CMS Price Transparency Data

X-ray, hip

Facility: Sanford Clear Lake Medical Center

Billing Code: 73502 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73502
Insurance Median: $278
Cash Discount Price: $270
vs. Medicare Baseline: 3.13x Medicare

The contracted insurance negotiated median rate for a X-ray, hip at Sanford Clear Lake Medical Center is $278. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $270. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.13x the Medicare baseline. Located in 701 Third Avenue South, Clear Lake, SD.

Cash / Self-Pay

$270

Average discount available for prompt cash payment at this facility.

Insurance Median

$278

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: $270 (304%)

Insurance Median: $278 (313%)

Cash: $270 (304% of Medicare)

Ins. Median: $278 (313% 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 313% of the Medicare baseline (a markup of 213%). 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	$173	195%
Security Health Plan	$185	208%
Ucare	$186 - $296	209%
Wellmark Sd	$186	209%
Aetna	$187 - $293	210%
Health Partners	$187 - $253	210%
Medicare (plans)	$187	210%
UnitedHealthcare	$187 - $281	210%
Primewest	$191	215%
Sanford Health Plan	$234 - $313	263%
Blue Cross Blue Shield	$276 - $312	310%
Medica	$278 - $297	313%
Wellmark	$290 - $293	326%
Cigna	$303	341%
First Choice Health Network	$303	341%
Healthez	$303	341%
Multiplan	$303	341%

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 $270.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73502.

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 73502.
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.