CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Franciscan Health Michigan City

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $4,152
Cash Discount Price: $1,435
vs. Medicare Baseline: 4.73x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Franciscan Health Michigan City is $4,152. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,435. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 4.73x the Medicare baseline. Located in 3500 Franciscan Way, Michigan City, IN.

Cash / Self-Pay

$1,435

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,152

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: $1,435 (164%)

Insurance Median: $4,152 (473%)

Cash: $1,435 (164% of Medicare)

Ins. Median: $4,152 (473% 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 473% of the Medicare baseline (a markup of 373%). 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
Mdwise [1175]	$780	89%
Medicaid / KanCare	$780 - $4,272	89%
Medicare (plans)	$909	104%
Blue Cross Blue Shield	$1,216 - $3,448	139%
Workers Comp [1172]	$1,817	207%
Aetna	$2,543 - $5,173	290%
Managed Care [2000]	$2,543 - $6,207	290%
Unicare [1150]	$2,619 - $3,133	299%
Managed Health Services [1302]	$3,669	418%
Commercial [2001]	$4,131 - $6,897	471%
United Medical Resources [1158]	$4,131	471%
United Medical Resources [1301]	$4,131 - $4,593	471%
UnitedHealthcare	$4,131 - $4,593	471%
Cigna	$4,166 - $4,828	475%
Great West Insurance [1055]	$4,166	475%

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 $1,435.
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 Franciscan Health Michigan City 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.