CMS Price Transparency Data
Sleep study (overnight, in lab)
Facility: Newton Medical Center
Billing Code: 95810 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 95810
- Insurance Median: $1,181
- Cash Discount Price: $1,181
- vs. Medicare Baseline: 1.35x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Newton Medical Center is $1,181. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,181. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.35x the Medicare baseline. Located in 175 High St, Newton, NJ.
Cash / Self-Pay
$1,181
Average discount available for prompt cash payment at this facility.
Insurance Median
$1,181
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: $1,181 (135%)
Insurance Median: $1,181 (135%)
Cash: $1,181 (135% of Medicare)
Ins. Median: $1,181 (135% 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.
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 Caritas Vip Care Ip Splits [5460] | $472 | 54% |
| Amerihealth Caritas Vip Care [5313] | $472 | 54% |
| Medicare (plans) | $489 - $1,180 | 56% |
| Wtc Health Program [5273] | $1,086 | 124% |
| Cosmetic Surgery/Lap Band/Gastric Bypass [5289] | $1,112 | 127% |
| Fairos [5491] | $1,112 | 127% |
| Karen Ann Quinlan [5285] | $1,112 | 127% |
| Medicaid / KanCare | $1,112 | 127% |
| Specialty Imaging [5433] | $1,112 | 127% |
| Horizon Nj Health [5021] | $1,162 | 132% |
| Aetna | $1,180 - $2,424 | 134% |
| Ambetter / Centene | $1,180 | 134% |
| Amerihealth Administrators Supplemental [5512] | $1,180 | 134% |
| Amerihealth Medigap [5049] | $1,180 | 134% |
| Blue Cross Blue Shield | $1,180 | 134% |
| Champva [5354] | $1,180 | 134% |
| Cigna | $1,180 | 134% |
| Claim Watcher/Homestead [5488] | $1,180 | 134% |
| Claimdoc [5434] | $1,180 | 134% |
| Highmark Wholecare Health Plan Ip Splits [5464] | $1,180 | 134% |
| Highmark Wholecare Health Plan [5413] | $1,180 | 134% |
| Luminare Health AHS Retiree [5013] | $1,180 | 134% |
| Sedgwick Wtc Health Program Wc [5514] | $1,180 | 134% |
| Tricare | $1,180 | 134% |
| UPMC [5455] | $1,180 | 134% |
| Us Family Health Plan [5258] | $1,180 | 134% |
| VA Community Care Network [5403] | $1,180 | 134% |
| Wellcare Behavioral Health [5335] | $1,180 | 134% |
| Wellcare Health Plans Ip Splits [5475] | $1,180 | 134% |
| Wellcare Health Plans [5269] | $1,180 | 134% |
| Kindred Giralda Hospital [5341] | $1,299 | 148% |
| 1199 Seiu Benefit and Pension [5037] | $2,424 | 276% |
| Allied Benefit Systems [5046] | $2,424 | 276% |
| Banner Health Network [5510] | $2,424 | 276% |
| Boon-Chapman [5441] | $2,424 | 276% |
| Christian Brothers Services [5439] | $2,424 | 276% |
| Continental Assurance [5091] | $2,424 | 276% |
| Evolution Healthcare [5438] | $2,424 | 276% |
| Healthez [5445] | $2,424 | 276% |
| Healthsmart Benefit Solutions [5446] | $2,424 | 276% |
| Luminare Health Benefits [5483] | $2,424 | 276% |
| Marpai Health [5449] | $2,424 | 276% |
| Meritain Health [5185] | $2,424 | 276% |
| Nippon Benefit Life [5201] | $2,424 | 276% |
| Starmark [5240] | $2,424 | 276% |
| Webtpa [5447] | $2,424 | 276% |
| Amerihealth [5008] | $3,533 - $4,343 | 403% |
| Oxford Behavioral Health [5291] | $4,575 | 521% |
| Oxford [5024] | $4,575 | 521% |
| UnitedHealthcare | $4,575 - $4,717 | 521% |
| Apwu Healthcare [5053] | $4,717 | 538% |
| Geha [5119] | $4,717 | 538% |
| Golden Rule Insurance [5124] | $4,717 | 538% |
| Harvard Pilgrim Healthcare [5133] | $4,717 | 538% |
| Ntca [5208] | $4,717 | 538% |
| Surest [5437] | $4,717 | 538% |
| Centivo [5405] | $5,533 | 631% |