We can save money during initial prototyping, by creating a small test structure as small as 1mmm^2, which reduces the cost of a prototype run to 5k$ - 10k$. Some services that provide this are MOSIS [0] in the US, and Europractice [1] in the EU. But when we go to a full production run, there's no way to get around creating a 'full reticle' design, as image sensors have a physical dimension determined by focal plan size requirement of imaging application. For example, in digital camera, if a sensor is 'full frame' then it obviously has to be 36mm x 24mm, regardless of if the process node would have let you shrink it. And if you make a serious mistake, then you need to do another production run, which means you pay the 300k$ - 1m$ once again.
In terms of the circuit functionality, image sensors require a mixture of analog and digital design, but in this area, even many of the digital circuits are custom designed, rather than relying on foundry-provided 'standard cells' and an automatic place-and-route flow.
Regarding node sizes for image sensors, TSMC built a 28nm fab recently for Sony exclusively to make their latest sensors. There was actually a HN post about that a couple years ago [1]. Also, it's important to note that in many applications, the image sensor layer is now actually stacked, with a layer of DRAM (in 45 nm, for example) between, and a ISP (image signal processor) chip on the bottom made in a smaller digital process. You can see an image of that stack up here [2].
[0] https://image-sensors-world.blogspot.com/2020/08/tsmc-report... [1] https://news.ycombinator.com/item?id=24321804 [2] https://fuse.wikichip.org/news/763/iedm-2017-sonys-3-layer-s...