CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Nemours Children's Hospital, Delaware

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 95810
  • Insurance Median: $5,441
  • Cash Discount Price: $9,545
  • vs. Medicare Baseline: 6.20x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Nemours Children's Hospital, Delaware is $5,441. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $9,545. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 6.20x the Medicare baseline. Located in 1600 Rockland Rd Po Box 269, Wilmington, DE.
Cash / Self-Pay
$9,545

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,441

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: $9,545 (1088%)
Insurance Median: $5,441 (620%)
Cash: $9,545 (1088% of Medicare)
Ins. Median: $5,441 (620% 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 620% of the Medicare baseline (a markup of 520%). 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
Us Family Health Plan $690 79%
Celtic Transplant $1,045 - $9,545 119%
Tricare $1,064 121%
Keystone First Hlth Plan $1,905 - $4,224 217%
Amerihealth Caritas Delaware $2,925 - $5,441 333%
Blue Cross Blue Shield $2,955 - $8,429 337%
Celtic Transplant For De First Health $3,341 381%
Delaware First Health $3,436 392%
UnitedHealthcare $3,503 - $5,956 399%
Wellpoint Maryland $3,532 403%
Kidz Partners $3,610 411%
Health Partners $3,703 422%
Upmc $3,780 431%
Fidelis $3,818 435%
Aetna $4,049 - $5,536 462%
Priority Partners John Hopkins $4,682 534%
Six Degrees Health Transplant $4,772 544%
Cigna $5,250 - $6,013 598%
Great West-One Health Plan $5,250 - $6,013 598%
Ambetter / Centene $5,441 620%
Geisinger Health Plan $5,727 653%
Integra Administrative Group $5,727 653%
National Transplant Network (Ntn) $6,204 707%
Six Degrees Health $6,204 707%
Star Healthcare Network $6,204 707%
Life Trac Solid Organ And Bmt Transplant $6,682 762%
First Health Network $9,068 1034%
Insurance Administrators Of America $9,068 1034%
Interlink Transplant Network $9,068 1034%
Multiplan $9,068 1034%
Preferred Healthcare $9,068 1034%
Private Healthcare Systems $9,068 1034%
Three Rivers Provider Network $9,068 1034%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1600 Rockland Rd Po Box 269, Wilmington, DE 19899
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens