CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Carle Eureka Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $1,858
Cash Discount Price: $5,038
vs. Medicare Baseline: 2.12x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Carle Eureka Hospital is $1,858. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,038. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 2.12x the Medicare baseline. Located in 101 S Major St, Eureka, IL.

Cash / Self-Pay

$5,038

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,858

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: $5,038 (574%)

Insurance Median: $1,858 (212%)

Cash: $5,038 (574% of Medicare)

Ins. Median: $1,858 (212% 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 212% of the Medicare baseline (a markup of 112%). 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
Cigna	$82 - $4,429	9%
Aetna	$217 - $4,722	25%
Meridian	$293 - $3,429	33%
Humana	$566 - $3,214	65%
Molina	$587 - $3,429	67%
Wellcare	$920	105%
UnitedHealthcare	$1,320 - $4,407	150%
Community Partners Health Plan (Cphp)	$1,760 - $4,286	201%
Healthlink	$1,906 - $4,643	217%
Blue Cross Blue Shield	$1,965 - $6,000	224%
Multiplan/Phcs	$2,200 - $5,357	251%

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 $5,038.
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 Carle Eureka Hospital 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.