CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Clearwater Valley Hospital & Clinics

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $2,398
Cash Discount Price: $2,058
vs. Medicare Baseline: 2.73x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Clearwater Valley Hospital & Clinics is $2,398. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,058. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 2.73x the Medicare baseline. Located in 301 Cedar Street, Orofino, ID.

Cash / Self-Pay

$2,058

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,398

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: $2,058 (235%)

Insurance Median: $2,398 (273%)

Cash: $2,058 (235% of Medicare)

Ins. Median: $2,398 (273% 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 273% of the Medicare baseline (a markup of 173%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Humana	$115 - $4,307	13%
Nimiipuu Mcr Adv-All Plans	$115 - $2,422	13%
Regence Blue Shield Mcr	$115 - $2,398	13%
Veterans Amin-All Plans	$115 - $2,398	13%
Pacific Source - All Plans	$118 - $2,398	13%
Blue Cross Blue Shield	$132 - $3,627	15%
Aetna	$184 - $4,129	21%
UnitedHealthcare	$207	24%
Cigna	$232 - $3,996	26%
Corizon Correctnal Med-All Plans	$625 - $3,241	71%
Idaho Phys Network-All Plans	$996 - $4,218	114%
Multiplan / Phcs-All Plans	$1,006 - $4,307	115%
Geha-All Plans	$1,017 - $4,351	116%
First Choice-All Plans	$1,027 - $4,351	117%
Regence Blue Shield-All Other Plans	$4,440	506%

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 $2,058.
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 Clearwater Valley Hospital & Clinics 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.