South Dakota · 72050

X-Ray Of Upper Spine, 4-5 Views in South Dakota

South Dakota Medicare Avg
$23.08
5% below national avg
National Medicare Avg
$24.42
All states combined
Billed Charge (SD)
$126.04
What providers submit
Est. Commercial (SD)
$66.39
National avg: $75.32
Est. Cash / Self-Pay (SD)
$58.95
Typical self-pay discount

Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.

1.3K
Services in SD
215
Providers
N/A
Min Payment
N/A
Max Payment

South Dakota Pricing in Context

In South Dakota, CPT code 72050 (X-Ray Of Upper Spine, 4-5 Views) carries an average Medicare payment of $23.08 — 5% below the national benchmark of $24.42. 215 providers across the state submitted claims for this procedure in 2023, performing 1.3K total services. Individual payments in SD ranged from N/A at the low end to N/A at the high end, reflecting differences in provider setting (office vs. facility), modifiers, and the specific geographic locality code applied within the state.

The average billed charge in South Dakota is $126.04, which is the figure uninsured patients would most likely encounter before any negotiation or charity discount. Medicare, by statute, only reimburses the allowed amount — the balance between billed and paid is written off under provider participation agreements. Insured patients generally pay a negotiated rate that falls between these two figures; the exact amount depends on plan design, deductible status, and in-network participation. Because South Dakota sits below the national Medicare average, commercial rates in the state may also run lower than the US median.

Using RAND 2024 commercial-to-Medicare ratios for X-Ray procedures, the estimated commercial insurance price in South Dakota lands near $66.39, with self-pay cash prices typically around $58.95. Before scheduling, patients can request a Good Faith Estimate under the No Surprises Act, compare cash rates from hospital Machine-Readable Files, and confirm whether the provider is in-network with their specific plan. This page presents CMS reference data for informational use; it does not constitute medical or financial advice.

Frequently Asked Questions

How much does X-Ray Of Upper Spine, 4-5 Views cost in South Dakota?

The average Medicare payment for X-Ray Of Upper Spine, 4-5 Views in South Dakota is $23.08, which is 5% below the national average of $24.42. Providers in SD typically bill $126.04 for this procedure.

What does X-Ray Of Upper Spine, 4-5 Views cost with insurance in South Dakota?

With commercial insurance in South Dakota, X-Ray Of Upper Spine, 4-5 Views costs an estimated $66.39. Without insurance, the estimated cash price is $58.95. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.

How many providers perform X-Ray Of Upper Spine, 4-5 Views in South Dakota?

215 providers in South Dakota billed Medicare for X-Ray Of Upper Spine, 4-5 Views in 2023, performing 1.3K total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is X-Ray Of Upper Spine, 4-5 Views cheaper in South Dakota than the national average?

Yes — X-Ray Of Upper Spine, 4-5 Views costs 5% below the national average in South Dakota. The state average Medicare payment is $23.08 compared to $24.42 nationally. Factors like local cost of living, provider competition, and regional Medicare fee schedules all influence state-level pricing.

Related

Data sourced from the CMS Medicare Physician and Other Practitioners dataset. See our methodology for details. Retrieved and formatted by PlainProcedure Editorial