healthcosts.net
Established Patient Office Visit (level 1) at Sanford Medical Center Hillsboro
12 3rd St SE, Hillsboro, ND · Sanford Health · · NPI 1184725194
$125.60
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.
$157.00
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.
$10.41 with Blue Cross Blue Shield of Minnesota vs $39.93 with Sanford Health Plan — 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 | $10.41 | ↓ -92% |
| Sanford Health Plan Align | Medicare Replacement | $19.61 | ↓ -84% |
| Ucare | Medicare Replacement | $21.07 | ↓ -83% |
| Aetna | Medicare Replacement | $21.24 | ↓ -83% |
| Blue Cross Blue Shield of North Dakota | Medicare Replacement | $21.24 | ↓ -83% |
| Great Plains Medicare Advantage | Medicare Replacement | $21.24 | ↓ -83% |
| Health Partners | Medicare Replacement | $21.24 | ↓ -83% |
| United Healthcare | Medicare Replacement | $21.24 | ↓ -83% |
| Primewest | Medicare Replacement | $21.67 | ↓ -83% |
| Security Health Plan | Commercial | $23.65 | ↓ -81% |
| Blue Cross Blue Shield of North Dakota | Commercial | $27.92 | ↓ -78% |
| Health Partners | Commercial | $33.54 | ↓ -73% |
| Sanford Health Plan | SD Exchange True | $33.94 | ↓ -73% |
| Medica | Choice | $35.48 | ↓ -72% |
| United Healthcare | Commercial + Top 20 | $35.91 | ↓ -71% |
| Aetna | Commercial | $37.37 | ↓ -70% |
| Ucare | Commercial | $37.78 | ↓ -70% |
| Medica | Elect | $37.93 | ↓ -70% |
| First Choice Health Network | Commercial | $38.70 | ↓ -69% |
| Healthez | Commercial | $38.70 | ↓ -69% |
| Multiplan | Commercial | $38.70 | ↓ -69% |
| Blue Cross Blue Shield of Minnesota | Commercial | $39.78 | ↓ -68% |
| Sanford Health Plan | Commercial/ND Pers/Group Health/True/SD Exchange Commercial | $39.93 | ↓ -68% |
Visitor-reported prices
Comments
Established Patient Office Visit (level 1) at other North-dakota hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Sanford Medical Center Bismarck | Bismarck | $248.80 | $21.36 – $153.90 |
| Sanford Medical Center Mayville | Mayville | $125.60 | $10.41 – $38.70 |
| Sanford Fargo Medical Center | Fargo | $388.00 | $15.55 – $144.00 |