CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Valley Children's Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 95810
  • Insurance Median: $2,879
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 3.28x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Valley Children's Hospital is $2,879. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 3.28x the Medicare baseline. Located in 9300 Valley Childrens Place, Madera, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,879

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%)
Insurance Median: $2,879 (328%)
Ins. Median: $2,879 (328% 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 328% of the Medicare baseline (a markup of 228%). 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
Allcare Ipa $499 57%
Community Care Ipa $499 - $789 57%
Kaiser $505 - $3,372 58%
Dignity Ipa_Formerly Img $699 80%
La Salle Ipa $699 80%
Sante Ipa $699 80%
Central Valley Medical Providers Ipa $749 - $2,594 85%
Sequoia Health Ipa $749 85%
Univseral Healthcare Ipa $749 85%
United Physicians Network Ipa $774 88%
Adventist $881 100%
Blue Cross Blue Shield $904 - $2,945 103%
Cencal Health $987 112%
Kern Family Health Care $998 114%
Central California Alliance For Health $1,016 116%
Health Net $1,825 - $3,396 208%
Dignity Health Central Coast $2,570 293%
Community Health $2,853 325%
Stanislaus Partners In Health $2,853 325%
Physicians Choice Medical Group $2,905 331%
Health Plan Of San Joaquin $3,112 355%
Fowler Packing $3,216 367%
Dignity (Formerly Managed Care Systems) $3,268 372%
Kern Legacy $3,372 384%
Blue Shield $3,464 - $3,935 395%
UnitedHealthcare $3,469 - $3,694 395%
Aetna $3,475 396%
First Health Formerly Coventry $3,838 437%
Bakersfield Family Medical Group $3,890 443%
Network By Design $4,020 458%
Community Care Health Plan $4,148 473%
Health Smart $4,150 473%
Key Medical Ipa $4,150 473%
Sutter Health $4,409 503%
Multiplan $4,962 566%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9300 Valley Childrens Place, Madera, CA 93636
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens