CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Adventist Health Reedley

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $499
Cash Discount Price: $649
vs. Medicare Baseline: 0.57x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Adventist Health Reedley is $499. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $649. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 0.57x the Medicare baseline. Located in 372 W Cypress Ave, Reedley, CA.

Cash / Self-Pay

$649

Average discount available for prompt cash payment at this facility.

Insurance Median

$499

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: $649 (74%)

Insurance Median: $499 (57%)

Cash: $649 (74% of Medicare)

Ins. Median: $499 (57% 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.

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 Shield Mcare	$123 - $1,104	14%
Fhcn Pace Mcr Adv-All Plans	$123 - $1,104	14%
Lasalle Med Assoc Profee Only - All Plans	$123	14%
Tricare	$123 - $1,104	14%
UnitedHealthcare	$123 - $9,663	14%
Upn Mcr Adv Profee Only	$123	14%
Healthnet- All Other Plans	$125 - $3,015	14%
Blue Shield Epn - All Other Plans	$127 - $3,063	14%
Western Growers/Pinnacle- All Plans	$132 - $3,188	15%
Ah Employee Health Plan - All Plans	$135 - $1,988	15%
Cigna	$140 - $4,504	16%
Kaiser - All Other Plans	$144 - $3,465	16%
Blue Shield Non Epn	$147 - $3,548	17%
Community Care Ipa Mcal-All Plans	$147 - $649	17%
Kaiser Mcr Adv	$165 - $1,104	19%
Physicians Med Group Op/Profee Only- All Plans	$230 - $5,544	26%
Blue Cross Blue Shield	$283 - $2,366	32%
Bc Mcal	$287 - $348	33%
Cal Viva Hlth Mcal - All Plans	$287 - $499	33%
Central Ca Alliance Ccs Profee Only	$287 - $522	33%
Central Ca Alliance Chdp Profee Only	$287 - $696	33%
Central Ca Alliance Comm Profee Only - All Other P	$287 - $522	33%
Central Ca Alliance Mcal Profee Only	$287 - $348	33%
Dignity Mcal Op/Profee Only-All Other Plans	$287 - $549	33%
Kern Health Systems Mcal-All Plans	$287 - $499	33%
Medi-Cal	$287 - $499	33%
Upn Mcal Profee Only-All Other Plans	$287 - $348	33%
Healthnet Medi-Cal	$596	68%
Aetna	$629 - $2,998	72%
Dignity Mcr Adv Op/Profee Only	$1,104	126%
Healthnet- Mcr Adv	$1,104	126%
Phs Prime Health Srvcs	$1,104	126%
Bright Health Mcr Adv - All Plans	$1,734	198%

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 $649.
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 Adventist Health Reedley 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.