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 |
|---|---|---|---|---|
| Brace knee support neoprene padded open patella med HCPCS L1810 | $126.40 | $158.00 | $45.03 – $142.20 | 15 |
| Brace m arm board HCPCS L3809 | $97.60 | $122.00 | $31.92 – $100.80 | 15 |
| Brace or Splint Fitting and Training (each 15 minutes) CPT 97760 | $134.40 | $168.00 | $47.88 – $151.20 | 15 |
| Brace ortho tlso 2xl 19in strnl y bar wst belt pd shldr HCPCS L0456 | $995.20 | $1,244.00 | $354.54 – $1,119.60 | 15 |
| Brace oths wrist hnd fngr without HCPCS L3807 | $89.60 | $112.00 | $15.11 – $47.70 | 15 |
| Brace wrist classic lft sm HCPCS L3908 | $99.20 | $124.00 | $11.12 – $35.10 | 15 |
| Brain MRA (blood vessel MRI, with and without contrast) CPT 70546 | $3,977.60 | $4,972.00 | $1,417.02 – $4,474.80 | 15 |
| Brain MRA (blood vessel MRI, with contrast) CPT 70545 | $3,096.00 | $3,870.00 | $1,102.95 – $3,483.00 | 15 |
| Brain MRA (blood vessel MRI, without contrast) CPT 70544 | $2,816.80 | $3,521.00 | $1,003.49 – $3,168.90 | 15 |
| Brain MRI (with and without contrast) CPT 70553 | $4,494.40 | $5,618.00 | $1,601.13 – $5,056.20 | 15 |
| Brain MRI (with contrast) CPT 70552 | $3,381.60 | $4,227.00 | $1,204.70 – $3,804.30 | 15 |
| Brain MRI (without contrast) CPT 70551 | $3,087.20 | $3,859.00 | $1,099.82 – $3,473.10 | 15 |
| Breastbone (Sternum) X-ray CPT 71120 | $288.00 | $360.00 | $102.60 – $324.00 | 15 |
| Breast punct aspir cyst, bil CPT 19000 | $1,110.40 | $1,388.00 | $395.58 – $1,249.20 | 15 |
| Bronchial allergy tests CPT 95070 | $876.80 | $1,096.00 | $312.36 – $986.40 | 15 |
| Bronchial challenge CPT 94070 | $1,048.80 | $1,311.00 | $373.64 – $1,179.90 | 15 |
| Budesonide non-comp unit HCPCS J7626 | $19.61 | $24.51 | $1.93 – $6.08 | 15 |
| Bumetanide in d5w IV syringe 0.04 mg/ml (neo/ped) - cnr HCPCS J1939 | $62.62 | $78.27 | $21.51 – $67.93 | 15 |
| Bundled special stain group 1 microorganisms CPT 88312 | $412.00 | $515.00 | $146.78 – $463.50 | 15 |
| Bundled special stain group 2 CPT 88313 | $288.00 | $360.00 | $102.60 – $324.00 | 15 |
| Bupivacaine 0.1 % epidural pca - 1 hour dose limit HCPCS J0665 | $66.24 | $82.80 | $21.65 – $68.38 | 15 |
| Bx breast perq without image 19100 CPT 19100 | $2,585.60 | $3,232.00 | $921.12 – $2,908.80 | 15 |
| Bx/exc lymph node/open/superfic 38500 CPT 38500 | $3,636.00 | $4,545.00 | $1,295.33 – $4,090.50 | 15 |
| Bx thyroid/percutan core needle 60100 CPT 60100 | $1,351.20 | $1,689.00 | $481.37 – $1,520.10 | 15 |
| C-1 esterase, berinert HCPCS J0597 | not published | not published | $69.64 – $69.64 | 1 |
| C-1 esterase, cinryze HCPCS J0598 | not published | not published | $65.44 – $65.44 | 1 |
| C1 esterase inhibitor func - sendout CPT 86161 | $56.80 | $71.00 | $20.24 – $63.90 | 15 |
| Cadd pump refill CPT 96521 | $629.60 | $787.00 | $224.30 – $708.30 | 15 |
| Caffeine citrate 20 mg/ml inj for po HCPCS J0706 | $63.72 | $79.64 | $22.70 – $71.68 | 15 |
| Calcium 24 hour urine CPT 82340 | $43.20 | $54.00 | $15.39 – $48.60 | 15 |
| Calcium chloride 100 mg/ml (10 %) intravenous syringe HCPCS J0618 | $66.40 | $83.00 | $22.16 – $69.97 | 15 |
| Calcium gluconate 100 mg/ml (10 %) intravenous solution HCPCS J0612 | $66.16 | $82.70 | $22.52 – $71.11 | 15 |
| Calcium ionized CPT 82330 | $140.80 | $176.00 | $50.16 – $158.40 | 15 |
| Calcium total CPT 82310 | $34.40 | $43.00 | $12.26 – $38.70 | 15 |
| Calprotectin fecal CPT 83993 | $107.20 | $134.00 | $38.19 – $120.60 | 15 |
| Canakinumab injection HCPCS J0638 | not published | not published | $130.24 – $130.24 | 1 |
| Cannula ercp contour 5-4-3 tip HCPCS C1889 | $416.00 | $520.00 | $148.20 – $468.00 | 15 |
| Carbamazepine free CPT 80157 | $71.20 | $89.00 | $25.37 – $80.10 | 15 |
| Carbamazepine total therapeutic drug level CPT 80156 | $128.80 | $161.00 | $45.89 – $144.90 | 15 |
| Carbon dioxide CPT 82374 | $36.80 | $46.00 | $13.11 – $41.40 | 15 |
| Carboplatin 10 mg/ml desensitization HCPCS J9045 | $232.61 | $290.76 | $70.08 – $221.31 | 15 |
| Carboxyhemoglobin quantitative CPT 82375 | $101.60 | $127.00 | $36.20 – $114.30 | 15 |
| Carcinoembryonic ag (cea) CPT 82378 | $100.00 | $125.00 | $35.63 – $112.50 | 15 |
| Cardiac perf spect sgl/ef/wm rst/strs CPT 78451 | $3,348.80 | $4,186.00 | $1,193.01 – $3,767.40 | 15 |
| Cardiac rehabilitation op phase 2 w/continous ecg monitoring CPT 93798 | $272.00 | $340.00 | $96.90 – $306.00 | 15 |
| Cardiolipin antibody iga CPT 86147 | $128.80 | $161.00 | $21.09 – $66.60 | 15 |
| Cardioversion (Scheduled Heart Rhythm Shock) CPT 92960 | $1,783.20 | $2,229.00 | $635.27 – $2,006.10 | 15 |
| Caregiver training strategies&tq 1st 30 minutes CPT 97550 | $122.40 | $153.00 | $43.61 – $137.70 | 15 |
| Caregiver training strategies&tq ea addl 15 min CPT 97551 | $60.80 | $76.00 | $21.66 – $68.40 | 15 |
| Carotid Artery Ultrasound (Duplex) CPT 93880 | $1,165.60 | $1,457.00 | $415.25 – $1,311.30 | 15 |
| Car seat/bed test 60 minutes CPT 94780 | $96.00 | $120.00 | $34.20 – $108.00 | 15 |
| Car seat/bed test additional 30 minutes CPT 94781 | $48.00 | $60.00 | $17.10 – $54.00 | 15 |
| Caspofungin acetate HCPCS J0637 | $565.30 | $706.62 | $201.39 – $635.96 | 15 |
| Cath cv dl inj 7fx16cm HCPCS C1751 | $701.60 | $877.00 | $25.94 – $81.90 | 15 |
| Catheterization collection of specimen single patient all places of service HCPCS P9612 | $16.80 | $21.00 | $5.99 – $18.90 | 15 |
| Cath groshong MRI 8fr plstc port HCPCS C1788 | $1,044.00 | $1,305.00 | $268.76 – $848.70 | 15 |
| Cath malecot 28fr 4-wing ltx HCPCS C1729 | $1,962.40 | $2,453.00 | $37.62 – $118.80 | 15 |
| Cath/saline/contrast/sis/hysteosal 58340 CPT 58340 | $549.60 | $687.00 | $195.80 – $618.30 | 15 |
| Cath uret open tp 6fx70cm HCPCS C1758 | $102.40 | $128.00 | $16.82 – $53.10 | 15 |
| Cdna analysis for variants CPT 81403 | $529.60 | $662.00 | $188.67 – $595.80 | 15 |
| Cefazolin 10 mg/10 ml (dilution #2) IV desensitization - cnr HCPCS J0690 | $97.29 | $121.61 | $21.57 – $68.10 | 15 |
| Cefepime 1 gram solution for injection HCPCS J0692 | $64.47 | $80.58 | $22.05 – $69.62 | 15 |
| Cefoxitin 1 gram intravenous solution HCPCS J0694 | $125.25 | $156.56 | $22.14 – $69.93 | 15 |
| Ceftazidime 4.5 mg/0.2 ml intraocular injection - cnr HCPCS J0713 | $120.39 | $150.48 | $22.22 – $70.18 | 15 |
| Ceftriaxone 1 gram solution for injection HCPCS J0696 | $123.78 | $154.72 | $21.57 – $68.11 | 15 |
| Cell count body fluid CPT 89050 | $107.20 | $134.00 | $38.19 – $120.60 | 15 |
| Cell count w differential body fluid CPT 89051 | $60.00 | $75.00 | $21.38 – $67.50 | 15 |
| Cemiplimab-rwlc 50 mg/ml intravenous solution HCPCS J9119 | not published | not published | $33.82 – $33.82 | 1 |
| Certolizumab pegol 400 mg (200 mg x 2 vials) subcutaneous kit HCPCS J0717 | $8,848.12 | $11,060.14 | $4.73 – $2,413.10 | 15 |
| Cetuximab 100 mg/50 ml intravenous solution HCPCS J9055 | $841.92 | $1,052.40 | $299.93 – $947.16 | 15 |
| Change cystostomy tube simple CPT 51705 | $701.60 | $877.00 | $249.95 – $789.30 | 15 |
| Chemo adm cns w/lmbr punct CPT 96450 | not published | not published | $386.40 – $386.40 | 1 |
| Chemodenervation/face muscl/unilat 64612 CPT 64612 | $529.60 | $662.00 | $188.67 – $595.80 | 15 |
| Chemo ia infuse each addl hr CPT 96423 | not published | not published | $176.00 – $176.00 | 1 |
| Chemo ia infusion up to 1 hr CPT 96422 | not published | not published | $378.40 – $378.40 | 1 |
| Chemo ia push tecnique CPT 96420 | not published | not published | $247.20 – $247.20 | 1 |
| Chemo intralesional over 7 CPT 96406 | not published | not published | $314.40 – $314.40 | 1 |
| Chemo intralesional up to 7 96405 CPT 96405 | not published | not published | $201.60 – $201.60 | 1 |
| Chemotherapy injection 96542 CPT 96542 | not published | not published | $316.80 – $316.80 | 1 |
| Chemotx admn pertl cav impl CPT 96446 | not published | not published | $387.20 – $387.20 | 1 |
| Chest 2 vws w oblique CPT 71048 | $260.80 | $326.00 | $92.91 – $293.40 | 15 |
| Chest apical lordotic proj CPT 71047 | $247.20 | $309.00 | $88.07 – $278.10 | 15 |
| Chest CT scan (with and without contrast) CPT 71270 | $3,041.60 | $3,802.00 | $1,083.57 – $3,421.80 | 15 |
| Chest CT scan (with contrast) CPT 71260 | $2,748.80 | $3,436.00 | $979.26 – $3,092.40 | 15 |
| Chest CT scan (without contrast) CPT 71250 | $2,108.00 | $2,635.00 | $750.98 – $2,371.50 | 15 |
| Chest Physiotherapy (first session) CPT 94667 | $234.40 | $293.00 | $83.51 – $263.70 | 15 |
| Chest Physiotherapy (follow-up session) CPT 94668 | $149.60 | $187.00 | $53.30 – $168.30 | 15 |
| Chest Ultrasound CPT 76604 | $594.40 | $743.00 | $211.76 – $668.70 | 15 |
| Chest X-ray CPT 71046 | $340.00 | $425.00 | $121.13 – $382.50 | 15 |
| Chest X-ray (single view) CPT 71045 | $253.60 | $317.00 | $90.35 – $285.30 | 15 |
| Chg pr pul rehab for copd patients CPT 94626 | $214.40 | $268.00 | $76.38 – $241.20 | 15 |
| Chlamydia culture CPT 87110 | $132.00 | $165.00 | $47.03 – $148.50 | 15 |
| Chloramphenicol sodium injec HCPCS J0720 | $71.40 | $89.24 | $25.43 – $80.32 | 15 |
| Chloride CPT 82435 | $28.80 | $36.00 | $10.26 – $32.40 | 15 |
| Chloride 24 hour urine CPT 82436 | $53.60 | $67.00 | $19.10 – $60.30 | 15 |
| Chlorpromazine 0.125 mg/ml IV syringe - cnr HCPCS J3230 | $76.85 | $96.06 | $23.40 – $73.90 | 15 |
| Chmotx admn plrl cav thrcnts CPT 96440 | not published | not published | $1,822.40 – $1,822.40 | 1 |
| Cholangiography and/or pancreatography intraoperative supervision & interpretation CPT 74300 | $1,092.00 | $1,365.00 | $389.03 – $1,228.50 | 15 |
| Cholesterol CPT 82465 | $38.40 | $48.00 | $13.68 – $43.20 | 15 |
| Cholesterol (Lipid) Test CPT 80061 | $100.00 | $125.00 | $35.63 – $112.50 | 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.