CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Southern Ocean Medical Center

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $6,281
Cash Discount Price: $1,112
vs. Medicare Baseline: 7.16x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Southern Ocean Medical Center is $6,281. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,112. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 7.16x the Medicare baseline. Located in 1140 Rt 72 W, Manahawkin, NJ.

Cash / Self-Pay

$1,112

Average discount available for prompt cash payment at this facility.

Insurance Median

$6,281

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: $1,112 (127%)

Insurance Median: $6,281 (716%)

Cash: $1,112 (127% of Medicare)

Ins. Median: $6,281 (716% 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 716% of the Medicare baseline (a markup of 616%). 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
Karna	$190 - $1,065	22%
Oxford	$889	101%
Blue Cross Blue Shield	$1,112	127%
Vaccn	$1,112	127%
Wellcare	$1,112	127%
United Community/Americhoice	$1,167	133%
Aetna	$1,212 - $7,659	138%
UnitedHealthcare	$1,334 - $9,295	152%
Horizon	$1,580 - $8,238	180%
Clover	$1,622	185%
Seoul Medical Group	$1,847	211%
Amerihealth	$5,844 - $6,507	666%
Bergen Risk	$6,758	770%
Cigna	$7,209 - $8,617	822%
Multiplan - PHCS	$7,659	873%
Brighton Health Plan	$8,110	924%
Qualcare	$8,182	933%

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 $1,112.
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 Southern Ocean 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.