CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Atrium Health Navicent Rehabilitation Hopsital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $554
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.63x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Atrium Health Navicent Rehabilitation Hopsital is $554. 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 0.63x the Medicare baseline. Located in 3351 Northside Dr, Macon, GA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$554

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: $554 (63%)

Ins. Median: $554 (63% 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 - $1,094	12%
Blue Cross Blue Shield	$109 - $1,017	12%
Georgia Health Advantage	$109 - $1,017	12%
Humana	$109 - $1,236	12%
UnitedHealthcare	$109 - $1,523	12%
Care Source	$111 - $1,038	13%
Clover	$111 - $1,038	13%
Eon Health	$111 - $1,038	13%
Pruitt Health	$115 - $1,017	13%
Alliant	$131 - $1,221	15%
Ambetter / Centene	$147 - $741	17%
Cigna	$439 - $1,014	50%
Ibg	$514 - $1,194	59%
Securehealth	$518 - $1,647	59%
Kaiser	$587 - $1,357	67%

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 $X.
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 Rehabilitation Hopsital 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.