healthcosts.net
ER Visit (level 5, high severity) at Sanford Clear Lake Medical Center
701 3rd Ave S, Clear Lake, SD · Sanford Health · · NPI 1851305296
$1,428.00
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.
$1,785.00
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.
$915.71 with Sanford Health Plan Align vs $1,659.87 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 |
|---|---|---|---|
| Sanford Health Plan Align | Medicare Replacement | $915.71 | ↓ -36% |
| Security Health Plan | Commercial | $981.75 | ↓ -31% |
| Ucare | Medicare Replacement | $983.54 | ↓ -31% |
| Wellmark SD | Medicare Replacement | $983.54 | ↓ -31% |
| Aetna | Medicare Replacement | $992.46 | ↓ -31% |
| Great Plains Medicare Advantage | Medicare Replacement | $992.46 | ↓ -31% |
| Health Partners | Medicare Replacement | $992.46 | ↓ -31% |
| United Healthcare | Medicare Replacement | $992.46 | ↓ -31% |
| Primewest | Medicare Replacement | $1,012.10 | ↓ -29% |
| Health Partners | State Employees | $1,154.90 | ↓ -19% |
| Sanford Health Plan | SD Exchange True | $1,237.36 | ↓ -13% |
| Health Partners | Commercial | $1,338.75 | ↓ -6% |
| Sanford Health Plan | Group Health/True | $1,410.86 | ↓ -1% |
| Sanford Health Plan | SD Exchange Commercial | $1,455.67 | ↑ +2% |
| Blue Cross Blue Shield of Minnesota | State Employees | $1,460.13 | ↑ +2% |
| Medica | Choice | $1,472.63 | ↑ +3% |
| United Healthcare | Commercial + Top 20 | $1,490.48 | ↑ +4% |
| Wellmark | PPO | $1,535.10 | ↑ +8% |
| Aetna | Commercial | $1,551.17 | ↑ +9% |
| Ucare | Commercial | $1,568.30 | ↑ +10% |
| Medica | Elect | $1,574.37 | ↑ +10% |
| Cigna | Commercial | $1,606.50 | ↑ +13% |
| First Choice Health Network | Commercial | $1,606.50 | ↑ +13% |
| Healthez | Commercial | $1,606.50 | ↑ +13% |
| Multiplan | Commercial | $1,606.50 | ↑ +13% |
| Blue Cross Blue Shield of Minnesota | Commercial/Federal | $1,651.48 | ↑ +16% |
| Sanford Health Plan | Commercial/ND Pers | $1,659.87 | ↑ +16% |
Visitor-reported prices
Comments
ER Visit (level 5, high severity) at other South-dakota hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Sanford USD Medical Center | Sioux Falls | $2,037.60 | $173.10 – $2,292.30 |
| Sanford Hospital Webster | Webster | $1,441.60 | $565.83 – $1,621.80 |
| Sanford Chamberlain Medical Center | Chamberlain | $1,805.60 | $771.89 – $2,031.30 |
| Sanford Canton Inwood Medical Center | Canton | $1,930.40 | $825.25 – $2,171.70 |
| Sanford Vermillion Hospital | Vermillion | $1,895.20 | $698.86 – $2,132.10 |
| Sanford Aberdeen Medical Center | Aberdeen | $1,569.60 | $582.45 – $1,765.80 |