How many shoppable procedure prices are published for Sanford Wheaton Medical Center?

Sanford Wheaton Medical Center in Wheaton, MN currently has 107 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Sanford Wheaton Medical Center's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Sanford Wheaton Medical Center's median negotiated commercial rate is 1.3× the regionally adjusted fair BaseRate benchmark.

Hospital Profile Critical Access Hospital Voluntary non-profit - Private 15 Beds · rural Updated: 2026-03-04

Sanford Wheaton Medical Center

401 12Th Street North, Wheaton, MN 56296 · 107 Priced Procedures

CMS Overall Rating No CMS Rating

Above Fair Market · Negotiate

1.26×vs. Fair Market Price

Typical commercial prices here are +26% above the fair benchmark (1.26×) even after accounting for local nurse/doctor wages and patient complexity.

89/100 · Verified

89/100Self-Pay Cash Beats Insurance 74% of the Time

File Completeness100

Price Logic87

Peer Alignment72

Clean Billing84

Real Cash Discount100

Premium Quality Tier

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

Behavioral Pricing FingerprintUpper-Quartile Spread · +66% Tail Jump

Wide Procedure Spread · Upper-Quartile Skew Pricer

Sanford Wheaton Medical Center prices routine shoppable procedures at 1.6× Medicare (median 1.03× Fair BaseRate) while upper-quartile commercial rates jump +66% to 1.71× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.

#48 of 76 in MN · 61st State Percentile#2,163 of 3,385 in U.S. · 63rd National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.99× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 74% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (85/100 safety score) with 72% patient recommendation
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (80.8% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (1.26× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
Commercial insurance median sits at 1.03× Fair BaseRate (1.6× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 1.71×) jump +66% above the median procedure ratio (Q50 1.03×)
Unnegotiated chargemaster list prices average 8.8× Medicare (29¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

1.6× Medicare

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

Back-Door Captive & ER0.63× Divergence

1.0× Medicare

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

Quantile Tail Spread+66% Upper Tail

Q25 0.99× · Q50 1.03× · Q75 1.71×

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

1.6× MedicareGood

Outpatient Surgery & ORBack-Door Captive

0.6× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

0.9× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

0.6× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

0.6× MedicareGood

Specialty & Infusion Drugs (J-Codes)Back-Door Captive

0.5× MedicareGood

Self-Pay Cash Honesty & 501(r)Integrity & Outcomes

74% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 85/100Good

Procedure Prices at Sanford Wheaton Medical Center

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 107 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Total hip replacement CPT Code: `27130`	—	$13,510	$13,413	1.0×
Total knee replacement CPT Code: `27447`	—	$13,510	$13,523	1.0×
Gallbladder removal (laparoscopic) CPT Code: `47562`	—	$6,126	$6,109	1.0×
Breast lump removal CPT Code: `19120`	—	$4,021	$3,875	1.0×
Inguinal hernia repair CPT Code: `49505`	—	$3,706	$3,629	1.0×
Knee arthroscopy with meniscus repair CPT Code: `29881`	—	$3,407	$3,372	1.0×
Bunion correction surgery CPT Code: `28296`	—	$3,407	$3,446	1.0×
Cataract surgery with lens implant CPT Code: `66984`	—	$2,395	$2,540	0.9×
Rabies immune globulin HCPCS Code: `90375`	$1,943	$1,943	$322	6.0×
Colonoscopy (diagnostic) CPT Code: `45378`	—	$1,371	$981	1.4×
Trauma team activation HCPCS Code: `G0390`	$1,573	$1,389	$1,453	1.0×
Colonoscopy with biopsy CPT Code: `45380`	—	$1,238	$1,256	1.0×
Upper endoscopy with biopsy CPT Code: `43239`	—	$1,135	$987	1.1×
Sleep study (overnight, in lab) CPT Code: `95810`	$3,907	$1,068	$1,021	1.0×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$1,398	$850	$583	1.5×
Injection procedure for pain management HCPCS Code: `G0260`	—	$727	$855	0.9×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$2,489	$608	$448	1.4×
MRI, brain (with and without contrast) CPT Code: `70553`	$3,705	$608	$511	1.2×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$1,922	$578	$303	1.9×
MRI, lower back (no contrast) CPT Code: `72148`	$2,810	$578	$338	1.7×
MRI, brain (no contrast) CPT Code: `70551`	$2,677	$578	$343	1.7×
MRI, knee or other leg joint CPT Code: `73721`	$2,514	$578	$369	1.6×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$523	$523	$148	3.5×
CT scan, head (no contrast) CPT Code: `70450`	$1,663	$470	$160	2.9×
CT scan, head (with contrast) CPT Code: `70460`	$2,254	$447	$242	1.8×
CT scan, head (with and without contrast) CPT Code: `70470`	$2,338	$447	$258	1.7×
Blood transfusion CPT Code: `36430`	$1,045	$459	$498	0.9×
Psychological testing by technician CPT Code: `96138`	—	$419	$395	1.1×
CT scan, pelvis CPT Code: `72192`	$1,703	$353	$163	2.2×
CT scan, sinuses CPT Code: `70486`	$1,630	$353	$166	2.1×
CT scan, chest (no contrast) CPT Code: `71250`	$1,728	$353	$167	2.1×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,872	$353	$168	2.1×
CT scan, neck (cervical spine) CPT Code: `72125`	$1,886	$353	$169	2.1×
Neurobehavioral status check CPT Code: `96116`	—	$327	$231	1.4×
Speech therapy (language evaluation) CPT Code: `92507`	$269	$252	$86	2.9×
Screening mammogram (both breasts) CPT Code: `77067`	$453	$248	$123	2.0×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$1,256	$254	$272	0.9×
Office visit, established patient (20-29 min) CPT Code: `99213`	$164	$164	$87	1.9×
New patient office visit (30-44 min) CPT Code: `99203`	$186	$186	$110	1.7×
Office visit, established patient (30-39 min) CPT Code: `99214`	$200	$200	$123	1.6×
Behavioral health assessment HCPCS Code: `H0001`	$174	$174	$157	1.1×
Psychotherapy session (45 minutes) CPT Code: `90834`	—	$169	$166	1.0×
Family therapy session CPT Code: `90847`	—	$169	$173	1.0×
Psychotherapy session (60 minutes) CPT Code: `90837`	—	$169	$181	0.9×
Psychiatric evaluation (first visit) CPT Code: `90791`	$333	$169	$185	0.9×
Orthotic fitting and training CPT Code: `97760`	$131	$131	$51	2.6×
Psychological testing evaluation CPT Code: `96136`	—	$135	$128	1.1×
Physical therapy (gait training) CPT Code: `97116`	$101	$101	$33	3.1×
Physical therapy (manual therapy) CPT Code: `97140`	$109	$95	$34	2.8×
Diagnostic procedure preparation HCPCS Code: `G0279`	$97	$97	$35	2.8×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$112	$95	$35	2.7×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$113	$95	$38	2.5×
Residential substance abuse treatment HCPCS Code: `H2035`	$119	$119	$88	1.4×
X-ray, chest (two views) CPT Code: `71046`	$328	$118	$93	1.3×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$225	$80	$64	1.3×
Group therapy session CPT Code: `90853`	—	$97	$100	1.0×
Breathing treatment (nebulizer) CPT Code: `94640`	$118	$118	$201	0.6×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$104	$91	$40	2.3×
X-ray, pelvis CPT Code: `72170`	$310	$112	$110	1.0×
X-ray, chest (single view) CPT Code: `71045`	$284	$92	$92	1.0×
X-ray, lower back CPT Code: `72110`	$547	$112	$112	1.0×
X-ray, shoulder CPT Code: `73030`	$350	$92	$92	1.0×
X-ray, foot CPT Code: `73630`	$293	$92	$92	1.0×
X-ray, neck (cervical spine) CPT Code: `72040`	$319	$92	$93	1.0×
X-ray, hand CPT Code: `73130`	$330	$92	$93	1.0×
X-ray, hip CPT Code: `73502`	$341	$92	$93	1.0×
X-ray, ankle CPT Code: `73610`	$327	$92	$93	1.0×
Ultrasound, abdomen (limited) CPT Code: `76705`	$704	$112	$126	0.9×
Ultrasound, pelvis CPT Code: `76856`	$777	$112	$130	0.9×
Ultrasound, thyroid and neck CPT Code: `76536`	$674	$112	$132	0.8×
Ultrasound, abdomen (complete) CPT Code: `76700`	$898	$112	$134	0.8×
Occupational therapy (self-care training) CPT Code: `97535`	$86	$86	$38	2.3×
Typhoid vaccine HCPCS Code: `90675`	$467	$467	$347	1.3×
Blood test, liver function panel CPT Code: `80076`	$114	$114	$9	12.7×
Blood test, basic metabolic panel CPT Code: `80048`	$107	$107	$9	11.9×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$123	$123	$11	11.2×
Culture, blood CPT Code: `87040`	$119	$119	$11	10.8×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$117	$117	$20	5.8×
Blood test, complete blood count (CBC) CPT Code: `85025`	$90	$90	$8	11.3×
Culture, bacterial CPT Code: `87070`	$87	$87	$9	9.7×
Blood test, ferritin (iron stores) CPT Code: `82728`	$106	$106	$14	7.6×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$102	$102	$14	7.3×
Blood test, thyroid (TSH) CPT Code: `84443`	$104	$104	$18	5.8×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$62	$62	$3	20.7×
Blood test, lipase CPT Code: `83690`	$74	$74	$7	10.6×
Blood test, amylase CPT Code: `82150`	$68	$68	$7	9.7×
Blood test, vitamin B12 CPT Code: `82607`	$89	$89	$16	5.6×
Blood test, PSA (prostate screen) CPT Code: `84153`	$90	$90	$19	4.7×
Blood test, vitamin D CPT Code: `82306`	$88	$88	$31	2.8×
Blood antibody screen CPT Code: `86850`	$94	$94	$46	2.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$46	$46	$4	11.5×
Blood test, glucose (blood sugar) CPT Code: `82947`	$45	$45	$4	11.3×
Blood test, creatinine (kidney) CPT Code: `82565`	$46	$46	$5	9.2×
Blood test, potassium CPT Code: `84132`	$46	$46	$5	9.2×
Blood test, sodium CPT Code: `84295`	$46	$46	$5	9.2×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$69	$69	$10	6.9×
Blood test, calcium CPT Code: `82310`	$43	$43	$5	8.6×
Hepatitis C antibody test CPT Code: `86803`	$64	$64	$15	4.3×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$68	$68	$56	1.2×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$32	$32	$5	6.4×
Blood test, hemoglobin CPT Code: `85018`	$19	$19	$3	6.3×
Blood test, clotting time (PTT) CPT Code: `85730`	$36	$36	$6	6.0×
Blood test, magnesium CPT Code: `83735`	$36	$36	$7	5.1×
Community mental health services HCPCS Code: `H0038`	$37	$37	$16	2.3×
Hepatitis B vaccine HCPCS Code: `90744`	$56	$56	$37	1.5×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$47	$47	$39	1.2×
Hospital observation (per hour) HCPCS Code: `G0378`	$53	$53	$86	0.6×

Showing top 25 high-impact procedures of 107 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 80.8%

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

CMS CCN: 241304

CPT 27130

Select Procedure to Audit:

Fair BaseRate™ $13,413

Medicare Rate $13,117

Self-Pay Cash Request Quote

Insurer Median $13,510

1. Amount on Your Bill or Quote ($) Pre-filled with Sanford Wheaton Medical Center’s charged/list benchmark

2. Household Annual Income ($) Screened against 2026 HHS Federal Poverty Guidelines

3. Household Size (1–8) 2026 FPL: $15,650 + $5,500 per additional person

Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $26,182 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $26,182

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (80.8% of gross = $26,182).

Step 2 · Cash vs. Insurance Arbitrage Request Prompt-Pay Quote

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Sanford Wheaton Medical Center's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.

Step 3 · Fair BaseRate Target +$19,011 Above Fair BaseRate

Negotiate Toward $13,413 Fair BaseRate ($13,117 Medicare)

Your bill ($32,424) is $19,011 above the denoised Fair BaseRate ($13,413) and 2.5× the $13,117 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)

EIN: 450409348

Filing Period: 201104

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 (80.8% 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 Composite85/100

Median ER Wait103 min

Left ER Before Seen0%

Source: CMS Hospital Care Compare. 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

Higher-Quality, Above-Median Price Tier

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

Price Index: 1.53× regional baseline

Quality: 57/100 CMS composite

Median Household Income$65,931U.S. Census ACS

Local Uninsured Share3.2%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 89/100 · Verified CMS CCN 241304 EIN 450409348

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 241304) ↗ Verify IRS Form 990 (EIN 450409348) ↗ CMS HCRIS Cost Reports ↗

Published MRF File450409348_sanford-wheaton_standardcharges.csv

Publication / Vintage2026-03-04 · 49.96 MB

Validated Rate Rows3,501 (CMS v3.0.0)

File Integrity Digest934c06d0d9ef32faad57…

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

Sanford Wheaton Medical Center

Wide Procedure Spread · Upper-Quartile Skew Pricer

Where They're Good (Patient & Payer Edge)

Where You Can Get Burned (Markup Traps)

REA Pricing Decompiler · 5-Layer Cost-to-Charge Reverse Engineering

Insurer Bargaining Power & Cash-Vulnerability Matrix

Procedure Prices at Sanford Wheaton Medical Center

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

Statutory 501(r) AGB Cap Limits Bill to $26,182

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Negotiate Toward $13,413 Fair BaseRate ($13,117 Medicare)

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

Clinical Quality, Patient Experience & Infection Benchmarks

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

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