healthcosts.net
Established Patient Office Visit (level 4) at Sanford Wheaton
401 12th St N, Wheaton, MN · Sanford Health · · NPI 1154615573
$200.00
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.
$250.00
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.
$60.53 with Blue Cross Blue Shield of Minnesota vs $235.00 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 | $60.53 | ↓ -70% |
| Sanford Health Plan Align | Medicare Replacement | $126.00 | ↓ -37% |
| Ucare | Medicare Replacement | $135.25 | ↓ -32% |
| Aetna | Medicare Replacement | $136.50 | ↓ -32% |
| Blue Cross Blue Shield of Minnesota | Medicare Replacement | $136.50 | ↓ -32% |
| Great Plains Medicare Advantage | Medicare Replacement | $136.50 | ↓ -32% |
| Health Partners | Medicare Replacement | $136.50 | ↓ -32% |
| United Healthcare | Medicare Replacement | $136.50 | ↓ -32% |
| Security Health Plan | Commercial | $137.50 | ↓ -31% |
| Primewest | Medicare Replacement | $139.13 | ↓ -30% |
| Primewest | Medicaid Managed Care | $151.25 | ↓ -24% |
| Blue Cross Blue Shield of North Dakota | Commercial | $172.08 | ↓ -14% |
| Sanford Health Plan | Group Health/True | $197.35 | ↓ -1% |
| Health Partners | Commercial | $202.50 | ↑ +1% |
| United Healthcare | Commercial + Top 20 | $208.75 | ↑ +4% |
| Aetna | Commercial | $217.25 | ↑ +9% |
| Ucare | Commercial | $219.65 | ↑ +10% |
| Medica | Choice | $219.75 | ↑ +10% |
| First Choice Health Network | Commercial | $225.00 | ↑ +13% |
| Healthez | Commercial | $225.00 | ↑ +13% |
| Multiplan | Commercial | $225.00 | ↑ +13% |
| Blue Cross Blue Shield of Minnesota | Commercial/Federal | $231.30 | ↑ +16% |
| Sanford Health Plan | Commercial/ND Pers/SD Exchange Commercial | $232.18 | ↑ +16% |
| Sanford Health Plan | SD Exchange True | $232.18 | ↑ +16% |
| Medica | Elect | $235.00 | ↑ +18% |
| Ucare | Medicaid Managed Care | not published by hospital | — |
Visitor-reported prices
Comments
Established Patient Office Visit (level 4) at other Minnesota hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Sanford Canby Medical Center | Canby | $192.00 | $55.44 – $206.10 |
| Sanford Westbrook Hospital | Westbrook | $256.00 | $51.81 – $192.60 |
| Sanford Bagley Medical Center | Bagley | $253.60 | $76.75 – $285.30 |
| Sanford Luverne Medical Center | Luverne | $273.60 | $82.80 – $307.80 |
| Sanford Bemidji Medical Center | Bemidji | $253.60 | $117.08 – $250.20 |
| Sanford Worthington Medical Center | Worthington | $680.80 | $88.78 – $206.10 |
| Sanford Tracy Hospital | Tracy | $256.00 | $51.81 – $192.60 |