Occupational Therapy Evaluation (high complexity) at Sanford Wheaton
401 12th St N, Wheaton, MN · Sanford Health · · NPI 1154615573
$228.00
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.
?
What you pay up front if you don't use insurance.
$285.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$69.00 with Blue Cross Blue Shield of Minnesota vs $267.90 with Medica — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $69.00 | ↓ -70% |
| Sanford Health Plan Align | Medicare Replacement | $143.64 | ↓ -37% |
| Ucare | Medicare Replacement | $154.19 | ↓ -32% |
| Blue Cross Blue Shield of Minnesota | Medicare Replacement | $155.61 | ↓ -32% |
| United Healthcare | Medicare Replacement | $155.61 | ↓ -32% |
| Aetna | Medicare Replacement | $155.61 | ↓ -32% |
| Great Plains Medicare Advantage | Medicare Replacement | $155.61 | ↓ -32% |
| Health Partners | Medicare Replacement | $155.61 | ↓ -32% |
| Security Health Plan | Commercial | $156.75 | ↓ -31% |
| Primewest | Medicare Replacement | $158.60 | ↓ -30% |
| Primewest | Medicaid Managed Care | $172.43 | ↓ -24% |
| Blue Cross Blue Shield of North Dakota | Commercial | $196.17 | ↓ -14% |
| Sanford Health Plan | Group Health/True | $224.98 | ↓ -1% |
| Health Partners | Commercial | $230.85 | ↑ +1% |
| United Healthcare | Commercial + Top 20 | $237.98 | ↑ +4% |
| Aetna | Commercial | $247.67 | ↑ +9% |
| Ucare | Commercial | $250.40 | ↑ +10% |
| Medica | Choice | $250.52 | ↑ +10% |
| Multiplan | Commercial | $256.50 | ↑ +13% |
| First Choice Health Network | Commercial | $256.50 | ↑ +13% |
| Healthez | Commercial | $256.50 | ↑ +13% |
| Blue Cross Blue Shield of Minnesota | Commercial/Federal | $263.68 | ↑ +16% |
| Sanford Health Plan | SD Exchange True | $264.68 | ↑ +16% |
| Sanford Health Plan | Commercial/ND Pers/SD Exchange Commercial | $264.68 | ↑ +16% |
| Medica | Elect | $267.90 | ↑ +18% |
| Ucare | Medicaid Managed Care | not published by hospital | — |
Visitor-reported prices
Comments
Occupational Therapy Evaluation (high complexity) at other Minnesota hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Sanford Canby Medical Center | Canby | $348.80 | $105.56 – $392.40 |
| Sanford Westbrook Hospital | Westbrook | $386.40 | $116.93 – $434.70 |
| Sanford Bagley Medical Center | Bagley | $303.20 | $91.76 – $341.10 |
| Sanford Luverne Medical Center | Luverne | $264.80 | $80.14 – $297.90 |
| Sanford Bemidji Medical Center | Bemidji | $303.20 | $95.88 – $341.10 |
| Sanford Worthington Medical Center | Worthington | $266.40 | $95.88 – $299.70 |
| Sanford Tracy Hospital | Tracy | $386.40 | $116.93 – $434.70 |
| Sanford Thief River Falls Medical Center | Thief River Falls | $292.80 | $125.72 – $329.40 |