CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Sanford Worthington Medical Center

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $2,994
Cash Discount Price: $3,722
vs. Medicare Baseline: 3.41x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Sanford Worthington Medical Center is $2,994. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,722. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 3.41x the Medicare baseline. Located in 1018 Sixth Avenue Po Box 997, Worthington, MN.

Cash / Self-Pay

$3,722

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,994

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: $3,722 (424%)

Insurance Median: $2,994 (341%)

Cash: $3,722 (424% of Medicare)

Ins. Median: $2,994 (341% 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 341% of the Medicare baseline (a markup of 241%). 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
Blue Cross Blue Shield	$771 - $2,847	88%
Sanford Health Plan Align	$949	108%
Ucare	$1,018 - $4,274	116%
Aetna	$1,028 - $4,488	117%
Health Partners	$1,028 - $3,886	117%
Medicare (plans)	$1,028	117%
UnitedHealthcare	$1,028 - $4,570	117%
Primewest	$1,048 - $1,119	119%
Sanford Health Plan	$1,486 - $2,496	169%
Security Health Plan	$2,108 - $3,010	240%
Medica	$3,419 - $5,227	390%
First Choice Health Network	$3,450 - $4,926	393%
Healthez	$3,450 - $4,926	393%
Multiplan	$3,450 - $4,926	393%

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 $3,722.
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 Sanford Worthington 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.