CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Goshen Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $981
Cash Discount Price: $3,655
vs. Medicare Baseline: 1.12x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Goshen Hospital is $981. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,655. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.12x the Medicare baseline. Located in 200 High Park Ave, Goshen, IN.

Cash / Self-Pay

$3,655

Average discount available for prompt cash payment at this facility.

Insurance Median

$981

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: $3,655 (417%)

Insurance Median: $981 (112%)

Cash: $3,655 (417% of Medicare)

Ins. Median: $981 (112% 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
Advantage Health Solutions	$981	112%
Aetna	$981	112%
Atrio Health Plans	$981	112%
Bc Federal Employee	$981	112%
Bc Mcr Advantage Ppo	$981	112%
Blue Cross Blue Shield	$981 - $3,327	112%
Buckeye Health Plan	$981	112%
Cigna	$981	112%
Coventry Health And Life	$981	112%
Emblem Health	$981	112%
Freedom Healthcare	$981	112%
Geisinger Health Plan	$981	112%
Health First	$981	112%
Healthspring	$981	112%
Humana	$981	112%
Iehp Empire Health Plan	$981	112%
Independent Care Health Plan	$981	112%
Kaiser Permanente	$981	112%
Mcr Advantra Freedom	$981	112%
Mcr Allwell Mhs	$981	112%
Mcr Banner Health	$981	112%
Mcr Complete	$981	112%
Mcr Complete Ppo	$981	112%
Mcr Complete Wellmed	$981	112%
Mcr Health Alliance	$981	112%
Mcr Health Partners Plans	$981	112%
Mcr Medical Mutual Of Ohio	$981	112%
Mcr Passport Advantage	$981	112%
Mcr Secure Horizons Ppo	$981	112%
Mcr Texan Plus	$981	112%
Mcr Upmc For Life	$981	112%
Medicare (plans)	$981 - $1,040	112%
Meridian Complete	$981	112%
Optimum Healthcare	$981	112%
Paramount Elite	$981	112%
Primetime Health Plan	$981	112%
Simply Complete Hmo	$981	112%
The Umwa H&R Funds	$981	112%
Todays Options Pyramid Life	$981	112%
Trillium Advantage	$981	112%
Ucare For Seniors	$981	112%
Ucare Minnesota	$981	112%
UnitedHealthcare	$981	112%
Wellcare	$981	112%
Champva	$1,010	115%
Tricare	$1,010	115%
Mcr Devoted Health Plan	$1,040	119%
Mcr Provider Partners Hlth Pln	$1,111	127%
Ambetter / Centene	$1,414	161%
Mkt Caresource	$1,414	161%
Bc Allied	$3,327	379%

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 $3,655.
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 Goshen 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.