CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Essentia Health Virginia

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $2,065
Cash Discount Price: $3,024
vs. Medicare Baseline: 2.35x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Essentia Health Virginia is $2,065. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,024. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 2.35x the Medicare baseline. Located in 901 9Th Street North, Virginia, MN.

Cash / Self-Pay

$3,024

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: $3,024 (345%)

Insurance Median: $2,065 (235%)

Cash: $3,024 (345% 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.

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
Advocare/Security Health	$998	114%
Blue Cross Blue Shield	$998 - $3,716	114%
Freedom Blue Ppo	$998	114%
Healthpartners Care Msho / Mcr Adv	$998	114%
Imcare Msho Pcc Prime	$998	114%
Imcare Msho Ref Req	$998	114%
Medica Advantage Solutions	$998	114%
Medica Msho/Dual Solutions	$998	114%
Medica Prime Solution Group	$998	114%
Medicare (plans)	$998	114%
Nd Va Administration	$998	114%
Platinum Blue/Vantage Blue	$998	114%
Primewest Msho	$998	114%
Secure Blue Msho	$998	114%
Ubh Cost Plan	$998	114%
Ubh Msho	$998	114%
Ucare Msho	$998	114%
UnitedHealthcare	$998 - $4,237	114%
Primewest	$1,008	115%
Itasca Med Care	$1,017	116%
Medica Access	$1,107	126%
Sanford Healthplan	$1,802 - $2,065	205%
Healthpartners Care Pmap	$1,916	218%
Blue Plus Pmap Pcc Prime	$2,261	258%
Medica	$3,067 - $3,409	350%
Medica Uplan	$3,067	350%
Ucare	$3,168	361%
Healthpartners	$3,438 - $4,353	392%
Wea	$3,467 - $3,708	395%
Medica Choice	$3,510	400%
Security Health	$3,708	423%
America'S Ppo	$3,732	425%
Wps	$4,045	461%
Aetna	$4,093	467%
Cigna	$4,353	496%
Healthpartners Pcc Prime	$4,353	496%

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 $3,024.
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 Essentia Health Virginia 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.