CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Monmouth Medical Center

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $3,964
Cash Discount Price: $1,703
vs. Medicare Baseline: 4.52x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Monmouth Medical Center is $3,964. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,703. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 4.52x the Medicare baseline. Located in 300 Second Avenue, Long Branch, NJ.

Cash / Self-Pay

$1,703

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,964

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: $1,703 (194%)

Insurance Median: $3,964 (452%)

Cash: $1,703 (194% of Medicare)

Ins. Median: $3,964 (452% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 452% of the Medicare baseline (a markup of 352%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Aetna	$1,126 - $4,670	128%
Blue Cross Blue Shield	$1,126 - $7,527	128%
Clover Health	$1,126	128%
Fidelis Care	$1,126 - $1,971	128%
Humana	$1,126	128%
Wellpoint	$1,126 - $4,436	128%
UnitedHealthcare	$1,134 - $4,663	129%
Emblem Health	$1,971	225%
Wellcare	$2,241	255%
Amerihealth	$3,083 - $3,577	351%
Cigna	$3,806 - $4,836	434%
First Health	$4,670	532%
Qualcare Inc	$5,977 - $6,374	681%

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 $1,703.
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 Monmouth 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.