CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Gundersen Moundview Hospital and Clinics

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $3,164
Cash Discount Price: $3,382
vs. Medicare Baseline: 3.61x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Gundersen Moundview Hospital and Clinics is $3,164. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,382. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 3.61x the Medicare baseline. Located in 402 W Lake St, Friendship, WI.

Cash / Self-Pay

$3,382

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,164

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: $3,382 (385%)

Insurance Median: $3,164 (361%)

Cash: $3,382 (385% of Medicare)

Ins. Median: $3,164 (361% 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 361% of the Medicare baseline (a markup of 261%). 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
Amerigroup	$330	38%
UnitedHealthcare	$1,591	181%
Blue Cross Blue Shield	$2,367 - $3,214	270%
Iowa Total Care	$2,367	270%
Managed Health Service	$2,367	270%
Health Partners	$3,032 - $5,821	346%
Security Health Plan	$3,032	346%
Ucare	$3,032 - $5,274	346%
Quartz	$3,593	410%
Wps	$5,082	579%
Wps - Arise	$5,082	579%
Dean Health Plan	$5,241	597%
Aspirus Arise Health	$5,471	624%
Humana	$5,603	639%
Multiplan/Healtheos	$5,801 - $6,328	661%
Coventry Health Care	$6,262	714%

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 $3,382.
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 Gundersen Moundview Hospital and Clinics 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.