Outpatient office visit, established patient, level 5 at Sanford Sheldon Medical Center

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

ESTAB LEVEL 5

Sheldon, IA

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Pricing by billing methodology

Price type

How this price compares nationally

Sanford Sheldon Medical Center’s median price of $173 is 18% below the median hospital's median price ($210), higher than 38% of the 1,976 hospitals reporting CPT 99215. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 99215 at Sanford Sheldon Medical Center

Negotiated rates from the hospital’s own file: 8 payers, 27 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.

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1	Sanford Health Plan medicare replacement percent of total billed charges · outpatientfrom % of charges	$76.38	$76.38	$76.38 – $76.38
2	Ucare medicare replacement percent of total billed charges · outpatientfrom % of charges	$82.01	$82.01	$82.01 – $82.01
3	Aetna medicare replacement percent of total billed charges · outpatientfrom % of charges	$82.81	$82.81	$82.81 – $82.81
4	Bcbs Nd medicare replacement percent of total billed charges · outpatientfrom % of charges	$82.81	$82.81	$82.81 – $82.81
5	UnitedHealthcare medicare replacement percent of total billed charges · outpatientfrom % of charges	$82.81	$82.81	$82.81 – $82.81
6	Wellmark hmo percent of total billed charges · inpatientfrom % of charges	$134.00	$134.00	$134.00 – $134.00
7	Wellmark ppo percent of total billed charges · inpatientfrom % of charges	$139.36	$139.36	$139.36 – $139.36
8	Sanford Health Plan group health/true percent of total billed charges · inpatientfrom % of charges	$143.59	$143.59	$143.59 – $143.59
9	Sanford Health Plan group health/true percent of total billed charges · outpatientfrom % of charges	$143.59	$143.59	$143.59 – $143.59
10	Sanford Health Plan sd exchange true percent of total billed charges · inpatientfrom % of charges	$143.59	$143.59	$143.59 – $143.59
11	Sanford Health Plan sd exchange true percent of total billed charges · outpatientfrom % of charges	$143.59	$143.59	$143.59 – $143.59
12	Sanford Health Plan commercial/nd pers percent of total billed charges · inpatientfrom % of charges	$168.92	$168.92	$168.92 – $168.92
13	Sanford Health Plan commercial/nd pers percent of total billed charges · outpatientfrom % of charges	$168.92	$168.92	$168.92 – $168.92
14	Sanford Health Plan sd exchange commercial percent of total billed charges · inpatientfrom % of charges	$168.92	$168.92	$168.92 – $168.92
15	Sanford Health Plan sd exchange commercial percent of total billed charges · outpatientfrom % of charges	$168.92	$168.92	$168.92 – $168.92
16	Medica choice percent of total billed charges · inpatientfrom % of charges	$221.10	$221.10	$221.10 – $221.10
17	Medica choice percent of total billed charges · outpatientfrom % of charges	$221.10	$221.10	$221.10 – $221.10
18	UnitedHealthcare commercial + top 20 percent of total billed charges · inpatientfrom % of charges	$223.78	$223.78	$223.78 – $223.78
19	UnitedHealthcare commercial + top 20 percent of total billed charges · outpatientfrom % of charges	$223.78	$223.78	$223.78 – $223.78
20	Aetna commercial percent of total billed charges · inpatientfrom % of charges	$232.89	$232.89	$232.89 – $232.89
21	Aetna commercial percent of total billed charges · outpatientfrom % of charges	$232.89	$232.89	$232.89 – $232.89
22	Ucare commercial percent of total billed charges · inpatientfrom % of charges	$235.46	$235.46	$235.46 – $235.46
23	Ucare commercial percent of total billed charges · outpatientfrom % of charges	$235.46	$235.46	$235.46 – $235.46
24	Medica elect percent of total billed charges · inpatientfrom % of charges	$236.38	$236.38	$236.38 – $236.38
25	Medica elect percent of total billed charges · outpatientfrom % of charges	$236.38	$236.38	$236.38 – $236.38

Page 1 of 2 · 27 rates

Last updated: Mar 4, 2026

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