 |
| Infliximab 100 mg intravenous solution HCPCS J1745 | $1,587.80 | $1,984.74 | $32.81 – $1,786.27 | 15 |
| Infliximab-axxq 100 mg intravenous solution HCPCS Q5121 | $753.01 | $941.26 | $21.68 – $847.13 | 15 |
| Infliximab-dyyb 100 mg intravenous solution HCPCS Q5103 | $801.01 | $1,001.26 | $13.88 – $901.13 | 15 |
| Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis CPT 94642 | $320.00 | $400.00 | $114.00 – $360.00 | 15 |
| Inj, acetaminophen (b braun) HCPCS J0136 | $76.83 | $96.03 | $27.37 – $86.43 | 15 |
| Inj acetaminophen -fresenius HCPCS J0134 | $97.51 | $121.88 | $34.74 – $109.69 | 15 |
| Inj, adzynma, 10 iu HCPCS J7171 | not published | not published | $35.25 – $35.25 | 1 |
| Inj alymsys 10 mg HCPCS Q5126 | $2,472.50 | $3,090.62 | $236.24 – $746.01 | 15 |
| Inj anifrolumab-fnia 1mg HCPCS J0491 | not published | not published | $17.63 – $17.63 | 1 |
| Inj. asceniv HCPCS J1554 | not published | not published | $500.66 – $500.66 | 1 |
| Inj aval alfa-nqpt 4mg HCPCS J0219 | not published | not published | $79.24 – $79.24 | 1 |
| Inj., benralizumab, 1 mg HCPCS J0517 | $8,621.41 | $10,776.76 | $170.48 – $9,055.42 | 15 |
| Inj, bupivacaine liposome HCPCS J0666 | $60.00 | $75.00 | $21.38 – $67.50 | 15 |
| Inj, cefepime hcl (b braun) HCPCS J0703 | $124.31 | $155.38 | $44.28 – $139.84 | 15 |
| Inj., cerliponase alfa 1 mg HCPCS J0567 | not published | not published | $116.40 – $116.40 | 1 |
| Inj, cipaglucosidase, 5 mg HCPCS J1203 | not published | not published | $89.74 – $89.74 | 1 |
| Inj cutaquig 100 mg HCPCS J1551 | not published | not published | $14.78 – $14.78 | 1 |
| Inj cuvitru, 100 mg HCPCS J1555 | not published | not published | $17.14 – $17.14 | 1 |
| Inj, daptomycin (hospira) HCPCS J0877 | $86.38 | $107.97 | $30.77 – $97.17 | 15 |
| Inj, donanemab-azbt, 2 mg HCPCS J0175 | not published | not published | $4.16 – $4.16 | 1 |
| Inj dx for sinogram CPT 20501 | $728.00 | $910.00 | $259.35 – $819.00 | 15 |
| Injection arthrography hip without anesthesia (both sides) CPT 27093 | $753.60 | $942.00 | $268.47 – $847.80 | 15 |
| Injection, burosumab-twza 1m HCPCS J0584 | not published | not published | $478.43 – $478.43 | 1 |
| Injection, casimersen, 10 mg HCPCS J1426 | not published | not published | $160.00 – $160.00 | 1 |
| Injection, daratumumab 10 mg HCPCS J9145 | not published | not published | $78.01 – $78.01 | 1 |
| Injection, edaravone, 1 mg HCPCS J1301 | not published | not published | $22.58 – $22.58 | 1 |
| Injection epidural blood patch or clot CPT 62273 | $1,869.60 | $2,337.00 | $562.59 – $1,776.60 | 15 |
| Injection for bladder x-ray CPT 51600 | $747.20 | $934.00 | $266.19 – $840.60 | 15 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.