healthcosts.net
Established Patient Office Visit (level 3) at Sanford Wheaton
401 12th St N, Wheaton, MN · Sanford Health · · NPI 1154615573
$164.00
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.
$205.00
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.
$49.63 with Blue Cross Blue Shield of Minnesota vs $192.70 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 | $49.63 | ↓ -70% |
| Sanford Health Plan Align | Medicare Replacement | $103.32 | ↓ -37% |
| Ucare | Medicare Replacement | $110.91 | ↓ -32% |
| Aetna | Medicare Replacement | $111.93 | ↓ -32% |
| Blue Cross Blue Shield of Minnesota | Medicare Replacement | $111.93 | ↓ -32% |
| Great Plains Medicare Advantage | Medicare Replacement | $111.93 | ↓ -32% |
| Health Partners | Medicare Replacement | $111.93 | ↓ -32% |
| United Healthcare | Medicare Replacement | $111.93 | ↓ -32% |
| Security Health Plan | Commercial | $112.75 | ↓ -31% |
| Primewest | Medicare Replacement | $114.08 | ↓ -30% |
| Primewest | Medicaid Managed Care | $124.03 | ↓ -24% |
| Blue Cross Blue Shield of North Dakota | Commercial | $141.10 | ↓ -14% |
| Sanford Health Plan | Group Health/True | $161.83 | ↓ -1% |
| Health Partners | Commercial | $166.05 | ↑ +1% |
| United Healthcare | Commercial + Top 20 | $171.18 | ↑ +4% |
| Aetna | Commercial | $178.15 | ↑ +9% |
| Ucare | Commercial | $180.11 | ↑ +10% |
| Medica | Choice | $180.20 | ↑ +10% |
| First Choice Health Network | Commercial | $184.50 | ↑ +13% |
| Healthez | Commercial | $184.50 | ↑ +13% |
| Multiplan | Commercial | $184.50 | ↑ +13% |
| Blue Cross Blue Shield of Minnesota | Commercial/Federal | $189.67 | ↑ +16% |
| Sanford Health Plan | Commercial/ND Pers/SD Exchange Commercial | $190.38 | ↑ +16% |
| Sanford Health Plan | SD Exchange True | $190.38 | ↑ +16% |
| Medica | Elect | $192.70 | ↑ +18% |
| Ucare | Medicaid Managed Care | not published by hospital | — |
Visitor-reported prices
Comments
Established Patient Office Visit (level 3) at other Minnesota hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Sanford Canby Medical Center | Canby | $153.60 | $44.30 – $164.70 |
| Sanford Westbrook Hospital | Westbrook | $202.40 | $40.43 – $150.30 |
| Sanford Bagley Medical Center | Bagley | $193.60 | $58.59 – $217.80 |
| Sanford Luverne Medical Center | Luverne | $205.60 | $62.22 – $231.30 |
| Sanford Bemidji Medical Center | Bemidji | $193.60 | $83.39 – $166.50 |
| Sanford Worthington Medical Center | Worthington | $453.60 | $66.30 – $153.90 |
| Sanford Tracy Hospital | Tracy | $202.40 | $40.43 – $150.30 |