Avera Health · Sioux Falls, SD
36
In-network payers
415
Disclosed rate categories
547
Beds
4
Care quality
Avera Mckennan Hospital & University Health Center is a 547-bed voluntary non-profit - private hospital in Sioux Falls, SD, affiliated with Avera Health. Below you'll find publicly disclosed negotiated rates and facility details, including 36 in-network payers and 415 disclosed rate categories.
CCN (Medicare provider number)
430016
NPI
1568460772
Type
Short Term Acute Care Hospital
Ownership
Voluntary Non-Profit - Private
Beds
547
Care Quality
4
Insurance acceptance may vary by specific plan, network status, and services required. Contact your insurance provider or the hospital's billing department to confirm coverage details.
The 24 services Avera Mckennan Hospital & University Health Center most likely performs, ranked by likely volume and what it is paid. Each service names one insurer. * marks hidden insurer names; A, B and C rank the remaining rates from low to high and reset for each service.
Book a demo to see hidden insurer names, more payer rates, and hospital data.
Childbirth · Inpatient
MS-DRG 807
$6,607 - $10,353
from 3 insurers · median $9,480
CMS lists this service as CPT 59400, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 807, so these are facility case rates.
Hospital reports neonatal nursery services to CMS
Childbirth · Inpatient
MS-DRG 788
$9,396 - $14,305
from 3 insurers · median $13,482
CMS lists this service as CPT 59510, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 788, so these are facility case rates.
Hospital reports neonatal nursery services to CMS
Medicine & Surgery · Inpatient
MS-DRG 470
$21,139 - $32,055
from 4 insurers · median $24,431
164 Medicare discharges for this DRG in CMS hospital data
CT imaging
CPT 74177
$1,173 - $4,093
from 2 insurers · median $2,633
Common here, based on CMS Medicare volume
Medicine & Surgery · Inpatient
MS-DRG 460
$38,873 - $95,184
from 4 insurers · median $55,968
37 Medicare discharges for this DRG in CMS hospital data
Gynecology
CPT 58558
$8,338
negotiated rate
62 Medicare claims in Level 4 Gynecologic Procedures (CMS 2024)
Medicine & Surgery
CPT 47562
$14,332
negotiated rate
248 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
Digestive procedures
CPT 49650
$20,702
negotiated rate
248 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
CT imaging
CPT 70450
$1,173 - $1,326
from 2 insurers · median $1,250
Common here, based on CMS Medicare volume
Childbirth · Inpatient
MS-DRG 807
$6,607 - $10,353
from 3 insurers · median $9,480
CMS lists this service as CPT 59610, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 807, so these are facility case rates.
Hospital reports neonatal nursery services to CMS
CT imaging
CPT 74176
$1,173 - $3,341
from 2 insurers · median $2,257
Common here, based on CMS Medicare volume
CT imaging
CPT 71275
$1,173 - $2,579
from 2 insurers · median $1,876
Common here, based on CMS Medicare volume
MRI imaging
CPT 70553
$1,520 - $3,422
from 2 insurers · median $2,471
Common here, based on CMS Medicare volume
Nuclear imaging
CPT 78452
$5,137
negotiated rate
Common here, based on CMS Medicare volume
Cardiology and vascular testing
CPT 93306
$1,838
negotiated rate
Common here, based on CMS Medicare volume
Gynecology
CPT 58571
$8,978
negotiated rate
176 Medicare claims in Level 2 Laparoscopy and Related Services (CMS 2024)
Medicine & Surgery · Inpatient
MS-DRG 216
$107,210 - $163,333
from 3 insurers · median $134,634
Hospital reports cardiac thoracic surgery services to CMS
Medicine & Surgery
CPT 49505
$16,590
negotiated rate
82 Medicare claims in Level 1 Abdominal/Peritoneal/Biliary and Related Procedures (CMS 2024)
MRI imaging
CPT 73721
$1,520 - $2,730
from 2 insurers · median $2,125
Common here, based on CMS Medicare volume
Urology
CPT 52000
$8,767
negotiated rate
416 Medicare claims in Level 2 Urology and Related Services (CMS 2024)
Digestive procedures
CPT 45385
$4,822
negotiated rate
Common here, based on CMS Medicare volume
MRI imaging
CPT 72148
$1,520 - $2,622
from 2 insurers · median $2,071
Common here, based on CMS Medicare volume
Digestive procedures
CPT 43239
$3,863
negotiated rate
Common here, based on CMS Medicare volume
Digestive procedures
CPT 47563
$13,198
negotiated rate
248 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
Median rate as a percent of Medicare across the outpatient services above, and how many services sit above or below the same insurer's median at nearby hospitals. * marks hidden insurer names. These table labels track the same insurers across services; the labels on each service card reset.
| Insurer | Services | Median % of Medicare | Above nearby | Below nearby |
|---|---|---|---|---|
| Insurer A* | 13 | 624% | 0 | 2 |
| Insurer B* | 24 | 435% | 15 | 4 |
| Insurer C* | 2 | - | 2 | 0 |
| Insurer D* | 6 | - | 0 | 2 |
How we chose these services: 9 appear in this hospital's own Medicare claims, 11 are common here based on CMS Medicare volume, and 4 are typical for the service lines it reports to CMS. Rates come from insurer and hospital price transparency files as of October 2026. Rates under a quarter of Medicare or over 20 times Medicare are left out as likely physician-fee rows or file errors. Book a demo to see all 300 CMS shoppable services for Avera Mckennan Hospital & University Health Center.
1325 South Cliff Avenue, Sioux Falls, SD 57105
(605) 322-8000
The nearest hospitals of similar type and size. Their rates are compared with Avera Mckennan Hospital & University Health Center for the same insurers and services above.
Sanford Usd Medical Center
Rates about the same as Avera Mckennan Hospital & University Health Center (21 services)
Unitypoint Health St Lukes Regional Medical Center
▼ Rates typically 57% lower than Avera Mckennan Hospital & University Health Center (12 services)
Mercyone Siouxland Medical Center
▼ Rates typically 41% lower than Avera Mckennan Hospital & University Health Center (21 services)
Chi Health Immanuel
▼ Rates typically 30% lower than Avera Mckennan Hospital & University Health Center (21 services)
Nebraska Methodist Hospital
▼ Rates typically 57% lower than Avera Mckennan Hospital & University Health Center (21 services)
The Nebraska Medical Center
▼ Rates typically 58% lower than Avera Mckennan Hospital & University Health Center (21 services)
Avera Heart Hospital Of South Dakota
Sioux Falls Specialty Hospital
Avera St. Mary S Hospital
About Avera Mckennan Hospital & University Health Center's rates and hospital price transparency.
For MRI brain before and after contrast (CPT 70553), published negotiated rates at Avera Mckennan Hospital & University Health Center range from $1,520 to $3,422 across 2 insurers. Cigna's rate is $1,520. The median at nearby comparable hospitals is $723. What a patient pays depends on their plan's deductible, coinsurance and network status.
For CT abdomen and pelvis with contrast (CPT 74177), published negotiated rates at Avera Mckennan Hospital & University Health Center range from $1,173 to $4,093 across 2 insurers. Cigna's rate is $1,173. The median at nearby comparable hospitals is $817. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Colonoscopy with polyp removal (CPT 45385), published negotiated rates at Avera Mckennan Hospital & University Health Center range from $4,822 to $4,822 across 1 insurers. Aetna's rate is $4,822. The median at nearby comparable hospitals is $4,907. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Vaginal delivery, hospital stay (MS-DRG 807), published negotiated rates at Avera Mckennan Hospital & University Health Center range from $6,607 to $10,353 across 3 insurers. UnitedHealthcare's rate is $10,353. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Major lower-extremity joint replacement without MCC (MS-DRG 470), published negotiated rates at Avera Mckennan Hospital & University Health Center range from $21,139 to $32,055 across 4 insurers. Aetna's rate is $25,849. The median at nearby comparable hospitals is $30,135. What a patient pays depends on their plan's deductible, coinsurance and network status.
Avera Mckennan Hospital & University Health Center has 547 beds. Facility type: Short Term Acute Care Hospital.
Avera Mckennan Hospital & University Health Center is located at 1325 South Cliff Avenue, Sioux Falls, SD 57105. Its main phone number is (605) 322-8000.
Avera Mckennan Hospital & University Health Center's CMS Certification Number (CCN), also called its Medicare provider number, is 430016.
The National Provider Identifier (NPI) on file for Avera Mckennan Hospital & University Health Center is 1568460772.
Avera Mckennan Hospital & University Health Center is affiliated with Avera Health.
Avera Mckennan Hospital & University Health Center lists 36 in-network payers, including Aetna, Ameri Health, Aspirus Health Plan, Avera Health Plans, and is Medicare-certified. Insurance acceptance may vary by plan, so confirm coverage with your insurer or the hospital's billing department.
415 disclosed rate categories. Each shows the payer, category, code type and group with its code range, and contract type, along with how the rate compares with the state average.
Under 45 CFR Part 180, every US hospital must publish a machine-readable file of its standard charges, including gross charges, discounted cash prices and payer-specific negotiated rates, in the CMS template format. PayerPrice can help hospitals publish and maintain these files.
A chargemaster (charge description master, or CDM) is a hospital's master list of billable items, with codes, descriptions and gross charges. A chargemaster review looks at those lines for accuracy and pricing. PayerPrice can help hospitals review their chargemaster; contact us to discuss your needs.
For hospital finance and compliance teams
The data on this page comes from the files hospitals and payers publish. We help hospitals publish theirs correctly, and take a fresh look at their chargemaster.
We turn your chargemaster and payer contracts into the CMS template file, then keep it current as rates change.
{
"description": "MRI of brain (no contrast)",
"code_information": [
{ "code": "611", "type": "RC" },
{ "code": "70551", "type": "CPT" }
],
"standard_charges": [{
"setting": "outpatient",
"minimum": 250,
"maximum": 400,
"gross_charge": 1200,
"discounted_cash": 1080,
"payers_information": [
{
"payer_name": "Platform Health Insurance",
"plan_name": "PPO",
"methodology": "fee schedule",
"standard_charge_dollar": 400
},
{
"payer_name": "Region Health Insurance",
"plan_name": "HMO",
"methodology": "fee schedule",
"standard_charge_dollar": 250
}
]
}]
}Your chargemaster sets the gross charge on every claim, and many payer contracts base payment on it through percent-of-charge, lesser-of and stop-loss terms. We audit it line by line and show how your charges and negotiated rates compare with peer hospitals before your next negotiation.
What a review covers