healthcosts.net
ER Visit (level 5, high severity) at Sanford Wheaton
401 12th St N, Wheaton, MN · Sanford Health · · NPI 1154615573
$1,270.40
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.
$1,588.00
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.
$384.45 with Blue Cross Blue Shield of Minnesota vs $1,492.72 with Medica — 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 |
|---|---|---|---|
| Blue Cross Blue Shield of Minnesota | PMAP | $384.45 | ↓ -70% |
| Ucare | Medicaid Managed Care | $643.76 | ↓ -49% |
| Sanford Health Plan Align | Medicare Replacement | $800.35 | ↓ -37% |
| Ucare | Medicare Replacement | $859.11 | ↓ -32% |
| Aetna | Medicare Replacement | $867.05 | ↓ -32% |
| Blue Cross Blue Shield of Minnesota | Medicare Replacement | $867.05 | ↓ -32% |
| Great Plains Medicare Advantage | Medicare Replacement | $867.05 | ↓ -32% |
| Health Partners | Medicare Replacement | $867.05 | ↓ -32% |
| United Healthcare | Medicare Replacement | $867.05 | ↓ -32% |
| Security Health Plan | Commercial | $873.40 | ↓ -31% |
| Primewest | Medicare Replacement | $883.72 | ↓ -30% |
| Primewest | Medicaid Managed Care | $960.74 | ↓ -24% |
| Blue Cross Blue Shield of North Dakota | Commercial | $1,093.02 | ↓ -14% |
| Sanford Health Plan | Group Health/True | $1,253.57 | ↓ -1% |
| Health Partners | Commercial | $1,286.28 | ↑ +1% |
| United Healthcare | Commercial + Top 20 | $1,325.98 | ↑ +4% |
| Aetna | Commercial | $1,379.97 | ↑ +9% |
| Ucare | Commercial | $1,395.22 | ↑ +10% |
| Medica | Choice | $1,395.85 | ↑ +10% |
| First Choice Health Network | Commercial | $1,429.20 | ↑ +13% |
| Healthez | Commercial | $1,429.20 | ↑ +13% |
| Multiplan | Commercial | $1,429.20 | ↑ +13% |
| Blue Cross Blue Shield of Minnesota | Commercial/Federal | $1,469.22 | ↑ +16% |
| Sanford Health Plan | Commercial/ND Pers/SD Exchange Commercial | $1,474.78 | ↑ +16% |
| Sanford Health Plan | SD Exchange True | $1,474.78 | ↑ +16% |
| Medica | Elect | $1,492.72 | ↑ +18% |
Visitor-reported prices
Comments
ER Visit (level 5, high severity) at other Minnesota hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Sanford Canby Medical Center | Canby | $1,670.40 | $505.50 – $1,879.20 |
| Sanford Westbrook Hospital | Westbrook | $1,752.80 | $530.44 – $1,971.90 |
| Sanford Bagley Medical Center | Bagley | $2,052.80 | $621.23 – $2,309.40 |
| Sanford Luverne Medical Center | Luverne | $1,766.40 | $534.56 – $1,987.20 |
| Sanford Bemidji Medical Center | Bemidji | $2,052.80 | $463.38 – $2,309.40 |
| Sanford Worthington Medical Center | Worthington | $1,335.20 | $473.40 – $1,502.10 |
| Sanford Tracy Hospital | Tracy | $1,752.80 | $530.44 – $1,971.90 |
| Sanford Thief River Falls Medical Center | Thief River Falls | $1,622.40 | $643.76 – $1,825.20 |