CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Sanford Clear Lake Medical Center

Billing Code: 77067 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$114

about 0.9× the $126 Medicare rate · typically $74–$287

modeled estimate · not a bill or quote

What this hospital charges insurers

$330

Well above the fair price

about $216 over the fair price · 2.6× Medicare

Medicare pays $126 Fair price $114 This hospital $330 Cash price $487 Hospital's list price $609

How we calculate the fair BaseRate →

How this hospital compares to other SD hospitals

Highest price of the 8 SD hospitals we have prices for — worth calling around.

Cheapest $88 Priciest $330

Black dot = this hospital, among the 8 SD hospitals with a price for this procedure. Full list below.

A fair price for a Screening mammogram (both breasts) is about $114 (about 0.9× the $126 Medicare rate). Sanford Clear Lake Medical Center charges insurers about $330, or about $487 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 $114. 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	$339 - $509	269%
Blue Cross Blue Shieldmajor	$330 - $530	261%
Aetnamajor	$339 - $529	269%
Cignamajor	$548	434%
Health Net	$548	434%
HealthPartners	$339 - $457	269%
Medica	$502 - $537	398%
Sanford Health Plan	$312 - $566	247%
Security Health Plan	$335	265%
UCare	$336 - $535	266%
+ 2 smaller / regional plans	$345 - $548

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

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 487), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 77067.

Insurance Before you use insurance

Call your insurance company to confirm Sanford Clear Lake Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 77067.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

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

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Sanford Clear Lake Medical Center

Compare: Screening mammogram (both breasts) at other SD hospitals

Insurance negotiated median for the same procedure, sorted lowest first.