CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Promedica Monroe Regional Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $1,982
Cash Discount Price: $3,221
vs. Medicare Baseline: 2.26x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Promedica Monroe Regional Hospital is $1,982. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,221. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 2.26x the Medicare baseline. Located in 718 N Macomb St, Monroe, MI.

Cash / Self-Pay

$3,221

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,982

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: $3,221 (367%)

Insurance Median: $1,982 (226%)

Cash: $3,221 (367% of Medicare)

Ins. Median: $1,982 (226% 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 226% of the Medicare baseline (a markup of 126%). 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
Meridian	$470	54%
Priority Health	$470 - $2,726	54%
Amerihealth	$489	56%
Blue Cross Blue Shield	$494 - $2,934	56%
Aetna	$508 - $3,489	58%
Molina Healthcare Of Michigan	$508	58%
UnitedHealthcare	$517 - $4,024	59%
Paramount Healthcare Inc	$599 - $3,767	68%
Health Alliance Plan	$614 - $4,064	70%
Humana	$632 - $877	72%
Veterans Affairs	$865	99%
Frontpath	$2,874	328%
Encore Health Network	$3,469	395%
Health Ohio Network, Llc	$3,469	395%
Cofinity	$3,534	403%
Multiplan	$4,460	508%

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 $3,221.
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 Promedica Monroe Regional 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.