Acyclovir 400 mg tablet at Sanford Bemidji Medical Center

1300 Anne Street NW, Bemidji, MN · Sanford Health · · NPI 1801870191

Source: hospital's published price file ↗ · Published Mar 4, 2026 · Ingested Aug 12, 2026

$742.65

Cash price

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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.

Full explanation →

What you pay up front if you don't use insurance.

$928.31

Gross charge

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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.

Full explanation →

The hospital's undiscounted list price — almost no one pays this.

$2.89 with Blue Cross Blue Shield of Minnesota vs $5.78 with Healthez — 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 →

Payer
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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
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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
Blue Cross Blue Shield of Minnesota PMAP $2.89 ↓ -100%
Blue Cross Blue Shield of Minnesota Commercial/Federal $2.89 ↓ -100%
Sanford Health Plan SD Exchange True $2.93 ↓ -100%
Sanford Health Plan Group Health/True $3.34 ↓ -100%
Sanford Health Plan SD Exchange Commercial $3.44 ↓ -100%
Security Health Plan Commercial $3.53 ↓ -100%
Sanford Health Plan Commercial $3.92 ↓ -99%
Health Partners Commercial $4.49 ↓ -99%
Ucare Commercial $4.51 ↓ -99%
United Healthcare CSP Top 20 $4.89 ↓ -99%
Aetna Commercial $5.26 ↓ -99%
United Healthcare Commercial $5.36 ↓ -99%
Medica Choice $5.39 ↓ -99%
Medica Elect $5.77 ↓ -99%
Multiplan Commercial $5.78 ↓ -99%
Cigna Commercial $5.78 ↓ -99%
First Choice Health Network Commercial $5.78 ↓ -99%
Healthez Commercial $5.78 ↓ -99%
United Healthcare Medicare Replacement not published by hospital —
Aetna Medicare Replacement not published by hospital —
Blue Cross Blue Shield of Minnesota Medicare Replacement not published by hospital —
Great Plains Medicare Advantage Medicare Replacement not published by hospital —
Health Partners Medicare Replacement not published by hospital —
Primewest Medicaid Managed Care not published by hospital —
Primewest Medicare Replacement not published by hospital —
Sanford Health Plan Align Medicare Replacement not published by hospital —
Ucare Medicaid Managed Care not published by hospital —
Ucare Medicare Replacement not published by hospital —

Visitor-reported prices

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Acyclovir 400 mg tablet at other Minnesota hospitals

Hospital City Cash price Negotiated range
Sanford Canby Medical Center Canby $6.97 $0.36 – $1.35
Sanford Westbrook Hospital Westbrook $5.62 $0.36 – $1.35
Sanford Bagley Medical Center Bagley $622.03 $1.46 – $5.44
Sanford Luverne Medical Center Luverne $355.80 $0.36 – $1.35
Sanford Worthington Medical Center Worthington $5.20 $0.58 – $1.35
Sanford Tracy Hospital Tracy $5.15 $0.36 – $1.35
Sanford Thief River Falls Medical Center Thief River Falls $8.06 $2.06 – $5.40
Sanford Behavioral Health Thief River Falls Thief River Falls $8.06 $2.06 – $5.40

All Minnesota hospitals for this procedure →