CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Northside Hospital Duluth

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 95810
  • Insurance Median: $307
  • Cash Discount Price: $2,874
  • vs. Medicare Baseline: 0.35x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Northside Hospital Duluth is $307. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,874. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 0.35x the Medicare baseline. Located in 3620 Howell Ferry Road, Duluth, GA.
Cash / Self-Pay
$2,874

Average discount available for prompt cash payment at this facility.

Insurance Median
$307

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: $2,874 (328%)
Insurance Median: $307 (35%)
Cash: $2,874 (328% of Medicare)
Ins. Median: $307 (35% 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.

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
Ambetter / Centene $68 - $3,437 8%
Medicaid / KanCare $73 - $1,510 8%
Blue Cross Blue Shield $99 - $5,096 11%
Tricare $112 - $872 13%
Aetna $121 - $3,335 14%
Caresource $121 - $2,720 14%
Coventry $121 - $4,972 14%
Humana $121 - $881 14%
Kaiser $121 - $2,178 14%
Medicare (plans) $121 - $1,017 14%
UnitedHealthcare $121 - $2,831 14%
Va Ccn $121 - $848 14%
Wellcare $121 - $873 14%
Cigna $125 - $4,607 14%
Clear Springs Eon Health $127 - $848 14%
Clover Health $127 - $890 14%
Pruitt Health Premier $127 - $890 14%
Georgia Reproductive Specialists $141 - $2,925 16%
Medlien Healthcare Services $141 - $2,925 16%
Med Care Solutions $159 - $3,290 18%
Oscar $164 - $3,437 19%
Health One Alliance_Ppo $194 - $4,022 22%
Quick Trip $194 - $4,022 22%
Northside Health Network $199 - $4,533 23%
Georgia Workers Compensation $234 - $2,665 27%
Novanet_Ppo $247 - $5,118 28%
Phcs $265 - $5,484 30%
Beech Steet $300 - $6,215 34%
Multiplan $300 - $6,215 34%
Multiplan Workers Comp $300 - $6,215 34%
Careiq $353 - $7,312 40%
Champus Va $353 - $495 40%
Dekalb_Department Of Health $353 - $7,312 40%
Fifa $353 - $7,312 40%
Institutional Marietta Surgery Center $353 - $7,312 40%
Institutional Veterans Evaluation Services $353 - $7,312 40%
Johnson Ferry Imaging $353 - $7,312 40%
Marietta Dermatology Clinical Research Inc $353 - $7,312 40%
Rabun County Boc $353 - $7,312 40%
West Paces Imaging Agreement $353 - $7,312 40%
Mti $827 94%
One Call Diagnostics $827 94%
Us Dept Of Labor Wc $854 97%
Bccp $861 98%
Cbww $861 98%
Truths Community $861 98%
Homelink $879 100%
Amerigroup $924 - $1,313 105%
Institutional Gwinnett County Govt $924 - $1,313 105%
Fairly Group $974 111%
Genex/Priority Care Solutions $2,132 243%
Spreemo $2,132 243%
Authentic 4D $2,399 273%
Streamline Imaging $2,399 273%
Corvel Workers Comp $2,532 289%
Employers Choice Network $2,532 289%
Fieldale Farms Wc $2,665 304%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3620 Howell Ferry Road, Duluth, GA 30096
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals