CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Wheatland Memorial Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $10,887
Cash Discount Price: $11,460
vs. Medicare Baseline: 12.41x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Wheatland Memorial Hospital is $10,887. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $11,460. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 12.41x the Medicare baseline. Located in 530 3Rd St Nw, Harlowton, MT.

Cash / Self-Pay

$11,460

Average discount available for prompt cash payment at this facility.

Insurance Median

$10,887

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: $11,460 (1306%)

Insurance Median: $10,887 (1241%)

Cash: $11,460 (1306% of Medicare)

Ins. Median: $10,887 (1241% 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 1241% of the Medicare baseline (a markup of 1141%). 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
Healthnet Federal-All Plans	$6,990	797%
Humana	$6,990	797%
Medica Prime Solutions-All Plans	$6,990	797%
Pacific Source Mcr Adv	$6,990	797%
Triwest-All Plans	$6,990	797%
Amish Old Orders-All Plans	$8,595	980%
Allegiance Provider-All Plans	$9,741	1110%
6 Degrees Health-All Plans	$10,887	1241%
Americas Choice-All Plans	$10,887	1241%
Community Health Ntwk-All Plans	$10,887	1241%
Fedmed Network-All Plans	$10,887	1241%
First Choice Big Sky-All Plans	$10,887	1241%
Interwest Ppo-All Plans	$10,887	1241%
Mountain Health Co-Op-All Plans	$10,887	1241%
Pacific Source-All Other Plans	$10,887	1241%
Pacific Steel & Recycling-All Plans	$10,887	1241%
Rocky Mountain Health Network-All Plans	$10,887	1241%
Three Rivers-All Plans	$10,887	1241%
First Health-All Plans	$11,001	1254%
Ccn-All Plans	$11,116	1267%
UnitedHealthcare	$11,230	1280%
City Of Billings-All Plans	$17,189	1959%

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 $11,460.
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 Wheatland Memorial Hospital 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.