CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Sanford Clear Lake Medical Center

Billing Code: 72131 (CPT)

The BaseRate · fair price medium confidence
A fair price for this
$149
about 1.4× the $107 Medicare rate · typically $101–$719
modeled estimate · not a bill or quote
What this hospital charges insurers
$705
Well above the fair price
about $556 over the fair price · 6.6× Medicare
Medicare pays $107 Fair price $149 This hospital $705 Cash price $2,539 Hospital's list price $3,174

How we calculate the fair BaseRate →

How this hospital compares to other SD hospitals

Highest price of the 9 SD hospitals we have prices for — worth calling around.

Cheapest $94 Priciest $705

Black dot = this hospital, among the 9 SD hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a CT scan, lower back (lumbar spine) is about $149 (about 1.4× the $107 Medicare rate). Sanford Clear Lake Medical Center charges insurers about $705, or about $2,539 in cash — well above the fair price. Located in Clear Lake, SD.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $149. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $1,765 - $2,650 1652%
Blue Cross Blue Shieldmajor $705 - $2,761 660%
Aetnamajor $1,765 - $2,758 1652%
Cignamajor $2,857 2675%
Health Net $2,857 2675%
HealthPartners $1,765 - $2,380 1652%
Medica $2,619 - $2,799 2452%
Sanford Health Plan $1,628 - $2,952 1524%
Security Health Plan $1,746 1635%
UCare $1,749 - $2,789 1637%
+ 2 smaller / regional plans $1,800 - $2,857
Government programs also on file: Medicare.
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Insurance Before you use insurance

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

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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