Sanford Sheldon Medical Center — price list
← Hospital overviewVerified from Sanford Sheldon Medical Center’s published price file
Includes cash prices, list prices, insurance-negotiated rates. Open any row for plan-level negotiated rates. This is public hospital price transparency data, not a guaranteed estimate of your bill.
Showing the first 1,500 prices from a large file. Search a procedure or code below to narrow the list.
How to read these columns
- List
- The hospital’s full undiscounted (gross) charge — rarely what anyone actually pays.
- Cash
- The discounted self-pay price for paying directly, without insurance.
- Negotiated
- Rates agreed with insurers; open a row for plan-level detail. Your share depends on your benefits.
These are the hospital’s published reference prices, not a personalized estimate of your bill.
1,500 prices shown.
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| ,Insulin Aspart Soln Pen-injector 100 Unit/ML,Insulin Aspart Soln Cartridge 100 Unit/ML Inpatient | 0250 RC | $74.05 | $59.24 | $37.03 – $66.65 | — | |
| Abatacept For IV Soln 250 MG Inpatient | J0129 HCPCS | $2,614 | $2,091 | $1,307 – $2,352 | — | |
| Acamprosate Calcium Tab Delayed Release 333 MG Inpatient | 0250 RC | $6.33 | $5.07 | $3.17 – $5.70 | — | |
| Acetaminophen Chew Tab 160 MG Inpatient | 0250 RC | $1.50 | $1.20 | $0.75 – $1.35 | — | |
| Acetaminophen IV Soln 10 MG/ML Inpatient | J0131 HCPCS | $172 | $138 | $86.09 – $155 | — | |
| Acetaminophen IV Soln 10 MG/ML Inpatient | J0134 HCPCS | $122 | $97.51 | $60.94 – $110 | — | |
| Acetaminophen IV Soln 10 MG/ML Inpatient | J0136 HCPCS | $96.03 | $76.83 | $48.02 – $86.43 | — | |
| Acetaminophen Soln 160 MG/5ML Inpatient | J3490 HCPCS | $6.48 | $5.19 | $3.24 – $5.83 | — | |
| Acetaminophen Suppos 120 MG Inpatient | 0250 RC | $1.50 | $1.20 | $0.75 – $1.35 | — | |
| Acetaminophen Suppos 325 MG Inpatient | 0250 RC | $1.50 | $1.20 | $0.75 – $1.35 | — | |
| Acetaminophen Suppos 650 MG Inpatient | 0250 RC | $1.50 | $1.20 | $0.75 – $1.35 | — | |
| Acetaminophen Susp 160 MG/5ML Inpatient | 0250 RC | $8.97 | $7.18 | $4.49 – $8.07 | — | |
| Acetaminophen Tab 500 MG Inpatient | J3490 HCPCS | $1.50 | $1.20 | $0.75 – $1.35 | — | |
| Acetaminophen w/ Codeine Soln 120-12 MG/5ML Inpatient | 0250 RC | $4.50 | $3.60 | $2.25 – $4.05 | — | |
| Acetaminophen w/ Codeine Tab 300-30 MG Inpatient | 0250 RC | $123 | $98.40 | $61.50 – $111 | — | |
| Acetazolamide Sodium For Inj 500 MG Inpatient | J1120 HCPCS | $97.37 | $77.90 | $48.69 – $87.63 | — | |
| Acetazolamide Tab 125 MG Inpatient | 0250 RC | $6.63 | $5.31 | $3.32 – $5.97 | — | |
| Acetic Acid Irrigation Soln 0.25% Inpatient | 0250 RC | $50.00 | $40.00 | $25.00 – $45.00 | — | |
| Acetic Acid Otic Soln 2% Inpatient | 0250 RC | $67.12 | $53.70 | $33.56 – $60.41 | — | |
| Acetylcysteine Cap 600 MG Inpatient | 0250 RC | $1.50 | $1.20 | $0.75 – $1.35 | — | |
| Acetylcysteine Inhal Soln 20% Inpatient | 0250 RC | $14.64 | $11.72 | $7.32 – $13.18 | — | |
| Acetylcysteine Inhal Soln 20% Inpatient | J7608 HCPCS | $14.64 | $11.72 | $7.32 – $13.18 | — | |
| Acetylcysteine Inj 200 MG/ML Inpatient | J0132 HCPCS | $460 | $368 | $230 – $414 | — | |
| Acyclovir Sodium IV Soln 50 MG/ML Inpatient | J0133 HCPCS | $78.13 | $62.51 | $39.07 – $70.32 | — | |
| Acyclovir Susp 200 MG/5ML Inpatient | 0250 RC | $5.96 | $4.77 | $2.98 – $5.36 | — | |
| Acyclovir Tab 400 MG Inpatient | 0250 RC | $1.50 | $1.20 | $0.75 – $1.35 | — | |
| Adenoidectomy Inpatient | 0360 RC | $2,900 | $2,320 | $1,450 – $2,610 | — | |
| Adenosine IV Soln 12 MG/4ML Inpatient | J0153 HCPCS | $77.60 | $62.08 | $38.80 – $69.84 | — | |
| Adenosine IV Soln 6 MG/2ML Inpatient | J0153 HCPCS | $80.76 | $64.61 | $40.38 – $72.68 | — | |
| Albumin, Human Inj 25% Inpatient | P9047 HCPCS | $181 | $145 | $90.63 – $163 | — |