CMS Price Transparency Data

X-ray, lower back

Facility: Sanford Usd Medical Center

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72110
  • Insurance Median: $352
  • Cash Discount Price: $776
  • vs. Medicare Baseline: 3.30x Medicare
The contracted insurance negotiated median rate for a X-ray, lower back at Sanford Usd Medical Center is $352. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $776. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.30x the Medicare baseline. Located in 1305 W 18Th St Post Office Box 5039, Sioux Falls, SD.
Cash / Self-Pay
$776

Average discount available for prompt cash payment at this facility.

Insurance Median
$352

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)
Cash / Self-Pay: $776 (727%)
Insurance Median: $352 (330%)
Cash: $776 (727% of Medicare)
Ins. Median: $352 (330% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 330% of the Medicare baseline (a markup of 230%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Blue Cross Blue Shield $49 - $138 46%
Sanford Health Plan $52 49%
Sanford Health Plan Align $101 95%
Ucare $108 - $682 101%
Aetna $110 - $742 103%
Health Partners $110 - $378 103%
Medicare (plans) $110 103%
UnitedHealthcare $110 - $855 103%
Primewest $112 - $115 105%
Security Health Plan $534 500%
Medica $654 - $699 612%
First Choice Health Network $873 817%
Healthez $873 817%
Multiplan $873 817%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1305 W 18Th St Post Office Box 5039, Sioux Falls, SD 57117
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals