CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Saint Francis Hospital-Evanston

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $943
Cash Discount Price: $915
vs. Medicare Baseline: 1.07x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Saint Francis Hospital-Evanston is $943. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $915. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.07x the Medicare baseline. Located in 355 Ridge Ave, Evanston, IL.

Cash / Self-Pay

$915

Average discount available for prompt cash payment at this facility.

Insurance Median

$943

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: $915 (104%)

Insurance Median: $943 (107%)

Cash: $915 (104% of Medicare)

Ins. Median: $943 (107% 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
Ravenswood Physicians Associates Ipa	$563 - $916	64%
Resurrection Physicians Provider Group Ipa	$563 - $916	64%
Blue Cross Blue Shield	$870 - $1,282	99%
Aetna	$916 - $993	104%
Celtic (Wellcare)	$916	104%
Cigna	$916	104%
Clear Spring Health Of Illinois	$916	104%
Devoted Health	$916	104%
Essential Health Partners	$916 - $1,053	104%
Humana	$916 - $1,007	104%
Illinois Physicians Alliance	$916	104%
Longevity Health Plan Of Illinois	$916	104%
Medicare (plans)	$916	104%
Self-Pay	$916	104%
Tricare	$916	104%
UnitedHealthcare	$916 - $2,025	104%
Molina	$943 - $1,374	107%
Zing Health Provider Network	$943	107%
Meridian	$962 - $1,042	110%
Provider Partners Health Plan (Pphp)	$962	110%
Standard Eapg Logic - Contracts	$992	113%
Countycare	$993	113%
Medicaid / KanCare	$993	113%
Access Community Health Network	$1,099	125%
Clifton Health Systems	$1,419	162%
Ambetter / Centene	$1,483	169%

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 $915.
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 Saint Francis Hospital-Evanston 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.