CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: HSHS St Elizabeth's Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 95810
  • Insurance Median: $2,783
  • Cash Discount Price: $4,080
  • vs. Medicare Baseline: 3.17x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at HSHS St Elizabeth's Hospital is $2,783. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,080. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 3.17x the Medicare baseline. Located in One St Elizabeth Boulevard, O Fallon, IL.
Cash / Self-Pay
$4,080

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,783

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: $4,080 (465%)
Insurance Median: $2,783 (317%)
Cash: $4,080 (465% of Medicare)
Ins. Median: $2,783 (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
Molina Healthcare $360 - $1,189 41%
Meridian Health Plan $377 - $754 43%
Aetna $568 - $3,990 65%
Blue Cross Blue Shield $568 - $5,667 65%
Clear Spring Health Of Illinois $568 - $1,136 65%
Health Alliance Medical Plans $568 - $4,817 65%
Health Partners $568 - $1,136 65%
Humana $568 - $1,136 65%
Sae Hospice $568 - $1,136 65%
UnitedHealthcare $568 - $5,667 65%
Celtic Insurance Company $1,135 - $2,270 129%
Naphcare $1,231 - $2,462 140%
Hopetrust $1,363 - $2,727 155%
Claim Doc $1,420 - $2,840 162%
Amish Community $1,587 181%
Wellfirst $3,649 416%
First Health $4,216 481%
Cigna $4,477 - $5,667 510%
Healthlink $4,505 - $5,667 513%
Caterpillar, Inc. $4,551 519%
Consociate Group $4,987 568%
Choicecare $5,100 581%
Healthcare Finest Network (Hfn) $5,100 581%
Multiplan/Phcs $5,100 581%
Provider Network Of America $5,100 581%
City Of Springfield $5,667 646%
Current Health Solutions $5,667 646%
Healthscope $5,667 646%
Illinois Breast And Cervical Cancer Program $5,667 646%
Interplan $5,667 646%
Live360 $5,667 646%
Wexford $5,667 646%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One St Elizabeth Boulevard, O Fallon, IL 62269
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals