CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Sanford Vermillion Medical Center

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $3,612
Cash Discount Price: $4,099
vs. Medicare Baseline: 4.12x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Sanford Vermillion Medical Center is $3,612. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,099. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 4.12x the Medicare baseline. Located in 20 South Plum Street, Vermillion, SD.

Cash / Self-Pay

$4,099

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,612

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: $4,099 (467%)

Insurance Median: $3,612 (412%)

Cash: $4,099 (467% of Medicare)

Ins. Median: $3,612 (412% 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 412% of the Medicare baseline (a markup of 312%). 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	$1,512	172%
Wellmark Sd	$1,558	178%
Ucare	$1,670 - $4,502	190%
Aetna	$1,691 - $4,453	193%
Health Partners	$1,691 - $3,843	193%
Medicare (plans)	$1,691	193%
UnitedHealthcare	$1,691 - $4,279	193%
Primewest	$1,722	196%
Sanford Health Plan	$2,029 - $2,721	231%
Security Health Plan	$2,818	321%
Medica	$4,227 - $4,519	482%
Wellmark	$4,407 - $4,458	502%
First Choice Health Network	$4,612	526%
Healthez	$4,612	526%
Multiplan	$4,612	526%

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 $4,099.
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 Vermillion Medical Center 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.