CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Saint Michael's Medical Center

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 95810
  • Insurance Median: $1,394
  • Cash Discount Price: $995
  • vs. Medicare Baseline: 1.59x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Saint Michael's Medical Center is $1,394. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $995. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.59x the Medicare baseline. Located in 111 Central Avenue, Newark, NJ.
Cash / Self-Pay
$995

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,394

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: $995 (113%)
Insurance Median: $1,394 (159%)
Cash: $995 (113% of Medicare)
Ins. Median: $1,394 (159% 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
Tricare $797 91%
Aetna $996 - $2,111 114%
Amerihealth $996 114%
Horizon $996 - $2,038 114%
Humana $996 114%
Medicare (plans) $996 114%
New Jersey Out of State $996 114%
UnitedHealthcare $996 - $5,320 114%
Wellpoint Amerigroup $996 114%
Wellcare $1,026 - $1,344 117%
Clover Health $1,036 118%
Curana $1,046 119%
Employer Direct Healthcare $1,394 159%
Naphcare $1,544 176%
Cigna $1,592 181%
Fairprice Healthcare Holdings - Fphh $1,593 182%
Coventry $1,992 227%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 111 Central Avenue, Newark, NJ 07102
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals