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 |
|---|---|---|---|---|
| Complx repair sal addl 5 cm/> 13122 CPT 13122 | $656.80 | $821.00 | $233.99 – $738.90 | 15 |
| Complx repair trunk 1.1-2.5 cm 13100 CPT 13100 | $1,675.20 | $2,094.00 | $596.79 – $1,884.60 | 15 |
| Complx repair trunk addl 5cm/< 13102 CPT 13102 | $1,230.40 | $1,538.00 | $438.33 – $1,384.20 | 15 |
| Computed tomographic angiography head and neck with contrast CPT 70471 | $3,008.00 | $3,760.00 | $1,071.60 – $3,384.00 | 15 |
| Concentration infection agents any type CPT 87015 | $52.80 | $66.00 | $18.81 – $59.40 | 15 |
| Condylomata destruction 56420 CPT 56420 | $388.80 | $486.00 | $138.51 – $437.40 | 15 |
| Conjugated estrogens 25 mg solution for injection HCPCS J1410 | $420.04 | $525.04 | $149.64 – $472.54 | 15 |
| Consultation pathology during surgery cytological exam initial site CPT 88333 | $220.00 | $275.00 | $78.38 – $247.50 | 15 |
| Consultation pathology during surgery frozen section each additional block CPT 88332 | $153.60 | $192.00 | $54.72 – $172.80 | 15 |
| Consultation pathology during surgery frozen section first tissue block CPT 88331 | $453.60 | $567.00 | $161.60 – $510.30 | 15 |
| Contrast x-ray of hip CPT 73525 | $1,037.60 | $1,297.00 | $369.65 – $1,167.30 | 15 |
| Contrast x-ray of knee joint CPT 73580 | $1,105.60 | $1,382.00 | $393.87 – $1,243.80 | 15 |
| Control nosebleed pack+caut 30905 CPT 30905 | $356.00 | $445.00 | $126.83 – $400.50 | 15 |
| Control nose/throat bleeding w/pst nsl packs 42970 CPT 42970 | $338.40 | $423.00 | $120.56 – $380.70 | 15 |
| Control of nosebleed ant comp 30903 CPT 30903 | $338.40 | $423.00 | $120.56 – $380.70 | 15 |
| Control of nosebleedantersmpl 30901 CPT 30901 | $302.40 | $378.00 | $107.73 – $340.20 | 15 |
| Control oropharyngeal hemorr/simp 42960 CPT 42960 | $2,558.40 | $3,198.00 | $911.43 – $2,878.20 | 15 |
| Coombs direct CPT 86880 | $52.80 | $66.00 | $18.81 – $59.40 | 15 |
| Coombs indirect titer reference CPT 86886 | $56.00 | $70.00 | $19.95 – $63.00 | 15 |
| Copper intrauterine device HCPCS J7300 | $3,324.00 | $4,155.00 | $1,184.18 – $3,739.50 | 15 |
| Cortisol total am CPT 82533 | $121.60 | $152.00 | $16.53 – $52.20 | 15 |
| Cosyntropin 0.25 mg solution for injection HCPCS J0834 | $219.49 | $274.36 | $25.64 – $80.97 | 15 |
| Counseling smoke cess interm >10mins CPT 99407 | $79.20 | $99.00 | $28.22 – $89.10 | 15 |
| Covid-19 administration immunization im inj 1st/only component CPT 90480 | $71.20 | $89.00 | $25.37 – $80.10 | 15 |
| Covid-19 convalescent plasma HCPCS C9507 | $880.00 | $1,100.00 | $313.50 – $990.00 | 15 |
| #covid19rsv-rsv CPT 87634 | $171.20 | $214.00 | $60.99 – $192.60 | 15 |
| #coxa-coxsackie a serotype a16 CPT 86658 | $100.80 | $126.00 | $35.91 – $113.40 | 15 |
| CPAP or BiPAP Setup (first day) CPT 94660 | $635.20 | $794.00 | $226.29 – $714.60 | 15 |
| C-peptide CPT 84681 | $101.60 | $127.00 | $36.20 – $114.30 | 15 |
| CPR (Cardiopulmonary Resuscitation) CPT 92950 | $1,220.80 | $1,526.00 | $434.91 – $1,373.40 | 15 |
| C-reactive protein CPT 86140 | $59.20 | $74.00 | $21.09 – $66.60 | 15 |
| C-reactive protein high sensitivity CPT 86141 | $104.80 | $131.00 | $37.34 – $117.90 | 15 |
| Creatine kinase CPT 82550 | $48.80 | $61.00 | $17.39 – $54.90 | 15 |
| Creatine kinase isoenzymes CPT 82552 | $108.00 | $135.00 | $38.48 – $121.50 | 15 |
| Creatine kinase mb CPT 82553 | $133.60 | $167.00 | $47.60 – $150.30 | 15 |
| Creatinine CPT 82565 | $33.60 | $42.00 | $11.97 – $37.80 | 15 |
| Creatinine 24 hour urine CPT 82570 | $48.80 | $61.00 | $6.27 – $19.80 | 15 |
| Creatinine clearance urine CPT 82575 | $56.80 | $71.00 | $20.24 – $63.90 | 15 |
| #creutz-prot.,western blot CPT 84182 | $114.40 | $143.00 | $40.76 – $128.70 | 15 |
| Critical care each additional 30 minutes CPT 99292 | $827.20 | $1,034.00 | $294.69 – $930.60 | 15 |
| Critical Care (first 30 to 74 minutes) CPT 99291 | $2,859.20 | $3,574.00 | $1,018.59 – $3,216.60 | 15 |
| Crizanlizumab-tmca 10 mg/ml intravenous solution HCPCS J0791 | not published | not published | $130.95 – $130.95 | 1 |
| Crystal identification light microscopy CPT 89060 | $57.60 | $72.00 | $20.52 – $64.80 | 15 |
| CT 3d report other modality w/workstation CPT 76377 | $1,065.60 | $1,332.00 | $379.62 – $1,198.80 | 15 |
| CT Angiogram of Abdomen and Pelvis CPT 74174 | $4,990.40 | $6,238.00 | $1,777.83 – $5,614.20 | 15 |
| CT Angiogram of the Abdomen CPT 74175 | $3,057.60 | $3,822.00 | $1,089.27 – $3,439.80 | 15 |
| CT Angiogram of the Chest (for blood clot) CPT 71275 | $2,847.20 | $3,559.00 | $1,014.32 – $3,203.10 | 15 |
| CT Angiogram of the Head CPT 70496 | $2,859.20 | $3,574.00 | $1,018.59 – $3,216.60 | 15 |
| CT Angiogram of the Neck CPT 70498 | $2,859.20 | $3,574.00 | $1,018.59 – $3,216.60 | 15 |
| CT angio pelvis CPT 72191 | $3,117.60 | $3,897.00 | $1,110.65 – $3,507.30 | 15 |
| CT limited or localized follow-up study CPT 76380 | $1,032.00 | $1,290.00 | $367.65 – $1,161.00 | 15 |
| CT lwr extremity w/o&w/dye CPT 73702 | $2,696.00 | $3,370.00 | $960.45 – $3,033.00 | 15 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $5,248.80 | $6,561.00 | $1,869.89 – $5,904.90 | 15 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $4,468.80 | $5,586.00 | $1,592.01 – $5,027.40 | 15 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $3,804.80 | $4,756.00 | $1,355.46 – $4,280.40 | 15 |
| CT uppr extremity w/o&w/dye CPT 73202 | $2,664.00 | $3,330.00 | $949.05 – $2,997.00 | 15 |
| Culture aerobic additional method definitive id each CPT 87077 | $92.80 | $116.00 | $31.64 – $99.90 | 15 |
| Culture afb any source CPT 87116 | $101.60 | $127.00 | $20.52 – $64.80 | 15 |
| Culture anaerobic additional method definitive id each CPT 87076 | $72.00 | $90.00 | $25.65 – $81.00 | 15 |
| Culture anaerobic except blood CPT 87075 | $125.60 | $157.00 | $44.75 – $141.30 | 15 |
| Culture bact stool aero addl path ea CPT 87046 | $51.20 | $64.00 | $17.96 – $56.70 | 15 |
| Culture body fluid CPT 87070 | $104.80 | $131.00 | $28.22 – $89.10 | 15 |
| Culture fungi definitive id mold CPT 87107 | $82.40 | $103.00 | $29.36 – $92.70 | 15 |
| Culture fungi definitive id yeast CPT 87106 | $137.60 | $172.00 | $49.02 – $154.80 | 15 |
| Culture fungi other (except blood) CPT 87102 | $111.20 | $139.00 | $39.62 – $125.10 | 15 |
| Culture fungi skin/hair/nail CPT 87101 | $112.00 | $140.00 | $39.90 – $126.00 | 15 |
| Culture mycobacteria definitive id each isolate CPT 87118 | $196.00 | $245.00 | $69.83 – $220.50 | 15 |
| Culture mycoplasma any source CPT 87109 | $190.40 | $238.00 | $67.83 – $214.20 | 15 |
| Culture screening strep group a CPT 87081 | $57.60 | $72.00 | $20.24 – $63.90 | 15 |
| Culture typing immunologic CPT 87147 | $33.60 | $42.00 | $11.97 – $37.80 | 15 |
| Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets CPT 87154 | $576.00 | $720.00 | $205.20 – $648.00 | 15 |
| Culture typing nucleic acid probe amplified per culture/isolate each organism CPT 87150 | $248.00 | $310.00 | $88.35 – $279.00 | 15 |
| Culture urine each isolate CPT 87088 | $56.00 | $70.00 | $19.95 – $63.00 | 15 |
| Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution HCPCS J3420 | $63.36 | $79.19 | $21.63 – $68.31 | 15 |
| Cyclic citrullinated peptide antibody CPT 86200 | $120.80 | $151.00 | $43.04 – $135.90 | 15 |
| Cyclophosphamide 1 gram intravenous powder for solution HCPCS J9075 | $1,039.99 | $1,299.98 | $202.02 – $637.97 | 15 |
| Cyclosporine 2 hour CPT 80158 | $211.20 | $264.00 | $75.24 – $237.60 | 15 |
| Cyclosporine modified 25 mg capsule HCPCS J7515 | $7.38 | $9.22 | $1.87 – $5.91 | 15 |
| Cyp2c19 gene com variants CPT 81225 | $256.00 | $320.00 | $91.20 – $288.00 | 15 |
| Cystogram >= 3 views supervision & interpretation CPT 74430 | $838.40 | $1,048.00 | $298.68 – $943.20 | 15 |
| Cystoscopy (Bladder Scope) CPT 52000 | $3,592.80 | $4,491.00 | $1,279.94 – $4,041.90 | 15 |
| Cytogenetics 25-99 CPT 88274 | $103.20 | $129.00 | $36.77 – $116.10 | 15 |
| Cytogenetics 3-5 CPT 88272 | $99.20 | $124.00 | $35.34 – $111.60 | 15 |
| Cytomegalovirus (cmv) antibody igg CPT 86644 | $107.20 | $134.00 | $38.19 – $120.60 | 15 |
| Cytomegalovirus (cmv) antibody igm CPT 86645 | $111.20 | $139.00 | $39.62 – $125.10 | 15 |
| Cytopathology cellular enhancement technique non-gyn CPT 88112 | $267.20 | $334.00 | $95.19 – $300.60 | 15 |
| Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review CPT 88175 | $140.00 | $175.00 | $49.88 – $157.50 | 15 |
| Cytopathology concentration technique smears & interpretation CPT 88108 | $304.00 | $380.00 | $108.30 – $342.00 | 15 |
| Cytopathology fluids/washings/brushings smears with interpretation CPT 88104 | $319.20 | $399.00 | $113.72 – $359.10 | 15 |
| Cytopathology fna adequacy evaluation first episode each site interp/rpt CPT 88173 | $664.00 | $830.00 | $236.55 – $747.00 | 15 |
| Cytopath smear other source CPT 88160 | $270.40 | $338.00 | $96.33 – $304.20 | 15 |
| Dalbavancin 500 mg intravenous solution HCPCS J0875 | $2,699.20 | $3,374.00 | $961.59 – $3,036.60 | 15 |
| Daptomycin 500 mg/10 ml intravenous solution HCPCS J0878 | $726.68 | $908.34 | $24.59 – $77.64 | 15 |
| Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln HCPCS J9144 | not published | not published | $61.60 – $61.60 | 1 |
| Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe HCPCS J0881 | $2,156.00 | $2,695.00 | $68.76 – $217.13 | 15 |
| Dch glucoscan CPT 82948 | $18.40 | $23.00 | $6.56 – $20.70 | 15 |
| Dch pulmonary stress test CPT 94621 | $1,247.20 | $1,559.00 | $444.32 – $1,403.10 | 15 |
| Dch validity tests CPT 81002 | $22.40 | $28.00 | $7.98 – $25.20 | 15 |
| Deamidated gliadin antibody iga CPT 86258 | $54.40 | $68.00 | $15.11 – $47.70 | 15 |
| Debrid ecz/inf skin up tp 10% body 11000 CPT 11000 | $963.20 | $1,204.00 | $343.14 – $1,083.60 | 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.