CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Sanford Clear Lake Medical Center

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 95810
  • Insurance Median: $4,497
  • Cash Discount Price: $4,361
  • vs. Medicare Baseline: 5.13x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Sanford Clear Lake Medical Center is $4,497. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,361. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 5.13x the Medicare baseline. Located in 701 Third Avenue South, Clear Lake, SD.
Cash / Self-Pay
$4,361

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,497

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: $4,361 (497%)
Insurance Median: $4,497 (513%)
Cash: $4,361 (497% of Medicare)
Ins. Median: $4,497 (513% 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 513% of the Medicare baseline (a markup of 413%). 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
Sanford Health Plan Align $2,796 319%
Security Health Plan $2,998 342%
Ucare $3,004 - $4,789 342%
Wellmark Sd $3,004 342%
Aetna $3,031 - $4,737 345%
Health Partners $3,031 - $4,088 345%
Medicare (plans) $3,031 345%
UnitedHealthcare $3,031 - $4,552 345%
Primewest $3,091 352%
Sanford Health Plan $3,779 - $5,069 431%
Blue Cross Blue Shield $4,459 - $5,043 508%
Medica $4,497 - $4,808 513%
Wellmark $4,688 - $4,742 534%
Cigna $4,906 559%
First Choice Health Network $4,906 559%
Healthez $4,906 559%
Multiplan $4,906 559%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 701 Third Avenue South, Clear Lake, SD 57226
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals