CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Monroe Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $904
Cash Discount Price: $904
vs. Medicare Baseline: 1.03x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Monroe Hospital is $904. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $904. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.03x the Medicare baseline. Located in 4011 S Monroe Medical Park Blvd, Bloomington, IN.

Cash / Self-Pay

$904

Average discount available for prompt cash payment at this facility.

Insurance Median

$904

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: $904 (103%)

Insurance Median: $904 (103%)

Cash: $904 (103% of Medicare)

Ins. Median: $904 (103% 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
Aetna	$522 - $904	59%
Americas Choice Provider Network Acpn	$522 - $1,754	59%
Blue Cross Blue Shield	$522 - $3,560	59%
Care Source	$522 - $3,560	59%
Corvel Workers Compensation	$522 - $1,573	59%
Employer Direct Healthcare	$522 - $1,266	59%
Encore Health Network Workers Compensation	$522 - $1,772	59%
Medicaid / KanCare	$522 - $3,560	59%
Medicare (plans)	$522 - $904	59%
Monroe Medical Group And Managed Health Services	$522 - $3,560	59%
Multiplan	$522 - $1,754	59%
Prime Health Services	$522 - $1,754	59%
Provider Network Of America	$522 - $1,808	59%
Provider Partners Health Plan	$522 - $995	59%
Provider Select	$522 - $1,790	59%
Three Rivers	$522 - $1,754	59%
Tricare	$522 - $904	59%
UnitedHealthcare	$522 - $3,560	59%
Usa Senior Care Network	$522 - $904	59%
Workers Compensation	$522 - $1,808	59%
Worthington Christian Fellowship	$522 - $904	59%
Zelis Healthcare Fka Stratose	$522 - $1,718	59%

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 $904.
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 Monroe 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.