CMS Price Transparency Data

X-ray, ankle

Facility: Sanford Clear Lake Medical Center

Billing Code: 73610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73610
Insurance Median: $389
Cash Discount Price: $377
vs. Medicare Baseline: 4.38x Medicare

The contracted insurance negotiated median rate for a X-ray, ankle at Sanford Clear Lake Medical Center is $389. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $377. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.38x the Medicare baseline. Located in 701 Third Avenue South, Clear Lake, SD.

Cash / Self-Pay

$377

Average discount available for prompt cash payment at this facility.

Insurance Median

$389

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$88.91

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $88.91 (100%)

Cash / Self-Pay: $377 (424%)

Insurance Median: $389 (438%)

Cash: $377 (424% of Medicare)

Ins. Median: $389 (438% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $88.91 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 438% of the Medicare baseline (a markup of 338%). 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	$242	272%
Security Health Plan	$259	291%
Ucare	$260 - $414	292%
Wellmark Sd	$260	292%
Aetna	$262 - $409	295%
Health Partners	$262 - $353	295%
Medicare (plans)	$262	295%
UnitedHealthcare	$262 - $393	295%
Primewest	$267	300%
Sanford Health Plan	$326 - $438	367%
Blue Cross Blue Shield	$385 - $436	433%
Medica	$389 - $415	438%
Wellmark	$405 - $410	456%
Cigna	$424	477%
First Choice Health Network	$424	477%
Healthez	$424	477%
Multiplan	$424	477%

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 $377.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73610.

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 73610.
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.