CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Wooster Community Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 95810
  • Insurance Median: $4,800
  • Cash Discount Price: $5,999
  • vs. Medicare Baseline: 5.47x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Wooster Community Hospital is $4,800. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,999. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 5.47x the Medicare baseline. Located in 1761 Beall Avenue, Wooster, OH.
Cash / Self-Pay
$5,999

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,800

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: $5,999 (684%)
Insurance Median: $4,800 (547%)
Cash: $5,999 (684% of Medicare)
Ins. Median: $4,800 (547% 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 547% of the Medicare baseline (a markup of 447%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Buckeye Mcaid-All Other Plans $617 70%
Caresource Mcaid $617 70%
UnitedHealthcare $617 - $5,700 70%
Molina Mcaid $629 72%
Blue Cross Blue Shield $635 - $5,520 72%
Aetna $648 - $5,999 74%
Amerihealth Mcaid-All Plans $648 74%
Tricare $813 93%
Buckeye Mcare $830 95%
Caresource Mcr Adv $830 95%
Humana $830 - $5,640 95%
Med Mutual Of Oh Mcr $830 95%
Molina Mcr $830 95%
Summacare Mcr $830 95%
The Health Plan Mcr Adv $830 95%
Valor Hp Mcr-All Plans $830 95%
Magnipower-All Plans $1,079 123%
Caresource Exch - All Other Plans $1,187 135%
Molina Marketplace - All Other Plans $1,411 161%
Clarity Health - All Plans $1,618 184%
Aultcare/Primecare Mcr Adv $2,940 335%
Cerco-All Plans $4,200 479%
Aultcare Wayne County $4,500 513%
Aultcare/Primetime Exch $4,500 513%
Rayco-All Plans $4,500 513%
Christian Health Ministries-All Plans $4,800 547%
Cigna $4,800 547%
Health Ohio Network Employer $4,800 547%
Wayne County-All Plans $4,800 547%
Healthsmart Accel $4,980 568%
Summacare Preferred Choice $4,980 568%
Health Ohio Network Ppo-All Other Plans $5,100 581%
Healthsmart Complete Ppo-All Other Plans $5,100 581%
Ohio Health Choice Supp $5,100 581%
Ohio Health Group Hlthy - All Other Plans $5,100 581%
Med Mutual Of Oh Exchange $5,160 588%
Med Mutual Of Oh Supermed $5,160 588%
Med Mutual Of Oh Trad-All Other Plans $5,160 588%
Health Plan Of Upper Ohio-All Plans $5,286 603%
The Health Plan Comm - All Other Plans $5,286 603%
Ohio Health Group Pref $5,340 609%
Aultcare/Primetime-All Other Plans $5,400 615%
Healthsmart Ppo $5,460 622%
Summacare-All Other Plans $5,580 636%
Ohio Health Choice-All Other Plans $5,640 643%
Healthsmart Hpo $5,700 650%
Osu-All Plans $5,700 650%
Central Benefits-All Plans $5,760 657%
First Health-All Plans $5,760 657%
Flora-All Plans $5,760 657%
Beech Street-All Plans $5,820 663%
Phcs-All Plans $5,820 663%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1761 Beall Avenue, Wooster, OH 44691
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals