CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Southwest Health Center

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $4,384
Cash Discount Price: $4,216
vs. Medicare Baseline: 5.00x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Southwest Health Center is $4,384. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,216. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 5.00x the Medicare baseline. Located in 1400 East Side Rd, Platteville, WI.

Cash / Self-Pay

$4,216

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,384

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: $4,216 (481%)

Insurance Median: $4,384 (500%)

Cash: $4,216 (481% of Medicare)

Ins. Median: $4,384 (500% 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 500% of the Medicare baseline (a markup of 400%). 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
Blue Cross Blue Shield	$1,686 - $5,621	192%
Care Wisconsin	$1,686 - $3,654	192%
UnitedHealthcare	$1,743 - $4,609	199%
Quartz	$3,485 - $4,384	397%
Dean Health Plan	$4,008	457%
Wps	$4,216	481%
Cigna	$4,216	481%
Group Health Cooperative of Sc	$4,497 - $4,890	513%
Humana	$5,059	577%
Healthchoice	$5,340	609%
Group Health South Central	$5,621	641%
Group Health Eau Claire	$5,621	641%

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 $4,216.
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 Southwest Health 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.