CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Ascension Providence Hospital, Southfield and Novi

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $653
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.74x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Ascension Providence Hospital, Southfield and Novi is $653. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 0.74x the Medicare baseline. Located in 16001 W Nine Mile Rd, Southfield, MI.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$653

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%)

Insurance Median: $653 (74%)

Ins. Median: $653 (74% 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
Bc Metro Detroit Epo	$82 - $321	9%
Bc Metro Detroit Hmo	$82 - $321	9%
Bcn Local Network Southeast	$82 - $321	9%
Blue Care Network	$82 - $321	9%
Blue Cross Blue Shield	$82 - $321	9%
Molina Health	$450 - $578	51%
Blue Caid Michigan	$578	66%
Harbor Health Mcd	$578	66%
Medicaid / KanCare	$578 - $997	66%
Total Health Care	$578	66%
UnitedHealthcare	$578	66%
Hap Alliance Health	$599	68%
Hap Hmo Pos	$599	68%
Hap Preferred	$706	80%
Aetna	$712 - $997	81%
Amerihealth Vip Care Mcr	$857 - $987	98%
Auto Insurance	$997	114%
Jvhl - Mcr Replacement	$997	114%
Mcr Replacement	$997	114%
Veterans Choice	$997	114%
Humana	$1,007	115%
Meridian Wellcare	$1,047	119%
Molina Advantage	$1,047	119%
Ambetter / Centene	$1,246	142%
Molina Marketplace	$1,246	142%
Smart Health	$1,376	157%

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 $X.
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 Ascension Providence Hospital, Southfield and Novi 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.