CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Memorial Medical Center

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $4,620
Cash Discount Price: $7,700
vs. Medicare Baseline: 5.27x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Memorial Medical Center is $4,620. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,700. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 5.27x the Medicare baseline. Located in 701 N First St, Springfield, IL.

Cash / Self-Pay

$7,700

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,620

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: $7,700 (878%)

Insurance Median: $4,620 (527%)

Cash: $7,700 (878% of Medicare)

Ins. Median: $4,620 (527% 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 527% of the Medicare baseline (a markup of 427%). 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
Blue Cross Blue Shield	$618 - $7,700	70%
Veterans Administration	$652	74%
Aetna	$906 - $5,852	103%
Health Alliance	$906 - $5,005	103%
Medicare (plans)	$906 - $7,700	103%
Tricare	$906	103%
UnitedHealthcare	$906 - $4,774	103%
Humana	$951 - $4,620	108%
Medicaid / KanCare	$992	113%
Molina	$1,012	115%
Current Health Network Ppo	$3,465	395%
Healthlink	$3,850 - $4,851	439%
Commercial Workers Compensation	$3,892	444%
Cigna	$4,042	461%
Illinois Workers Compensation	$4,096	467%
Phcs/Multiplan	$4,158 - $4,620	474%
6 Degrees Health	$4,620	527%
Hopetrust	$4,620	527%
Hst	$4,620	527%
Magellan	$4,620	527%
Consociate	$5,005	570%
Hfn	$5,005	570%
Preferred Plan	$5,775	658%
Soi Mcfarland	$5,775	658%
Soi Rushville	$5,775	658%
Corvel	$6,160	702%
Methodist First Choice	$6,160	702%
Mutual Medical Plans	$6,545	746%
Liability	$7,700	878%

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 $7,700.
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 Memorial Medical Center 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.