Avera is proud to be a leader in providing consumers with easily accessible, understandable and reliable information about health care costs. You can use an online price estimator tool and other resources on this page to help you understand your financial responsibility for health care services.
Price Estimate Tool
You can compare price estimates for a wide range of health care services using our online tool.
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Understanding Pricing
We are committed to sharing information in ways that will help you make informed decisions about health care services. Here are things to know.
- 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
Hospital pricing can be complex and include many factors:
- 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 payers 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.
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.
Hospital Shoppable Services
The Centers for Medicare and Medicaid Services (CMS) 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.
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Hospital Standard Charges
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.
Iowa Standard Charges
Minnesota Standard Charges
Nebraska Standard Charges
South Dakota Standard Charges
Minnesota Clinic Price Transparency
Price transparency legal requirements in Minnesota require primary care and pediatric clinics to annually post in clinic waiting areas the Medical Assistance rate, the Medicare rate, the provider’s charge and the average payment for commercial health insurance.
Access documents for specific Avera Minnesota clinics
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.
“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care — like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider. Learn more about surprise billing or how to receive a good faith estimate (English | Spanish).
Understand Your Coverage
For most patients, traditional health insurance covers most of the cost of hospital care, so they are more likely to be interested in what their personal out-of-pocket costs will be for their procedure or hospital stay. We are also committed to responding to the needs of individuals with other types of health care accounts, including:
- High-deductible health savings accounts (HSA)
- Health Maintenance Organization (HMO) coverage
