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Hospital Profile Critical Access Hospital Voluntary non-profit - Private 25 Beds · rural Updated: 2026-03-04

Sanford Sheldon Medical Center

118 North Seventh Avenue, Po Box 250, Sheldon, IA 51201 · 88 Priced Procedures · 69% Patient Recommendation

CMS Overall Rating No CMS Rating
Pillar 1 · The BaseRate™ CompositeHow 1.00× Fair BaseRate Works: Raw price averages unfairly penalize hospitals in high-wage cities or trauma centers treating sicker patients. We adjust for local CMS hospital wage levels and patient complexity first. A 1.00× score means right at the fair price average, 0.85× means 15% cheaper than fair market, and 1.30× means 30% above fair market.Near Fair BaseRate Benchmark
1.00×vs. Fair Market Price
Position vs. 1.00× Fair PriceRight at U.S. Average (0%) 1.00× (center of the bar) is the U.S. fair price average after accounting for local hospital wages and patient complexity. Left of center (<1.00×) is below fair price; right of center (>1.00×) is above fair price.

Typical commercial prices here match the fair market benchmark (1.00×) after accounting for local nurse/doctor wages and patient complexity.

Pillar 2 · VeriRate™ Data TrustHow VeriRate™ (0–100) Works: Hospitals are legally required to publish machine-readable price files, but some bury fake $0.01 numbers or omit cash discounts. VeriRate audits each file across 5 checks (hover any badge below to see what it tests).82/100 · Corroborated
82/100Self-Pay Cash Beats Insurance 47% of the Time
File Completeness51Provenance (File Completeness): Checks whether the hospital published a complete, up-to-date machine-readable price file with valid CPT and MS-DRG billing codes instead of leaving blanks.
Price Logic98Coherence (Price Logic): Checks whether the hospital’s numbers make basic sense — e.g., self-pay cash price is lower than gross list price, with no fake $0.01 or $999,999 placeholder numbers.
Peer Alignment72Concordance (Peer Alignment): Checks whether reported prices sit in a realistic range compared to Medicare and nearby hospitals rather than wild 100× unit errors.
Clean Billing89Regularity (Clean Billing): Checks whether rates are structured consistently across procedures without erratic statistical spikes or hidden unbundled facility fees.
Real Cash Discount100Cash Honesty (Real Cash Discount): Checks whether the hospital offers a genuine self-pay cash discount that beats or matches commercial insurance rates instead of billing full sticker price.
Pillar 3 · Clinical Quality & ER SpeedChecks whether higher hospital prices actually buy better clinical quality — combining CMS Star Ratings, hospital safety scores, and emergency room wait times.Regional Value Leader
CMS Star RatingNot RatedOfficial CMS Overall Hospital Quality Star Rating (1 to 5 stars) summarizing mortality, safety of care, readmissions, and patient experience.
Safety Score69/100Composite patient safety score (0–100) derived from CMS hospital-acquired infection rates (CLABSI, CAUTI, MRSA, C. diff), surgical complications, and HCAHPS surveys.
Typical ER Wait115 minMedian minutes patients spent in the emergency department before leaving from the visit, as reported to CMS Timely and Effective Care.

Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.

Behavioral Pricing FingerprintHigh Infusion / OR Multiples

Specialty Drug & Surgical Margin Engine

Sanford Sheldon Medical Center concentrates commercial margin in outpatient surgical suites (8.6× Medicare) and specialty drug infusions (2.5× Medicare) relative to routine diagnostics (10.1×). Comparing freestanding ambulatory surgery centers or specialty pharmacy options before treatment yields substantial savings.

Regional Benchmark in IAU.S. National Reference Pool
Advantage

Where They're Good (Patient & Payer Edge)

  • Bottom-quartile procedures (Q25) price at 0.78× the peer BaseRate benchmark
  • Self-pay cash beats commercial insurance on 47% of shoppable procedures (99/100 Cash Honesty)
  • CMS clinical safety score (69/100 safety score) with 69% patient recommendation
  • IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (63.0% AGB cap)
Watchout

Where You Can Get Burned (Markup Traps)

  • Outpatient surgery & OR suites carry a 8.6× markup over Medicare rates
  • Commercial insurance median sits at 1.00× Fair BaseRate (6.9× Medicare), so insured patients should always compare the self-pay cash price before paying.
  • Upper-quartile procedures (Q75 1.28×) jump +28% above the median procedure ratio (Q50 1.00×)
  • Unnegotiated chargemaster list prices average 9.5× Medicare (25¢ true HCRIS cost per $1 gross)
Front-Door ShoppableElective / Imaging
6.9× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER0.75× Divergence
5.2× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+28% Upper Tail
Q25 0.78× · Q50 1.00× · Q75 1.28×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.
Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×
Front-Door Shoppable CareFront-Door Shoppable
6.9× MedicareWatchout
Outpatient Surgery & ORBack-Door Captive
8.6× MedicareWatchout
Diagnostic Imaging (CT/MRI)Front-Door Shoppable
10.1× MedicareWatchout
Back-Door Captive ER VisitsBack-Door Captive
1.6× MedicareGood
Inpatient Lab & PathologyBack-Door Captive
9.5× MedicareWatchout
Specialty & Infusion Drugs (J-Codes)Back-Door Captive
2.5× MedicareFair
Self-Pay Cash Honesty & 501(r)Integrity & Outcomes
47% Cash Edge · 99/100Good
CMS Clinical Safety & Star ValueIntegrity & Outcomes
3 CMS · 69/100Fair

Procedure Prices at Sanford Sheldon Medical Center

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 88 published procedures.

Sort:
Audit a Bill & 501(r) Cap ↓
Procedure & Billing Code This Hospital vs. Fair
CT scan, abdomen and pelvis (with contrast)
CPT Code: 74177
 $4,469 10.0×
MRI, brain (with and without contrast)
CPT Code: 70553
 $4,494 8.8×
Sleep study (overnight, in lab)
CPT Code: 95810
 $4,216 4.1×
CT scan, abdomen and pelvis (no contrast)
CPT Code: 74176
 $3,805 12.6×
MRI, lower back (no contrast)
CPT Code: 72148
 $3,166 9.4×
MRI, brain (no contrast)
CPT Code: 70551
 $3,087 9.0×
Rabies immune globulin
HCPCS Code: 90375
 $2,994 9.3×
MRI, knee or other leg joint
CPT Code: 73721
 $2,810 7.6×
CT scan, head (with contrast)
CPT Code: 70460
 $2,536 10.5×
CT scan, lower back (lumbar spine)
CPT Code: 72131
 $2,508 14.9×
CT scan, neck (cervical spine)
CPT Code: 72125
 $2,474 14.6×
CT scan, head (with and without contrast)
CPT Code: 70470
 $2,455 9.5×
Echocardiogram (heart ultrasound)
CPT Code: 93306
 $2,319 4.0×
CT scan, sinuses
CPT Code: 70486
 $2,112 12.7×
CT scan, chest (no contrast)
CPT Code: 71250
 $2,108 12.6×
CT scan, pelvis
CPT Code: 72192
 $2,004 12.3×
CT scan, head (no contrast)
CPT Code: 70450
 $1,914 12.0×
Trauma team activation
HCPCS Code: G0390
 $1,792 1.2×
Ultrasound, leg veins (duplex)
CPT Code: 93970
 $1,338 4.9×
Blood transfusion
CPT Code: 36430
 $1,040 2.1×
Ultrasound, abdomen (complete)
CPT Code: 76700
 $983 7.3×
Ultrasound, pelvis
CPT Code: 76856
 $957 7.4×
Ultrasound, abdomen (limited)
CPT Code: 76705
 $756 6.0×
Ultrasound, thyroid and neck
CPT Code: 76536
 $729 5.5×
X-ray, lower back
CPT Code: 72110
 $562 5.0×
Showing top 25 high-impact procedures of 88 total
Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 63.0%

Audit a Bill or Quote at Sanford Sheldon Medical Center (Zero PHI Required)

CMS CCN: 161381
CPT 74177
Fair BaseRate™ $448
Medicare Rate $356
Self-Pay Cash $4,469
Insurer Median $4,469
Pre-filled with Sanford Sheldon Medical Center’s charged/list benchmark
Screened against 2026 HHS Federal Poverty Guidelines
2026 FPL: $15,650 + $5,500 per additional person
Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $3,520 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $3,520

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (63.0% of gross = $3,520).

Step 2 · Cash vs. Insurance Arbitrage Save $1,117 Paying Cash

Self-Pay Cash Rate ($4,469) Beats Your Bill

Sanford Sheldon Medical Center's published 45 CFR § 180 self-pay cash rate is $4,469 (vs. $4,469 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$5,138 Above Fair BaseRate

Negotiate Toward $448 Fair BaseRate ($356 Medicare)

Your bill ($5,586) is $5,138 above the denoised Fair BaseRate ($448) and 15.7× the $356 Medicare rate.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.
IRS Form 990 Schedule H & 26 U.S.C. § 501(r) 501(c)(3) Nonprofit Hospital

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

Free Care Eligibility BenchmarkUp to 200% FPL100% charity write-off income threshold
Discounted Care EligibilityUp to 400% FPLSliding-scale & AGB billing cap tier
Charity Care Share of ExpensesSee Schedule HNet community financial assistance reported
26 U.S.C. § 501(r)(5) AGB Benchmark Method: lookback_commercial_median

Hospital-Specific CMS HCRIS Benchmark (63.0% of gross charges)

Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.

Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines: Calculate Your 501(r) Cap Above ↑
CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

Safety Composite69/100
Would Recommend69%
Rated 9 or 10 (HCAHPS)69%
Median ER Wait115 min
Left ER Before Seen0%
30-Day Mortality vs U.S.same
Unplanned Readmissionsame

CMS Price Transparency Administrative Enforcement Log

Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Sanford Sheldon Medical Center. Prior administrative notices do not necessarily reflect current compliance status.

  • 2025-07-08·administrative_or_closure

    Met Requirements

    Recorded
  • 2024-07-12·administrative_or_closure

    Closure Notice

    Recorded
  • 2024-05-22·cap_corrective_action

    CAP Request

    Recorded
  • 2024-02-14·warning_notice

    Warning Notice

    Recorded

Source: CMS Hospital Care Compare (63 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Above-Benchmark Price Tier

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Sanford Sheldon Medical Center.

Price Index: 1.85× regional baseline
Quality: 57/100 CMS composite
Median Household Income$68,216U.S. Census ACS
Local Uninsured Share3.6%Regional ACS estimate
200% FPL (1 Person)$31,920Common free-care ceiling
400% FPL (Family of 4)$128,600Common AGB cap ceiling
45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 82/100 · Corroborated CMS CCN 161381

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

MRF Portal Indexed (CMS_45_CFR_180_FILING.json) Verify on CMS Medicare.gov (CCN 161381) ↗ CMS HCRIS Cost Reports ↗
Published MRF FileCMS_45_CFR_180_FILING.json
Publication / Vintage2026-03-04
Validated Rate Rows4,360 (CMS v3.0.0)
File Integrity DigestVerified · CCN 161381

Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.

Submit MRF Update Correction Policy