CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Ohio State University State Health System

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $2,288
Cash Discount Price: Unavailable
vs. Medicare Baseline: 2.61x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Ohio State University State Health System is $2,288. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 2.61x the Medicare baseline. Located in 410 West 10Th Avenue, Columbus, OH.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,288

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%)

Insurance Median: $2,288 (261%)

Ins. Median: $2,288 (261% 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 261% of the Medicare baseline (a markup of 161%). 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
Aetna	$974 - $4,034	111%
Blue Cross Blue Shield	$974 - $4,883	111%
Medicare (plans)	$974 - $1,052	111%
Medigold	$974	111%
Mmo	$974 - $3,220	111%
Molina	$974 - $1,626	111%
Upper Ohio Valley	$974 - $3,312	111%
Humana	$993 - $2,308	113%
Buckeye Community	$1,003 - $1,510	114%
Caresource	$1,023 - $1,510	117%
Healthspan	$1,023 - $2,409	117%
Osu Health Plan	$1,556 - $2,509	177%
Ohio Ppo	$1,872 - $2,249	213%
Odrc	$2,040	233%
United	$2,676	305%
Cigna	$3,260	372%
Ohiohealth	$3,262 - $3,764	372%
Lifetrac	$3,412	389%
Frontpath	$4,014	458%
Multiplan	$4,014	458%
Healthsmart	$4,516	515%

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 $X.
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 Ohio State University State Health System 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.