Price Transparency
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Price Transparency

Pricing Questions

Avera is committed to providing pricing transparency. If you have specific questions about your Avera hospital billing, insurance coverage and financial responsibility, please contact us.

888-370-6525

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Get a price estimate for a medical procedure. You are entering a secure website. Any information you provide will be protected.

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Avera is proud to be a leader in providing consumers with easily accessible, understandable and reliable information about health care costs.

We offer an online tool to let consumers compare price estimates for a wide range of health care services.

The estimate is only for out-of-pocket cost for services at the selected Avera hospital. Additional services that may not be part of the estimate include, but are not limited to, professional fees, anesthesia services and radiology technician charges.

Understanding Pricing

We are committed to sharing information in ways that will help you make informed decisions about health care services.

Estimates vary based on the insurance plan coverage. Before any service, please contact your insurance company to confirm coverage under your plan and that Avera is a participating provider. The estimate for uninsured patients reflects the hospital’s discounts for uninsured patients.

State hospital associations in Iowa, Minnesota, Nebraska and South Dakota offer price compare websites that allow health care consumers to receive basic information about services and charges at hospitals within those states and compare overall charges between hospitals.

Hospital Pricing

Questions surrounding hospital pricing remain complex and include many factors, such as:

  • Prices vary based on patient needs and the level of services consumed.
  • A wide range of products and services are bundled into the price of a particular hospital service, including medications, supplies, tests and more.
  • Hospital reimbursement varies from patient to patient based on the payments mandated by different insurance companies, health plans, and government payors such as Medicare and Medicaid.
  • Professional fees — such as physician, radiologist, anesthesiologist and pathologist fees — are not included in your estimate. Your final bill may differ because of this.

All of these factors combine to make specific advance pricing information difficult to provide on an individual basis.

Financial Responsibility

No one likes to be surprised by the cost of their medical care. That’s why it’s important to understand the type of insurance you carry, along with other health care accounts, to determine what your financial responsibility is for your medical care.

Traditional Insurance

Because traditional insurance typically covers most of the cost of hospital care, patients with this type of coverage are more likely to be interested in what their personal out-of-pocket costs would be between hospitals, rather than overall hospital charges.

Other Health Care Accounts

We are committed to responding to the needs of individuals, beyond those with traditional insurance coverage. Other types of health care accounts include:

  • Patients with high-deductible health savings accounts (HSA).
  • Patients with Health Maintenance Organization (HMO) coverage.
  • Patients without insurance who have limited means of paying for health care will want to compare information, but ultimately will need to work within the charity and discount policies that are available. Learn more about charity and patient assistance programs at Avera.

Other Costs

Many costs related to hospital pricing are outside the control of Avera. These may include:

  • Product mark-ups for device manufacturers
  • Pharmaceuticals
  • Other medical service providers

Vendors are also encouraged to supply a transparent price list to help patients recognize the costs associated with health care services and procedures.

Our Commitment

We are committed to providing high-quality health care and pricing transparency. Our ongoing efforts in pricing transparency will focus on improving the quality of care while being mindful of the costs to our patients.

*As of January 2021, the Centers for Medicare and Medicaid Services (CMS) now requires hospitals to provide a price estimator tool for as many of the 70 CMS-specified shoppable services that are performed by the hospital, and as many additional hospital-selected shoppable services as is necessary for a combined total of at least 300 shoppable services.

The CMS rule also requires a comprehensive “standard charges” file be posted online, and offer information on things such as gross charges, discounted cash prices and payer-specific negotiated charges. This information can be found below.

Live Better. Live Balanced. Avera.

Avera is a health ministry rooted in the Gospel. Our mission is to make a positive impact in the lives and health of persons and communities by providing quality services guided by Christian values.

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