CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Adventist Health Howard Memorial

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $211
Cash Discount Price: $288
vs. Medicare Baseline: 0.24x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Adventist Health Howard Memorial is $211. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $288. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 0.24x the Medicare baseline. Located in 1 Marcela Dr, Willits, CA.

Cash / Self-Pay

$288

Average discount available for prompt cash payment at this facility.

Insurance Median

$211

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: $288 (33%)

Insurance Median: $211 (24%)

Cash: $288 (33% of Medicare)

Ins. Median: $211 (24% 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	14%
Medicare (plans)	$123	14%
Tricare	$123	14%
UnitedHealthcare	$123 - $784	14%
Ah Employee Health Plan - All Plans	$135 - $149	15%
Cigna	$140 - $244	16%
Blue Shield - All Other Plans	$154 - $197	18%
Western Growers/Pinnacle - All Plans	$175 - $215	20%
Healthnet - All Plans	$179 - $235	20%
Aetna	$193 - $697	22%
Blue Shield Epn	$196	22%
First Health Ppo - All Plans	$230	26%
Ghn Ppo - All Plans	$230	26%
Brms - All Plans	$244 - $1,391	28%
Medi-Cal	$287 - $348	33%
Blue Cross Blue Shield	$312 - $2,206	36%

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 $288.
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 Howard Memorial 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.