Madison, SD
38
In-network payers
189
Disclosed rate categories
22
Beds
Madison Regional Health System is a 22-bed voluntary non-profit - private hospital in Madison, SD. Below you'll find publicly disclosed negotiated rates and facility details, including 38 in-network payers and 189 disclosed rate categories.
CCN (Medicare provider number)
431300
NPI
1588644058
Type
Critical Access Hospital
Ownership
Voluntary Non-Profit - Private
Beds
22
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 Madison Regional Health System 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.
CT imaging
CPT 74177
$1,768 - $4,568
from 4 insurers · median $2,405
Typical for a hospital with this service line
CT imaging
CPT 70450
$880 - $1,230
from 3 insurers · median $1,178
Typical for a hospital with this service line
CT imaging
CPT 74176
$1,618 - $2,261
from 3 insurers · median $2,166
Typical for a hospital with this service line
Childbirth · Inpatient
MS-DRG 807
$4,165
negotiated rate
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 obstetrics / child birth services to CMS
MRI imaging
CPT 70553
$3,335 - $4,758
from 4 insurers · median $4,562
Typical for a hospital with this service line
CT imaging
CPT 71260
$1,462 - $3,008
from 4 insurers · median $2,517
Typical for a hospital with this service line
Mammography
CPT 77067
$363 - $573
from 4 insurers · median $491
Typical for a hospital with this service line
Childbirth · Inpatient
MS-DRG 788
$5,720
negotiated rate
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 obstetrics / child birth services to CMS
Cardiology and vascular testing
CPT 93306
$728 - $1,667
from 4 insurers · median $1,378
Typical for a hospital with this service line
MRI imaging
CPT 72148
$2,803 - $3,916
from 3 insurers · median $3,751
Typical for a hospital with this service line
MRI imaging
CPT 70551
$2,573 - $3,595
from 4 insurers · median $3,435
Typical for a hospital with this service line
Digestive procedures
CPT 45385
$1,835 - $2,929
from 4 insurers · median $2,496
Typical for a hospital with this service line
Digestive procedures
CPT 45380
$1,705 - $2,382
from 3 insurers · median $2,256
Typical for a hospital with this service line
Digestive procedures
CPT 43239
$1,303 - $1,820
from 3 insurers · median $1,724
Typical for a hospital with this service line
MRI imaging
CPT 73721
$2,355 - $3,290
from 3 insurers · median $3,151
Typical for a hospital with this service line
Ultrasound
CPT 76705
$543 - $805
from 4 insurers · median $735
Typical for a hospital with this service line
Medicine & Surgery
CPT 66984
$3,230 - $4,513
from 4 insurers · median $4,350
Typical for a hospital with this service line
X-ray and bone density
CPT 71046
$133 - $300
from 4 insurers · median $180
Typical for a hospital with this service line
Digestive procedures
CPT 45378
$1,598 - $2,232
from 3 insurers · median $2,115
Typical for a hospital with this service line
Laboratory and pathology
CPT 80053
$129 - $181
from 4 insurers · median $177
Typical for a hospital with this service line
Ultrasound
CPT 76642
$542 - $757
from 3 insurers · median $709
Typical for a hospital with this service line
Nuclear imaging
CPT 78452
$1,368 - $1,911
from 3 insurers · median $1,830
Hospital reports nuclear medicine services to CMS
Cardiology and vascular testing
CPT 93971
$453 - $952
from 4 insurers · median $787
Typical for a hospital with this service line
Laboratory and pathology
CPT 85025
$106 - $148
from 4 insurers · median $144
Typical for a hospital with this service line
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* | 22 | 781% | 9 | 0 |
| Insurer B* | 13 | 754% | 5 | 6 |
| Insurer C* | 22 | 732% | 10 | 8 |
| Insurer D* | 24 | 559% | 0 | 0 |
How we chose these services: 0 appear in this hospital's own Medicare claims, 0 are common here based on CMS Medicare volume, and 24 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 Madison Regional Health System.
323 Sw 10th Street, Madison, SD 57042
(605) 256-6551
The nearest hospitals of similar type and size. Their rates are compared with Madison Regional Health System for the same insurers and services above.
Avera Dells Area Hospital
â–¼ Rates typically 31% lower than Madison Regional Health System (17 services)
Avera Flandreau Hospital
â–¼ Rates typically 31% lower than Madison Regional Health System (17 services)
Avera De Smet Memorial Hospital
â–¼ Rates typically 20% lower than Madison Regional Health System (15 services)
Pipestone County Medical Center & Family Clinic Avera
â–¼ Rates typically 10% lower than Madison Regional Health System (21 services)
Freeman Regional Health Services
â–¼ Rates typically 10% lower than Madison Regional Health System (12 services)
Hendricks Community Hospital Association
â–¼ Rates typically 51% lower than Madison Regional Health System (20 services)
Avera Weskota Memorial Hospital
Avera Hand County Memorial Hospital
Bowdle Hospital
St. Michael S Hospital Avera
About Madison Regional Health System's rates and hospital price transparency.
For MRI brain before and after contrast (CPT 70553), published negotiated rates at Madison Regional Health System range from $3,335 to $4,758 across 4 insurers. Blue Cross Blue Shield's rate is $4,464. The median at nearby comparable hospitals is $1,834. 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 Madison Regional Health System range from $1,768 to $4,568 across 4 insurers. Aetna's rate is $4,568. The median at nearby comparable hospitals is $1,834. 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 Madison Regional Health System range from $1,835 to $2,929 across 4 insurers. Cigna's rate is $2,564. The median at nearby comparable hospitals is $3,857. 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 Madison Regional Health System range from $4,165 to $4,165 across 1 insurers. UnitedHealthcare's rate is $4,165. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Screening mammography, bilateral (CPT 77067), published negotiated rates at Madison Regional Health System range from $363 to $573 across 4 insurers. Aetna's rate is $573. The median at nearby comparable hospitals is $583. What a patient pays depends on their plan's deductible, coinsurance and network status.
Madison Regional Health System has 22 beds. Facility type: Critical Access Hospital.
Madison Regional Health System is located at 323 Sw 10th Street, Madison, SD 57042. Its main phone number is (605) 256-6551.
Madison Regional Health System's CMS Certification Number (CCN), also called its Medicare provider number, is 431300.
The National Provider Identifier (NPI) on file for Madison Regional Health System is 1588644058.
Madison Regional Health System lists 38 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.
189 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.
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{
"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