Puncture spinal lumbar diagnostic at Sanford Wheaton
401 12th St N, Wheaton, MN · Sanford Health · · NPI 1154615573
$1,243.20
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.
$1,554.00
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.
$376.22 with Blue Cross Blue Shield of Minnesota vs $1,460.76 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 | $376.22 | ↓ -70% |
| Ucare | Medicaid Managed Care | $727.15 | ↓ -42% |
| Sanford Health Plan Align | Medicare Replacement | $783.22 | ↓ -37% |
| Ucare | Medicare Replacement | $840.71 | ↓ -32% |
| Aetna | Medicare Replacement | $848.48 | ↓ -32% |
| United Healthcare | Medicare Replacement | $848.48 | ↓ -32% |
| Health Partners | Medicare Replacement | $848.48 | ↓ -32% |
| Blue Cross Blue Shield of Minnesota | Medicare Replacement | $848.48 | ↓ -32% |
| Great Plains Medicare Advantage | Medicare Replacement | $848.48 | ↓ -32% |
| Security Health Plan | Commercial | $854.70 | ↓ -31% |
| Primewest | Medicare Replacement | $864.80 | ↓ -30% |
| Primewest | Medicaid Managed Care | $940.17 | ↓ -24% |
| Blue Cross Blue Shield of North Dakota | Commercial | $1,069.62 | ↓ -14% |
| Sanford Health Plan | Group Health/True | $1,226.73 | ↓ -1% |
| Health Partners | Commercial | $1,258.74 | ↑ +1% |
| United Healthcare | Commercial + Top 20 | $1,297.59 | ↑ +4% |
| Aetna | Commercial | $1,350.43 | ↑ +9% |
| Ucare | Commercial | $1,365.34 | ↑ +10% |
| Medica | Choice | $1,365.97 | ↑ +10% |
| First Choice Health Network | Commercial | $1,398.60 | ↑ +13% |
| Multiplan | Commercial | $1,398.60 | ↑ +13% |
| Healthez | Commercial | $1,398.60 | ↑ +13% |
| Blue Cross Blue Shield of Minnesota | Commercial/Federal | $1,437.76 | ↑ +16% |
| Sanford Health Plan | SD Exchange True | $1,443.20 | ↑ +16% |
| Sanford Health Plan | Commercial/ND Pers/SD Exchange Commercial | $1,443.20 | ↑ +16% |
| Medica | Elect | $1,460.76 | ↑ +18% |
Visitor-reported prices
Comments
Puncture spinal lumbar diagnostic at other Minnesota hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Sanford Westbrook Hospital | Westbrook | $992.80 | $300.45 – $1,116.90 |
| Sanford Bagley Medical Center | Bagley | $1,302.40 | $394.14 – $1,465.20 |
| Sanford Luverne Medical Center | Luverne | $1,175.20 | $355.64 – $1,322.10 |
| Sanford Bemidji Medical Center | Bemidji | $1,302.40 | $498.90 – $1,465.20 |
| Sanford Worthington Medical Center | Worthington | $913.60 | $434.61 – $1,008.90 |
| Sanford Tracy Hospital | Tracy | $992.80 | $300.45 – $1,116.90 |
| Sanford Thief River Falls Medical Center | Thief River Falls | $1,176.80 | $505.29 – $1,323.90 |
| Sanford Behavioral Health Thief River Falls | Thief River Falls | $1,176.80 | $505.29 – $1,323.90 |