CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Sanford Sheldon Medical Center

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $3,624
  • Cash Discount Price: $4,494
  • vs. Medicare Baseline: 10.17x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Sanford Sheldon Medical Center is $3,624. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,494. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 10.17x the Medicare baseline. Located in 118 North Seventh Avenue, Po Box 250, Sheldon, IA.
Cash / Self-Pay
$4,494

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,624

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$356.43

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $356.43 (100%)
Cash / Self-Pay: $4,494 (1261%)
Insurance Median: $3,624 (1017%)
Cash: $4,494 (1261% of Medicare)
Ins. Median: $3,624 (1017% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $356.43 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 1017% of the Medicare baseline (a markup of 917%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Sanford Health Plan Align $1,601 449%
Ucare $1,719 - $4,936 482%
Aetna $1,736 - $4,882 487%
Blue Cross Blue Shield $1,736 487%
Health Partners $1,736 - $4,214 487%
Medicare (plans) $1,736 487%
UnitedHealthcare $1,736 - $4,691 487%
Primewest $1,770 497%
Wellmark $2,809 - $2,921 788%
Sanford Health Plan $3,010 - $3,541 844%
Security Health Plan $3,090 867%
Medica $4,635 - $4,955 1300%
First Choice Health Network $5,056 1419%
Healthez $5,056 1419%
Multiplan $5,056 1419%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 118 North Seventh Avenue, Po Box 250, Sheldon, IA 51201
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals