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Hospital Profile Critical Access Hospital Voluntary non-profit - Private 25 Beds · rural Updated: 2026-08-19

Coteau Des Prairies Health Care System

205 Orchard Dr, Sisseton, SD 57262 · 100 Priced Procedures · 47% Patient Recommendation

CMS Overall Rating 4 / 5 Stars
Pillar 1 · The BaseRate™ CompositeHow 1.00× Fair BaseRate Works: Raw price averages unfairly penalize hospitals in high-wage cities or trauma centers treating sicker patients. We adjust for local CMS hospital wage levels and patient complexity first. A 1.00× score means right at the fair price average, 0.85× means 15% cheaper than fair market, and 1.30× means 30% above fair market.Near Fair BaseRate Benchmark
1.00×vs. Fair Market Price
Position vs. 1.00× Fair PriceRight at U.S. Average (0%) 1.00× (center of the bar) is the U.S. fair price average after accounting for local hospital wages and patient complexity. Left of center (<1.00×) is below fair price; right of center (>1.00×) is above fair price.

Typical commercial prices here match the fair market benchmark (1.00×) after accounting for local nurse/doctor wages and patient complexity.

Pillar 2 · VeriRate™ Data TrustHow VeriRate™ (0–100) Works: Hospitals are legally required to publish machine-readable price files, but some bury fake $0.01 numbers or omit cash discounts. VeriRate audits each file across 5 checks (hover any badge below to see what it tests).74/100 · Corroborated
74/100Self-Pay Cash Beats Insurance 4% of the Time
File Completeness100Provenance (File Completeness): Checks whether the hospital published a complete, up-to-date machine-readable price file with valid CPT and MS-DRG billing codes instead of leaving blanks.
Price Logic98Coherence (Price Logic): Checks whether the hospital’s numbers make basic sense — e.g., self-pay cash price is lower than gross list price, with no fake $0.01 or $999,999 placeholder numbers.
Peer Alignment59Concordance (Peer Alignment): Checks whether reported prices sit in a realistic range compared to Medicare and nearby hospitals rather than wild 100× unit errors.
Clean Billing88Regularity (Clean Billing): Checks whether rates are structured consistently across procedures without erratic statistical spikes or hidden unbundled facility fees.
Real Cash Discount6Cash Honesty (Real Cash Discount): Checks whether the hospital offers a genuine self-pay cash discount that beats or matches commercial insurance rates instead of billing full sticker price.
Pillar 3 · Clinical Quality & ER SpeedChecks whether higher hospital prices actually buy better clinical quality — combining CMS Star Ratings, hospital safety scores, and emergency room wait times.High Quality · Fair Price
CMS Star Rating4/5 StarsOfficial CMS Overall Hospital Quality Star Rating (1 to 5 stars) summarizing mortality, safety of care, readmissions, and patient experience.
Safety Score64/100Composite patient safety score (0–100) derived from CMS hospital-acquired infection rates (CLABSI, CAUTI, MRSA, C. diff), surgical complications, and HCAHPS surveys.
Typical ER Wait48 minMedian minutes patients spent in the emergency department before leaving from the visit, as reported to CMS Timely and Effective Care.

4-Star CMS clinical quality rating paired with 1.00× fair market pricing.

Behavioral Pricing FingerprintConsistent Department Multiples

Aligned Regional Benchmark Peer

Coteau Des Prairies Health Care System prices shoppable and inpatient services (7.3× to 5.5× Medicare, divergence 0.75×) in alignment with regional hospital peers (1.00× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.

Regional Benchmark in SDU.S. National Reference Pool
Advantage

Where They're Good (Patient & Payer Edge)

  • Bottom-quartile procedures (Q25) price at 0.78× the peer BaseRate benchmark
  • Self-pay cash beats commercial insurance on 4% of shoppable procedures (25/100 Cash Honesty)
  • 4-Star CMS clinical rating with 47% patient recommendation (64/100 safety score)
  • IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (47.3% AGB cap)
Watchout

Where You Can Get Burned (Markup Traps)

  • Outpatient surgery & OR suites carry a 2.3× markup over Medicare rates
  • Commercial insurance median sits at 1.00× Fair BaseRate (7.3× Medicare), so insured patients should always compare the self-pay cash price before paying.
  • Upper-quartile procedures (Q75 1.28×) jump +28% above the median procedure ratio (Q50 1.00×)
  • Unnegotiated chargemaster list prices average 8.5× Medicare (21¢ true HCRIS cost per $1 gross)
Front-Door ShoppableElective / Imaging
7.3× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER0.75× Divergence
5.5× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+28% Upper Tail
Q25 0.78× · Q50 1.00× · Q75 1.28×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.
Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×
Front-Door Shoppable CareFront-Door Shoppable
7.3× MedicareWatchout
Outpatient Surgery & ORBack-Door Captive
2.3× MedicareFair
Diagnostic Imaging (CT/MRI)Front-Door Shoppable
2.8× MedicareFair
Back-Door Captive ER VisitsBack-Door Captive
2.3× MedicareFair
Inpatient Lab & PathologyBack-Door Captive
2.5× MedicareFair
Specialty & Infusion Drugs (J-Codes)Back-Door Captive
2.3× MedicareFair
Self-Pay Cash Honesty & 501(r)Integrity & Outcomes
4% Cash Edge · 25/100Watchout
CMS Clinical Safety & Star ValueIntegrity & Outcomes
4 CMS · 64/100Elevated

Procedure Prices at Coteau Des Prairies Health Care System

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 100 published procedures.

Sort:
Audit a Bill & 501(r) Cap ↓
Procedure & Billing Code This Hospital vs. Fair
MRI, brain (with and without contrast)
CPT Code: 70553
 $5,234 10.2×
Sleep study (overnight, in lab)
CPT Code: 95810
 $4,088 4.0×
MRI, brain (no contrast)
CPT Code: 70551
 $4,055 11.8×
MRI, knee or other leg joint
CPT Code: 73721
 $3,997 10.8×
MRI, lower back (no contrast)
CPT Code: 72148
 $3,931 11.6×
CT scan, abdomen and pelvis (with contrast)
CPT Code: 74177
 $3,718 8.3×
CT scan, abdomen and pelvis (no contrast)
CPT Code: 74176
 $3,543 11.7×
Trauma team activation
HCPCS Code: G0390
 $3,423 2.4×
CT scan, head (with and without contrast)
CPT Code: 70470
 $2,566 9.9×
CT scan, neck (cervical spine)
CPT Code: 72125
 $2,427 14.4×
CT scan, chest (no contrast)
CPT Code: 71250
 $2,368 14.2×
CT scan, head (with contrast)
CPT Code: 70460
 $2,292 9.5×
CT scan, head (no contrast)
CPT Code: 70450
 $2,196 13.7×
CT scan, pelvis
CPT Code: 72192
 $2,199 13.5×
CT scan, sinuses
CPT Code: 70486
 $2,196 13.2×
CT scan, lower back (lumbar spine)
CPT Code: 72131
 $2,199 13.1×
Echocardiogram (heart ultrasound)
CPT Code: 93306
 $1,665 2.9×
Inguinal hernia repair
CPT Code: 49505
 $1,626 0.4×
Ultrasound, abdomen (complete)
CPT Code: 76700
 $1,566 11.7×
Ultrasound, leg veins (duplex)
CPT Code: 93970
 $1,364 5.0×
Ultrasound, abdomen (limited)
CPT Code: 76705
 $1,308 10.4×
Colonoscopy with biopsy
CPT Code: 45380
 $1,310 1.0×
Ultrasound, thyroid and neck
CPT Code: 76536
 $1,211 9.2×
Gallbladder removal (laparoscopic)
CPT Code: 47562
 $1,211 0.2×
Ultrasound, pelvis
CPT Code: 76856
 $1,144 8.8×
Showing top 25 high-impact procedures of 100 total
Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 47.3%

Audit a Bill or Quote at Coteau Des Prairies Health Care System (Zero PHI Required)

CMS CCN: 431339
CPT 70553
Fair BaseRate™ $511
Medicare Rate $356
Self-Pay Cash $5,234
Insurer Median $5,234
Pre-filled with Coteau Des Prairies Health Care System’s charged/list benchmark
Screened against 2026 HHS Federal Poverty Guidelines
2026 FPL: $15,650 + $5,500 per additional person
Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $2,478 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $2,478

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (47.3% of gross = $2,478).

Step 2 · Cash vs. Insurance Arbitrage Published Cash: $5,234

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Coteau Des Prairies Health Care System's published 45 CFR § 180 self-pay cash rate is $5,234 (vs. $5,234 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$4,723 Above Fair BaseRate

Negotiate Toward $511 Fair BaseRate ($356 Medicare)

Your bill ($5,234) is $4,723 above the denoised Fair BaseRate ($511) and 14.7× the $356 Medicare rate.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.
IRS Form 990 Schedule H & 26 U.S.C. § 501(r) 501(c)(3) Nonprofit Hospital

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

EIN: 460278210
Filing Period: 196705
Free Care Eligibility BenchmarkUp to 200% FPL100% charity write-off income threshold
Discounted Care EligibilityUp to 400% FPLSliding-scale & AGB billing cap tier
Charity Care Share of ExpensesSee Schedule HNet community financial assistance reported
26 U.S.C. § 501(r)(5) AGB Benchmark Method: lookback_commercial_median

Hospital-Specific CMS HCRIS Benchmark (47.3% 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.

Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines: Calculate Your 501(r) Cap Above ↑
CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

CMS Overall4/5 Stars (4/5)
Safety Composite64/100
Would Recommend47%
Rated 9 or 10 (HCAHPS)70%
Median ER Wait48 min
Left ER Before Seen0%
30-Day Mortality vs U.S.same
Unplanned Readmissionsame

Source: CMS Hospital Care Compare (29 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Regional Value & Quality Leader Pareto Frontier (Price + Quality)

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Coteau Des Prairies Health Care System.

Price Index: 0.81× regional baseline
Quality: 64/100 CMS composite
Median Household Income$63,691U.S. Census ACS
Local Uninsured Share19.9%Regional ACS estimate
200% FPL (1 Person)$31,920Common free-care ceiling
400% FPL (Family of 4)$128,600Common AGB cap ceiling
45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 74/100 · Corroborated CMS CCN 431339 EIN 460278210

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 431339) ↗ Verify IRS Form 990 (EIN 460278210) ↗ CMS HCRIS Cost Reports ↗
Published MRF File460278210_coteau-des-prairies-hospital_standardcharges.csv
Publication / Vintage2026-08-19 · 26.53 MB
Validated Rate Rows1,920 (CMS v3.0.0)
File Integrity Digestb318114e4e43fe3fdf3a…

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.

Submit MRF Update Correction Policy