CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Essentia Health

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 95810
  • Insurance Median: $1,765
  • Cash Discount Price: $2,942
  • vs. Medicare Baseline: 2.01x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Essentia Health is $1,765. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,942. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 2.01x the Medicare baseline. Located in 3000 32Nd Ave South, Fargo, ND.
Cash / Self-Pay
$2,942

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,765

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: $2,942 (335%)
Insurance Median: $1,765 (201%)
Cash: $2,942 (335% of Medicare)
Ins. Median: $1,765 (201% 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 201% of the Medicare baseline (a markup of 101%). 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%
Advocare/Security Health $1,017 116%
Blue Cross Blue Shield $1,017 - $2,389 116%
Freedom Blue Ppo $1,017 116%
Healthpartners Care Msho / Mcr Adv $1,017 116%
Imcare Msho Pcc Prime $1,017 116%
Imcare Msho Ref Req $1,017 116%
Itasca Med Care $1,017 116%
Medica Advantage Solutions $1,017 116%
Medica Msho/Dual Solutions $1,017 116%
Medica Prime Solution Group $1,017 116%
Medicare (plans) $1,017 116%
Nd Va Administration $1,017 116%
Platinum Blue/Vantage Blue $1,017 116%
Primewest Msho $1,017 116%
Secure Blue Msho $1,017 116%
Ubh Cost Plan $1,017 116%
Ubh Msho $1,017 116%
Ucare Msho $1,017 116%
UnitedHealthcare $1,017 - $3,126 116%
Medica Access $1,051 120%
Healthpartners Care Pmap $1,526 174%
Sanford Health Plan $1,682 - $1,802 192%
Medica $2,173 - $2,416 248%
Medica Uplan $2,173 248%
Medica Choice $2,487 283%
Ucare $2,581 294%
Cigna $2,628 300%
Healthpartners $2,628 300%
Healthpartners Pcc Prime $2,628 300%
Wea $2,824 - $3,020 322%
America'S Ppo $3,040 347%
Wps $3,294 375%
Aetna $3,334 380%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3000 32Nd Ave South, Fargo, ND 58104
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals