healthcosts.net
New Patient Office Visit (level 5) at Sterling Regional Medical Center
615 Fairhurst Street, Sterling, CO · Banner Health · · NPI 1942238555
$1,016.06
Cash price Discounted cash price What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge. Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.
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What you pay up front if you don't use insurance.
$1,344.00
Gross charge Gross charge (chargemaster price) The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this. Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.
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The hospital's undiscounted list price — almost no one pays this.
$145.08 with Aetna vs $504.40 with Multiplan — same scan, same building. Share
Negotiated rates by payer
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →Payer ?Payer The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on. Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509. Full explanation → |
Plan ?Plan The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates. Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible. Full explanation → |
Negotiated rate | vs. cash |
|---|---|---|---|
| Aetna | Medicare Advantage | $145.08 | ↓ -86% |
| Anthem Blue Cross Blue Shield Colorado | Medicare | $161.20 | ↓ -84% |
| Banner Health | Banner Choice Plus/Banner Select | $161.20 | ↓ -84% |
| HealthSpring Life & Health Insurance Company, Inc. | Medicare Advantage | $161.20 | ↓ -84% |
| Medica | Medicare Advantage | $161.20 | ↓ -84% |
| Medicare | Traditional Medicare | $161.20 | ↓ -84% |
| Assist Health Group | AHG Specialty Network | $193.44 | ↓ -81% |
| Pinnacol Assurance Workers Comp | Pinnacol Assurance WC | $252.77 | ↓ -75% |
| United Healthcare | Colorado Navigate/Colorado Option | $301.60 | ↓ -70% |
| Denver Health Medical Plan | Commercial | $314.86 | ↓ -69% |
| Anthem Blue Cross Blue Shield Colorado | Pathway Standard | $377.42 | ↓ -63% |
| Anthem Blue Cross Blue Shield Colorado | Pathway | $383.66 | ↓ -62% |
| Anthem Blue Cross Blue Shield Colorado | Blue Priority/HMO/PPO/Indemnity | $395.15 | ↓ -61% |
| Medica | Commercial | $433.16 | ↓ -57% |
| United Healthcare | Colorado Doctor's Plan | $443.56 | ↓ -56% |
| Apostrophe, Inc. | Commercial | $468.00 | ↓ -54% |
| First Choice Health Network | Commercial | $468.00 | ↓ -54% |
| Aetna | Commercial/Medical Rental | $483.60 | ↓ -52% |
| United Healthcare | Commercial | $492.96 | ↓ -51% |
| First Choice of the Midwest | Commercial | $494.00 | ↓ -51% |
| Hue Health, Inc | Medicare Advantage | $494.00 | ↓ -51% |
| Rocky Mountain Health Plans | Private Plan/Self Insured Plan | $494.00 | ↓ -51% |
| Multiplan | Commercial | $504.40 | ↓ -50% |
| Molina Healthcare | Medicaid/CHIP | not published by hospital | — |
Visitor-reported prices
Comments
New Patient Office Visit (level 5) at other Colorado hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Banner Fort Collins Medical Center | Fort Collins | $912.83 | $233.70 – $975.53 |
| Banner North Colorado Medical Center - Loveland Campus | Loveland | $1,093.61 | $146.49 – $975.53 |
| East Morgan County Hospital | Brush | $1,237.82 | $219.13 – $504.40 |