CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: Sanford Clear Lake Medical Center

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76705
Insurance Median: $789
Cash Discount Price: $765
vs. Medicare Baseline: 7.39x Medicare

The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at Sanford Clear Lake Medical Center is $789. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $765. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.39x the Medicare baseline. Located in 701 Third Avenue South, Clear Lake, SD.

Cash / Self-Pay

$765

Average discount available for prompt cash payment at this facility.

Insurance Median

$789

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: $765 (716%)

Insurance Median: $789 (739%)

Cash: $765 (716% of Medicare)

Ins. Median: $789 (739% 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 739% of the Medicare baseline (a markup of 639%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

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

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Sanford Health Plan Align	$490	459%
Security Health Plan	$526	492%
Ucare	$527 - $840	493%
Wellmark Sd	$527	493%
Aetna	$532 - $831	498%
Health Partners	$532 - $717	498%
Medicare (plans)	$532	498%
UnitedHealthcare	$532 - $798	498%
Primewest	$542	507%
Sanford Health Plan	$663 - $889	621%
Blue Cross Blue Shield	$782 - $884	732%
Medica	$789 - $843	739%
Wellmark	$822 - $832	770%
Cigna	$860	805%
First Choice Health Network	$860	805%
Healthez	$860	805%
Multiplan	$860	805%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $765.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 76705.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Sanford Clear Lake Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 76705.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.