CMS Price Transparency Data
Sleep study (overnight, in lab)
Facility: Trinity Health Oakland Hospital
Billing Code: 95810 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 95810
- Insurance Median: $3,397
- Cash Discount Price: $3,247
- vs. Medicare Baseline: 3.87x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Trinity Health Oakland Hospital is $3,397. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,247. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 3.87x the Medicare baseline. Located in 44405 Woodward Ave, Pontiac, MI.
Cash / Self-Pay
$3,247
Average discount available for prompt cash payment at this facility.
Insurance Median
$3,397
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: $3,247 (370%)
Insurance Median: $3,397 (387%)
Cash: $3,247 (370% of Medicare)
Ins. Median: $3,397 (387% 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 387% of the Medicare baseline (a markup of 287%). 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.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicaid / KanCare | $470 - $480 | 54% |
| Blue Cross Blue Shield | $480 - $1,457 | 55% |
| Aetna | $839 - $3,127 | 96% |
| Blue Care Network Advantage | $839 | 96% |
| Medicare (plans) | $839 - $856 | 96% |
| Align Senior Care | $856 | 98% |
| Hospice Advantage | $856 | 98% |
| UnitedHealthcare | $881 - $3,746 | 100% |
| Cca - Zing Health | $906 | 103% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $964 | 110% |
| Molina Marketplace | $1,112 | 127% |
| U Of M Health Plan | $1,174 | 134% |
| Priority Health | $1,241 - $1,379 | 141% |
| Asr Health Benefits | $1,303 | 149% |
| Caresource | $1,303 | 149% |
| Hap | $1,303 - $3,637 | 149% |
| Varipro | $1,303 | 149% |
| Health Cost Solutions | $1,326 | 151% |
| Vitalcore | $1,326 | 151% |
| Wellpath | $1,326 | 151% |
| Bcn Domestic | $1,457 | 166% |
| Blue Benefit Administrators Of Massachusetts | $1,457 | 166% |
| Blue Care Network | $1,457 | 166% |
| Blue Distinction Transplant | $1,457 | 166% |
| Blue Shield - Ca | $1,457 | 166% |
| Blue Shield - Id (Regence) | $1,457 | 166% |
| Blue Shield - Ny Highmark Northeastern | $1,457 | 166% |
| Blue Shield - Ny Highmark Western | $1,457 | 166% |
| Blue Shield - Pa (Highmark) | $1,457 | 166% |
| Blue Shield - Wa (Regence) | $1,457 | 166% |
| Health Choices | $1,457 - $3,666 | 166% |
| Kaiser Domestic | $1,457 | 166% |
| Wc Accident Fund | $1,516 | 173% |
| Wc Advantage | $1,516 | 173% |
| Wc Aig | $1,516 | 173% |
| Wc Allied | $1,516 | 173% |
| Wc Amerisure | $1,516 | 173% |
| Wc Amtrust | $1,516 | 173% |
| Wc Asu Risk Mgt | $1,516 | 173% |
| Wc Berkley Admin | $1,516 | 173% |
| Wc Broadspire | $1,516 | 173% |
| Wc Bunch & Associates | $1,516 | 173% |
| Wc Ccmsi | $1,516 | 173% |
| Wc Emc Insurance Company | $1,516 | 173% |
| Wc Esis | $1,516 | 173% |
| Wc Fcci | $1,516 | 173% |
| Wc Federated | $1,516 | 173% |
| Wc Gallagher Bassett | $1,516 | 173% |
| Wc Genex Care For Ohio | $1,516 | 173% |
| Wc Guard Insurance Company | $1,516 | 173% |
| Wc Hartford | $1,516 | 173% |
| Wc Liberty Mutual | $1,516 | 173% |
| Wc Meijers | $1,516 | 173% |
| Wc Michigan | $1,516 | 173% |
| Wc Mitchell Frankenmuth | $1,516 | 173% |
| Wc Pma | $1,516 | 173% |
| Wc Sedgwick | $1,516 | 173% |
| Wc Sentry | $1,516 | 173% |
| Wc Travelers | $1,516 | 173% |
| Wc Tristar | $1,516 | 173% |
| Wc Walmart | $1,516 | 173% |
| Wc Zurich | $1,516 | 173% |
| Employee Benefit Logistic | $1,974 | 225% |
| Acs Benefit Services | $2,198 | 251% |
| Allied Benefit Systems | $2,198 | 251% |
| Claimchoice Adminstrators | $2,198 | 251% |
| Consociate | $2,198 | 251% |
| Cypress Benefit Administrators | $2,198 | 251% |
| Forest County Potawatomi | $2,198 | 251% |
| Health Smart | $2,198 | 251% |
| Healthgram | $2,198 | 251% |
| Healthscope | $2,198 | 251% |
| Secureone Preferred United Plans | $2,198 | 251% |
| Sisco Benefits | $2,198 | 251% |
| The Health Plan | $2,198 | 251% |
| Trustmark Small Business Benefits | $2,198 | 251% |
| Unified Group Services | $2,198 | 251% |
| Webtpa | $2,198 | 251% |
| Mclaren Health | $2,401 - $2,619 | 274% |
| Carelon Behavioral Health | $2,498 | 285% |
| Magellan Behavioral Health | $2,997 | 342% |
| Geha | $3,127 - $3,746 | 356% |
| Medical Mutual | $3,127 | 356% |
| Meritain | $3,127 | 356% |
| 1199 National Benefit Fund | $3,397 | 387% |
| Allied National Global Care | $3,397 | 387% |
| Asrm - Reliance Standard Life Insurance | $3,397 | 387% |
| Christian Care Ministry | $3,397 | 387% |
| Dean Health | $3,397 | 387% |
| Fallon Health | $3,397 | 387% |
| Family Life Insurance Company | $3,397 | 387% |
| Ghc Scw | $3,397 | 387% |
| Group Pension Administrators | $3,397 | 387% |
| International Benefit Administrators | $3,397 | 387% |
| Lifetime Benefit Solutions | $3,397 | 387% |
| Manhattan Life | $3,397 | 387% |
| Medi Share | $3,397 | 387% |
| Multiplan | $3,397 | 387% |
| Mvp | $3,397 | 387% |
| Pai | $3,397 | 387% |
| Pan-American Life | $3,397 | 387% |
| Paramount Hmo | $3,397 | 387% |
| Phcs | $3,397 | 387% |
| Trinity Health Share | $3,397 | 387% |
| Health Partners | $3,637 | 415% |
| Tufts Health Plan | $3,637 | 415% |
| Access Health | $3,666 | 418% |
| Acclaim | $3,666 | 418% |
| Administrative Concepts | $3,666 | 418% |
| Allegeant | $3,666 | 418% |
| Ameriben | $3,666 | 418% |
| American Family | $3,666 | 418% |
| American Healthcare Alliance | $3,666 | 418% |
| American National | $3,666 | 418% |
| American Republic | $3,666 | 418% |
| Amerihealth | $3,666 | 418% |
| Aultcare | $3,666 | 418% |
| Automated Benefit Services | $3,666 | 418% |
| Auxiant | $3,666 | 418% |
| Benefit Administrative Systems,Llc | $3,666 | 418% |
| Boon Chapman | $3,666 | 418% |
| Cam Administrative Services | $3,666 | 418% |
| Christian Brother Services | $3,666 | 418% |
| Christian Brothers Holy Cross | $3,666 | 418% |
| Comprehensive Benefits | $3,666 | 418% |
| Continental Life Insurance | $3,666 | 418% |
| Custom Benefit Administrators | $3,666 | 418% |
| Employee Benefit Concepts | $3,666 | 418% |
| Employee Benefit Management | $3,666 | 418% |
| Enterprise Group Planning | $3,666 | 418% |
| Freedom Life Insurance Company | $3,666 | 418% |
| Group Administrators | $3,666 | 418% |
| Group Marketing Services | $3,666 | 418% |
| Guardian | $3,666 | 418% |
| Health America | $3,666 | 418% |
| Healthcare Management Admin | $3,666 | 418% |
| Healthez | $3,666 | 418% |
| Humana | $3,666 | 418% |
| Insight | $3,666 | 418% |
| Intercare | $3,666 | 418% |
| Jfp Benefit Management | $3,666 | 418% |
| Jp Farley Corporation | $3,666 | 418% |
| Key Benefit Administrator | $3,666 | 418% |
| Liberty Union Life Assurance Co | $3,666 | 418% |
| Lucent Health | $3,666 | 418% |
| Luminare Health | $3,666 | 418% |
| Luminare Health (Detroit) | $3,666 | 418% |
| Magnacare | $3,666 | 418% |
| Medben | $3,666 | 418% |
| Medcost | $3,666 | 418% |
| Mutual Health Services | $3,666 | 418% |
| Mutual Of Omaha | $3,666 | 418% |
| Ncas | $3,666 | 418% |
| Nippon Life Ins | $3,666 | 418% |
| Nova | $3,666 | 418% |
| Painters Union Insurance Fund | $3,666 | 418% |
| Physicians Mutual | $3,666 | 418% |
| Plumbers Local 98 Insurance Fund | $3,666 | 418% |
| Prairie States | $3,666 | 418% |
| Preferred One | $3,666 | 418% |
| Primary Physician Care | $3,666 | 418% |
| Professional Benefit Administrators | $3,666 | 418% |
| Siho Insurance Services | $3,666 | 418% |
| The Loomis Company | $3,666 | 418% |
| Unicare | $3,666 | 418% |
| Us Health And Life | $3,666 | 418% |
| Valenz | $3,666 | 418% |
| Western & Southern Financial Group | $3,666 | 418% |
| Wps | $3,666 | 418% |
| Cigna | $3,702 | 422% |
| Coventry | $3,765 | 429% |
| First Health | $3,765 | 429% |
| Prime Health Services | $3,996 | 455% |
| Three Rivers Provider Network | $4,496 | 512% |
| Cmh Detroit Wayne Integrated Health Network | $4,995 | 569% |
| Cmh Lenawee County | $4,995 | 569% |
| Cmh Livingston County | $4,995 | 569% |
| Cmh Misc | $4,995 | 569% |
| Cmh Monroe County | $4,995 | 569% |
| Cmh Oakland County | $4,995 | 569% |
| Cmh Washtenaw County | $4,995 | 569% |