Sanford Sheldon Medical Center
Sanford Sheldon Medical Center in Sheldon, IA publishes cash prices for 39 common procedures listed here, from its own machine-readable price file updated Mar 4, 2026. Click a procedure to compare it with other hospitals nearby.
118 N 7th Ave, Sheldon, IA 51201-1235 Collected Sep 23, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD PELVIS W CONTRAST | $4,468.80 | $5,586.00 | 20% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD PELVIS W CONTRAST | $4,468.80 | $5,586.00 | 20% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONTRAST | $1,913.60 | $2,392.00 | 20% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO CONTRAST | $1,913.60 | $2,392.00 | 20% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CONTRAST | $2,244.00 | $2,805.00 | 20% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W CONTRAST | $2,244.00 | $2,805.00 | 20% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO DX BILAT INCL CAD | $517.60 | $647.00 | 20% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO DX BILAT INCL CAD | $517.60 | $647.00 | 20% |
| Diagnostic mammogram, one breast one side CPT 77065 MAMMO DX UNILAT INCL CAD | $508.00 | $635.00 | 20% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO DX UNILAT INCL CAD | $508.00 | $635.00 | 20% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LOWER EXT JT WO CONTRAST | $2,810.40 | $3,513.00 | 20% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI LOWER EXT JT WO CONTRAST | $2,810.40 | $3,513.00 | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LOWER EXT JT WO THEN W CONT | $4,069.60 | $5,087.00 | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI LOWER EXT JT WO THEN W CONT | $4,069.60 | $5,087.00 | 20% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO CONTRAST | $3,087.20 | $3,859.00 | 20% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO CONTRAST | $3,087.20 | $3,859.00 | 20% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN WO THEN W CONT | $4,494.40 | $5,618.00 | 20% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN WO THEN W CONT | $4,494.40 | $5,618.00 | 20% |
| MRI of the lower back, no contrast dye CPT 72148 MRI L SPINE WO CONTRAST | $3,165.60 | $3,957.00 | 20% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI L SPINE WO CONTRAST | $3,165.60 | $3,957.00 | 20% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PG UTR 2-3TRI SGL 1ST | $941.60 | $1,177.00 | 20% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PG UTR 2-3TRI SGL 1ST | $941.60 | $1,177.00 | 20% |
| Screening mammogram, both breasts both sides CPT 77067 MAMMO SCREEN BILAT INCL CAD | $444.80 | $556.00 | 20% |
| Screening mammogram, both breasts one side CPT 77067 MAMMO SCREEN UNILAT INCL CAD M52 | $444.80 | $556.00 | 20% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 MAMMO SCREEN BILAT INCL CAD | $444.80 | $556.00 | 20% |
| Screening mammogram, both breasts inpatient one side CPT 77067 MAMMO SCREEN UNILAT INCL CAD M52 | $444.80 | $556.00 | 20% |
| Sleep study in a lab (polysomnography) CPT 95810 PSG 4+ PARAMETERS | $4,216.00 | $5,270.00 | 20% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 PSG 4+ PARAMETERS | $4,216.00 | $5,270.00 | 20% |
| Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL | $809.60 | $1,012.00 | 20% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL | $809.60 | $1,012.00 | 20% |
| Ultrasound of the abdomen, complete CPT 76700 US ABD COMPLETE | $983.20 | $1,229.00 | 20% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US ABD COMPLETE | $983.20 | $1,229.00 | 20% |
| X-ray of the lower back, 4 or more views CPT 72110 RAD EXAM SPINE LUMB MIN 4 VWS | $562.40 | $703.00 | 20% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 RAD EXAM SPINE LUMB MIN 4 VWS | $562.40 | $703.00 | 20% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL 80048 | $64.00 | $80.00 | 20% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL 80048 | $64.00 | $80.00 | 20% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL 80061 | $100.00 | $125.00 | 20% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL 80061 | $100.00 | $125.00 | 20% |
| Complete blood count (CBC) with differential CPT 85025 COMPLETE CBC W/AUTO DIFF WBC 85025 | $57.60 | $72.00 | 20% |
| Complete blood count (CBC) with differential inpatient CPT 85025 COMPLETE CBC W/AUTO DIFF WBC 85025 | $57.60 | $72.00 | 20% |
| Complete blood count (CBC), no differential CPT 85027 BLOOD COUNT COMPLETE AUTOMATED 85027 | $36.00 | $45.00 | 20% |
| Complete blood count (CBC), no differential inpatient CPT 85027 BLOOD COUNT COMPLETE AUTOMATED 85027 | $36.00 | $45.00 | 20% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL 80053 | $77.60 | $97.00 | 20% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL 80053 | $77.60 | $97.00 | 20% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL 80069 | $64.80 | $81.00 | 20% |
| Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL 80069 | $64.80 | $81.00 | 20% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL 80076 | $61.60 | $77.00 | 20% |
| Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL 80076 | $61.60 | $77.00 | 20% |
| Obstetric blood test panel CPT 80055 OBSTETRIC PANEL 80055 | $316.00 | $395.00 | 20% |
| Obstetric blood test panel inpatient CPT 80055 OBSTETRIC PANEL 80055 | $316.00 | $395.00 | 20% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE 84154 | $141.60 | $177.00 | 20% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE 84154 | $141.60 | $177.00 | 20% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 CDMR ASSAY OF PSA TOTAL 84153 | $89.60 | $112.00 | 20% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 CDMR ASSAY OF PSA TOTAL 84153 | $89.60 | $112.00 | 20% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL PLASMA WHOLE BLOOD (PTT) 85730 | $44.00 | $55.00 | 20% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME PARTIAL PLASMA WHOLE BLOOD (PTT) 85730 | $44.00 | $55.00 | 20% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME 85610 | $44.00 | $55.00 | 20% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PT INR FINGERSTICK-QW 85610 | $48.80 | $61.00 | 20% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME 85610 | $44.00 | $55.00 | 20% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT INR FINGERSTICK-QW 85610 | $48.80 | $61.00 | 20% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE (TSH) 84443 | $124.00 | $155.00 | 20% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE (TSH) 84443 | $124.00 | $155.00 | 20% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS AUTO W/SCOPE 81001 | $40.00 | $50.00 | 20% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS AUTO W/SCOPE 81001 | $40.00 | $50.00 | 20% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS-DIPSTICK ONLY 81003 | $34.40 | $43.00 | 20% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS DIPSTICK POCT | $34.40 | $43.00 | 20% |
| Urinalysis without microscope exam, automated CPT 81003 URINE AUTO NO MICRO SGL ANALYT | $34.40 | $43.00 | 20% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS-DIPSTICK ONLY 81003 | $34.40 | $43.00 | 20% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINE AUTO NO MICRO SGL ANALYT | $34.40 | $43.00 | 20% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS DIPSTICK POCT | $34.40 | $43.00 | 20% |
| Urinalysis without microscope exam, manual CPT 81002 CLINITEST DIPSTICK TABLET81002 | $22.40 | $28.00 | 20% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 CLINITEST DIPSTICK TABLET81002 | $22.40 | $28.00 | 20% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Lower-back epidural injection, with imaging guidance CPT 62323 ED 62323 NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN | $2,048.00 | $2,560.00 | 20% |
| Lower-back epidural injection, with imaging guidance CPT 62323 TX RM 62323 TR RM INJ INTERLAMINAR LUMBR SAC W IMAG GUID | $2,048.00 | $2,560.00 | 20% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 TX RM 62323 TR RM INJ INTERLAMINAR LUMBR SAC W IMAG GUID | $2,048.00 | $2,560.00 | 20% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 ED 62323 NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN | $2,048.00 | $2,560.00 | 20% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| New patient office visit, about 30 minutes CPT 99203 NEW PATIENT LEVEL 3 | $160.00 | $200.00 | 20% |
| New patient office visit, about 30 minutes inpatient CPT 99203 NEW PATIENT LEVEL 3 | $160.00 | $200.00 | 20% |
| New patient office visit, about 45 minutes CPT 99204 NEW PATIENT LEVEL 4 | $244.00 | $305.00 | 20% |
| New patient office visit, about 45 minutes inpatient CPT 99204 NEW PATIENT LEVEL 4 | $244.00 | $305.00 | 20% |
| New patient office visit, about 60 minutes CPT 99205 NEW PATIENT LEVEL 5 | $306.40 | $383.00 | 20% |
| New patient office visit, about 60 minutes inpatient CPT 99205 NEW PATIENT LEVEL 5 | $306.40 | $383.00 | 20% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THER EXERCISE EA 15 MIN 97110 | $132.80 | $166.00 | 20% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THER EXERCISE EA 15 MIN 97110 | $132.80 | $166.00 | 20% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 OFFICE OP CONSULT NEW/EST LOW MDM 30 MIN MOD 25 | $213.60 | $267.00 | 20% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 OFFICE OP CONSULT EST LOW MDM 30 MIN | $213.60 | $267.00 | 20% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 OFFICE OP CONSULT NEW/EST LOW MDM 30 MIN MOD 25 | $213.60 | $267.00 | 20% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 OFFICE OP CONSULT EST LOW MDM 30 MIN | $213.60 | $267.00 | 20% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFFICE OP CONSULT NEW/EST MOD MDM 40 MIN MOD 25 | $304.00 | $380.00 | 20% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 OFFICE OP CONSULT NEW/EST MOD MDM 40 MIN MOD 25 | $304.00 | $380.00 | 20% |