CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Atrium Health Navicent the Medical Center

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $721
Cash Discount Price: $2,109
vs. Medicare Baseline: 0.82x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Atrium Health Navicent the Medical Center is $721. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,109. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 0.82x the Medicare baseline. Located in 777 Hemlock Street, Macon, GA.

Cash / Self-Pay

$2,109

Average discount available for prompt cash payment at this facility.

Insurance Median

$721

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: $2,109 (240%)

Insurance Median: $721 (82%)

Cash: $2,109 (240% of Medicare)

Ins. Median: $721 (82% 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
Aetna	$109 - $2,910	12%
Blue Cross Blue Shield	$109 - $2,009	12%
Georgia Health Advantage	$109 - $991	12%
Humana	$109 - $2,897	12%
UnitedHealthcare	$109 - $3,636	12%
Care Source	$111 - $1,011	13%
Clover	$111 - $1,011	13%
Eon Health	$111 - $1,011	13%
Pruitt Health	$115 - $991	13%
Alliant	$131 - $1,855	15%
Ambetter / Centene	$147 - $2,151	17%
Cigna	$439 - $2,775	50%
Securehealth	$518 - $1,647	59%
Kaiser	$587 - $2,741	67%
Multiplan	$2,741 - $3,374	312%
Ibg	$2,981	340%
Novanet	$3,374	385%
Three Rivers Provider Network	$3,584	409%
Beechstreet	$3,922	447%

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 $2,109.
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 Atrium Health Navicent the Medical Center 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.