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 |
|---|---|---|---|---|
| Debridement (>20 cm) charge pt CPT 97598 | $379.20 | $474.00 | $135.09 – $426.60 | 15 |
| Debridement/bone/20 sq cm or less 11046 CPT 11046 | $904.00 | $1,130.00 | $322.05 – $1,017.00 | 15 |
| Debridement subcutaneous tissue <= 20 sq cm CPT 11042 | $1,088.80 | $1,361.00 | $387.89 – $1,224.90 | 15 |
| Debride nail1-5 11720 CPT 11720 | $205.60 | $257.00 | $73.25 – $231.30 | 15 |
| Debride nail6 or more 11721 CPT 11721 | $231.20 | $289.00 | $82.37 – $260.10 | 15 |
| Debride skn/sq t/m/f necro infctj abdl wall 11005 CPT 11005 | $4,966.40 | $6,208.00 | $1,769.28 – $5,587.20 | 15 |
| Debride/subq tissue/ea add 20sq cm 11045 CPT 11045 | $784.00 | $980.00 | $279.30 – $882.00 | 15 |
| Decalcification CPT 88311 | $92.80 | $116.00 | $33.06 – $104.40 | 15 |
| Declotting thrombolytic agent implanted vas access device 36 CPT 36593 | $676.80 | $846.00 | $241.11 – $761.40 | 15 |
| Deferoxamine 500 mg solution for injection HCPCS J0895 | $85.49 | $106.86 | $23.75 – $75.00 | 15 |
| Delivery of placenta 59414 CPT 59414 | $1,267.20 | $1,584.00 | $451.44 – $1,425.60 | 15 |
| Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device CPT 94664 | $218.40 | $273.00 | $77.81 – $245.70 | 15 |
| Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution HCPCS J0897 | $2,841.64 | $3,552.04 | $942.93 – $2,977.67 | 15 |
| Desmopressin 4 mcg/ml injection solution HCPCS J2597 | $64.08 | $80.09 | $22.83 – $72.08 | 15 |
| Dexamethasone 4 mg tablet HCPCS J8540 | $50.84 | $63.54 | $0.43 – $1.35 | 15 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $65.88 | $82.35 | $1.81 – $5.72 | 15 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | $235.99 | $294.98 | $41.35 – $130.58 | 15 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | $40.00 | $50.00 | $14.25 – $45.00 | 15 |
| Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 | $40.00 | $50.00 | $14.25 – $45.00 | 15 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | $144.00 | $180.00 | $14.25 – $45.00 | 15 |
| Dextrose 5 % IV bolus HCPCS J7070 | $40.00 | $50.00 | $14.25 – $45.00 | 15 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $164.80 | $206.00 | $58.71 – $185.40 | 15 |
| Diabetes (HbA1c) Test CPT 83036 | $68.80 | $86.00 | $24.51 – $77.40 | 15 |
| Diab manage trn ind/group HCPCS G0109 | $67.20 | $84.00 | $23.94 – $75.60 | 15 |
| Diagnostic anoscopy spx 46600 CPT 46600 | $220.00 | $275.00 | $78.38 – $247.50 | 15 |
| Diagnostic laryngoscopy 31505 CPT 31505 | $290.40 | $363.00 | $103.46 – $326.70 | 15 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $517.60 | $647.00 | $184.40 – $582.30 | 15 |
| Diagnostic Mammogram (one breast) CPT 77065 | $508.00 | $635.00 | $180.98 – $571.50 | 15 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $69.20 | $86.50 | $22.38 – $70.66 | 15 |
| Diffusing capacity CPT 94729 | $366.40 | $458.00 | $130.53 – $412.20 | 15 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $62.92 | $78.65 | $22.25 – $70.27 | 15 |
| Digoxin total therapeutic drug level CPT 80162 | $99.20 | $124.00 | $35.34 – $111.60 | 15 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | $102.60 | $128.25 | $32.92 – $103.95 | 15 |
| Dilate esophagus CPT 43453 | $2,577.60 | $3,222.00 | $918.27 – $2,899.80 | 15 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | $1,504.80 | $1,881.00 | $536.09 – $1,692.90 | 15 |
| Diltiazem 5 mg/ml intravenous solution HCPCS J1163 | $61.23 | $76.53 | $21.53 – $67.98 | 15 |
| Dimethyl sulfoxide 50% 50 ml HCPCS J1212 | $515.85 | $644.81 | $183.77 – $580.33 | 15 |
| Diphenhydramine 12.5 mg/5 ml oral elixir HCPCS Q0163 | $1.20 | $1.50 | $0.43 – $1.35 | 15 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $60.64 | $75.80 | $21.60 – $68.21 | 15 |
| Disability dlco CPT 94727 | $302.40 | $378.00 | $107.73 – $340.20 | 15 |
| Dna antibody native/double stranded CPT 86225 | $111.20 | $139.00 | $39.62 – $125.10 | 15 |
| Dna probe chlamydia CPT 87490 | $122.40 | $153.00 | $43.61 – $137.70 | 15 |
| Dna probe gc CPT 87590 | $119.20 | $149.00 | $42.47 – $134.10 | 15 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $145.91 | $182.38 | $22.66 – $71.55 | 15 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $119.91 | $149.88 | $21.77 – $68.76 | 15 |
| Doppler echo complete CPT 93320 | $748.80 | $936.00 | $266.76 – $842.40 | 15 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $888.80 | $1,111.00 | $316.64 – $999.90 | 15 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $530.40 | $663.00 | $188.96 – $596.70 | 15 |
| Dostarlimab-gxly 50 mg/ml intravenous solution HCPCS J9272 | not published | not published | $283.24 – $283.24 | 1 |
| Doxycycline hyclate 100 mg intravenous powder for solution HCPCS J1271 | $73.84 | $92.30 | $25.42 – $80.27 | 15 |
| Drainage absc/cyst/hmtma/vestibule mouth smpl CPT 40800 | $606.40 | $758.00 | $216.03 – $682.20 | 15 |
| Drainage ext aud canal abscess 69020 CPT 69020 | $757.60 | $947.00 | $269.90 – $852.30 | 15 |
| Drainage external ear simple 69000 CPT 69000 | $785.60 | $982.00 | $279.87 – $883.80 | 15 |
| Drain blood from under nail 11740 CPT 11740 | $195.20 | $244.00 | $69.54 – $219.60 | 15 |
| Drain finger abscess;simple 26010 CPT 26010 | $451.20 | $564.00 | $160.74 – $507.60 | 15 |
| Drain thigh/knee lesion 27301 CPT 27301 | $4,856.80 | $6,071.00 | $1,730.24 – $5,463.90 | 15 |
| Dress/debride pt-tck burn/5-10% bs 16025 CPT 16025 | $393.60 | $492.00 | $140.22 – $442.80 | 15 |
| Dress/debride pt-thick burn/<5% bs 16020 CPT 16020 | $359.20 | $449.00 | $127.97 – $404.10 | 15 |
| Dress/debrid prtl-thick burn l 16030 CPT 16030 | $578.40 | $723.00 | $206.06 – $650.70 | 15 |
| Dressing change not for burn w/anes 15852 CPT 15852 | $585.60 | $732.00 | $208.62 – $658.80 | 15 |
| Drng of finger abscess comp 26011 CPT 26011 | $2,197.60 | $2,747.00 | $782.90 – $2,472.30 | 15 |
| Drng of scrotum abscess 55100 CPT 55100 | $1,908.00 | $2,385.00 | $679.73 – $2,146.50 | 15 |
| Droperidol 2.5 mg/ml injection solution HCPCS J1790 | $63.48 | $79.35 | $22.61 – $71.42 | 15 |
| Drug assay caffeine CPT 80155 | $93.60 | $117.00 | $33.35 – $105.30 | 15 |
| Drug of abuse screen urine CPT 80305 | $58.40 | $73.00 | $20.81 – $65.70 | 15 |
| Drug screen quant tiagabine CPT 80199 | $71.20 | $89.00 | $25.37 – $80.10 | 15 |
| Drug test prsmv instrmnt CPT 80306 | $103.20 | $129.00 | $31.35 – $99.00 | 15 |
| Drug test(s) presumptive any class instrument chemistry analyzers CPT 80307 | $304.80 | $381.00 | $103.17 – $325.80 | 15 |
| Dup scan/lwr xtr vasc stdy bilat 93924 CPT 93924 | $959.20 | $1,199.00 | $341.72 – $1,079.10 | 15 |
| Dup scan/ue art/graft/bilat/comp 93930 CPT 93930 | $1,220.00 | $1,525.00 | $434.63 – $1,372.50 | 15 |
| Durvalumab 50 mg/ml intravenous solution HCPCS J9173 | not published | not published | $98.03 – $98.03 | 1 |
| Ear irrigation 69209 CPT 69209 | $132.00 | $165.00 | $47.03 – $148.50 | 15 |
| Ecallantide injection HCPCS J1290 | not published | not published | $576.49 – $576.49 | 1 |
| Ecg external < 48 hours recording CPT 93225 | $633.60 | $792.00 | $225.72 – $712.80 | 15 |
| Ecg external < 48 hours scanning analysis w/report CPT 93226 | $732.80 | $916.00 | $261.06 – $824.40 | 15 |
| Ecg external > 48 hours up to 7 days recording CPT 93242 | $181.60 | $227.00 | $64.70 – $204.30 | 15 |
| Ecg external >7 days up to 15 days recording CPT 93246 | $218.40 | $273.00 | $77.81 – $245.70 | 15 |
| Ecg record/review CPT 93268 | $180.80 | $226.00 | $64.41 – $203.40 | 15 |
| Echocardiogram (Heart Ultrasound) CPT 93306 | $2,319.20 | $2,899.00 | $826.22 – $2,609.10 | 15 |
| Echocardiogram (Limited Follow-Up Heart Ultrasound) CPT 93308 | $1,033.60 | $1,292.00 | $368.22 – $1,162.80 | 15 |
| Echocardiography doppler color flow mapping CPT 93325 | $640.00 | $800.00 | $228.00 – $720.00 | 15 |
| Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler HCPCS C8929 | $2,617.60 | $3,272.00 | $932.52 – $2,944.80 | 15 |
| Echocardiograpy doppler follow up/limited study CPT 93321 | $465.60 | $582.00 | $165.87 – $523.80 | 15 |
| Echo exam of fetal heart CPT 76825 | $1,549.60 | $1,937.00 | $552.05 – $1,743.30 | 15 |
| Echo exam of fetal heart CPT 76826 | $1,096.80 | $1,371.00 | $390.74 – $1,233.90 | 15 |
| Echo exam of fetal heart CPT 76827 | $750.40 | $938.00 | $267.33 – $844.20 | 15 |
| Echo exam of fetal heart CPT 76828 | $571.20 | $714.00 | $203.49 – $642.60 | 15 |
| Echo exam uterus 76831- CPT 76831 | $887.20 | $1,109.00 | $316.07 – $998.10 | 15 |
| Echo guide for amniocentesis CPT 76946 | $650.40 | $813.00 | $231.71 – $731.70 | 15 |
| Echo guide villus sampling CPT 76945 | $744.00 | $930.00 | $265.05 – $837.00 | 15 |
| Echo stress CPT 93350 | $2,123.20 | $2,654.00 | $756.39 – $2,388.60 | 15 |
| Echo transthoracic CPT 93303 | $2,024.00 | $2,530.00 | $721.05 – $2,277.00 | 15 |
| Echo transthoracic CPT 93304 | $1,454.40 | $1,818.00 | $518.13 – $1,636.20 | 15 |
| Echo tte 2d comp wo ctrst wo clr/dplr CPT 93307 | $1,628.00 | $2,035.00 | $579.98 – $1,831.50 | 15 |
| Eculizumab injection HCPCS J1300 | not published | not published | $228.86 – $228.86 | 1 |
| Eeg recording awake and asleep CPT 95819 | $1,219.20 | $1,524.00 | $434.34 – $1,371.60 | 15 |
| Efgartigimod alfa-fcab 20 mg/ml intravenous solution HCPCS J9332 | not published | not published | $33.19 – $33.19 | 1 |
| EKG tracing for initial prev HCPCS G0404 | $122.40 | $153.00 | $43.61 – $137.70 | 15 |
| EKG (Tracing Only) CPT 93005 | $284.80 | $356.00 | $101.46 – $320.40 | 15 |
| Elbow X-ray (2 views, both sides) CPT 73070 | $300.00 | $375.00 | $106.88 – $337.50 | 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.