Emergency Room Visit Cost in South Dakota (2026): Average Prices & What You'll Pay
What does a emergency room visit cost in South Dakota?
A typical emergency room visit in South Dakota costs $333–$652 for a commercially insured patient, including facility and physician fees. The median reported facility price across 47 hospitals is $299. This estimate is based on CMS fee schedules and hospital price transparency data published under federal law.
Sanford Health and Monument Health are the dominant systems. The Sanford Health network extends across both Dakotas and into Minnesota and Iowa, giving it extraordinary commercial contracting leverage. South Dakota's rural geography - and the Sanford network's reach - means most residents have very limited facility alternatives. Emergency room costs are driven by two separate charges: the facility fee (which varies by ER level, E1–E5) and the physician fee (billed by an independent emergency medicine group). Most patients are unaware that ER physicians are frequently out-of-network even when the hospital itself is in-network - the No Surprises Act limits your liability in this case, but billing disputes still occur. Using an urgent care center for non-emergency conditions typically costs 80–90% less than an ER visit for equivalent care.
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Example: two commercially insured patients in Sioux Falls could pay ~$229 and ~$376 for the identical procedure - a $147 difference driven entirely by facility choice.
Where emergency room visit costs vary in South Dakota
Pins show hospitals with price-transparency data (colored by vs. state average) and nearby ambulatory surgery centers, imaging centers, and other facilities (colored by type). Click any pin for facility name and estimated cost range.
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Cheapest Emergency Room Visit Providers in South Dakota
Based on declared cash/self-pay prices from CMS hospital price transparency files.
| # | Facility | City | Price | vs Median |
|---|---|---|---|---|
| 1 | Avera Queen of Peace | Mitchell, SD | $184 | -$115 |
| 2 | Sanford USD Medical Center | Sioux Falls, SD | $184 | -$115 |
| 3 | Prairie Lakes Health Care System Inc. | SD | $185 | -$114 |
| 4 | Wagner Community Memorial | Wagner, SD | $185 | -$114 |
| 5 | Brookings Health System | Brookings, SD | $185 | -$114 |
| 6 | Freeman Regional Health Svcs. | Freeman, SD | $191 | -$108 |
Prices are declared self-pay rates. Contact each facility for a formal quote before scheduling.
Quick take
- Avera Queen of Peace is the lowest-cost option at $184 - $115 below the state median, just by choosing where you go.
- Ask for the cash price if your deductible isn't met - the median cash price here is $299, and it's often lower than what insurance pays before your deductible is satisfied.
- Ask whether this procedure can be done at a freestanding ambulatory surgical center - they're typically 30-60% cheaper than a hospital for identical care, and most aren't in this hospital-only dataset.
How where you go changes what you pay for emergency room visit
The same emergency room visit bundles different services depending on the setting - facility fee, surgeon fee, and anesthesia each arrive as separate bills. Estimated ranges below reflect the typical full bundled cost, including all expected charges.
- Facility fee $153–$1,358
- Professional fee $17–$832
Estimated from CMS fee schedules + commercial rate multipliers
- Facility fee $153–$587
- Professional fee $17–$832
Estimated from CMS fee schedules + commercial rate multipliers
South Dakota Emergency Room Visit prices by facility
All prices below come from hospital chargemasters - the official price lists each hospital must publish under federal law. Gross charge is the undiscounted list price; cash price is the self-pay rate; negotiated range covers the spread across insurance contracts.
How we calculate "Your Price"
We prioritize cash price (the self-pay rate) over the negotiated rate, and only fall back to the gross charge, the inflated list price few people actually pay, when nothing else is reported.
| # | Facility | City | Your Price | vs Median | Gross Charge |
|---|---|---|---|---|---|
| #1 | Avera Flandreau Hospital | Flandreau, SD | $504 | +$205 | $520–$2,159 |
| #2 | Community Memorial Hospital, Inc | Burke, SD | $157 | -$142 | $155–$2,302 |
| #3 | Douglas County Memorial Hospital | SD | $155 | -$144 | $173–$2,127 |
| #4 | Community Memorial Hospital | Redfield, SD | $376 | +$77 | $443–$1,904 |
| #5 | Black Hills Surgical Hospital | Rapid City, SD | $178 | -$121 | $231–$1,164 |
| #6 | Faulkton Area Medical Center | Faulkton, SD | $233 | -$66 | $259–$1,349 |
| #7 | Avera Queen of Peace | Mitchell, SD | $431 | +$132 | $445–$4,116 |
| #8 | Sanford USD Medical Center | Sioux Falls, SD | $184 | -$115 | $55–$3,492 |
| #9 | Prairie Lakes Health Care System Inc. | SD | $185 | -$114 | $185–$5,974 |
| #10 | Brookings Health System | Brookings, SD | $185 | -$114 | $149–$1,559 |
| #11 | Wagner Community Memorial | Wagner, SD | $185 | -$114 | $206–$3,957 |
| #12 | Freeman Regional Health Svcs. | Freeman, SD | $534 | +$235 | $551–$3,308 |
| #13 | Avera Missouri River Health Center | Gettysburg, SD | $192 | -$107 | $198–$3,113 |
| #14 | Avera McKennan Hospital | Sioux Falls, SD | $404 | +$105 | $161–$3,841 |
| #15 | Avera Specialty Hospital | Sioux Falls, SD | $404 | +$105 | $161–$3,841 |
| #16 | Platte Healthcare | Platte, SD | $587 | +$288 | $587–$3,774 |
| #17 | Pioneer Memorial Hospital and Health Services | Viborg, SD | $205 | -$94 | $141–$2,207 |
| #18 | Winner Regional Healthcare Center | Winner, SD | $225 | -$74 | $225–$2,545 |
| #19 | Monument Health Network Inc Custer Hospital | Custer, SD | $213 | -$86 | $72–$2,988 |
| #20 | Monument Health Network Inc Sturgis Hospital | Sturgis, SD | $213 | -$86 | $72–$2,988 |
| #21 | Monument Health Network Inc Lead-Deadwood Hospital | Deadwood, SD | $213 | -$86 | $72–$2,988 |
| #22 | Avera St. Benedicts | Parkston, SD | $525 | +$226 | $542–$3,068 |
| #23 | Coteau des Prairies Hospital | Sisseton, SD | $229 | -$70 | $85–$2,413 |
| #24 | Landmann-Jungman Hosp | Scotland, SD | $229 | -$70 | $236–$1,280 |
| #25 | Fall River Health Services | "1201 Hwy 71 Hot Springs, SD | $239 | -$60 | $239–$1,999 |
| #26 | Avera Milbank Hospital | Milbank, SD | $339 | +$40 | $350–$2,855 |
| #27 | Sanford Canton Inwood Medical Center | Canton, SD | $251 | -$48 | $314–$3,197 |
| #28 | Avera Hand County Hospital | Miller, SD | $482 | +$183 | $497–$4,815 |
| #29 | Avera Gregory Hospital | Gregory, SD | $535 | +$236 | $552–$2,372 |
| #30 | Avera Sacred Heart Hospital | Yankton, SD | $535 | +$236 | $552–$2,372 |
| #31 | Avera Dell Rapids Hospital | Dell Rapids, SD | $299 | +$0 | $309–$2,378 |
| #32 | Bennett County Hospital & Nursing Home | Martin, SD | $261 | -$38 | $261–$1,905 |
| #33 | Sanford Vermillion Hospital | Vermillion, SD | $268 | -$31 | $336–$3,278 |
| #34 | Madison Regional Health System | Madison, SD | $278 | -$21 | $278–$2,122 |
| #35 | Sanford Chamberlain Medical Center | Chamberlain, SD | $291 | -$8 | $364–$3,375 |
| #36 | Sanford Webster Hospital | Webster, SD | $300 | +$1 | $375–$3,180 |
| #37 | Sanford Clear Lake Medical Center | Clear Lake, SD | $302 | +$3 | $378–$3,796 |
| #38 | Sanford Aberdeen Medical Center | Aberdeen, SD | $309 | +$10 | $387–$3,564 |
| #39 | Avera St. Luke's | Aberdeen, SD | $311 | +$12 | $346–$2,438 |
| #40 | Avera Heart Hospital | Sioux Falls, SD | $329 | +$30 | $144–$3,558 |
| #41 | Avera St. Mary's Hospital | Pierre, SD | $340 | +$41 | $378–$3,113 |
| #42 | Bowdle Healthcare Center | Bowdle, SD | $482 | +$183 | $482–$1,765 |
| #43 | Philip Health Service Inc | Philip, SD | $369 | +$70 | $369–$2,660 |
| #44 | Avera DeSmet | De Smet, SD | $410 | +$111 | $423–$4,116 |
| #45 | St Michael's Hospital | Tyndall, SD | $572 | +$273 | $590–$3,443 |
| #46 | Marshall County Hospital | Britton, SD | $536 | +$237 | $536–$2,094 |
| #47 | Dunes Surgical Hospital | Dakota Dunes, SD | $1,358 | +$1,059 | $783 |
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Source: CMS hospital price transparency machine-readable files. vs Median = savings or premium relative to the state median price. Gross Charge = undiscounted list price for reference.
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Why prices vary - and what it means for your coverage
A small number of hospitals (1) report prices above $684, including Dunes Surgical Hospital at $1,358, which drives most of the overall spread - excluding them, most facilities cluster in a much tighter band. Setting matters too: the median outpatient price is $264 versus $276 inpatient, so where a procedure happens often matters more than which hospital you pick. Facility fees for emergency care scale with the severity level the hospital assigns your visit, which is why two visits that look similar from the exam table can bill very differently.
On top of the facility price, your actual bill depends on your deductible, your out-of-pocket maximum, and whether every provider involved - not just the facility - is in-network.
| Your situation | Estimated out-of-pocket |
|---|---|
| Deductible not yet met | ~$471 |
| Deductible met - 20% coinsurance | ~$94 |
| Out-of-network provider | $1,036+ |
Frequently asked questions: emergency room visit costs in South Dakota
How much does an emergency room visit cost in South Dakota?
Across 47 South Dakota hospitals that publish prices, an emergency room visit ranges from $55 to $5,974, with a median of $299. Most facilities fall between $217 and $376. What you pay depends on the facility, your insurance, and whether you have met your deductible.
Where is the cheapest place to get an emergency room visit in South Dakota?
Based on declared prices, the lowest-cost facility in our South Dakota data is Douglas County Memorial Hospital at about $155. By metro, Burke has the lowest median ($157). Freestanding ambulatory surgery and imaging centers are often cheaper still and may not appear in hospital price data - ask your doctor whether one is an option.
Why is an emergency room visit so much cheaper at some South Dakota hospitals?
Prices vary up to 108.6× because each hospital sets its own list price, cash discount, and insurer-negotiated rates. In South Dakota, the median cash (self-pay) price is $299 versus a median negotiated rate of $116 - about 2.6× higher. Asking for the cash price or your insurer's negotiated rate is often the single biggest lever on what you pay.
How much will I actually pay out of pocket for an emergency room visit in South Dakota?
Your out-of-pocket cost depends on your deductible, coinsurance, out-of-pocket maximum, and whether the facility is in-network - not just the sticker price. If you have not met your deductible, you will typically pay the negotiated rate in full until you do. Use the CostKits cost forecaster to estimate your specific out-of-pocket amount before you go.
Before you book
- Deductible vs out-of-pocket max
- How to negotiate your medical bills
- EOB vs medical bill: complete guide
- Already have a bill? Check it for errors
Other procedures in South Dakota
Emergency Room Visit, elsewhere
Other South Dakota Hospitals for Emergency Room Visit
These hospitals are registered in the CMS National Provider Identifier (NPI) registry as active hospitals in South Dakota. Cost estimates use the bundled service model for each place of service. Contact them directly for a formal quote.
| Provider | City | Type | Est. Cost | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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AVERA GETTYSBURG
6057652480 |
GETTYSBURG, SD | Critical Access Hospital | $170–$2,190 bundled est. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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AVERA GREGORY
6058355190 |
GREGORY, SD | Critical Access Hospital | $170–$2,190 bundled est. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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AVERA MCKENNAN
6054285431 |
DELL RAPIDS, SD | Critical Access Hospital | $170–$2,190 bundled est. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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AVERA MCKENNAN
6053226400 |
SIOUX FALLS, SD | General Acute Care Hospital | $170–$2,190 bundled est. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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AVERA MCKENNAN
6053226400 |
SIOUX FALLS, SD | General Acute Care Hospital | $170–$2,190 bundled est. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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AVERA MCKENNAN
6058358394 |
GREGORY, SD | Critical Access Hospital | $170–$2,190 bundled est. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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AVERA MCKENNAN
6059972433 |
FLANDREAU, SD | Critical Access Hospital | $170–$2,190 bundled est. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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AVERA MCKENNAN
6054324538 |
MILBANK, SD | Critical Access Hospital | $170–$2,190 bundled est. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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AVERA MCKENNAN
6053226400 |
SIOUX FALLS, SD | General Acute Care Hospital | $170–$2,190 bundled est. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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AVERA MCKENNAN
6053226400 |
SIOUX FALLS, SD | General Acute Care Hospital | $170–$2,190 bundled est. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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AVERA MCKENNAN
6053226400 |
SIOUX FALLS, SD | General Acute Care Hospital | $170–$2,190 bundled est. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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AVERA MCKENNAN
6058532421 |
MILLER, SD | Critical Access Hospital | $170–$2,190 bundled est. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Est. cost = bundled estimate (facility fee + professional fee + anesthesia where applicable) based on CMS fee schedules and commercial rate multipliers. Contact each provider for an actual quote.
Source: CMS NPPES NPI Registry. NPI numbers can be verified at npiregistry.cms.hhs.gov.
What matters before you schedule
What's on your bill
A emergency room visit involves multiple providers who bill separately - typically ED Facility Fee, Emergency Physician Professional Fee, Labs. Check each line item against your Explanation of Benefits to catch billing errors.
Cost by type
Which type your doctor orders for this emergency room visit changes the billing code, and what you pay. For example: A recognized variation that can change the billing code and what you owe.
Separate bills
A emergency room visit involves the facility, the operating physician, and often ancillary providers - each bills independently, and any one of them may be out-of-network even if the facility isn't. The No Surprises Act limits your exposure in many scenarios, but ask the facility to confirm every participating provider is in-network before your visit.
What to ask before you book
Get the CPT code from your doctor, confirm every provider involved (not just the facility) is in-network, ask for the cash-pay rate if you're uninsured or haven't met your deductible, and request a written estimate for emergency room visit before you schedule.
CostKits compiles hospital price transparency data to help families make informed decisions. Track and manage your healthcare costs (free account).
One ER visit typically generates 3–5 separate bills. Most patients learn this weeks later.
Your personalized cost report includes:
- ✓ Why a single visit becomes multiple bills - and which ones to scrutinize
- ✓ How the No Surprises Act limits your liability for out-of-network emergency care
- ✓ What "observation status" means and why it can cost you thousands extra
- ✓ The exact language to use when disputing ER charges
- ✓ A real patient billing breakdown, line by line
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About the Author
John Caruso, FSA, MAAA
Healthcare actuary with 20+ years of experience in insurance pricing, medical billing systems, and healthcare cost analytics.
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