healthcosts.net
Established Patient Office Visit (level 4) at Sanford Vermillion Hospital
20 S Plum St, Vermillion, SD · Sanford Health · · NPI 1790721280
$252.00
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.
$315.00
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 Sanford Health Plan Align vs $180.90 with Multiplan — 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 Align | Medicare Replacement | $59.30 | ↓ -76% |
| Wellmark SD | Medicare Replacement | $61.10 | ↓ -76% |
| Ucare | Medicare Replacement | $65.53 | ↓ -74% |
| Aetna | Medicare Replacement | $66.33 | ↓ -74% |
| Great Plains Medicare Advantage | Medicare Replacement | $66.33 | ↓ -74% |
| Health Partners | Medicare Replacement | $66.33 | ↓ -74% |
| United Healthcare | Medicare Replacement | $66.33 | ↓ -74% |
| Primewest | Medicare Replacement | $67.54 | ↓ -73% |
| Sanford Health Plan | SD Exchange True | $79.58 | ↓ -68% |
| Sanford Health Plan | Group Health/True | $90.73 | ↓ -64% |
| Sanford Health Plan | SD Exchange Commercial | $93.63 | ↓ -63% |
| Sanford Health Plan | Commercial/ND Pers | $106.75 | ↓ -58% |
| Security Health Plan | Commercial | $110.55 | ↓ -56% |
| Health Partners | State Employees | $132.66 | ↓ -47% |
| Health Partners | Commercial | $150.75 | ↓ -40% |
| Medica | Choice | $165.83 | ↓ -34% |
| United Healthcare | Commercial +20 | $167.84 | ↓ -33% |
| Wellmark | PPO | $172.86 | ↓ -31% |
| Aetna | Commercial | $174.67 | ↓ -31% |
| Ucare | Commercial | $176.60 | ↓ -30% |
| Medica | Elect | $177.28 | ↓ -30% |
| First Choice Health Network | Commercial | $180.90 | ↓ -28% |
| Healthez | Commercial | $180.90 | ↓ -28% |
| Multiplan | Commercial | $180.90 | ↓ -28% |
Visitor-reported prices
Comments
Established Patient Office Visit (level 4) at other South-dakota hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Sanford Clear Lake Medical Center | Clear Lake | $271.20 | $117.48 – $206.10 |
| Sanford USD Medical Center | Sioux Falls | $997.60 | $62.42 – $212.40 |
| Sanford Canton Inwood Medical Center | Canton | $158.40 | $67.72 – $178.20 |
| Sanford Aberdeen Medical Center | Aberdeen | $234.40 | $116.07 – $263.70 |