CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Mercyone Newton Medical Center

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 95810
  • Insurance Median: $2,784
  • Cash Discount Price: $3,901
  • vs. Medicare Baseline: 3.17x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Mercyone Newton Medical Center is $2,784. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,901. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 3.17x the Medicare baseline. Located in 204 N 4Th Ave E, Newton, IA.
Cash / Self-Pay
$3,901

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,784

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: $3,901 (445%)
Insurance Median: $2,784 (317%)
Cash: $3,901 (445% of Medicare)
Ins. Median: $2,784 (317% 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 317% of the Medicare baseline (a markup of 217%). 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
Aetna $813 - $5,624 93%
Medicare (plans) $813 - $846 93%
Blue Cross Blue Shield $821 - $877 94%
UnitedHealthcare $829 - $4,333 94%
Blue Benefit Administrators Of Massachusetts $877 100%
Blue Care Network $877 100%
Blue Distinction Transplant $877 100%
Blue Shield - Ca $877 100%
Blue Shield - Id (Regence) $877 100%
Blue Shield - Ny Highmark Northeastern $877 100%
Blue Shield - Ny Highmark Western $877 100%
Blue Shield - Pa (Highmark) $877 100%
Blue Shield - Wa (Regence) $877 100%
Iowa Total Care $990 113%
Medicaid / KanCare $1,000 - $1,004 114%
Amish Hospital Aid $1,103 126%
Oscar $1,179 134%
Centivo $1,197 136%
Ambetter / Centene $1,393 159%
Claimdoc $1,667 190%
Nova $1,667 190%
Newton Correctional Facility $3,901 445%
Geha $4,333 494%
Health Choices $4,532 517%
Medical Associates $4,532 517%
Health Partners $5,294 603%
Auxiant $5,522 629%
Cigna $5,522 629%
Health Alliance $5,522 629%
Medica $5,522 629%
Midlands $5,522 629%
Midlands Choice $5,522 629%
1199 National Benefit Fund $5,624 641%
Allied Benefit Systems $5,624 641%
Asr Health Benefits $5,624 641%
Christian Brother Services $5,624 641%
Coventry $5,624 641%
First Health $5,624 641%
Lucent Health $5,624 641%
Luminare Health $5,624 641%
Medical Mutual $5,624 641%
Meritain $5,624 641%
Trustmark Small Business Benefits $5,624 641%
Webtpa $5,624 641%
Crime Victim Assistance $6,002 684%
Iowa Dept Of Public Health $6,002 684%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 204 N 4Th Ave E, Newton, IA 50208
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals