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 |
|---|---|---|---|---|
| Elbow X-ray (3 or more views, both sides) CPT 73080 | $360.80 | $451.00 | $128.54 – $405.90 | 15 |
| Electrical Stimulation Therapy (each 15 minutes) CPT 97032 | $129.60 | $162.00 | $46.17 – $145.80 | 15 |
| Electrical stimulation/unattended 97014 CPT 97014 | $95.20 | $119.00 | $33.92 – $107.10 | 15 |
| Electrolyte panel CPT 80051 | $41.60 | $52.00 | $14.82 – $46.80 | 15 |
| Elosulfase alfa, injection HCPCS J1322 | not published | not published | $299.48 – $299.48 | 1 |
| Emb without cervical dilation 58100 CPT 58100 | $340.80 | $426.00 | $121.41 – $383.40 | 15 |
| Endoscopy swallow (fees) vid CPT 92612 | $430.40 | $538.00 | $153.33 – $484.20 | 15 |
| Endoscpy nsl/sns w/cntrl nsl hmrrgh CPT 31238 | $4,064.80 | $5,081.00 | $1,448.09 – $4,572.90 | 15 |
| Enoxaparin 30 mg/0.3 ml subcutaneous syringe HCPCS J1650 | $121.73 | $152.16 | $22.08 – $69.73 | 15 |
| Epinephrine 0.1 mg/ml injection syringe HCPCS J0168 | $68.51 | $85.63 | $24.40 – $77.07 | 15 |
| Epinephrine 1 mg/ml im kit - adult HCPCS J0169 | $69.36 | $86.69 | $22.04 – $69.61 | 15 |
| Epinephrine 1 mg/ml im kit - pediatric HCPCS J0165 | $64.90 | $81.12 | $23.12 – $73.01 | 15 |
| Epinephrine hcl (pf) 1 mg/ml (1 ml) injection solution HCPCS J0166 | $66.56 | $83.19 | $22.08 – $69.71 | 15 |
| Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr HCPCS J0885 | $800.00 | $1,000.00 | $285.00 – $900.00 | 15 |
| Epstein barr nuclear antigen antibody CPT 86664 | $82.40 | $103.00 | $29.36 – $92.70 | 15 |
| Epstein barr viral capsid antigen antibody igm CPT 86665 | $115.20 | $144.00 | $41.04 – $129.60 | 15 |
| Eptinezumab-jjmr 100 mg/ml intravenous solution HCPCS J3032 | not published | not published | $19.05 – $19.05 | 1 |
| Eribulin 1 mg/2 ml (0.5 mg/ml) intravenous solution HCPCS J9179 | $1,399.51 | $1,749.38 | $498.57 – $1,574.44 | 15 |
| Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr HCPCS J1335 | $199.46 | $249.32 | $30.31 – $95.71 | 15 |
| ER Visit (level 1, minor) CPT 99281 | $301.60 | $377.00 | $107.45 – $339.30 | 15 |
| ER Visit (level 2) CPT 99282 | $488.80 | $611.00 | $174.14 – $549.90 | 15 |
| ER Visit (level 3) CPT 99283 | $837.60 | $1,047.00 | $298.40 – $942.30 | 15 |
| ER Visit (level 4) CPT 99284 | $1,318.40 | $1,648.00 | $469.68 – $1,483.20 | 15 |
| ER Visit (level 5, high severity) CPT 99285 | $1,920.00 | $2,400.00 | $684.00 – $2,160.00 | 15 |
| Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only HCPCS J1805 | $508.67 | $635.83 | $21.97 – $69.38 | 15 |
| Established Patient Office Visit (level 1) CPT 99211 | $329.60 | $412.00 | $23.37 – $73.80 | 15 |
| Established Patient Office Visit (level 2) CPT 99212 | $167.20 | $209.00 | $35.91 – $113.40 | 15 |
| Established Patient Office Visit (level 3) CPT 99213 | $123.20 | $154.00 | $43.89 – $138.60 | 15 |
| Established Patient Office Visit (level 4) CPT 99214 | $160.00 | $200.00 | $57.00 – $180.00 | 15 |
| Established Patient Office Visit (level 5) CPT 99215 | $214.40 | $268.00 | $76.38 – $241.20 | 15 |
| Estradiol total CPT 82670 | $201.60 | $252.00 | $71.82 – $226.80 | 15 |
| Estrogens total-sendout CPT 82672 | $52.80 | $66.00 | $18.81 – $59.40 | 15 |
| Ethylene glycol -sendout CPT 82693 | $200.00 | $250.00 | $71.25 – $225.00 | 15 |
| Etonogestrel implant system HCPCS J7307 | $1,708.74 | $2,135.92 | $393.24 – $1,241.80 | 15 |
| Etoposide 20 mg/ml intravenous solution HCPCS J9181 | $203.85 | $254.81 | $72.62 – $229.33 | 15 |
| Eval/fit voice prosthesis iii, st CPT 92607 | $531.20 | $664.00 | $189.24 – $597.60 | 15 |
| Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen CPT 84112 | $296.00 | $370.00 | $105.45 – $333.00 | 15 |
| Evaluation of speech fluency 92521 CPT 92521 | $372.80 | $466.00 | $132.81 – $419.40 | 15 |
| Event monitor CPT 93270 | $404.00 | $505.00 | $143.93 – $454.50 | 15 |
| Evoked oa emissions ltd CPT 92587 | $279.20 | $349.00 | $99.47 – $314.10 | 15 |
| Exc benign tal 0.5 < cm 11400 CPT 11400 | $1,322.40 | $1,653.00 | $471.11 – $1,487.70 | 15 |
| Exc ben+marg excep skin tag feenlm <0.5cm 11440 CPT 11440 | $1,271.20 | $1,589.00 | $452.87 – $1,430.10 | 15 |
| Exc ben+marg excep skin tag feenlm 1.1-2cm 11442 CPT 11442 | $2,084.80 | $2,606.00 | $742.71 – $2,345.40 | 15 |
| Exc ben+marg excep skin tag feenlm 2.1-3cm 11443 CPT 11443 | $1,248.00 | $1,560.00 | $444.60 – $1,404.00 | 15 |
| Exc ben+marg excep skin tag snhfg 0.6-1cm 11421 CPT 11421 | $1,196.00 | $1,495.00 | $426.08 – $1,345.50 | 15 |
| Exc ben+marg excep skin tag snhfg 2.1-3cm 11423 CPT 11423 | $2,974.40 | $3,718.00 | $1,059.63 – $3,346.20 | 15 |
| Exc ben+marg excep skin tag snhfg >4cm 11426 CPT 11426 | $4,474.40 | $5,593.00 | $1,594.01 – $5,033.70 | 15 |
| Exc ben+marg excep skin tag tal 0.6-1cm 11401 CPT 11401 | $658.40 | $823.00 | $234.56 – $740.70 | 15 |
| Exc ben+marg excep skin tag tal 2.1-3/>cm 11403 CPT 11403 | $1,248.00 | $1,560.00 | $444.60 – $1,404.00 | 15 |
| Exc feenl mal+mrg 0.6-1 11641 CPT 11641 | $1,271.20 | $1,589.00 | $452.87 – $1,430.10 | 15 |
| Excise anal ext tag/papilla CPT 46220 | $1,956.80 | $2,446.00 | $697.11 – $2,201.40 | 15 |
| Excision benign lesion face/ears/eyelids/nose/lips/muc memb 0.6 - 1.0 cm CPT 11441 | $1,363.20 | $1,704.00 | $485.64 – $1,533.60 | 15 |
| Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm CPT 11422 | $2,374.40 | $2,968.00 | $845.88 – $2,671.20 | 15 |
| Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm CPT 11402 | $855.20 | $1,069.00 | $304.67 – $962.10 | 15 |
| Excision benign lesion trunk/arms/legs > 4.0 cm CPT 11406 | $3,984.00 | $4,980.00 | $1,419.30 – $4,482.00 | 15 |
| Excision tumor soft tissue back/flank subcutaneous >= 3 cm CPT 21931 | $2,272.00 | $2,840.00 | $809.40 – $2,556.00 | 15 |
| Exc malig feenl 1.1-2 11642 CPT 11642 | $1,090.40 | $1,363.00 | $388.46 – $1,226.70 | 15 |
| Exc mal+marg tal 1.1-2 cm 11602 CPT 11602 | $692.00 | $865.00 | $246.53 – $778.50 | 15 |
| Exc/pilonidal cyst/sinus/simple 11770 CPT 11770 | $6,529.60 | $8,162.00 | $2,326.17 – $7,345.80 | 15 |
| Exc thrombosed hemorrhoid 46320 CPT 46320 | $3,725.60 | $4,657.00 | $1,327.25 – $4,191.30 | 15 |
| Exercise tst brncspsm w/ecg CPT 94617 | $254.40 | $318.00 | $90.63 – $286.20 | 15 |
| Explore penetrating wnd/extremity 20103 CPT 20103 | $2,472.00 | $3,090.00 | $880.65 – $2,781.00 | 15 |
| Explore wound abdomen 20102 CPT 20102 | $4,564.80 | $5,706.00 | $1,626.21 – $5,135.40 | 15 |
| Explore woundchest 20101 CPT 20101 | $2,262.40 | $2,828.00 | $805.98 – $2,545.20 | 15 |
| Explore wound neck 20100 CPT 20100 | $5,156.00 | $6,445.00 | $1,836.83 – $5,800.50 | 15 |
| External chromosome analysis 20-25 cells CPT 88264 | $578.40 | $723.00 | $206.06 – $650.70 | 15 |
| External newborn metabolic screening panel HCPCS S3620 | $211.20 | $264.00 | $75.24 – $237.60 | 15 |
| External tissue culture neoplastic disorders bone marrow/blood cells CPT 88237 | $687.20 | $859.00 | $244.82 – $773.10 | 15 |
| Extractable nuclear antigen/antibody any method each antibody centromere CPT 86235 | $152.80 | $191.00 | $20.24 – $63.90 | 15 |
| Eye Socket (Orbit) X-ray CPT 70200 | $416.80 | $521.00 | $148.49 – $468.90 | 15 |
| Eye Socket, Pituitary or Ear CT Scan (with and without contrast) CPT 70482 | $2,783.20 | $3,479.00 | $991.52 – $3,131.10 | 15 |
| Eye Socket, Pituitary or Ear CT Scan (with contrast) CPT 70481 | $2,556.80 | $3,196.00 | $910.86 – $2,876.40 | 15 |
| Eye Socket, Pituitary or Ear CT Scan (without contrast) CPT 70480 | $2,129.60 | $2,662.00 | $758.67 – $2,395.80 | 15 |
| Face, Eye Socket and Neck MRI (with and without contrast) CPT 70543 | $4,310.40 | $5,388.00 | $1,535.58 – $4,849.20 | 15 |
| Face, Eye Socket and Neck MRI (without contrast) CPT 70540 | $3,165.60 | $3,957.00 | $1,127.75 – $3,561.30 | 15 |
| Facial Bones X-ray (1 to 2 views) CPT 70140 | $284.80 | $356.00 | $101.46 – $320.40 | 15 |
| Facial Bones X-ray (complete) CPT 70150 | $413.60 | $517.00 | $147.35 – $465.30 | 15 |
| Factor ix CPT 85250 | $222.40 | $278.00 | $79.23 – $250.20 | 15 |
| Factor viii CPT 85240 | $193.60 | $242.00 | $68.97 – $217.80 | 15 |
| Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr HCPCS J1308 | $60.52 | $75.65 | $21.51 – $67.93 | 15 |
| Fat/lipids feces qualitative CPT 82705 | $80.00 | $100.00 | $28.50 – $90.00 | 15 |
| Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper) HCPCS J3010 | $137.87 | $172.33 | $21.39 – $67.56 | 15 |
| Ferric carboxymaltose 50 mg iron/ml intravenous solution HCPCS J1439 | $1,254.94 | $1,568.67 | $447.07 – $1,411.80 | 15 |
| Ferritin CPT 82728 | $109.60 | $137.00 | $39.05 – $123.30 | 15 |
| Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution HCPCS Q0138 | $1,195.88 | $1,494.84 | $426.03 – $1,345.36 | 15 |
| Fetal biophys profile w/nst 76818 CPT 76818 | $898.40 | $1,123.00 | $320.06 – $1,010.70 | 15 |
| Fetal fibronectin CPT 82731 | $516.80 | $646.00 | $184.11 – $581.40 | 15 |
| Fetal hemoglobin (kleihauer betke) CPT 85460 | $121.60 | $152.00 | $43.32 – $136.80 | 15 |
| Fetal hemoglobin rosette CPT 85461 | $31.20 | $39.00 | $11.12 – $35.10 | 15 |
| Fetal non stress test CPT 59025 | $547.20 | $684.00 | $194.94 – $615.60 | 15 |
| Fibrin degradation d dimer quantitative CPT 85379 | $139.20 | $174.00 | $49.59 – $156.60 | 15 |
| Fibrin degrade semiquant CPT 85378 | $160.80 | $201.00 | $57.29 – $180.90 | 15 |
| Fibrinogen activity CPT 85384 | $48.00 | $60.00 | $17.10 – $54.00 | 15 |
| Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr HCPCS J1442 | $758.88 | $948.60 | $176.13 – $556.20 | 15 |
| Filgrastim-sndz 300 mcg/0.5 ml injection syringe HCPCS Q5101 | $470.88 | $588.60 | $109.44 – $345.60 | 15 |
| Fine needle asp without image guide 10021 CPT 10021 | $716.00 | $895.00 | $255.08 – $805.50 | 15 |
| Finger X-ray (both hands) CPT 73140 | $284.00 | $355.00 | $101.18 – $319.50 | 15 |
| Flebogamma injection HCPCS J1572 | not published | not published | $52.94 – $52.94 | 1 |
| Flexible Sigmoidoscopy CPT 45330 | $1,744.00 | $2,180.00 | $621.30 – $1,962.00 | 15 |
| Flow cytometry marker each additional CPT 88185 | $194.40 | $243.00 | $69.26 – $218.70 | 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.