CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Fairfield Medical Center

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $1,113
Cash Discount Price: $967
vs. Medicare Baseline: 1.27x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Fairfield Medical Center is $1,113. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $967. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.27x the Medicare baseline. Located in 401 North Ewing Street, Lancaster, OH.

Cash / Self-Pay

$967

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,113

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: $967 (110%)

Insurance Median: $1,113 (127%)

Cash: $967 (110% of Medicare)

Ins. Median: $1,113 (127% 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.

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
Medicaid / KanCare	$326 - $653	37%
Molina	$326 - $10,195	37%
UnitedHealthcare	$326 - $6,178	37%
Caresource	$330 - $8,032	38%
Blue Cross Blue Shield	$336 - $26,250	38%
Humana	$340 - $6,058	39%
Amerihealth Caritas Ohio	$343 - $686	39%
Buckeye Community Health	$343 - $9,577	39%
Aetna	$407 - $6,058	46%
Medical Mutual	$407 - $33,500	46%
Medicare (plans)	$407 - $6,058	46%
Medigold	$414 - $6,178	47%
Va Ccn	$414 - $6,178	47%
The Health Plan	$416 - $6,179	47%
Valor Health Plan	$416 - $6,179	47%
Bwc	$575 - $8,582	66%
Oscar	$766 - $6,882	87%
Allied Benefit Systems	$1,493	170%
Meritain Health	$1,493	170%
Quality Care Partners/Ohio Ppo Connect	$1,547	176%
The Ohio State Health Plan	$1,654	189%
Cigna	$1,770	202%
Ohio Healthy	$2,019	230%
Multiplan	$2,041	233%
Miscellaneous Plans	$2,148	245%

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 $967.
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 Fairfield 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.