CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Wilkes Regional Medical Center

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $1,721
Cash Discount Price: $1,666
vs. Medicare Baseline: 1.96x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Wilkes Regional Medical Center is $1,721. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,666. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.96x the Medicare baseline. Located in 1370 West D St, North Wilkesboro, NC.

Cash / Self-Pay

$1,666

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,721

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: $1,666 (190%)

Insurance Median: $1,721 (196%)

Cash: $1,666 (190% of Medicare)

Ins. Median: $1,721 (196% 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
Amerihealth	$623 - $1,935	71%
Carolina Complete	$623	71%
Healthblue	$623	71%
Partners	$623	71%
UnitedHealthcare	$630 - $1,779	72%
Vaya	$630	72%
Wellcare	$630	72%
Alliance	$636	72%
Trillium	$642	73%
Medcost	$959 - $2,378	109%
Healthteam	$1,001	114%
Aetna	$1,266 - $2,288	144%
Blue Cross Blue Shield	$1,337 - $1,944	152%
Ambetter / Centene	$1,409 - $2,029	161%
Cigna	$1,745 - $1,805	199%
Oscar	$1,832 - $2,165	209%
Directnet	$1,969	224%
Private Healthcare Systems	$2,998	342%
Multiplan	$3,065	349%

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 $1,666.
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 Wilkes Regional Medical Center 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.