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 |
|---|---|---|---|---|
| Ghs layered repair 20.1 - 30.0 cm -12056 CPT 12056 | $671.20 | $839.00 | $239.12 – $755.10 | 15 |
| Ghs layered repair over 30.0 cm -12047 CPT 12047 | $1,932.80 | $2,416.00 | $688.56 – $2,174.40 | 15 |
| Ghs layered repair over 3.0 cm -12057 CPT 12057 | $960.80 | $1,201.00 | $342.29 – $1,080.90 | 15 |
| Ghs mbp CPT 83873 | $140.80 | $176.00 | $50.16 – $158.40 | 15 |
| Ghs moderate sedation, > 5 yr, 30 min, other CPT 99156 | $239.20 | $299.00 | $85.22 – $269.10 | 15 |
| Ghs moderate sedation ea addtl 15 min, other CPT 99157 | $164.00 | $205.00 | $58.43 – $184.50 | 15 |
| Ghs nailbed repair/nail removal CPT 11760 | $845.60 | $1,057.00 | $301.25 – $951.30 | 15 |
| Ghs ng placement w fluoro guidance CPT 43752 | $456.80 | $571.00 | $162.74 – $513.90 | 15 |
| Ghs o2 uptake rest & indirect CPT 94690 | $380.80 | $476.00 | $135.66 – $428.40 | 15 |
| Ghs opcc repair cvp w subq port CPT 36576 | $3,695.20 | $4,619.00 | $1,316.42 – $4,157.10 | 15 |
| Ghs ot group caregiver training CPT 97552 | $52.00 | $65.00 | $18.53 – $58.50 | 15 |
| Ghs pacing - transcutaneous CPT 92953 | $755.20 | $944.00 | $269.04 – $849.60 | 15 |
| Ghs paravert facet/nerve lumb ea add bil CPT 64495 | $1,068.80 | $1,336.00 | $380.76 – $1,202.40 | 15 |
| Ghs phenylketonurid CPT 84030 | $21.60 | $27.00 | $7.70 – $24.30 | 15 |
| Ghs plngl fx pm cl CPT 26725 | $511.20 | $639.00 | $182.12 – $575.10 | 15 |
| Ghs ppd (tb intradermal) CPT 86580 | $39.20 | $49.00 | $13.97 – $44.10 | 15 |
| Ghs pr without cont pulse ox CPT 94625 | $212.00 | $265.00 | $75.53 – $238.50 | 15 |
| Ghs removal intranasal foreign body CPT 30300 | $244.80 | $306.00 | $87.21 – $275.40 | 15 |
| Ghs removal pharyngeal foreign body CPT 42809 | $472.80 | $591.00 | $168.44 – $531.90 | 15 |
| Ghs repair extensor tendon hand, ea tendon CPT 26410 | $3,118.40 | $3,898.00 | $1,110.93 – $3,508.20 | 15 |
| Ghs reticulocyte count CPT 85044 | $34.40 | $43.00 | $12.26 – $38.70 | 15 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | $204.80 | $256.00 | $72.96 – $230.40 | 15 |
| Ghs sedimentation rate CPT 85651 | $29.60 | $37.00 | $10.55 – $33.30 | 15 |
| Ghs sensitivity (per antimicro) CPT 87184 | $67.20 | $84.00 | $23.94 – $75.60 | 15 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $521.60 | $652.00 | $185.82 – $586.80 | 15 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $520.00 | $650.00 | $185.25 – $585.00 | 15 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $528.00 | $660.00 | $188.10 – $594.00 | 15 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | $618.40 | $773.00 | $220.31 – $695.70 | 15 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $441.60 | $552.00 | $157.32 – $496.80 | 15 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $407.20 | $509.00 | $145.07 – $458.10 | 15 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $484.80 | $606.00 | $172.71 – $545.40 | 15 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | $550.40 | $688.00 | $196.08 – $619.20 | 15 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | $478.40 | $598.00 | $170.43 – $538.20 | 15 |
| Ghs sleep study unattended CPT 95800 | $608.00 | $760.00 | $216.60 – $684.00 | 15 |
| Ghs sp train/fitting sp device - kx CPT 92609 | $316.80 | $396.00 | $112.86 – $356.40 | 15 |
| Ghs subcutaneous infus, for therapy ea. add. hr CPT 96370 | not published | not published | $38.40 – $38.40 | 1 |
| Ghs subcutaneous infus. for therapy init 1 hr CPT 96369 | not published | not published | $345.60 – $345.60 | 1 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $736.00 | $920.00 | $262.20 – $828.00 | 15 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | $620.80 | $776.00 | $221.16 – $698.40 | 15 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | $2,379.20 | $2,974.00 | $847.59 – $2,676.60 | 15 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $487.20 | $609.00 | $173.57 – $548.10 | 15 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | $467.20 | $584.00 | $166.44 – $525.60 | 15 |
| Ghs urine, porphyrins quant CPT 84120 | $50.40 | $63.00 | $17.96 – $56.70 | 15 |
| Ghs vaginal delivery only CPT 59409 | $3,452.80 | $4,316.00 | $1,230.06 – $3,884.40 | 15 |
| Ghs windowing of cast CPT 29730 | $219.20 | $274.00 | $78.09 – $246.60 | 15 |
| Giardia lamblia antibody CPT 86674 | $112.80 | $141.00 | $40.19 – $126.90 | 15 |
| Gi inhouse confirmation CPT 87045 | $50.40 | $63.00 | $17.96 – $56.70 | 15 |
| Glassia injection HCPCS J0257 | not published | not published | $5.66 – $5.66 | 1 |
| Glove finger flexion right lg xl HCPCS L3912 | $96.80 | $121.00 | $34.49 – $108.90 | 15 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $316.80 | $396.00 | $112.22 – $354.38 | 15 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | $246.10 | $307.62 | $81.85 – $258.48 | 15 |
| Glucose 1 hr post dose CPT 82950 | $36.00 | $45.00 | $12.83 – $40.50 | 15 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $28.80 | $36.00 | $10.26 – $32.40 | 15 |
| Glucose blood quantitative CPT 82947 | $48.80 | $61.00 | $17.39 – $54.90 | 15 |
| Glucose body fluid CPT 82945 | $37.60 | $47.00 | $13.40 – $42.30 | 15 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $99.20 | $124.00 | $35.34 – $111.60 | 15 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $31.20 | $39.00 | $11.12 – $35.10 | 15 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | $64.84 | $81.05 | $21.40 – $67.57 | 15 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $2,142.82 | $2,678.52 | $11.33 – $2,410.67 | 15 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $135.20 | $169.00 | $48.17 – $152.10 | 15 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $135.20 | $169.00 | $48.17 – $152.10 | 15 |
| Graft axiofill 1000mg HCPCS J3590 | $2,763.61 | $3,454.51 | $984.54 – $3,109.06 | 15 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $83.84 | $104.80 | $29.87 – $94.32 | 15 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $695.20 | $869.00 | $153.90 – $486.00 | 15 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $4,860.80 | $6,076.00 | $59.28 – $187.20 | 15 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $403.20 | $504.00 | $143.64 – $453.60 | 15 |
| Granisetron hcl injection HCPCS J1626 | $74.97 | $93.71 | $22.74 – $71.81 | 15 |
| Great toe with reduction 28495 CPT 28495 | $481.60 | $602.00 | $171.57 – $541.80 | 15 |
| Group train without patient HCPCS G0543 | $52.00 | $65.00 | $18.53 – $58.50 | 15 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $704.00 | $880.00 | $51.59 – $162.90 | 15 |
| Gw stiffened micro access kit HCPCS C1894 | $314.40 | $393.00 | $49.31 – $155.70 | 15 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $64.76 | $80.95 | $21.55 – $68.07 | 15 |
| Hands-On Manual Therapy (each 15 minutes) CPT 97140 | $128.00 | $160.00 | $45.60 – $144.00 | 15 |
| Hand X-ray CPT 73130 | $346.40 | $433.00 | $123.41 – $389.70 | 15 |
| Hand X-ray (2 views, both hands) CPT 73120 | $312.00 | $390.00 | $111.15 – $351.00 | 15 |
| Haptoglobin quantitative CPT 83010 | $100.80 | $126.00 | $35.91 – $113.40 | 15 |
| Hcg qualitative CPT 84703 | $61.60 | $77.00 | $21.95 – $69.30 | 15 |
| Hcg quantitative CPT 84702 | $108.80 | $136.00 | $38.76 – $122.40 | 15 |
| Head CT scan (with and without contrast) CPT 70470 | $2,455.20 | $3,069.00 | $874.67 – $2,762.10 | 15 |
| Head CT scan (with contrast) CPT 70460 | $2,536.00 | $3,170.00 | $903.45 – $2,853.00 | 15 |
| Head CT scan (without contrast) CPT 70450 | $1,913.60 | $2,392.00 | $681.72 – $2,152.80 | 15 |
| Heel (Calcaneus) X-ray (both feet) CPT 73650 | $284.80 | $356.00 | $101.46 – $320.40 | 15 |
| Helicobacter pylori antibody igm CPT 86677 | $108.00 | $135.00 | $38.48 – $121.50 | 15 |
| Hematocrit CPT 85014 | $19.20 | $24.00 | $6.84 – $21.60 | 15 |
| Hemoglobin CPT 85018 | $20.80 | $26.00 | $7.41 – $23.40 | 15 |
| Hemoglobin methemoglobin quantitative CPT 83050 | $89.60 | $112.00 | $31.92 – $100.80 | 15 |
| Hemorrhoidectomy intrnl lig rbbr band ligations CPT 46221 | $1,168.00 | $1,460.00 | $416.10 – $1,314.00 | 15 |
| Heparin assay CPT 85520 | $235.20 | $294.00 | $83.79 – $264.60 | 15 |
| Heparin bolus from bag HCPCS J1644 | $97.79 | $122.23 | $21.58 – $68.16 | 15 |
| Hepatitis a antibody igm CPT 86709 | $90.40 | $113.00 | $32.21 – $101.70 | 15 |
| Hepatitis b core antibody igm CPT 86705 | $89.60 | $112.00 | $31.92 – $100.80 | 15 |
| Hepatitis b core antibody total CPT 86704 | $90.40 | $113.00 | $32.21 – $101.70 | 15 |
| Hepatitis b surface antibody CPT 86706 | $86.40 | $108.00 | $30.78 – $97.20 | 15 |
| Hepatitis c antibody CPT 86803 | $135.20 | $169.00 | $48.17 – $152.10 | 15 |
| Herpes simplex type 1 antibody igg CPT 86695 | $113.60 | $142.00 | $40.47 – $127.80 | 15 |
| Herpes simplex type 2 antibody igg CPT 86696 | $116.80 | $146.00 | $41.61 – $131.40 | 15 |
| Heterophile antibodies screening CPT 86308 | $49.60 | $62.00 | $17.67 – $55.80 | 15 |
| Hip and Pelvis X-ray (2 views, both hips) CPT 73521 | $439.20 | $549.00 | $156.47 – $494.10 | 15 |
| Hip and Pelvis X-ray (3 to 4 views, both hips) CPT 73522 | $499.20 | $624.00 | $177.84 – $561.60 | 15 |
| Hip and Pelvis X-ray (single view, left side) CPT 73501 | $272.80 | $341.00 | $97.19 – $306.90 | 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.