CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Sanford Canton-Inwood Medical Center - Cah

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $3,663
Cash Discount Price: $3,947
vs. Medicare Baseline: 4.18x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Sanford Canton-Inwood Medical Center - Cah is $3,663. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,947. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 4.18x the Medicare baseline. Located in 440 North Hiawatha Drive, Canton, SD.

Cash / Self-Pay

$3,947

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,663

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: $3,947 (450%)

Insurance Median: $3,663 (418%)

Cash: $3,947 (450% of Medicare)

Ins. Median: $3,663 (418% 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 418% of the Medicare baseline (a markup of 318%). 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
Sanford Health Plan Align	$1,687	192%
Ucare	$1,811 - $4,335	206%
Wellmark	$1,811 - $4,293	206%
Aetna	$1,831 - $4,288	209%
Health Partners	$1,831 - $3,700	209%
Medicare (plans)	$1,831	209%
UnitedHealthcare	$1,831 - $4,120	209%
Primewest	$1,865	213%
Sanford Health Plan	$2,703 - $3,626	308%
Security Health Plan	$2,714	309%
Medica	$4,071 - $4,352	464%
First Choice Health Network	$4,441	506%
Healthez	$4,441	506%
Multiplan	$4,441	506%

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 $3,947.
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 Sanford Canton-Inwood Medical Center - Cah 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.