CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Witham Health Services

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $4,684
Cash Discount Price: $4,760
vs. Medicare Baseline: 5.34x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Witham Health Services is $4,684. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,760. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 5.34x the Medicare baseline. Located in 2605 N Lebanon St, Lebanon, IN.

Cash / Self-Pay

$4,760

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,684

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: $4,760 (543%)

Insurance Median: $4,684 (534%)

Cash: $4,760 (543% of Medicare)

Ins. Median: $4,684 (534% 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 534% of the Medicare baseline (a markup of 434%). 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
Blue Cross Blue Shield	$122 - $5,355	14%
Aetna	$145 - $5,033	17%
UnitedHealthcare	$153 - $5,305	17%
Phcs/Multiplan-All Plans	$179 - $6,189	20%
Sagamore-All Plans	$181 - $6,257	21%
Humana	$183 - $6,325	21%
Beech Street-All Plans	$185 - $6,393	21%
Encore-All Plans	$187 - $6,461	21%
Mhs Comml Exch-All Plans	$491 - $17,002	56%
Mdwise Health In-All Plans	$909	104%
Caresource Mcr Adv	$927	106%
Caresource Indiana Marketplace-All Other Plans	$1,726	197%

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 $4,760.
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 Witham Health Services 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.