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 |
|---|---|---|---|---|
| Panitumumab 20 mg/ml intravenous solution (wrapper) HCPCS J9303 | $3,967.11 | $4,958.88 | $1,413.28 – $4,462.99 | 15 |
| Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr HCPCS J2470 | $63.91 | $79.88 | $21.68 – $68.45 | 15 |
| Parathormone (pth) intact CPT 83970 | $306.40 | $383.00 | $109.16 – $344.70 | 15 |
| Parathyrd planar w/spect&ct CPT 78072 | $2,063.20 | $2,579.00 | $735.02 – $2,321.10 | 15 |
| Parathyroid planar img w/tomo spect CPT 78071 | $1,761.60 | $2,202.00 | $627.57 – $1,981.80 | 15 |
| Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector HCPCS J2506 | $7,933.38 | $9,916.72 | $31.73 – $6,385.23 | 15 |
| Pegfilgrastim-apgf 6 mg/0.6 ml subcutaneous syringe HCPCS Q5122 | $3,217.04 | $4,021.30 | $98.36 – $3,619.17 | 15 |
| Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe HCPCS Q5111 | $5,513.40 | $6,891.74 | $146.06 – $6,202.57 | 15 |
| Pegfilgrastim-fpgk 6 mg/0.6 ml subcutaneous syringe HCPCS Q5127 | $6,616.16 | $8,270.20 | $311.44 – $7,443.18 | 15 |
| Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe HCPCS Q5108 | not published | not published | $138.08 – $138.08 | 1 |
| Pegfilgrastim-pbbk 6 mg/0.6 ml subcutaneous syringe HCPCS Q5130 | not published | not published | $189.71 – $189.71 | 1 |
| Pegloticase 8 mg/ml intravenous solution HCPCS J2507 | not published | not published | $3,547.84 – $3,547.84 | 1 |
| Pegunigalsidase alfa-iwxj HCPCS J2508 | not published | not published | $227.78 – $227.78 | 1 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $2,769.60 | $3,462.00 | $986.67 – $3,115.80 | 15 |
| Pelvic CT scan (with contrast) CPT 72193 | $2,244.00 | $2,805.00 | $799.43 – $2,524.50 | 15 |
| Pelvic CT scan (without contrast) CPT 72192 | $2,004.00 | $2,505.00 | $713.93 – $2,254.50 | 15 |
| Pelvic MRI (with and without contrast) CPT 72197 | $4,138.40 | $5,173.00 | $1,474.31 – $4,655.70 | 15 |
| Pelvic MRI (without contrast) CPT 72195 | $2,972.80 | $3,716.00 | $1,059.06 – $3,344.40 | 15 |
| Pelvic Ultrasound (complete) CPT 76856 | $956.80 | $1,196.00 | $340.86 – $1,076.40 | 15 |
| Pelvic Ultrasound (limited) CPT 76857 | $514.40 | $643.00 | $183.26 – $578.70 | 15 |
| Pelvis X-ray (1 to 2 views) CPT 72170 | $327.20 | $409.00 | $116.57 – $368.10 | 15 |
| Pelvis X-ray (complete, 4 or more views) CPT 72190 | $406.40 | $508.00 | $144.78 – $457.20 | 15 |
| Pembrolizumab 25 mg/ml intravenous solution HCPCS J9271 | $6,414.79 | $8,018.48 | $69.76 – $7,089.86 | 15 |
| Pemetrexed disodium 100 mg intravenous powder for solution HCPCS J9305 | $3,448.94 | $4,311.17 | $328.40 – $1,037.06 | 15 |
| Pemivibart infusion HCPCS M0224 | $760.00 | $950.00 | $270.75 – $855.00 | 15 |
| Peng benzathine/procaine inj HCPCS J0558 | $247.83 | $309.78 | $30.04 – $94.88 | 15 |
| Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 | $369.52 | $461.90 | $131.64 – $415.71 | 15 |
| Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr HCPCS J2540 | $64.80 | $80.99 | $22.86 – $72.18 | 15 |
| Pentamidine non-comp unit HCPCS J2545 | $90.37 | $112.96 | $28.71 – $90.67 | 15 |
| Pericardiocentesis wwo imaging CPT 33016 | $2,251.20 | $2,814.00 | $801.99 – $2,532.60 | 15 |
| Pfc sigma fem post aug sz3 8mm HCPCS C1776 | $5,868.80 | $7,336.00 | $602.49 – $1,902.60 | 15 |
| Ph body fluid CPT 83986 | $20.80 | $26.00 | $7.41 – $23.40 | 15 |
| Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr HCPCS J2560 | $80.16 | $100.19 | $21.75 – $68.68 | 15 |
| Phenobarbital therapeutic drug level CPT 80184 | $71.20 | $89.00 | $22.23 – $70.20 | 15 |
| Phentolaine mesylate inj HCPCS J2760 | $750.39 | $937.98 | $216.59 – $683.96 | 15 |
| Phenylephrine 10 mg/ml injection solution HCPCS J2371 | $64.20 | $80.24 | $21.70 – $68.54 | 15 |
| Phenytoin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1165 | $62.61 | $78.26 | $21.59 – $68.18 | 15 |
| Phenytoin total therapeutic drug level CPT 80185 | $133.60 | $167.00 | $41.90 – $132.30 | 15 |
| Phlebotomy therapeutic CPT 99195 | $247.20 | $309.00 | $88.07 – $278.10 | 15 |
| Phosphorus CPT 84100 | $36.00 | $45.00 | $12.83 – $40.50 | 15 |
| Phosphorus 24 hour urine CPT 84105 | $32.80 | $41.00 | $11.69 – $36.90 | 15 |
| Physical Therapy Evaluation (high complexity) CPT 97163 | $331.20 | $414.00 | $117.99 – $372.60 | 15 |
| Physical Therapy Evaluation (low complexity) CPT 97161 | $256.00 | $320.00 | $91.20 – $288.00 | 15 |
| Physical Therapy Evaluation (moderate complexity) CPT 97162 | $280.00 | $350.00 | $99.75 – $315.00 | 15 |
| Physical Therapy Re-Evaluation CPT 97164 | $184.80 | $231.00 | $65.84 – $207.90 | 15 |
| Phytonadione (vitamin k1) 10 mg/ml injection solution HCPCS J3430 | $91.00 | $113.75 | $22.40 – $70.75 | 15 |
| Pinworm exam CPT 87172 | $56.80 | $71.00 | $20.24 – $63.90 | 15 |
| Piperacillin-tazobactam 3.375 gram intravenous solution HCPCS J2543 | $70.99 | $88.73 | $22.02 – $69.53 | 15 |
| Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides) CPT 19281 | $1,108.80 | $1,386.00 | $395.01 – $1,247.40 | 15 |
| Platelet aggregation each agent teg CPT 85576 | $98.40 | $123.00 | $35.06 – $110.70 | 15 |
| Platelet automated CPT 85049 | $33.60 | $42.00 | $11.97 – $37.80 | 15 |
| Platelet pheresis each unit HCPCS P9034 | $1,389.60 | $1,737.00 | $495.05 – $1,563.30 | 15 |
| Platelets each unit HCPCS P9019 | $345.60 | $432.00 | $123.12 – $388.80 | 15 |
| Platelets leukocytes reduced each unit HCPCS P9031 | $383.20 | $479.00 | $136.52 – $431.10 | 15 |
| Platelets pheresis leukocytes reduced irradiated each unit HCPCS P9037 | $1,887.20 | $2,359.00 | $672.32 – $2,123.10 | 15 |
| Plethysmography lung volumes/airway resistance CPT 94726 | $551.20 | $689.00 | $196.37 – $620.10 | 15 |
| Poct blood gases ph pco2 po2 arterial calculated o2 CPT 82803 | $208.00 | $260.00 | $74.10 – $234.00 | 15 |
| Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap CPT 95811 | $4,618.40 | $5,773.00 | $1,597.14 – $5,043.60 | 15 |
| Potassium 24 hour urine CPT 84133 | $36.80 | $46.00 | $13.11 – $41.40 | 15 |
| Potassium chloride 10 meq/100ml in sterile water intravenous piggyback HCPCS J3480 | $98.79 | $123.48 | $21.69 – $68.49 | 15 |
| Potassium serum/plasma/whole blood CPT 84132 | $34.40 | $43.00 | $12.26 – $38.70 | 15 |
| Pralidoxime 1 gram solution for injection HCPCS J2730 | $194.36 | $242.94 | $69.24 – $218.65 | 15 |
| Pr application of long arm splint CPT 29105 | $309.60 | $387.00 | $110.30 – $348.30 | 15 |
| Pr application splint static short arm CPT 29125 | $272.80 | $341.00 | $97.19 – $306.90 | 15 |
| Pr biopsy skin punch single lesion CPT 11104 | $517.60 | $647.00 | $184.40 – $582.30 | 15 |
| Pr counseling smoke/tobacco intermediate greater 3 - 10 minutes CPT 99406 | $58.40 | $73.00 | $20.81 – $65.70 | 15 |
| Prealbumin CPT 84134 | $66.40 | $83.00 | $23.66 – $74.70 | 15 |
| Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution HCPCS J7510 | $3.60 | $4.50 | $1.28 – $4.05 | 15 |
| Pregnancy Ultrasound (complete, after first trimester) CPT 76805 | $941.60 | $1,177.00 | $335.45 – $1,059.30 | 15 |
| Pregnancy Ultrasound (first trimester) CPT 76801 | $788.80 | $986.00 | $281.01 – $887.40 | 15 |
| Pregnancy Ultrasound (limited) CPT 76815 | $538.40 | $673.00 | $191.81 – $605.70 | 15 |
| Pr excision benign lesion scalp/neck/hands/feet/genitalia <= 0.5 cm CPT 11420 | $2,129.60 | $2,662.00 | $758.67 – $2,395.80 | 15 |
| Pr excision benign lesion trunk/arms/legs 3.1 - 4.0 cm CPT 11404 | $2,117.60 | $2,647.00 | $754.40 – $2,382.30 | 15 |
| Pr excision nail/nail matrix partial/complete permanent removal CPT 11750 | $857.60 | $1,072.00 | $305.52 – $964.80 | 15 |
| Pr incision & drainage abscess complicated/multiple CPT 10061 | $855.20 | $1,069.00 | $304.67 – $962.10 | 15 |
| Pr incision & drainage abscess simple/single CPT 10060 | $473.60 | $592.00 | $168.72 – $532.80 | 15 |
| Pr incision & drainage abscess vulva/perineal CPT 56405 | $543.20 | $679.00 | $193.52 – $611.10 | 15 |
| Pr incision & removal foreign body subcutaneous tissues simple CPT 10120 | $810.40 | $1,013.00 | $288.71 – $911.70 | 15 |
| Procainamide 100 mg/ml injection (wrapper) HCPCS J2690 | $64.40 | $80.49 | $22.08 – $69.73 | 15 |
| Procalcitonin CPT 84145 | $265.60 | $332.00 | $94.62 – $298.80 | 15 |
| Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution HCPCS J0780 | $68.82 | $86.02 | $21.82 – $68.91 | 15 |
| Proctosigmoidoscopy dilate 45303 CPT 45303 | $3,265.60 | $4,082.00 | $1,163.37 – $3,673.80 | 15 |
| Progesterone CPT 84144 | $151.20 | $189.00 | $53.87 – $170.10 | 15 |
| Prolactin CPT 84146 | $144.00 | $180.00 | $17.39 – $54.90 | 15 |
| Propofol infusion 10 mg/ml HCPCS J2704 | $64.28 | $80.34 | $21.38 – $67.50 | 15 |
| Protamine 10 mg/ml intravenous solution HCPCS J2720 | $61.99 | $77.48 | $21.72 – $68.60 | 15 |
| Protein c activity CPT 85303 | $260.80 | $326.00 | $92.91 – $293.40 | 15 |
| Protein electrophoretic fractionation & quantitation serum CPT 84165 | $86.40 | $108.00 | $28.50 – $90.00 | 15 |
| Protein s total CPT 85305 | $204.00 | $255.00 | $72.68 – $229.50 | 15 |
| Protein total 24 hour urine CPT 84156 | $60.80 | $76.00 | $18.81 – $59.40 | 15 |
| Protein total body fluid CPT 84157 | $39.20 | $49.00 | $13.97 – $44.10 | 15 |
| Protein total serum plasma whole blood CPT 84155 | $32.80 | $41.00 | $11.69 – $36.90 | 15 |
| Prothrombin complex kcentra HCPCS J7168 | $1,572.80 | $1,966.00 | $560.31 – $1,769.40 | 15 |
| Pr removal foreign body external auditory canal without anesthesia CPT 69200 | $278.40 | $348.00 | $99.18 – $313.20 | 15 |
| Pr removal intrauterine device CPT 58301 | $560.80 | $701.00 | $199.79 – $630.90 | 15 |
| Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm CPT 12032 | $750.40 | $938.00 | $267.33 – $844.20 | 15 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm CPT 12011 | $367.20 | $459.00 | $130.82 – $413.10 | 15 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm CPT 12013 | $388.00 | $485.00 | $138.23 – $436.50 | 15 |
| Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm CPT 12001 | $455.20 | $569.00 | $162.17 – $512.10 | 15 |
| Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm CPT 12002 | $373.60 | $467.00 | $133.10 – $420.30 | 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.