CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Baldwin Health

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 95810
  • Insurance Median: $3,553
  • Cash Discount Price: $4,738
  • vs. Medicare Baseline: 4.05x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Baldwin Health is $3,553. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,738. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 4.05x the Medicare baseline. Located in 1613 North McKenzie Street, Foley, AL.
Cash / Self-Pay
$4,738

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,553

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: $4,738 (540%)
Insurance Median: $3,553 (405%)
Cash: $4,738 (540% of Medicare)
Ins. Median: $3,553 (405% 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 405% of the Medicare baseline (a markup of 305%). 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
Medicaid / KanCare $369 42%
Veterans Eval Services $430 49%
Tricare $774 88%
Triwest $798 91%
Blue Cross Blue Shield $802 - $1,052 91%
Humana $802 91%
Medicare (plans) $802 91%
UnitedHealthcare $802 - $4,854 91%
Windsor Health Plan $802 91%
Community Hospice $815 93%
Hospice $815 93%
Mercy Medical Hospice $815 93%
Node Champva $815 93%
Node Va $815 93%
Cigna $818 - $3,597 93%
Node Devoted Health Mcr Adv $818 93%
Node Clover Health Mcr Adv $823 94%
Select Health $823 94%
Aetna $826 - $17,767 94%
Node Wellcare Mcr Adv $831 95%
Us Dol $1,018 116%
Ambetter / Centene $1,222 139%
First Choice $1,320 150%
Self Pay $3,553 - $5,922 405%
American Employee Alliance $7,897 900%
Multiplan $11,253 - $16,188 1283%
First Health $14,806 - $15,941 1688%
Alamed $15,102 1721%
Multiplan Inc $15,102 1721%
Coventry Work Comp Al $15,438 1760%
One Health $15,793 1800%
Pro America $15,793 1800%
Novanet $15,941 1817%
Alabama Wc $16,780 1913%
Gulf Health $16,780 1913%
Principal Ppo $16,780 1913%
Viva Health $16,780 1913%
National Health $17,767 2025%
Galaxy $17,965 2048%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1613 North McKenzie Street, Foley, AL 36535
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals