healthcosts.net
Established Patient Office Visit (level 5) at Sanford Clear Lake Medical Center
701 3rd Ave S, Clear Lake, SD · Sanford Health · · NPI 1851305296
$327.20
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.
$409.00
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.
$146.72 with Sanford Health Plan Align vs $265.95 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 | $146.72 | ↓ -55% |
| Security Health Plan | Commercial | $157.30 | ↓ -52% |
| Ucare | Medicare Replacement | $157.59 | ↓ -52% |
| Wellmark SD | Medicare Replacement | $157.59 | ↓ -52% |
| Aetna | Medicare Replacement | $159.02 | ↓ -51% |
| Great Plains Medicare Advantage | Medicare Replacement | $159.02 | ↓ -51% |
| Health Partners | Medicare Replacement | $159.02 | ↓ -51% |
| United Healthcare | Medicare Replacement | $159.02 | ↓ -51% |
| Primewest | Medicare Replacement | $162.16 | ↓ -50% |
| Health Partners | State Employees | $185.04 | ↓ -43% |
| Sanford Health Plan | SD Exchange True | $198.26 | ↓ -39% |
| Health Partners | Commercial | $214.50 | ↓ -34% |
| Sanford Health Plan | Group Health/True | $226.05 | ↓ -31% |
| Sanford Health Plan | SD Exchange Commercial | $233.23 | ↓ -29% |
| Blue Cross Blue Shield of Minnesota | State Employees | $233.95 | ↓ -28% |
| Medica | Choice | $235.95 | ↓ -28% |
| United Healthcare | Commercial + Top 20 | $238.81 | ↓ -27% |
| Wellmark | PPO | $245.96 | ↓ -25% |
| Aetna | Commercial | $248.53 | ↓ -24% |
| Ucare | Commercial | $251.28 | ↓ -23% |
| Medica | Elect | $252.25 | ↓ -23% |
| Cigna | Commercial | $257.40 | ↓ -21% |
| First Choice Health Network | Commercial | $257.40 | ↓ -21% |
| Healthez | Commercial | $257.40 | ↓ -21% |
| Multiplan | Commercial | $257.40 | ↓ -21% |
| Blue Cross Blue Shield of Minnesota | Commercial/Federal | $264.61 | ↓ -19% |
| Sanford Health Plan | Commercial/ND Pers | $265.95 | ↓ -19% |
Visitor-reported prices
Comments
Established Patient Office Visit (level 5) at other South-dakota hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Sanford USD Medical Center | Sioux Falls | $1,095.20 | $66.92 – $227.70 |
| Sanford Vermillion Hospital | Vermillion | $322.40 | $118.89 – $362.70 |
| Sanford Aberdeen Medical Center | Aberdeen | $306.40 | $162.87 – $344.70 |