CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Norton-King's Daughters' Health

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $4,661
Cash Discount Price: $1,306
vs. Medicare Baseline: 5.31x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Norton-King's Daughters' Health is $4,661. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,306. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 5.31x the Medicare baseline. Located in 1373 East Sr 62, Madison, IN.

Cash / Self-Pay

$1,306

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,661

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: $1,306 (149%)

Insurance Median: $4,661 (531%)

Cash: $1,306 (149% of Medicare)

Ins. Median: $4,661 (531% 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 531% of the Medicare baseline (a markup of 431%). 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
Aetna	$130 - $5,225	15%
Blue Cross Blue Shield	$398 - $4,383	45%
Managed Health Services Of Indiana	$913	104%
UnitedHealthcare	$913 - $4,661	104%
Humana	$1,066	122%
Managed Health Services	$1,098 - $1,652	125%
Caresource Of Kentucky	$1,492	170%
Caresource Of Indiana	$1,599	182%
Custom Design Benefits	$2,132 - $2,969	243%
Cigna	$5,047	575%
Encore	$5,047	575%
Quality Care Partners	$5,285	602%
Bluegrass	$5,344	609%
First Health	$5,344	609%
Healthlink	$5,344	609%
Vha/Tristate	$5,344	609%
Multiplan/Phcs	$5,463	623%
Indiana Health Network	$5,641	643%
Siho	$5,641	643%

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 $1,306.
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 Norton-King's Daughters' Health 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.