How many shoppable procedure prices are published for Encompass Health Rehabilitation Hospital of Sioux Falls?

Encompass Health Rehabilitation Hospital of Sioux Falls in Sioux Falls, SD currently has 61 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

Hospital Profile General Acute Care Hospital Updated: 2026-01-01

Encompass Health Rehabilitation Hospital of Sioux Falls

4700 W 69Th St, Sioux Falls, SD 57108 · 61 Priced Procedures

CMS Overall Rating No CMS Rating

Near Fair BaseRate Benchmark

1.00×vs. Fair Market Price

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

81/100 · Corroborated

81/100Self-Pay Cash Beats Insurance 0% of the Time

File Completeness100

Price Logic100

Peer Alignment73

Clean Billing20

Real Cash Discount100

Regional Value Leader

Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.

Behavioral Pricing FingerprintMedian-Gamed · High Captive Markup

Loss-Leader / Captive Ancillary Cross-Subsidizer

Encompass Health Rehabilitation Hospital of Sioux Falls prices routine shoppable procedures near 4.7× Medicare (p50 1.00×) while skewing captive emergency, lab, and upper-quartile codes to 7.7× Medicare (p75 1.28×, +28% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.

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 0% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (54/100 safety score) with 72% patient recommendation
Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 5.9× markup over Medicare rates
Captive ER (6.8×) & laboratory (7.2×) services average 1.64× higher multiples than routine shoppable care (4.7×)
Upper-quartile procedures (Q75 1.28×) jump +28% above the median procedure ratio (Q50 1.00×)
Unnegotiated chargemaster list prices average 5.1× Medicare (33¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

4.7× Medicare

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

Back-Door Captive & ER1.64× Divergence

7.7× 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

4.7× MedicareWatchout

Outpatient Surgery & ORBack-Door Captive

5.9× MedicareWatchout

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

4.1× MedicareElevated

Back-Door Captive ER VisitsBack-Door Captive

6.8× MedicareWatchout

Inpatient Lab & PathologyBack-Door Captive

7.2× MedicareWatchout

Specialty & Infusion Drugs (J-Codes)Back-Door Captive

5.4× MedicareWatchout

Self-Pay Cash Honesty & 501(r)Integrity & Outcomes

0% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 54/100Elevated

Procedure Prices at Encompass Health Rehabilitation Hospital of Sioux Falls

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 61 published procedures.

Sort:

Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$972	$972	$448	2.2×
MRI, brain (with and without contrast) CPT Code: `70553`	$972	$972	$511	1.9×
Blood transfusion CPT Code: `36430`	$894	$894	$498	1.8×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$638	$638	$272	2.3×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$638	$638	$303	2.1×
MRI, lower back (no contrast) CPT Code: `72148`	$638	$638	$338	1.9×
MRI, brain (no contrast) CPT Code: `70551`	$638	$638	$343	1.9×
MRI, knee or other leg joint CPT Code: `73721`	$638	$638	$369	1.7×
CT scan, head (with contrast) CPT Code: `70460`	$523	$523	$242	2.2×
CT scan, head (with and without contrast) CPT Code: `70470`	$523	$523	$258	2.0×
Ultrasound, abdomen (limited) CPT Code: `76705`	$365	$365	$126	2.9×
Ultrasound, pelvis CPT Code: `76856`	$365	$365	$130	2.8×
Ultrasound, thyroid and neck CPT Code: `76536`	$365	$365	$132	2.8×
Ultrasound, abdomen (complete) CPT Code: `76700`	$365	$365	$134	2.7×
CT scan, head (no contrast) CPT Code: `70450`	$365	$365	$160	2.3×
CT scan, pelvis CPT Code: `72192`	$365	$365	$163	2.2×
CT scan, sinuses CPT Code: `70486`	$365	$365	$166	2.2×
CT scan, chest (no contrast) CPT Code: `71250`	$365	$365	$167	2.2×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$365	$365	$168	2.2×
CT scan, neck (cervical spine) CPT Code: `72125`	$365	$365	$169	2.2×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$309	$309	$583	0.5×
X-ray, chest (single view) CPT Code: `71045`	$281	$281	$92	3.1×
X-ray, shoulder CPT Code: `73030`	$281	$281	$92	3.1×
X-ray, foot CPT Code: `73630`	$281	$281	$92	3.1×
X-ray, chest (two views) CPT Code: `71046`	$281	$281	$93	3.0×
X-ray, neck (cervical spine) CPT Code: `72040`	$281	$281	$93	3.0×
X-ray, hand CPT Code: `73130`	$281	$281	$93	3.0×
X-ray, hip CPT Code: `73502`	$281	$281	$93	3.0×
X-ray, ankle CPT Code: `73610`	$281	$281	$93	3.0×
X-ray, pelvis CPT Code: `72170`	$281	$281	$110	2.6×
X-ray, lower back CPT Code: `72110`	$281	$281	$112	2.5×
Speech therapy (language evaluation) CPT Code: `92507`	$243	$243	$86	2.8×
Neurobehavioral status check CPT Code: `96116`	$239	$239	$231	1.0×
Physical therapy (functional capacity test) CPT Code: `97750`	$104	$104	$38	2.7×
Physical therapy (gait training) CPT Code: `97116`	$83	$83	$33	2.5×
Physical therapy (manual therapy) CPT Code: `97140`	$85	$85	$34	2.5×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$86	$86	$35	2.5×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$89	$89	$38	2.3×
Occupational therapy (self-care training) CPT Code: `97535`	$86	$86	$38	2.3×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$89	$89	$40	2.2×
Blood test, vitamin D CPT Code: `82306`	$176	$176	$31	5.7×
Blood test, PSA (prostate screen) CPT Code: `84153`	$110	$110	$19	5.8×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$59	$59	$10	5.9×
Blood test, complete blood count (CBC) CPT Code: `85025`	$47	$47	$8	5.9×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$64	$64	$11	5.8×
Hepatitis C antibody test CPT Code: `86803`	$86	$86	$15	5.7×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$80	$80	$14	5.7×
Blood test, thyroid (TSH) CPT Code: `84443`	$100	$100	$18	5.6×
Culture, bacterial CPT Code: `87070`	$53	$53	$9	5.9×
Culture, blood CPT Code: `87040`	$62	$62	$11	5.6×
Speech therapy (group session) CPT Code: `92508`	$71	$71	$27	2.6×
Blood test, potassium CPT Code: `84132`	$29	$29	$5	5.8×
Blood test, basic metabolic panel CPT Code: `80048`	$50	$50	$9	5.6×
Electrical stimulation therapy HCPCS Code: `G0283`	$44	$44	$14	3.1×
Blood antibody screen CPT Code: `86850`	$53	$53	$46	1.2×
Blood test, glucose (blood sugar) CPT Code: `82947`	$24	$24	$4	6.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$24	$24	$4	6.0×
Blood test, sodium CPT Code: `84295`	$29	$29	$5	5.8×
Blood test, liver function panel CPT Code: `80076`	$49	$49	$9	5.4×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$20	$20	$3	6.7×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$24	$24	$5	4.8×

Showing top 25 high-impact procedures of 61 total

Inline Bill X-Ray & 501(r) Calculator For-Profit Facility · Cash & Fair BaseRate Audit

Audit a Bill or Quote at Encompass Health Rehabilitation Hospital of Sioux Falls (Zero PHI Required)

CMS CCN: 433027

CPT 74177

Select Procedure to Audit:

Fair BaseRate™ $448

Medicare Rate $356

Self-Pay Cash $972

Insurer Median $972

1. Amount on Your Bill or Quote ($) Pre-filled with Encompass Health Rehabilitation Hospital of Sioux Falls’s charged/list benchmark

2. Household Annual Income ($) Screened against 2026 HHS Federal Poverty Guidelines

3. Household Size (1–8) 2026 FPL: $15,650 + $5,500 per additional person

Step 1 · 501(r) Charity Care Check 274% of 2026 FPL

Above Standard 400% FPL Financial-Assistance Ceiling

At 274% FPL, you exceed the standard 400% FPL tier, though medical-hardship caps (when bills exceed 10% of annual income) may still apply.

Step 2 · Cash vs. Insurance Arbitrage Save $324 Paying Cash

Self-Pay Cash Rate ($972) Beats Your Bill

Encompass Health Rehabilitation Hospital of Sioux Falls's published 45 CFR § 180 self-pay cash rate is $972 (vs. $972 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$848 Above Fair BaseRate

Negotiate Toward $448 Fair BaseRate ($356 Medicare)

Your bill ($1,296) is $848 above the denoised Fair BaseRate ($448) and 3.6× 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) For-Profit / Non-501(c)(3)

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

EIN: 832549368

Public IRS & CMS ownership records classify Encompass Health Rehabilitation Hospital of Sioux Falls as a non-501(c)(3) facility. Federal 26 U.S.C. § 501(r) statutory charity-care caps apply specifically to tax-exempt nonprofit hospitals, though state hospital fair-pricing statutes and prompt-pay self-pay discounts may still apply.

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

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

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

Regional Quality & Price Benchmark

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Encompass Health Rehabilitation Hospital of Sioux Falls.

Price Index: 0.32× regional baseline

Quality: 54/100 CMS composite

Median Household Income$96,184U.S. Census ACS

Local Uninsured Share2.7%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 81/100 · Corroborated CMS CCN 433027 EIN 832549368

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 433027) ↗ Verify IRS Form 990 (EIN 832549368) ↗ CMS HCRIS Cost Reports ↗

Published MRF File832549368_Encompass-Health-Rehabilitation-Hospital-of-Sioux-Falls_standardcharges.csv

Publication / Vintage2026-01-01 · 3.74 MB

Validated Rate Rows61 (CMS v3.0.0)

File Integrity Digestf74ad97d6659dce2b4df…

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