healthcosts.net
Shoulder MRI (with and without contrast) at Sanford USD Medical Center
1305 W 18th St, Sioux Falls, SD · Sanford Health · · NPI 1821017880
$4,187.20
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.
?
What you pay up front if you don't use insurance.
$5,234.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$170.46 with Blue Cross Blue Shield of Minnesota vs $4,710.60 with Multiplan — 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 |
|---|---|---|---|
| Blue Cross Blue Shield of Minnesota | PMAP | $170.46 | ↓ -96% |
| Sanford Health Plan Align | Medicare Replacement | $339.27 | ↓ -92% |
| Ucare | Medicare Replacement | $364.27 | ↓ -91% |
| Aetna | Medicare Replacement | $367.84 | ↓ -91% |
| Blue Cross Blue Shield of Minnesota | Medicare Replacement | $367.84 | ↓ -91% |
| Great Plains Medicare Advantage | Medicare Replacement | $367.84 | ↓ -91% |
| Health Partners | Medicare Replacement | $367.84 | ↓ -91% |
| United Healthcare | Medicare Replacement | $367.84 | ↓ -91% |
| Primewest | Medicare Replacement | $374.99 | ↓ -91% |
| Sanford Health Plan | Commercial/ND Pers | $397.79 | ↓ -90% |
| Sanford Health Plan | Group Health/True | $397.79 | ↓ -90% |
| Sanford Health Plan | SD Exchange Commercial | $397.79 | ↓ -90% |
| Sanford Health Plan | SD Exchange True | $397.79 | ↓ -90% |
| Primewest | Medicaid Managed Care | $403.06 | ↓ -90% |
| Ucare | Medicaid Managed Care | $403.06 | ↓ -90% |
| Blue Cross Blue Shield of Minnesota | State Employees | $472.36 | ↓ -89% |
| Blue Cross Blue Shield of Minnesota | Commercial | $483.70 | ↓ -88% |
| Health Partners | State Employees | $1,753.39 | ↓ -58% |
| Health Partners | Commercial | $2,041.26 | ↓ -51% |
| Security Health Plan | Commercial | $2,878.70 | ↓ -31% |
| United Healthcare | CSP Top 20 | $3,522.48 | ↓ -16% |
| Medica | Choice | $3,527.72 | ↓ -16% |
| Ucare | Commercial | $3,678.98 | ↓ -12% |
| Medica | Elect | $3,773.71 | ↓ -10% |
| Aetna | Commercial | $4,004.01 | ↓ -4% |
| United Healthcare | Commercial | $4,611.15 | ↑ +10% |
| First Choice Health Network | Commercial | $4,710.60 | ↑ +13% |
| Healthez | Commercial | $4,710.60 | ↑ +13% |
| Multiplan | Commercial | $4,710.60 | ↑ +13% |
| Wellmark | HMO/PPO | not published by hospital | — |
Visitor-reported prices
Comments
Shoulder MRI (with and without contrast) at other South-dakota hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Sanford Clear Lake Medical Center | Clear Lake | $4,104.00 | $1,215.50 – $4,617.00 |
| Sanford Hospital Webster | Webster | $3,925.60 | $1,540.80 – $4,416.30 |
| Sanford Chamberlain Medical Center | Chamberlain | $4,070.40 | $1,740.10 – $4,579.20 |
| Sanford Canton Inwood Medical Center | Canton | $3,819.20 | $1,632.71 – $4,296.60 |
| Sanford Vermillion Hospital | Vermillion | $3,837.60 | $1,415.12 – $4,317.30 |
| Sanford Aberdeen Medical Center | Aberdeen | $3,900.80 | $339.27 – $4,388.40 |