CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: North Adams Regional Hospital Corporation

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 95810
  • Insurance Median: $2,681
  • Cash Discount Price: $5,221
  • vs. Medicare Baseline: 3.06x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at North Adams Regional Hospital Corporation is $2,681. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,221. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 3.06x the Medicare baseline. Located in 71 Hospital Avenue, North Adams, MA.
Cash / Self-Pay
$5,221

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,681

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: $5,221 (595%)
Insurance Median: $2,681 (306%)
Cash: $5,221 (595% of Medicare)
Ins. Median: $2,681 (306% 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 306% of the Medicare baseline (a markup of 206%). 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
Mcd Masshealth $479 - $2,233 55%
Mcd New York $479 - $1,104 55%
Mcd Out Of State $479 - $2,233 55%
Mcdmanaged Cdphp $479 - $2,233 55%
Mcdmanaged Hne Mcdaco $479 - $2,233 55%
Medicaid / KanCare $479 - $2,418 55%
Comm Network Qhpsub $527 - $3,105 60%
Mcdmanaged Network $527 - $3,105 60%
Mcdmanaged Bmchnp $551 - $2,323 63%
Tricare $640 - $2,067 73%
Medicare (plans) $693 - $1,276 79%
Comm Hospice $704 - $1,264 80%
Mcr Miscellaneous $704 - $1,264 80%
Mcrmanaged Usa Family $704 - $1,264 80%
Mcrmanaged Va $704 - $1,264 80%
Oth United Vaccn $704 - $1,264 80%
Blue Cross Blue Shield $797 - $4,671 91%
Mcrmanaged Cca One Care $797 - $1,251 91%
Aetna $831 - $4,149 95%
Wc Workers Comp $948 - $3,334 108%
Comm Fallon Qhp $962 - $3,111 110%
Comm Hne Hmo $1,155 - $3,791 132%
Comm Hne $1,227 - $4,011 140%
Comm Hne Ppo $1,227 - $4,028 140%
Comm Unicare $1,368 - $3,564 156%
Comm Network Qhpnonsub $3,517 - $3,952 401%
Comm Nhp $3,556 405%
Comm Tufts $4,353 496%
UnitedHealthcare $4,726 539%
Cigna $4,946 - $5,111 564%
Comm Cdphp $4,946 564%
Comm Mvp $4,946 564%
Comm Oxford $4,946 564%
Comm First Health $5,111 - $5,221 583%
Comm Connecticare $5,221 595%
Comm Consolidated Health $5,221 595%
Comm Harvard $5,221 595%
Comm Other $5,221 595%
Comm Phcs $5,221 595%
Comm Self Pay $5,221 595%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 71 Hospital Avenue, North Adams, MA 01247
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Federal
  • Hospital Type: Critical Access Hospitals