CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Essentia Health St Mary's Medical Center

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 95810
  • Insurance Median: $2,065
  • Cash Discount Price: $3,178
  • vs. Medicare Baseline: 2.35x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Essentia Health St Mary's Medical Center is $2,065. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,178. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 2.35x the Medicare baseline. Located in 402 East Second Street, Duluth, MN.
Cash / Self-Pay
$3,178

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,065

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: $3,178 (362%)
Insurance Median: $2,065 (235%)
Cash: $3,178 (362% of Medicare)
Ins. Median: $2,065 (235% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 235% of the Medicare baseline (a markup of 135%). 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
Primewest $1,008 115%
Itasca Med Care $1,017 116%
Advocare/Security Health $1,020 116%
Blue Cross Blue Shield $1,020 - $3,659 116%
Freedom Blue Ppo $1,020 116%
Healthpartners Care Msho / Mcr Adv $1,020 116%
Imcare Msho (Ref Req) $1,020 116%
Imcare Msho Pcc Prime $1,020 116%
Imcare Msho Ref Req $1,020 116%
Medica Advantage Solutions $1,020 116%
Medica Msho/Dual Solutions $1,020 116%
Medica Prime Solution Group $1,020 116%
Medicare (plans) $1,020 116%
Nd Va Administration $1,020 116%
Platinum Blue / Vantage Blue $1,020 116%
Primewest Msho $1,020 116%
Secure Blue Msho $1,020 116%
Ubh Cost Plan $1,020 116%
Ubh Msho $1,020 116%
Ucare Msho $1,020 116%
UnitedHealthcare $1,020 - $3,525 116%
Medica Access $1,594 182%
Sanford Health Plan $1,802 - $2,174 205%
Healthpartners Care Pmap $1,916 218%
Blue Plus Pmap Pcc Prime $2,126 242%
Medica $2,663 - $2,735 304%
Medica Uplan $2,663 304%
Healthpartners $2,884 - $3,443 329%
Medica Choice $2,942 335%
Ucare $3,168 361%
Cigna $3,443 392%
Healthpartners Pcc Prime $3,443 392%
Wea $3,467 - $3,708 395%
Security Health $3,708 423%
America'S Ppo $3,732 425%
Wps $4,045 461%
Aetna $4,093 467%
Healthscope Benefits $4,093 467%
Healtheos $4,141 472%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 402 East Second Street, Duluth, MN 55805
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals