CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Sanford Clear Lake Medical Center

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74176
  • Insurance Median: $4,170
  • Cash Discount Price: $4,067
  • vs. Medicare Baseline: 17.11x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Sanford Clear Lake Medical Center is $4,170. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,067. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 17.11x the Medicare baseline. Located in 701 Third Avenue South, Clear Lake, SD.
Cash / Self-Pay
$4,067

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,170

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)
Cash / Self-Pay: $4,067 (1668%)
Insurance Median: $4,170 (1711%)
Cash: $4,067 (1668% of Medicare)
Ins. Median: $4,170 (1711% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $243.77 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 1711% of the Medicare baseline (a markup of 1611%). 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 $1,156 474%
Sanford Health Plan Align $2,608 1070%
Security Health Plan $2,796 1147%
Ucare $2,801 - $4,467 1149%
Wellmark Sd $2,801 1149%
Aetna $2,827 - $4,418 1160%
Health Partners $2,827 - $3,813 1160%
Medicare (plans) $2,827 1160%
UnitedHealthcare $2,827 - $4,245 1160%
Primewest $2,883 1183%
Sanford Health Plan $3,524 - $4,728 1446%
Medica $4,194 - $4,484 1720%
Wellmark $4,372 - $4,423 1793%
Cigna $4,576 1877%
First Choice Health Network $4,576 1877%
Healthez $4,576 1877%
Multiplan $4,576 1877%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 701 Third Avenue South, Clear Lake, SD 57226
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals