Sanford Hillsboro
12 Third Street Se, Hillsboro, ND 58045 · 94 Priced Procedures
Typical commercial prices here are +155% above the fair benchmark (2.55×) even after accounting for local nurse/doctor wages and patient complexity.
Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.
Cash-Arbitrage Bifurcated Pricer
Sanford Hillsboro maintains elevated commercial insurance contracts (2.55× Fair BaseRate) while offering direct self-pay cash discounts that beat commercial negotiated medians on 67% of procedures. High-deductible and uninsured patients should always request the self-pay cash rate prior to billing.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 2.03× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 67% of shoppable procedures (99/100 Cash Honesty)
- CMS clinical safety score (69/100 safety score) with 72% patient recommendation
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (78.9% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 1.3× markup over Medicare rates
- Commercial insurance median sits at 2.55× Fair BaseRate (3.4× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Even at low-cost facilities (2.55× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
- Unnegotiated chargemaster list prices average 7.3× Medicare (30¢ true HCRIS cost per $1 gross)
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
Procedure Prices at Sanford Hillsboro
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 94 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Cataract surgery with lens implant CPT Code: 66984 | $4,161 | 1.6× |
| Sleep study (overnight, in lab) CPT Code: 95810 | $3,965 | 3.9× |
| Colonoscopy (diagnostic) CPT Code: 45378 | $2,057 | unverified |
| Colonoscopy with biopsy CPT Code: 45380 | $1,787 | unverified |
| Upper endoscopy with biopsy CPT Code: 43239 | $1,703 | 1.7× |
| Trauma team activation HCPCS Code: G0390 | $1,573 | 1.1× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $1,275 | 2.2× |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $928 | 3.4× |
| Rabies immune globulin HCPCS Code: 90375 | $935 | 2.9× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $912 | 2.0× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $912 | 1.8× |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $867 | 2.9× |
| MRI, lower back (no contrast) CPT Code: 72148 | $867 | 2.6× |
| MRI, brain (no contrast) CPT Code: 70551 | $867 | 2.5× |
| MRI, knee or other leg joint CPT Code: 73721 | $867 | 2.3× |
| Blood transfusion CPT Code: 36430 | $845 | 1.7× |
| CT scan, head (no contrast) CPT Code: 70450 | $705 | 4.4× |
| Family therapy session CPT Code: 90847 | $676 | 3.9× |
| CT scan, head (with contrast) CPT Code: 70460 | $670 | 2.8× |
| CT scan, head (with and without contrast) CPT Code: 70470 | $670 | 2.6× |
| Psychotherapy session (45 minutes) CPT Code: 90834 | $604 | 3.6× |
| Psychotherapy session (60 minutes) CPT Code: 90837 | $616 | 3.4× |
| Group therapy session CPT Code: 90853 | $588 | 5.9× |
| Ultrasound, abdomen (complete) CPT Code: 76700 | $582 | 4.3× |
| Ultrasound, pelvis CPT Code: 76856 | $549 | 4.2× |
Audit a Bill or Quote at Sanford Hillsboro (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $4,106
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (78.9% of gross = $4,106).
Self-Pay Cash Rate ($4,161) Beats Your Bill
Sanford Hillsboro's published 45 CFR § 180 self-pay cash rate is $4,161 (vs. $4,161 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $2,540 Fair BaseRate ($2,358 Medicare)
Your bill ($5,201) is $2,661 above the denoised Fair BaseRate ($2,540) and 2.2× the $2,358 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (78.9% of gross charges)
Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.
Clinical Quality, Patient Experience & Infection Benchmarks
Source: CMS Hospital Care Compare. Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Sanford Hillsboro.
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.