CMS Price Transparency Data

X-ray, lower back

Facility: Sanford Clear Lake Medical Center

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72110
  • Insurance Median: $637
  • Cash Discount Price: $618
  • vs. Medicare Baseline: 5.96x Medicare
The contracted insurance negotiated median rate for a X-ray, lower back at Sanford Clear Lake Medical Center is $637. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $618. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.96x the Medicare baseline. Located in 701 Third Avenue South, Clear Lake, SD.
Cash / Self-Pay
$618

Average discount available for prompt cash payment at this facility.

Insurance Median
$637

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: $618 (579%)
Insurance Median: $637 (596%)
Cash: $618 (579% of Medicare)
Ins. Median: $637 (596% 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 596% of the Medicare baseline (a markup of 496%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 $396 371%
Security Health Plan $425 398%
Ucare $425 - $678 398%
Wellmark Sd $425 398%
Aetna $429 - $671 402%
Health Partners $429 - $579 402%
Medicare (plans) $429 402%
UnitedHealthcare $429 - $645 402%
Primewest $438 410%
Sanford Health Plan $535 - $718 501%
Blue Cross Blue Shield $632 - $714 592%
Medica $637 - $681 596%
Wellmark $664 - $672 622%
Cigna $695 651%
First Choice Health Network $695 651%
Healthez $695 651%
Multiplan $695 651%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 701 Third Avenue South, Clear Lake, SD 57226
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals