Hospital prices in South Dakota

15 South Dakota hospitals reported 21,042 Medicare inpatient stays in 2024. The median hospital charged 3.53 times what it was paid — below the national median of 4.15×, number 33 of 51. The widest gap was at Avera Heart Hospital of South Dakota (5.94×), the narrowest at Prairie Lakes Hospital (2.25×). CMS's price-transparency list records 112 enforcement actions involving 56 South Dakota hospitals.

1Median charge ÷ paid 3.53×
2Hospitals reporting 16
3Medicare inpatient stays 21,042
4Price-transparency actions 112

Inpatient charge-to-payment ratio, the 15 South Dakota hospitals with the widest gap (100+ Medicare stays), bars to scale. Source: CMS DY2024.

Most common stays in South Dakota

DRG	Stays	SD avg charge	US avg charge	SD avg paid
871 Septicemia or Severe Sepsis without MV >96 Hours with...	1,761	$67,007	$90,297	$17,025
291 Heart Failure and Shock with MCC	888	$44,214	$56,380	$11,100
470 Major Hip and Knee Joint Replacement or Reattachment of...	678	$52,397	$93,184	$13,781
189 Pulmonary Edema and Respiratory Failure	502	$47,652	$57,570	$11,675
193 Simple Pneumonia and Pleurisy with MCC	482	$41,232	$59,757	$11,334
177 Respiratory Infections and Inflammations with MCC	466	$53,881	$70,592	$14,370
885 Psychoses	379	$33,069	$44,040	$12,028
481 Hip and Femur Procedures except Major Joint with CC	365	$71,440	$100,756	$17,602
378 Gastrointestinal Hemorrhage with CC	350	$35,864	$48,550	$8,702
322 Percutaneous Cardiovascular Procedures with Intraluminal...	341	$92,229	$114,560	$15,395

Every hospital

Hospital	Stays	Ratio	Actions
Sanford Usd Medical Center Sioux Falls	5,684	4.56×	5
Avera Mckennan Hospital & University Health Center Sioux Falls	5,621	4.93×	5
Monument Health Rapid City Hospital Rapid City	4,633	3.68×	3
Avera Heart Hospital of South Dakota Sioux Falls	1,405	5.94×	–
Avera St Lukes Aberdeen	872	4.2×	–
Black Hills Surgical Hospital LLC Rapid City	738	3.28×	–
Avera Sacred Heart Hospital Yankton	613	2.87×	4
Prairie Lakes Hospital Watertown	560	2.25×	2
Avera St Mary's Hospital Pierre	200	3.38×	1
Sanford Aberdeen Medical Center Aberdeen	187	2.56×	4
Sioux Falls Specialty Hospital Llp Sioux Falls	185	4.04×	1
Brookings Health System Brookings	147	2.84×	6
Monument Health Spearfish Hospital Spearfish	98	2.44×	2
Dunes Surgical Hospital Dakota Dunes	85	4×	1
Pine Ridge Ihs Hospital Pine Ridge	14	1.18×	–
Same Day Surgery Center LLC Rapid City	0	–	–

Price-transparency enforcement in South Dakota

40 “met requirements” findings, 31 warning notices, 26 closure notices, 15 corrective-action-plan requests — CMS's actions under the hospital price-transparency rule since 2021. See the enforcement page for what each step means.

Sources: CMS Medicare Inpatient Hospitals — by Provider and Service / by Geography and Service, data year 2024; CMS Hospital Price Transparency Enforcement Activities and Outcomes, July 2026. Checked 2026-10-24. Methodology.