CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Sanford Usd Medical Center

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 95810
  • Insurance Median: $2,311
  • Cash Discount Price: $3,698
  • vs. Medicare Baseline: 2.63x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Sanford Usd Medical Center is $2,311. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,698. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 2.63x the Medicare baseline. Located in 1305 W 18Th St Post Office Box 5039, Sioux Falls, SD.
Cash / Self-Pay
$3,698

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,311

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: $3,698 (422%)
Insurance Median: $2,311 (263%)
Cash: $3,698 (422% of Medicare)
Ins. Median: $2,311 (263% 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 263% of the Medicare baseline (a markup of 163%). 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
Blue Cross Blue Shield $463 - $1,315 53%
Sanford Health Plan $623 71%
Health Partners $860 - $2,505 98%
Sanford Health Plan Align $967 110%
Ucare $1,038 - $4,514 118%
Aetna $1,048 - $4,913 119%
Medicare (plans) $1,048 119%
UnitedHealthcare $1,048 - $5,658 119%
Primewest $1,068 - $1,096 122%
Security Health Plan $1,412 - $3,532 161%
Medica $1,731 - $4,630 197%
First Choice Health Network $2,311 - $5,780 263%
Healthez $2,311 - $5,780 263%
Multiplan $2,311 - $5,780 263%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1305 W 18Th St Post Office Box 5039, Sioux Falls, SD 57117
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals