CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Helen Newberry Joy Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $620
Cash Discount Price: $403
vs. Medicare Baseline: 0.71x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Helen Newberry Joy Hospital is $620. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $403. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 0.71x the Medicare baseline. Located in 502 W Harrie St, Newberry, MI.

Cash / Self-Pay

$403

Average discount available for prompt cash payment at this facility.

Insurance Median

$620

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: $403 (46%)

Insurance Median: $620 (71%)

Cash: $403 (46% of Medicare)

Ins. Median: $620 (71% 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
Uphp Mcaid - All Plans	$229 - $2,018	26%
Va - All Plans	$253 - $1,760	29%
Mi Wc - All Plans	$256 - $2,748	29%
Aetna	$321 - $4,078	37%
Blue Cross Blue Shield	$321 - $4,238	37%
Humana	$321 - $1,717	37%
Mi Health Link - All Plans	$321 - $1,717	37%
Uphg Tpa - All Plans	$361 - $3,864	41%
First Health - All Plans	$381 - $4,078	43%
Ppom/Cofinity - All Plans	$381 - $4,078	43%
Cigna	$389 - $4,164	44%
Health Alliance - All Plans	$389 - $4,164	44%
Healtheos - All Plans	$389 - $4,164	44%
Priority Health - All Plans	$389 - $4,164	44%
UnitedHealthcare	$389 - $4,164	44%
Vital Core - All Plans	$389 - $4,165	44%

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 $403.
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 Helen Newberry Joy 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.