CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Pomerene Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $224
Cash Discount Price: $2,024
vs. Medicare Baseline: 0.26x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Pomerene Hospital is $224. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,024. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 0.26x the Medicare baseline. Located in 981 Wooster Road, Millersburg, OH.

Cash / Self-Pay

$2,024

Average discount available for prompt cash payment at this facility.

Insurance Median

$224

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: $2,024 (231%)

Insurance Median: $224 (26%)

Cash: $2,024 (231% of Medicare)

Ins. Median: $224 (26% 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
Aetna	$114 - $4,257	13%
Aultcare Ma	$114 - $796	13%
Blue Cross Blue Shield	$114 - $4,039	13%
Humana	$114 - $796	13%
Medical Mutual Of Ohio Mcr Adv	$114 - $796	13%
Medicare (plans)	$114 - $796	13%
Molina Healthcare Of Ohio Mcr Adv	$114 - $796	13%
Summacare Health Plan Ma	$114 - $796	13%
UnitedHealthcare	$114 - $4,257	13%
Aultcare	$195 - $4,208	22%
Summacare Health Plan	$208 - $4,498	24%
Amerihealth Caritas Ohio - Nontransportation Mce	$224	26%
Caresource Oh Mce	$224	26%
Medicaid / KanCare	$224	26%
Molina Healthcare Of Ohio Mcd Rep	$224	26%
Paramount Care Mcd Rep	$224	26%
Cigna	$259 - $4,281	30%
Valor Health Plan	$796	91%
Medical Mutual Of Ohio	$4,257	485%

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 $2,024.
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 Pomerene Hospital 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.