CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Trinity Regional Medical Center

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $985
Cash Discount Price: $1,397
vs. Medicare Baseline: 1.12x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Trinity Regional Medical Center is $985. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,397. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.12x the Medicare baseline. Located in 802 Kenyon Rd, Fort Dodge, IA.

Cash / Self-Pay

$1,397

Average discount available for prompt cash payment at this facility.

Insurance Median

$985

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$877.34

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $877.34 (100%)

Cash / Self-Pay: $1,397 (159%)

Insurance Median: $985 (112%)

Cash: $1,397 (159% of Medicare)

Ins. Median: $985 (112% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $877.34 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.

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
Aetna	$108 - $1,587	12%
Blue Cross Blue Shield	$110 - $1,477	13%
Humana	$114 - $985	13%
UnitedHealthcare	$114 - $2,670	13%
Wellmark Uph Self-Funded	$232 - $1,255	26%
Health Partners Open Network	$246 - $1,611	28%
Cigna	$285 - $2,237	32%
Amerigroup	$867	99%
Iowa Total Care	$867	99%
Medica Exchange Insure	$1,618	184%
Medica Exchange Inspire	$2,971	339%

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 $1,397.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 95810.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Trinity Regional Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 95810.
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.