healthcosts.net
Cataract Surgery at Sanford USD Medical Center
1305 W 18th St, Sioux Falls, SD · Sanford Health · · NPI 1821017880
not published by hospital
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.
not published by hospital
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.
$537.26 with Sanford Health Plan vs $2,931.04 with Blue Cross Blue Shield of Minnesota — 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 |
|---|---|---|---|
| Sanford Health Plan | Commercial/ND Pers | $537.26 | — |
| Sanford Health Plan | Group Health/True | $537.26 | — |
| Sanford Health Plan | SD Exchange Commercial | $537.26 | — |
| Sanford Health Plan | SD Exchange True | $537.26 | — |
| Blue Cross Blue Shield of Minnesota | PMAP | $1,032.90 | — |
| Sanford Health Plan Align | Medicare Replacement | $2,166.69 | — |
| Ucare | Medicare Replacement | $2,326.34 | — |
| Aetna | Medicare Replacement | $2,349.15 | — |
| Blue Cross Blue Shield of Minnesota | Medicare Replacement | $2,349.15 | — |
| Great Plains Medicare Advantage | Medicare Replacement | $2,349.15 | — |
| Health Partners | Medicare Replacement | $2,349.15 | — |
| United Healthcare | Medicare Replacement | $2,349.15 | — |
| Primewest | Medicare Replacement | $2,394.77 | — |
| Primewest | Medicaid Managed Care | $2,442.39 | — |
| Ucare | Medicaid Managed Care | $2,442.39 | — |
| Blue Cross Blue Shield of Minnesota | State Employees | $2,862.36 | — |
| Blue Cross Blue Shield of Minnesota | Commercial | $2,931.04 | — |
Visitor-reported prices
Comments
Cataract Surgery at other South-dakota hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Sanford Aberdeen Medical Center | Aberdeen | not published | $2,166.69 – $2,394.77 |