CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Munson Healthcare Otsego Memorial Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $659
Cash Discount Price: $2,907
vs. Medicare Baseline: 0.75x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Munson Healthcare Otsego Memorial Hospital is $659. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,907. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 0.75x the Medicare baseline. Located in 825 N Center Ave, Gaylord, MI.

Cash / Self-Pay

$2,907

Average discount available for prompt cash payment at this facility.

Insurance Median

$659

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: $2,907 (331%)

Insurance Median: $659 (75%)

Cash: $2,907 (331% of Medicare)

Ins. Median: $659 (75% 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
Mclaren Health Plan	$74 - $2,868	8%
Meridian	$74 - $448	8%
Molina	$74 - $924	8%
Priority Health	$74 - $1,661	8%
UnitedHealthcare	$74 - $2,739	8%
Blue Cross Blue Shield	$75 - $2,136	9%
Blue Care Network	$117 - $856	13%
Hap (Health Alliance Plan)	$117 - $2,736	13%
Humana	$117 - $856	13%
Medicare (plans)	$117 - $856	13%
Michigan Amish Medical Board	$117 - $856	13%
Northern Michigan Mennonite Group	$117 - $856	13%
Aetna	$118 - $2,770	13%
Cigna	$159 - $1,661	18%
Asr Physicians Care Network	$176 - $2,736	20%
Nomi Health	$187 - $2,736	21%
Employee Benefit Logistics	$199 - $1,455	23%
Munson Hospice	$852 - $2,394	97%
Hospice Of Michigan	$2,052	234%
Enterprise Group Planning/Employee Benefit Plan	$2,736	312%
Cofinity	$2,907	331%
Provider Network Of America/Hawaii Mainland Administrative Group Health	$2,907	331%
Three Rivers Provider Network	$2,907	331%

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 $2,907.
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 Munson Healthcare Otsego Memorial 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.