Surgical pathology level 6 gross & microscopic examination at Sanford USD Medical Center
1305 W 18th St, Sioux Falls, SD · Sanford Health · · NPI 1821017880
$996.80
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.
$1,246.00
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.
$381.13 with Blue Cross Blue Shield of Minnesota vs $1,121.40 with Healthez — 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 |
|---|---|---|---|
| Blue Cross Blue Shield of Minnesota | PMAP | $381.13 | ↓ -62% |
| Health Partners | State Employees | $417.41 | ↓ -58% |
| Sanford Health Plan | SD Exchange Commercial | $432.07 | ↓ -57% |
| Sanford Health Plan | SD Exchange True | $432.07 | ↓ -57% |
| Sanford Health Plan | Commercial/ND Pers | $432.07 | ↓ -57% |
| Sanford Health Plan | Group Health/True | $432.07 | ↓ -57% |
| Health Partners | Commercial | $485.94 | ↓ -51% |
| Security Health Plan | Commercial | $685.30 | ↓ -31% |
| Sanford Health Plan Align | Medicare Replacement | $776.06 | ↓ -22% |
| Ucare | Medicare Replacement | $833.24 | ↓ -16% |
| United Healthcare | CSP Top 20 | $838.56 | ↓ -16% |
| Medica | Choice | $839.80 | ↓ -16% |
| Aetna | Medicare Replacement | $841.41 | ↓ -16% |
| Health Partners | Medicare Replacement | $841.41 | ↓ -16% |
| Blue Cross Blue Shield of Minnesota | Medicare Replacement | $841.41 | ↓ -16% |
| Great Plains Medicare Advantage | Medicare Replacement | $841.41 | ↓ -16% |
| United Healthcare | Medicare Replacement | $841.41 | ↓ -16% |
| Primewest | Medicare Replacement | $857.75 | ↓ -14% |
| Ucare | Commercial | $875.81 | ↓ -12% |
| Medica | Elect | $898.37 | ↓ -10% |
| Aetna | Commercial | $953.19 | ↓ -4% |
| Blue Cross Blue Shield of Minnesota | State Employees | $1,056.19 | ↑ +6% |
| Blue Cross Blue Shield of Minnesota | Commercial | $1,081.53 | ↑ +9% |
| United Healthcare | Commercial | $1,097.73 | ↑ +10% |
| First Choice Health Network | Commercial | $1,121.40 | ↑ +13% |
| Multiplan | Commercial | $1,121.40 | ↑ +13% |
| Healthez | Commercial | $1,121.40 | ↑ +13% |
| 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
Surgical pathology level 6 gross & microscopic examination at other South-dakota hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Sanford Clear Lake Medical Center | Clear Lake | $894.40 | $573.53 – $1,006.20 |
| Sanford Hospital Webster | Webster | $829.60 | $325.62 – $933.30 |
| Sanford Chamberlain Medical Center | Chamberlain | $740.80 | $316.69 – $833.40 |
| Sanford Canton Inwood Medical Center | Canton | $968.00 | $413.82 – $1,089.00 |
| Sanford Vermillion Hospital | Vermillion | $963.20 | $355.18 – $1,083.60 |
| Sanford Aberdeen Medical Center | Aberdeen | $1,336.00 | $740.65 – $1,503.00 |