CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Bayshore Medical Center

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $6,438
Cash Discount Price: $1,126
vs. Medicare Baseline: 7.34x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Bayshore Medical Center is $6,438. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,126. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 7.34x the Medicare baseline. Located in 727 N Beers St, Holmdel, NJ.

Cash / Self-Pay

$1,126

Average discount available for prompt cash payment at this facility.

Insurance Median

$6,438

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: $1,126 (128%)

Insurance Median: $6,438 (734%)

Cash: $1,126 (128% of Medicare)

Ins. Median: $6,438 (734% 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 734% of the Medicare baseline (a markup of 634%). 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
Blue Cross Blue Shield	$1,126	128%
Wellcare	$1,126	128%
Vaccn	$1,126	128%
United Community/Americhoice	$1,182	135%
Aetna	$1,227 - $7,056	140%
UnitedHealthcare	$1,351 - $8,526	154%
Horizon	$1,518 - $7,778	173%
Clover	$1,622	185%
Seoul Medical Group	$1,685	192%
Oxford	$5,634	642%
Amerihealth	$5,782 - $6,438	659%
Bergen Risk	$6,758	770%
Qualcare	$7,002 - $7,930	798%
Cigna	$7,209 - $8,617	822%
Multiplan - PHCS	$7,659	873%
Brighton Health Plan	$8,110	924%

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 $1,126.
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 Bayshore 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.