CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Northwest Health - Porter

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 95810
  • Insurance Median: $3,119
  • Cash Discount Price: $2,498
  • vs. Medicare Baseline: 3.56x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Northwest Health - Porter is $3,119. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,498. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 3.56x the Medicare baseline. Located in 85 East Us Hwy 6, Valparaiso, IN.
Cash / Self-Pay
$2,498

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,119

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: $2,498 (285%)
Insurance Median: $3,119 (356%)
Cash: $2,498 (285% of Medicare)
Ins. Median: $3,119 (356% 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 356% of the Medicare baseline (a markup of 256%). 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
Veterans Eval Services $455 52%
One Call $627 71%
UnitedHealthcare $805 - $3,560 92%
Tricare $863 98%
Aetna $894 - $4,021 102%
Blue Cross Blue Shield $894 - $3,703 102%
Humana $894 - $3,560 102%
Medicare (plans) $894 - $954 102%
Node Mhs Mcr Adv $894 102%
Healthy Indiana Plan $909 104%
Node Hospice Non Par Agree $909 104%
Node Va $909 104%
Node Devoted Health Mcr Adv $912 104%
Care Improvement Plus $939 107%
In Dept Of Correction $945 108%
Node Us Dept Of Labor $1,136 129%
Align Network $1,454 166%
One Call Work Comp $1,454 166%
Encore Health $1,635 - $6,344 186%
Prime Health $1,635 - $5,948 186%
Indiana Work Comp $1,817 207%
Lutheran Preferred $1,817 - $4,758 207%
Managed Health Services $1,817 - $3,560 207%
Lutheran Preferred Chs Employees $1,903 217%
Self Pay $2,141 - $2,855 244%
Node Encore Kba Epo $2,181 249%
Porter County $2,181 249%
Preferred Network Access $2,181 249%
Cigna $2,205 251%
Magnacare Ma $2,314 264%
Physicians Health Plan $3,039 346%
Php Freedom $3,276 373%
Sagamore Health Network $3,505 - $4,695 400%
Caresource $3,560 406%
Medicaid / KanCare $3,560 406%
Mhs $3,560 406%
First Health Coventry $3,886 443%
Encore Ppo $3,965 452%
Southeastem Indiana Health Operations $5,551 - $5,948 633%
Network Synergy Group $5,948 678%
Multiplan/Phcs $6,661 759%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 85 East Us Hwy 6, Valparaiso, IN 46383
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals