CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Sparrow Ionia Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $790
Cash Discount Price: $494
vs. Medicare Baseline: 0.90x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Sparrow Ionia Hospital is $790. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $494. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 0.90x the Medicare baseline. Located in 3565 S State Road, Ionia, MI.

Cash / Self-Pay

$494

Average discount available for prompt cash payment at this facility.

Insurance Median

$790

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: $494 (56%)

Insurance Median: $790 (90%)

Cash: $494 (56% of Medicare)

Ins. Median: $790 (90% 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
Medicaid / KanCare	$74 - $965	8%
Medicare (plans)	$110 - $935	13%
Blue Cross Blue Shield	$146 - $2,211	17%
Aetna	$247 - $2,644	28%
Covenant Advantage	$247 - $882	28%
Medigold	$247 - $882	28%
Senior Community Care	$247 - $882	28%
Humana	$259 - $2,856	30%
Priority	$606 - $2,164	69%
UnitedHealthcare	$758 - $2,704	86%
Cigna	$782 - $2,793	89%
Great West Healthcare	$782 - $2,793	89%
Asr	$790 - $2,821	90%
Blue Care Network	$790 - $2,821	90%
Health Alliance Plan	$790 - $2,821	90%
Cofinity	$800 - $2,856	91%
Priority Health Medihmo	$877	100%
Mclaren Commercial	$880 - $3,142	100%

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 $494.
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 Sparrow Ionia 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.