Afo w/ankle joint, prefab at Sanford USD Medical Center
1305 W 18th St, Sioux Falls, SD · Sanford Health · · NPI 1821017880
$141.60
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.
$177.00
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.
$59.30 with Health Partners vs $717.87 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 |
|---|---|---|---|
| Health Partners | State Employees | $59.30 | ↓ -58% |
| Health Partners | Commercial | $69.03 | ↓ -51% |
| Security Health Plan | Commercial | $97.35 | ↓ -31% |
| United Healthcare | CSP Top 20 | $119.12 | ↓ -16% |
| Medica | Choice | $119.30 | ↓ -16% |
| Ucare | Commercial | $124.41 | ↓ -12% |
| Medica | Elect | $127.62 | ↓ -10% |
| Aetna | Commercial | $135.41 | ↓ -4% |
| United Healthcare | Commercial | $155.94 | ↑ +10% |
| Healthez | Commercial | $159.30 | ↑ +13% |
| Multiplan | Commercial | $159.30 | ↑ +13% |
| First Choice Health Network | Commercial | $159.30 | ↑ +13% |
| Blue Cross Blue Shield of Minnesota | PMAP | $523.98 | ↑ +270% |
| Blue Cross Blue Shield of Minnesota | Commercial | $523.98 | ↑ +270% |
| Blue Cross Blue Shield of Minnesota | State Employees | $523.98 | ↑ +270% |
| Sanford Health Plan Align | Medicare Replacement | $542.37 | ↑ +283% |
| Sanford Health Plan | SD Exchange True | $570.92 | ↑ +303% |
| Ucare | Medicare Replacement | $582.34 | ↑ +311% |
| Blue Cross Blue Shield of Minnesota | Medicare Replacement | $588.05 | ↑ +315% |
| Great Plains Medicare Advantage | Medicare Replacement | $588.05 | ↑ +315% |
| Aetna | Medicare Replacement | $588.05 | ↑ +315% |
| Health Partners | Medicare Replacement | $588.05 | ↑ +315% |
| United Healthcare | Medicare Replacement | $588.05 | ↑ +315% |
| Primewest | Medicare Replacement | $599.47 | ↑ +323% |
| Sanford Health Plan | Group Health/True | $642.34 | ↑ +354% |
| Sanford Health Plan | SD Exchange Commercial | $662.72 | ↑ +368% |
| Sanford Health Plan | Commercial/ND Pers | $717.87 | ↑ +407% |
| Wellmark | HMO/PPO | not published by hospital | — |
| Primewest | Medicaid Managed Care | not published by hospital | — |
| Ucare | Medicaid Managed Care | not published by hospital | — |
Visitor-reported prices
Comments
Afo w/ankle joint, prefab at other South-dakota hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Sanford Aberdeen Medical Center | Aberdeen | not published | $639.05 – $706.31 |