CMS Price Transparency Data

X-ray, foot

Facility: Sanford Clear Lake Medical Center

Billing Code: 73630 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73630
Insurance Median: $362
Cash Discount Price: $351
vs. Medicare Baseline: 4.07x Medicare

The contracted insurance negotiated median rate for a X-ray, foot at Sanford Clear Lake Medical Center is $362. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $351. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.07x the Medicare baseline. Located in 701 Third Avenue South, Clear Lake, SD.

Cash / Self-Pay

$351

Average discount available for prompt cash payment at this facility.

Insurance Median

$362

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: $351 (395%)

Insurance Median: $362 (407%)

Cash: $351 (395% of Medicare)

Ins. Median: $362 (407% 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 407% of the Medicare baseline (a markup of 307%). 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	$225	253%
Security Health Plan	$241	271%
Ucare	$242 - $386	272%
Wellmark Sd	$242	272%
Aetna	$244 - $381	274%
Health Partners	$244 - $329	274%
Medicare (plans)	$244	274%
UnitedHealthcare	$244 - $367	274%
Primewest	$249	280%
Sanford Health Plan	$304 - $408	342%
Blue Cross Blue Shield	$359 - $406	404%
Medica	$362 - $387	407%
Wellmark	$378 - $382	425%
Cigna	$395	444%
First Choice Health Network	$395	444%
Healthez	$395	444%
Multiplan	$395	444%

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 $351.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73630.

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 73630.
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.