CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Fishermen's Community Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 95810
  • Insurance Median: $3,682
  • Cash Discount Price: $4,228
  • vs. Medicare Baseline: 4.20x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Fishermen's Community Hospital is $3,682. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,228. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 4.20x the Medicare baseline. Located in 3301 Overseas Hwy, Marathon, FL.
Cash / Self-Pay
$4,228

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,682

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: $4,228 (482%)
Insurance Median: $3,682 (420%)
Cash: $4,228 (482% of Medicare)
Ins. Median: $3,682 (420% 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 420% of the Medicare baseline (a markup of 320%). 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
Amerigroup $471 54%
Medicaid / KanCare $471 - $519 54%
UnitedHealthcare $471 - $6,505 54%
Wellcare $495 56%
Sunshine State $500 57%
Aetna $509 - $4,983 58%
Vista $509 58%
Blue Cross Blue Shield $1,086 - $6,505 124%
Leon Medical $1,366 156%
Medica Health Plan $1,366 156%
Medicare (plans) $1,366 - $1,844 156%
Humana $1,489 170%
Avmed $1,503 - $5,386 171%
Cigna $1,557 - $5,204 177%
Non Contracted $2,387 272%
International $4,228 482%
Amerihealth $4,879 556%
Dimension Health Plan $4,879 - $5,854 556%
Affordable $5,854 667%
Phcs $5,854 667%
Quality Health $5,854 667%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3301 Overseas Hwy, Marathon, FL 33050
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals