CMS Price Transparency Data

X-ray, hand

Facility: Sanford Clear Lake Medical Center

Billing Code: 73130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73130
Insurance Median: $367
Cash Discount Price: $356
vs. Medicare Baseline: 4.13x Medicare

The contracted insurance negotiated median rate for a X-ray, hand at Sanford Clear Lake Medical Center is $367. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $356. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.13x the Medicare baseline. Located in 701 Third Avenue South, Clear Lake, SD.

Cash / Self-Pay

$356

Average discount available for prompt cash payment at this facility.

Insurance Median

$367

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: $356 (400%)

Insurance Median: $367 (413%)

Cash: $356 (400% of Medicare)

Ins. Median: $367 (413% 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 413% of the Medicare baseline (a markup of 313%). 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	$228	256%
Security Health Plan	$245	276%
Ucare	$245 - $391	276%
Wellmark Sd	$245	276%
Aetna	$247 - $387	278%
Health Partners	$247 - $334	278%
Medicare (plans)	$247	278%
UnitedHealthcare	$247 - $372	278%
Primewest	$252	283%
Sanford Health Plan	$308 - $414	346%
Blue Cross Blue Shield	$364 - $412	409%
Medica	$367 - $392	413%
Wellmark	$383 - $387	431%
Cigna	$400	450%
First Choice Health Network	$400	450%
Healthez	$400	450%
Multiplan	$400	450%

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 $356.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73130.

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 73130.
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.