CMS Price Transparency Data

Colorectal cancer screening (alternative)

Facility: Sanford Usd Medical Center

Billing Code: G0145 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: G0145
  • Insurance Median: $63
  • Cash Discount Price: $90
  • vs. Medicare Baseline: 2.38x Medicare
The contracted insurance negotiated median rate for a Colorectal cancer screening (alternative) at Sanford Usd Medical Center is $63. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $90. Compared to the federal Medicare reimbursement reference rate of $26.49, this hospital’s rate is 2.38x the Medicare baseline. Located in 1305 W 18Th St Post Office Box 5039, Sioux Falls, SD.
Cash / Self-Pay
$90

Average discount available for prompt cash payment at this facility.

Insurance Median
$63

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$26.49

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $26.49 (100%)
Cash / Self-Pay: $90 (340%)
Insurance Median: $63 (238%)
Cash: $90 (340% of Medicare)
Ins. Median: $63 (238% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $26.49 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 238% of the Medicare baseline (a markup of 138%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Sanford Health Plan Align $25 94%
Blue Cross Blue Shield $26 - $27 98%
Health Partners $27 - $44 102%
UnitedHealthcare $27 - $100 102%
Ucare $27 - $79 102%
Medicare (plans) $27 102%
Aetna $27 - $86 102%
Primewest $28 106%
Sanford Health Plan $54 - $73 204%
Security Health Plan $62 234%
Medica $76 - $81 287%
Healthez $102 385%
First Choice Health Network $102 385%
Multiplan $102 385%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1305 W 18Th St Post Office Box 5039, Sioux Falls, SD 57117
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals