Incision of hip tendons at Sanford USD Medical Center
1305 W 18th St, Sioux Falls, SD · Sanford Health · · NPI 1821017880
$5,496.00
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.
$6,870.00
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.
$722.01 with Sanford Health Plan vs $6,183.00 with First Choice Health Network — 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 | Group Health/True | $722.01 | ↓ -87% |
| Sanford Health Plan | SD Exchange True | $722.01 | ↓ -87% |
| Sanford Health Plan | SD Exchange Commercial | $722.01 | ↓ -87% |
| Sanford Health Plan | Commercial/ND Pers | $722.01 | ↓ -87% |
| Blue Cross Blue Shield of Minnesota | PMAP | $1,434.68 | ↓ -74% |
| Health Partners | State Employees | $2,301.45 | ↓ -58% |
| Health Partners | Commercial | $2,679.30 | ↓ -51% |
| Sanford Health Plan Align | Medicare Replacement | $3,082.38 | ↓ -44% |
| Ucare | Medicare Replacement | $3,309.50 | ↓ -40% |
| Great Plains Medicare Advantage | Medicare Replacement | $3,341.95 | ↓ -39% |
| Health Partners | Medicare Replacement | $3,341.95 | ↓ -39% |
| United Healthcare | Medicare Replacement | $3,341.95 | ↓ -39% |
| Aetna | Medicare Replacement | $3,341.95 | ↓ -39% |
| Blue Cross Blue Shield of Minnesota | Medicare Replacement | $3,341.95 | ↓ -39% |
| Primewest | Medicaid Managed Care | $3,392.43 | ↓ -38% |
| Ucare | Medicaid Managed Care | $3,392.43 | ↓ -38% |
| Primewest | Medicare Replacement | $3,406.84 | ↓ -38% |
| Security Health Plan | Commercial | $3,778.50 | ↓ -31% |
| Blue Cross Blue Shield of Minnesota | State Employees | $3,975.75 | ↓ -28% |
| Blue Cross Blue Shield of Minnesota | Commercial | $4,071.15 | ↓ -26% |
| United Healthcare | CSP Top 20 | $4,623.51 | ↓ -16% |
| Medica | Choice | $4,630.38 | ↓ -16% |
| Ucare | Commercial | $4,828.92 | ↓ -12% |
| Medica | Elect | $4,953.27 | ↓ -10% |
| Aetna | Commercial | $5,255.55 | ↓ -4% |
| United Healthcare | Commercial | $6,052.47 | ↑ +10% |
| Multiplan | Commercial | $6,183.00 | ↑ +13% |
| Healthez | Commercial | $6,183.00 | ↑ +13% |
| First Choice Health Network | Commercial | $6,183.00 | ↑ +13% |
| Wellmark | HMO/PPO | not published by hospital | — |
Visitor-reported prices
Comments
Incision of hip tendons at other South-dakota hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Sanford Aberdeen Medical Center | Aberdeen | not published | $3,082.38 – $3,406.84 |