healthcosts.net
Established Patient Office Visit (level 1) at Sanford Worthington Medical Center
1018 6th Ave, Worthington, MN · Sanford Health · · NPI 1396712618
$167.20
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.
?
What you pay up front if you don't use insurance.
$209.00
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.
$15.55 with Blue Cross Blue Shield of Minnesota vs $78.31 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 | Commercial/Federal | $15.55 | ↓ -91% |
| Blue Cross Blue Shield of Minnesota | PMAP | $15.55 | ↓ -91% |
| Sanford Health Plan Align | Medicare Replacement | $21.69 | ↓ -87% |
| Ucare | Medicare Replacement | $23.29 | ↓ -86% |
| Aetna | Medicare Replacement | $23.51 | ↓ -86% |
| Blue Cross Blue Shield of Minnesota | Medicare Replacement | $23.51 | ↓ -86% |
| Great Plains Medicare Advantage | Medicare Replacement | $23.51 | ↓ -86% |
| Health Partners | Medicare Replacement | $23.51 | ↓ -86% |
| United Healthcare | Medicare Replacement | $23.51 | ↓ -86% |
| Primewest | Medicare Replacement | $23.97 | ↓ -86% |
| Sanford Health Plan | Group Health/True | $31.79 | ↓ -81% |
| Sanford Health Plan | SD Exchange True | $31.79 | ↓ -81% |
| Blue Cross Blue Shield of Minnesota | State Employees | $36.90 | ↓ -78% |
| Sanford Health Plan | Commercial/ND Pers | $37.40 | ↓ -78% |
| Sanford Health Plan | SD Exchange Commercial | $37.40 | ↓ -78% |
| Security Health Plan | Commercial | $45.10 | ↓ -73% |
| Health Partners | State Employees | $50.51 | ↓ -70% |
| Health Partners | Commercial | $58.22 | ↓ -65% |
| Ucare | Commercial | $64.04 | ↓ -62% |
| Aetna | Commercial | $67.24 | ↓ -60% |
| United Healthcare | Commercial + Top 20 | $68.47 | ↓ -59% |
| Medica | Choice | $73.14 | ↓ -56% |
| First Choice Health Network | Commercial | $73.80 | ↓ -56% |
| Healthez | Commercial | $73.80 | ↓ -56% |
| Multiplan | Commercial | $73.80 | ↓ -56% |
| Medica | Elect | $78.31 | ↓ -53% |
| Ucare | Medicaid Managed Care | not published by hospital | — |
| Primewest | Medicaid Managed Care | not published by hospital | — |
Visitor-reported prices
Comments
Established Patient Office Visit (level 1) at other Minnesota hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Sanford Canby Medical Center | Canby | $241.60 | $22.27 – $82.80 |
| Sanford Westbrook Hospital | Westbrook | $150.40 | $30.02 – $111.60 |
| Sanford Bagley Medical Center | Bagley | $140.00 | $19.85 – $73.80 |
| Sanford Wheaton | Wheaton | $140.00 | $29.05 – $108.00 |
| Sanford Luverne Medical Center | Luverne | $135.20 | $40.91 – $152.10 |
| Sanford Bemidji Medical Center | Bemidji | $140.00 | $15.83 – $66.60 |
| Sanford Tracy Hospital | Tracy | $150.40 | $30.02 – $111.60 |
| Sanford Thief River Falls Medical Center | Thief River Falls | $221.60 | $28.51 – $74.70 |