Health care cost estimator tools
Knowing what your health care costs will be ahead of time can help you make informed decisions for both your well-being and your budget. Our health care cost estimator tools make it easy for HealthPartners plan members to understand provider costs, estimate out-of-pocket expenses and more.
How to estimate health care costs
You can get a cost estimate if you have any medical insurance plan with us (except Medicare or Medical Assistance). Just answer a few questions about the health care service you need, which health care provider you’re planning to see and where you’re planning to see them. For the most accurate estimate, ask your provider’s billing office which billing code(s) they plan to use.
Our estimator will consider your plan’s coverage, provider network, and your progress toward your
What affects your health care costs
There are several factors that can determine how much you pay for health care, including:
What your health plan covers
Health care coverage varies by plan. Knowing what’s covered by your specific health plan can help you figure out what your costs could be, including what you might have to pay out of pocket.
Which providers are in your plan’s network
Health care providers in your health plan’s network provide high-quality care at a discount, so if you see someone outside your network, you’ll often pay more. That means knowing how to find an in-network doctor is an easy way to save some money.
Where you choose to go for care
What you pay for your health care also depends on where you get it. From getting care over a video call to being seen at an emergency room, there are plenty of options. But it’s important to pick the right one depending on whether your concerns are minor, serious, chronic or immediate. Finding care at the right place can make a big difference in what you’ll pay out of pocket.
Why price transparency in health care matters
One part of making educated decisions about your health is knowing how much your care will cost. But as anyone who’s visited a clinic or hospital realizes, there are many people involved in managing your care. Prices for services often differ between providers and locations. That means your out-of-pocket costs also often differ depending on what care you need, who you see and where you go.
Recent laws enable health care organizations like us to provide more information and tools up front to help you better understand your costs in advance. This way, it’s easier to shop around and compare costs, and you can get the information you need to make more informed choices for you and your family.
More health care price transparency resources
Machine-readable files (for health care industry professionals)
The
Please note:
- For price information on specific procedures or services,
eligible members should use our cost estimators . The provider rates in the files below are not specific to a member’s benefit plan out-of-pocket cost. - The files below are very large and in formats that are impractical for direct consumer use. The goal of the Transparency in Coverage rule is to give researchers and third-party developers the comprehensive data they need to create solutions that help people understand the costs associated with health care, make better price comparisons and choose the care that’s right for them.
In-network provider-negotiated payment rates between plans and providers
These files include applicable in-network rates for certain HealthPartners networks, including rates from contracted network partners. Posted rates include negotiated rates, claims-derived amounts for providers who are reimbursed on a discount from billed charges and underlying fee schedule rates where reimbursement is based on another methodology.
| Network | Markets | National wrap? | Network file |
|---|---|---|---|
| Open Access | All | Yes* | |
| HP Select | Minnesota small group, large group, individual | Yes (small group, large group)* No (individual) | |
| TieredChoice | Minnesota small group, large group | Yes* | |
| Robin Select | NE Wisconsin small group, large group, individual | No | |
| Robin Focused | NE Wisconsin small group, large group | Yes* | |
| Robin Oak | NE Wisconsin individual | No | |
| Achieve | Minnesota large group | Yes* | |
| Achieve SE | Minnesota small group | Yes* | |
| Peak | Minnesota individual | No | |
| Cornerstone | Minnesota small group, large group, individual | Yes (small group, large group)* No (individual) |
A single employer may offer multiple networks. Employer names are repeated where applicable.
| Network | Employers | National wrap? | Network file |
|---|---|---|---|
| Coborn’s | Coborn’s | Yes* | |
| Essentia | Butler Machinery Carr's Tree Service Choice Financial Christianson Companies Cloverdale Foods East River's Edge Eventide Fargo Public School District FMI JDS Moline d/b/a Service Master by Moline Johnson Laffen Galloway Ltd d/b/a JLG Architects Northern Plains Laboratory Peterson Farms Seed SKL d/b/a Home Heating, Plumbing & Air Conditioning Small Wonders Preschool & Child Care Center Western State Agency | Depends on plan* | |
| Essentia – ND | Butler Machinery Cloverdale Foods | Yes* | |
| MercyOne Tier 1 | Academy Roofing & Sheet Metal Accel Holdings Dr Greg J McCarthy d/b/a Siouxland Podiatry Associates Forge Financial And Management Grey Dog Media Hickory Hill Farms Iowa City Reunion Kline Electric Northeast Iowa Area Agency On Aging Petroblend Prairie Lakes Church Precision Millwright Specialists Primary Health Care Siouxland Women's Health Care Tama County TKCO d/b/a Express Employment Professionals of Cedar Rapids Young Parents Network | Depends on plan* | |
| Monument Health Caregiver | Monument Health | Depends on plan* | |
| Northern School District Trust | Bayfield School District CESA 12 Crandon School District Hurley Schools Prentice School District School District of Ashland Solon Springs School District South Shore School District Winter School District | Yes* | |
| Olivia – New Business | Southern Minnesota Beet Sugar Cooperative | Yes* | |
| Spencer – Mahaska | Academy Roofing & Sheet Metal Northeast Iowa Area Agency On Aging | Depends on plan* | |
| State of Minnesota | State of Minnesota (SEGIP/PEIP) | No | |
| State of WI ETF | State of Wisconsin | No | |
| Trinity | Butler Machinery Cloverdale Foods Dakota Fence Company dba DFC | Yes* | |
| UIHC Tier 1 | Accel Holdings BGM Community School District Bob Brown Chevrolet City of Marshalltown Compass Memorial Healthcare Forge Financial And Management Consulting Hawarden Regional Healthcare Hickory Hill Farms Innovative Injection Technologies (i2Tech) Marshall County Northeast Iowa Area Agency On Aging Petroblend Prairie Lakes Church Primary Health Care Schuster Siouxland Women's Health Care Summit Agricultural Group Tama County Total Component Solutions University of Iowa Center for Advancement Wartburg College Waterloo Community School District Young Parents Network | Depends on plan* | |
| UIHC Tier 2 | Academy Roofing & Sheet Metal Dental Prosthetic Services DGR Engineering Dr Greg J McCarthy d/b/a Siouxland Podiatry Associates Earlham Community School District Grey Dog Media Iowa City Reunion Kline Electric Precision Millwright Specialists Story Construction TKCO d/b/a Express Employment Professionals of Cedar Rapids VGM Group | Depends on plan* | |
| VGM Group | VGM Group | Yes* | |
| Waterloo Community School District | Waterloo Community School District | No |
Allowed amounts for services provided by out-of-network (non-contracted) providers
This file includes historical payments to, and billed charges from, non-contracted providers. Rates are displayed only for providers with 20 or more claims to HealthPartners during the previous three-month reporting period.