CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Franciscan Health Crown Point

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $4,388
Cash Discount Price: $1,887
vs. Medicare Baseline: 5.00x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Franciscan Health Crown Point is $4,388. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,887. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 5.00x the Medicare baseline. Located in 1201 S Main St, Crown Point, IN.

Cash / Self-Pay

$1,887

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,388

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: $1,887 (215%)

Insurance Median: $4,388 (500%)

Cash: $1,887 (215% of Medicare)

Ins. Median: $4,388 (500% 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 500% of the Medicare baseline (a markup of 400%). 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
Managed Health Services [1302]	$780 - $3,669	89%
Mdwise [1175]	$780	89%
Medicaid / KanCare	$780 - $4,272	89%
Medicare (plans)	$888 - $909	101%
Blue Cross Blue Shield	$1,216 - $5,119	139%
Workers Comp [1172]	$1,817	207%
Aetna	$2,543 - $4,753	290%
Managed Care [2000]	$2,543 - $7,313	290%
Unicare [1150]	$2,619 - $2,986	299%
Commercial [2001]	$4,388 - $7,313	500%
Cigna	$4,987	568%
Great West Insurance [1055]	$4,987	568%
United Medical Resources [1158]	$5,046 - $5,558	575%
United Medical Resources [1301]	$5,046 - $5,558	575%
UnitedHealthcare	$5,046 - $5,558	575%

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 $1,887.
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 Crown Point 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.