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 |
|---|---|---|---|---|
| Morphine (pf) 0.25 mg/0.5 ml injection (neo/ped) - cnr HCPCS J2274 | $81.52 | $101.90 | $22.61 – $71.39 | 15 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain manual CPT 88360 | $390.40 | $488.00 | $139.08 – $439.20 | 15 |
| MRA abdomen post contrast CPT 74185 | $2,418.40 | $3,023.00 | $861.56 – $2,720.70 | 15 |
| MRI chest without & w/contrast CPT 71552 | $4,069.60 | $5,087.00 | $1,449.80 – $4,578.30 | 15 |
| MRI loex nonjt w IV cont CPT 73719 | $3,683.20 | $4,604.00 | $1,312.14 – $4,143.60 | 15 |
| MRI lower extremity other than joint without contrast (both sides) CPT 73718 | $2,810.40 | $3,513.00 | $1,001.21 – $3,161.70 | 15 |
| MRI lower extremity other than joint without & w/contrast (both sides) CPT 73720 | $4,060.00 | $5,075.00 | $1,446.38 – $4,567.50 | 15 |
| MRI orbit fac&nck w IV cont CPT 70542 | $3,648.80 | $4,561.00 | $1,299.89 – $4,104.90 | 15 |
| MRI tmj CPT 70336 | $2,824.80 | $3,531.00 | $1,006.34 – $3,177.90 | 15 |
| MRI upper extremity other than joint without contrast (both sides) CPT 73218 | $2,645.60 | $3,307.00 | $942.50 – $2,976.30 | 15 |
| MRI upper extremity other than joint without & w/contrast (both sides) CPT 73220 | $4,012.80 | $5,016.00 | $1,429.56 – $4,514.40 | 15 |
| Mucopolysaccharides CPT 83864 | $320.00 | $400.00 | $114.00 – $360.00 | 15 |
| Multiple sleep latency test CPT 95805 | $3,213.60 | $4,017.00 | $1,144.85 – $3,615.30 | 15 |
| Mumps antibody igg CPT 86735 | $109.60 | $137.00 | $39.05 – $123.30 | 15 |
| Mycophenolate mofetil 250 mg capsule HCPCS J7517 | $4.68 | $5.85 | $0.43 – $1.35 | 15 |
| Mycophenolic acid HCPCS J7518 | $14.07 | $17.58 | $0.43 – $1.35 | 15 |
| Mycoplasma antibody igm CPT 86738 | $108.00 | $135.00 | $38.48 – $121.50 | 15 |
| Myeloperoxidase ab multi step qualitative/semiquantitative CPT 83516 | $98.40 | $123.00 | $20.52 – $64.80 | 15 |
| Nafcillin 2 gram solution for injection HCPCS J2290 | $95.59 | $119.48 | $23.00 – $72.64 | 15 |
| Nalbuphine 10 mg/ml injection solution HCPCS J2300 | $62.56 | $78.19 | $22.02 – $69.54 | 15 |
| Naloxone 0.4 mg/ml injection (wrapper) HCPCS J2312 | $65.26 | $81.57 | $21.88 – $69.09 | 15 |
| Naltrexone, depot form HCPCS J2315 | $2,019.52 | $2,524.40 | $719.45 – $2,271.96 | 15 |
| Nasal/sinus endoscopy surg w/bx 31237 CPT 31237 | $2,348.80 | $2,936.00 | $836.76 – $2,642.40 | 15 |
| Natalizumab 300 mg/15 ml intravenous solution HCPCS J2323 | $13,194.96 | $16,493.70 | $24.60 – $14,844.33 | 15 |
| Natriuretic peptide CPT 83880 | $251.20 | $314.00 | $33.63 – $106.20 | 15 |
| Natural killer cells total count CPT 86357 | $197.60 | $247.00 | $70.40 – $222.30 | 15 |
| Ndl insj without njx 1 or 2 musc CPT 20560 | $39.20 | $49.00 | $13.97 – $44.10 | 15 |
| Ndl insj without njx 3+ musc CPT 20561 | $68.80 | $86.00 | $24.51 – $77.40 | 15 |
| Nebulizer Breathing Treatment CPT 94640 | $299.20 | $374.00 | $68.40 – $216.00 | 15 |
| Neck Airway (Soft Tissue) X-ray CPT 70360 | $314.40 | $393.00 | $112.01 – $353.70 | 15 |
| Neck (Cervical Spine) CT scan (with and without contrast) CPT 72127 | $1,867.20 | $2,334.00 | $665.19 – $2,100.60 | 15 |
| Neck (Cervical Spine) CT scan (with contrast) CPT 72126 | $2,577.60 | $3,222.00 | $918.27 – $2,899.80 | 15 |
| Neck (Cervical Spine) CT scan (without contrast) CPT 72125 | $2,473.60 | $3,092.00 | $881.22 – $2,782.80 | 15 |
| Neck (Cervical Spine) MRI (with and without contrast) CPT 72156 | $4,445.60 | $5,557.00 | $1,583.75 – $5,001.30 | 15 |
| Neck (Cervical Spine) MRI (with contrast) CPT 72142 | $3,444.00 | $4,305.00 | $1,226.93 – $3,874.50 | 15 |
| Neck (Cervical Spine) MRI (without contrast) CPT 72141 | $2,987.20 | $3,734.00 | $1,064.19 – $3,360.60 | 15 |
| Neck (Cervical Spine) X-ray (2 to 3 views) CPT 72040 | $372.00 | $465.00 | $132.53 – $418.50 | 15 |
| Neck (Cervical Spine) X-ray (4 to 5 views) CPT 72050 | $530.40 | $663.00 | $188.96 – $596.70 | 15 |
| Neck (Cervical Spine) X-ray (6 or more views) CPT 72052 | $620.80 | $776.00 | $221.16 – $698.40 | 15 |
| Neck MRA (blood vessel MRI, with and without contrast) CPT 70549 | $3,804.00 | $4,755.00 | $1,355.18 – $4,279.50 | 15 |
| Neck MRA (blood vessel MRI, with contrast) CPT 70548 | $2,907.20 | $3,634.00 | $1,035.69 – $3,270.60 | 15 |
| Neck MRA (blood vessel MRI, without contrast) CPT 70547 | $2,597.60 | $3,247.00 | $925.40 – $2,922.30 | 15 |
| Neck Soft Tissue CT Scan (with and without contrast) CPT 70492 | $2,835.20 | $3,544.00 | $1,010.04 – $3,189.60 | 15 |
| Neck Soft Tissue CT Scan (with contrast) CPT 70491 | $2,381.60 | $2,977.00 | $848.45 – $2,679.30 | 15 |
| Neck Soft Tissue CT Scan (without contrast) CPT 70490 | $1,920.80 | $2,401.00 | $684.29 – $2,160.90 | 15 |
| Neostigmine methylsulfate 1 mg/ml injection (wrapper) HCPCS J2710 | $67.03 | $83.78 | $21.40 – $67.58 | 15 |
| New Patient Office Visit (level 2) CPT 99202 | $112.00 | $140.00 | $39.90 – $126.00 | 15 |
| New Patient Office Visit (level 3) CPT 99203 | $160.00 | $200.00 | $57.00 – $180.00 | 15 |
| New Patient Office Visit (level 4) CPT 99204 | $244.00 | $305.00 | $86.93 – $274.50 | 15 |
| New Patient Office Visit (level 5) CPT 99205 | $306.40 | $383.00 | $109.16 – $344.70 | 15 |
| Nicardipine 25 mg/10 ml intravenous solution HCPCS J2404 | $333.35 | $416.68 | $64.12 – $202.48 | 15 |
| Nintedanib 150 mg capsule HCPCS J8999 | $44.28 | $55.34 | $0.43 – $1.35 | 15 |
| Nivolumab 10 mg/ml intravenous solution (wrapper) HCPCS J9299 | $7,853.93 | $9,817.41 | $38.06 – $8,835.67 | 15 |
| Nivolumab 240 mg-relatlimab-rmbw 80 mg/20 ml intravenous solution HCPCS J9298 | not published | not published | $228.20 – $228.20 | 1 |
| Njx interlaminar lmbr/sac CPT 62326 | $1,124.80 | $1,406.00 | $400.71 – $1,265.40 | 15 |
| Nm imaging cardiac blood pooling planar single study at rest or stress CPT 78472 | $2,076.80 | $2,596.00 | $739.86 – $2,336.40 | 15 |
| Nm imaging gastrointestinal acute blood loss CPT 78278 | $1,712.00 | $2,140.00 | $609.90 – $1,926.00 | 15 |
| Nm imaging kidney morphology vascular flow/function single study w/pharmacological intervention CPT 78708 | $2,182.40 | $2,728.00 | $777.48 – $2,455.20 | 15 |
| Nm imaging pulmonary ventilation/perfusion CPT 78582 | $2,011.20 | $2,514.00 | $716.49 – $2,262.60 | 15 |
| Nm imaging thyroid single/multiple uptake(s) quantitative measurement(s) CPT 78014 | $1,384.80 | $1,731.00 | $493.34 – $1,557.90 | 15 |
| No pt prsnt train add 15 HCPCS G0542 | $60.80 | $76.00 | $21.66 – $68.40 | 15 |
| No pt prsnt train initial 30 HCPCS G0541 | $122.40 | $153.00 | $43.61 – $137.70 | 15 |
| Nose (Nasal Bone) X-ray (complete) CPT 70160 | $341.60 | $427.00 | $121.70 – $384.30 | 15 |
| Nuclear Stress Test (Heart) CPT 78452 | $4,600.00 | $5,750.00 | $1,638.75 – $5,175.00 | 15 |
| Observation per hour HCPCS G0378 | $72.80 | $91.00 | $25.94 – $81.90 | 15 |
| Obstetrics panel CPT 80055 | $316.00 | $395.00 | $112.58 – $355.50 | 15 |
| Ob Ultrasound nuchal meas 1 gest CPT 76813 | $599.20 | $749.00 | $213.47 – $674.10 | 15 |
| Ob Ultrasound nuchal meas add-on CPT 76814 | $391.20 | $489.00 | $139.37 – $440.10 | 15 |
| Occupational Therapy Evaluation (high complexity) CPT 97167 | $345.60 | $432.00 | $123.12 – $388.80 | 15 |
| Occupational Therapy Evaluation (low complexity) CPT 97165 | $265.60 | $332.00 | $94.62 – $298.80 | 15 |
| Occupational Therapy Evaluation (moderate complexity) CPT 97166 | $316.00 | $395.00 | $112.58 – $355.50 | 15 |
| Ocrelizumab 30 mg/ml intravenous solution HCPCS J2350 | $28,535.04 | $35,668.80 | $60.94 – $32,101.92 | 15 |
| Octreotide acetate 100 mcg/ml injection (wrapper) HCPCS J2354 | $269.48 | $336.84 | $21.70 – $68.54 | 15 |
| Octreotide,microspheres ER 20 mg intramuscular susp, extended release HCPCS J2353 | $9,201.27 | $11,501.58 | $2,256.62 – $7,126.16 | 15 |
| Off/op cnsltj new/est low 30 CPT 99243 | $213.60 | $267.00 | $76.10 – $240.30 | 15 |
| Off/op cnsltj new/est mod 40 CPT 99244 | $304.00 | $380.00 | $108.30 – $342.00 | 15 |
| Off/op consltj new/est hi 55 CPT 99245 | $376.80 | $471.00 | $134.24 – $423.90 | 15 |
| Off/op consltj new/est sf 20 CPT 99242 | $193.60 | $242.00 | $68.97 – $217.80 | 15 |
| Olanzapine 10 mg intramuscular solution HCPCS J2359 | $84.69 | $105.86 | $24.85 – $78.48 | 15 |
| Omalizumab 150 mg/ml subcutaneous syringe (wrapper) HCPCS J2357 | not published | not published | $39.04 – $39.04 | 1 |
| Onco (ovar) five proteins CPT 81503 | $2,188.80 | $2,736.00 | $779.76 – $2,462.40 | 15 |
| Ondansetron 4 mg s0119 HCPCS S0119 | $4.80 | $6.00 | $0.43 – $1.35 | 15 |
| Ondansetron 8 mg disintegrating tablet HCPCS Q0162 | $4.44 | $5.55 | $0.43 – $1.35 | 15 |
| Ondansetron hcl (pf) 2 mg/ml injection (wrapper) HCPCS J2405 | $60.87 | $76.08 | $21.43 – $67.69 | 15 |
| Orphenadrine citrate 30 mg/ml injection solution HCPCS J2360 | $70.98 | $88.72 | $23.51 – $74.23 | 15 |
| Osmolality blood CPT 83930 | $67.20 | $84.00 | $23.94 – $75.60 | 15 |
| Osmolality urine CPT 83935 | $74.40 | $93.00 | $26.51 – $83.70 | 15 |
| Oth resp proc, group HCPCS G0239 | $173.60 | $217.00 | $61.85 – $195.30 | 15 |
| Oth resp proc, indiv HCPCS G0238 | $128.00 | $160.00 | $45.60 – $144.00 | 15 |
| Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes CPT 97763 | $126.40 | $158.00 | $45.03 – $142.20 | 15 |
| Ot re-evaluation patient/family CPT 97168 | $196.00 | $245.00 | $69.83 – $220.50 | 15 |
| Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes CPT 97130 | $112.80 | $141.00 | $40.19 – $126.90 | 15 |
| Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes CPT 97129 | $127.20 | $159.00 | $45.32 – $143.10 | 15 |
| Oxaliplatin 5 mg/ml desensitization HCPCS J9263 | $1,370.85 | $1,713.56 | $70.63 – $223.04 | 15 |
| Oxytocin 10 unit/ml injection solution HCPCS J2590 | $83.40 | $104.25 | $21.55 – $68.06 | 15 |
| Paclitaxel 6 mg/ml concentrate,intravenous HCPCS J9267 | $189.49 | $236.86 | $67.51 – $213.17 | 15 |
| Paclitaxel protein-bound 100 mg intravenous suspension HCPCS J9264 | $1,590.92 | $1,988.64 | $566.76 – $1,789.78 | 15 |
| Paliperidone 117 mg/0.75 ml inj HCPCS J2426 | $2,650.85 | $3,313.56 | $944.36 – $2,982.20 | 15 |
| Palivizumab 50 mg/0.5 ml inj CPT 90378 | $2,143.62 | $2,679.52 | $763.66 – $2,411.57 | 15 |
| Palonosetron hcl HCPCS J2469 | $220.48 | $275.60 | $28.43 – $89.79 | 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.