Does Monument Health Custer Hospital publish its standard charges and chargemaster?

Yes. Monument Health Custer Hospital publishes a machine-readable file with 43,955 standard-charge rows — gross charges, cash prices, and payer-negotiated rates, earning a CMS price transparency compliance grade of A. Browse the negotiated rates by procedure and payer on this page.

How much does Monument Health Custer Hospital charge for procedures?

Monument Health Custer Hospital (Custer, SD) publishes a separately negotiated rate for each insurance payer, plus a discounted cash price and a gross (list) charge, for every procedure in its price transparency file. This page compares each procedure's negotiated median against the national median so you can see whether a price is above or below market.

▸ Hospital · SD · CCN 431323

Monument Health Custer Hospital

Custer, SD, 57730-

12 bedsCritical Access Hospitals2

Compliance grade

100/100

Rates published

43,955

last crawl 2026-05-24

Procedures tracked

of 209 target codes

Payers

with negotiated rates

Procedures tracked

...

Payers

...

▸ Compare with other hospitals All SD hospitalsJSON

The report bundles all published codes × every payer rate + compliance grade as a downloadable PDF + CSV with a data-version manifest.

Source MRF: https://monument.health/wp-content/uploads/2025/02/460360899_Monument-Health-Network-Inc-Custer-Hospital_standardcharges.csv · CSV

Procedures & rates

vs nat'l shows this hospital's negotiated median against the national median for that code (green = at/below market, amber = 1–1.5×, red = >1.5× the national median).

Procedure	Type	Code	Payers	Gross	Cash	Neg min	Neg median	vs nat'l	Neg max
behavioral
Psychiatric diagnostic evaluation	CPT	90791	3	$529	$529	$148.12	$151.82	0.86×	$151.82
Psychotherapy 30 minutes	CPT	90832	3	$229	$229	$64.12	$65.72	0.44×	$65.72
Psychotherapy 45 minutes	CPT	90834	3	$302	$302	$84.56	$86.67	0.54×	$86.67
Psychotherapy 60 minutes	CPT	90837	3	$445	$445	$124.6	$127.72	0.67×	$127.72
emergency
ED visit level 1	CPT	99281	35	$319	$319	$48.61	$312.62	2.2×	$319
ED visit level 2	CPT	99282	35	$509	$509	$78.4	$498.82	2.1×	$509
ED visit level 3	CPT	99283	35	$817	$817	$85.12	$792.49	2.0×	$817
ED visit level 4	CPT	99284	35	$1,327	$1,327	$127.12	$1,287.19	1.9×	$1,327
ED visit level 5	CPT	99285	35	$1,892	$1,892	$190.68	$1,835.24	1.8×	$1,892
Critical care, first hour	CPT	99291	35	$2,868	$2,868	$329.28	$2,810.64	2.6×	$2,868
imaging
CT head without contrast	CPT	70450	35	$2,163	$2,163	$405.54	$2,119.74	10.2×	$2,163
CT head with and without contrast	CPT	70470	35	$3,266	$3,266	$590.56	$3,200.68	12.0×	$3,266
CT neck with contrast	CPT	70491	35	$2,931	$2,931	$502.72	$2,872.38	10.5×	$2,931
MRI brain without contrast	CPT	70551	35	$3,740	$3,740	$1,027.87	$3,665.2	9.1×	$3,740
MRI brain with and without contrast	CPT	70553	35	$5,035	$5,035	$1,308.2	$4,934.3	8.4×	$5,035
Chest X-ray single view	CPT	71045	35	$407	$407	$44.85	$398.86	4.2×	$407
Chest X-ray 2 views	CPT	71046	35	$428	$428	$59.8	$419.44	4.3×	$428
CT chest without contrast	CPT	71250	35	$2,319	$2,319	$493.38	$2,272.62	10.6×	$2,319
CT chest with contrast	CPT	71260	35	$3,110	$3,110	$568.13	$3,047.8	10.8×	$3,110
Lumbosacral spine X-ray	CPT	72100	35	$452	$452	$61.67	$442.96	4.3×	$452
CT cervical spine without contrast	CPT	72125	35	$2,319	$2,319	$485.9	$2,272.62	11.3×	$2,319
CT thoracic spine without contrast	CPT	72128	35	$2,319	$2,319	$485.9	$2,272.62	11.4×	$2,319
CT lumbar spine without contrast	CPT	72131	35	$2,268	$2,268	$485.9	$2,222.64	10.9×	$2,268
MRI cervical spine without contrast	CPT	72141	35	$3,808	$3,808	$1,027.87	$3,731.84	9.4×	$3,808
MRI thoracic spine without contrast	CPT	72146	35	$3,808	$3,808	$1,027.87	$3,731.84	10.0×	$3,808
MRI lumbar spine without contrast	CPT	72148	35	$3,808	$3,808	$1,027.87	$3,731.84	9.9×	$3,808
MRI cervical spine with and without contrast	CPT	72156	35	$5,002	$5,002	$1,308.2	$4,901.96	9.1×	$5,002
MRI lumbar spine with contrast	CPT	72158	35	$5,138	$5,138	$1,308.2	$5,035.24	9.2×	$5,138
CT pelvis without contrast	CPT	72192	35	$2,099	$2,099	$476.56	$2,057.02	10.3×	$2,099
CT pelvis with contrast	CPT	72193	35	$2,573	$2,573	$532.63	$2,521.54	9.0×	$2,573
Shoulder X-ray	CPT	73030	35	$398	$398	$11.2	$386.06	4.2×	$398
Humerus X-ray	CPT	73060	35	$341	$341	$52.33	$334.18	3.7×	$341
Hand X-ray 3 views	CPT	73130	35	$349	$349	$52.33	$342.02	3.7×	$349
MRI upper extremity joint without contrast	CPT	73221	35	$4,183	$4,183	$1,027.87	$4,099.34	9.9×	$4,183
MRI upper extremity joint with and without contrast	CPT	73223	35	$4,978	$4,978	$1,308.2	$4,878.44	8.0×	$4,978
Knee X-ray 1-2 views	CPT	73560	35	$314	$314	$46.72	$307.72	3.3×	$314
Ankle X-ray 3 views	CPT	73610	35	$325	$325	$52.33	$318.5	3.5×	$325
MRI lower extremity joint without contrast	CPT	73721	35	$3,692	$3,692	$1,027.87	$3,618.16	7.7×	$3,692
CT abdomen without contrast	CPT	74150	35	$2,257	$2,257	$467.22	$2,211.86	11.8×	$2,257
CT abdomen with contrast	CPT	74160	35	$3,545	$3,545	$556.92	$3,474.1	12.1×	$3,545
CT abdomen with and without contrast	CPT	74170	35	$3,976	$3,976	$672.79	$3,896.48	11.6×	$3,976
CT abdomen and pelvis without contrast	CPT	74176	35	$4,158	$4,158	$388.72	$4,074.84	11.2×	$4,158
CT abdomen and pelvis with contrast	CPT	74177	35	$5,471	$5,471	$609.25	$5,361.58	9.8×	$5,471
CT abdomen and pelvis with and without contrast	CPT	74178	35	$5,294	$5,294	$771.84	$5,188.12	9.0×	$5,294
MRI abdomen without contrast	CPT	74181	35	$4,171	$4,171	$1,027.87	$4,087.58	10.5×	$4,171
MRI abdomen with and without contrast	CPT	74183	35	$5,073	$5,073	$1,308.2	$4,971.54	8.8×	$5,073
Abdominal ultrasound complete	CPT	76700	35	$1,344	$1,344	$192.49	$1,317.12	8.8×	$1,344
Abdominal ultrasound limited	CPT	76705	35	$1,025	$1,025	$143.9	$1,004.5	6.9×	$1,025
Retroperitoneal ultrasound complete	CPT	76770	35	$1,025	$1,025	$186.89	$1,004.5	7.0×	$1,025
Obstetric ultrasound first trimester	CPT	76801	35	$577	$577	$149.51	$565.46	4.0×	$577
Obstetric ultrasound after first trimester	CPT	76805	35	$569	$569	$159.32	$557.62	3.7×	$569
Transvaginal ultrasound	CPT	76830	35	$675	$675	$186.89	$661.5	4.5×	$675
Pelvic ultrasound complete	CPT	76856	35	$1,199	$1,199	$168.2	$1,175.02	8.2×	$1,199
Scrotal ultrasound	CPT	76870	35	$1,147	$1,147	$149.51	$1,124.06	8.6×	$1,147
Screening mammography bilateral	CPT	77067	35	$564	$564	$124.73	$552.72	3.5×	$564
EKG complete	CPT	93000	3	$51	$51	$13.72	$14.17	0.58×	$14.64
EKG tracing only	CPT	93005	35	$281	$281	$25.75	$275.38	2.3×	$281
EKG interpretation only	CPT	93010	3	$25	$25	$7	$7.18	0.40×	$7.18
Transthoracic echocardiogram complete	CPT	93306	35	$2,796	$2,796	$470.02	$2,740.08	4.6×	$2,796
lab
Basic metabolic panel (BMP)	CPT	80048	35	$172	$172	$13.54	$166.84	5.1×	$172
General health panel	CPT	80050	35	$293	$293	$61.72	$284.21	2.6×	$293
Electrolyte panel	CPT	80051	35	$120	$120	$11.37	$116.4	4.9×	$120
Comprehensive metabolic panel	CPT	80053	35	$192	$192	$16.78	$186.24	4.2×	$192
Lipid panel	CPT	80061	35	$129	$129	$21.66	$125.13	3.3×	$129
Renal function panel	CPT	80069	35	$167	$167	$14.08	$161.99	5.9×	$167
Hepatic function panel	CPT	80076	35	$167	$167	$12.99	$161.99	6.1×	$167
Urinalysis automated	CPT	81003	35	$47	$47	$3.79	$45.59	3.3×	$47
Glucose quantitative	CPT	82947	35	$71	$71	$6.5	$68.87	3.9×	$71
Hemoglobin A1c	CPT	83036	35	$88	$88	$11.48	$40.59	1.5×	$88
Thyroid stimulating hormone (TSH)	CPT	84443	35	$192	$192	$7.56	$104	2.2×	$192
Complete blood count with automated differential	CPT	85025	35	$129	$129	$12.45	$125.13	4.7×	$129
Complete blood count without differential	CPT	85027	35	$102	$102	$10.29	$98.94	4.6×	$102
Urine culture identification	CPT	87088	35	$77	$77	$12.99	$74.69	3.4×	$77
Tissue exam by pathologist level IV	CPT	88305	35	$323	$323	$63.28	$222.72	2.2×	$323
office
Office visit, new patient, 15-29 min	CPT	99202	3	$216	$216	$60.48	$61.99	0.72×	$61.99
Office visit, new patient, 30-44 minutes	CPT	99203	3	$330	$330	$92.4	$94.71	0.77×	$94.71
Office visit, new patient, 45-59 min	CPT	99204	3	$492	$492	$137.76	$141.2	0.81×	$141.2
Office visit, new patient, 60-74 min	CPT	99205	3	$651	$651	$182.28	$186.84	0.84×	$186.84
Office visit, established patient, 5 min	CPT	99211	3	$70	$70	$19.6	$20.09	0.31×	$20.09
Office visit, established patient, 10-19 min	CPT	99212	3	$168	$168	$47.04	$48.22	0.60×	$48.22
Office visit, established patient, 20-29 minutes	CPT	99213	3	$269	$269	$75.32	$77.2	0.67×	$77.2
Office visit, established patient, 30-39 minutes	CPT	99214	3	$381	$381	$106.68	$109.35	0.72×	$109.35
Office visit, established patient, 40-54 min	CPT	99215	3	$535	$535	$149.8	$153.55	0.82×	$153.55

Rate history available after the next quarterly refresh. We re-crawl all hospital MRFs each quarter to track rate changes over time.

Payer mix (top 30)

Payer	Codes covered	Median rate
Blue Cross Blue Shield	83	$385.73
UnitedHealthcare	83	$661.5
Medicare	83	$145.32
Cigna	68	$1,014.75
coresource 38225 [3081146]	68	$922.5
employee benefit management 12x44 [3081079]	68	$922.5
fedmed inc [3081283]	68	$994.25
govt employees health assn [3081090]	68	$1,004.5
group and pension administrators inc [3081098]	68	$994.25
Health Net	68	$287
health partners sx009 [3081102]	68	$1,004.5
healthpartners [3081368]	68	$1,004.5
Humana	68	$1,025
key benefit administrators [3081332]	68	$1,014.75
medica (commercial) 94265 [3081118]	68	$1,004.5
Meritain Health	68	$1,014.75
midlands choice 47080 [3081136]	68	$1,014.75
Multiplan	68	$994.25
national telephone cooperative assn 52103 [3081149]	68	$1,004.5
pacificsource health plans [3081333]	68	$922.5
preferred one 41147 [3081160]	68	$1,014.75
risk admin svs [3081167]	68	$407.2
rocky mountain admin llc 83028 [3081168]	68	$922.5
sanford health plan 91184 [3081174]	68	$994.25
surest [3081369]	68	$1,004.5
tlc advantage llc [3081189]	68	$963.5
TRICARE	68	$415.03
triwest healthcare alliance [3081322]	68	$287
va black hills health care system 12115 [3081206]	68	$287
va black hills health care system 12115 [3081207]	68	$287

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