CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Memorial Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $2,789
Cash Discount Price: $5,249
vs. Medicare Baseline: 3.18x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Memorial Hospital is $2,789. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,249. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 3.18x the Medicare baseline. Located in 715 South Taft Avenue, Fremont, OH.

Cash / Self-Pay

$5,249

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,789

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: $5,249 (598%)

Insurance Median: $2,789 (318%)

Cash: $5,249 (598% of Medicare)

Ins. Median: $2,789 (318% 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 318% of the Medicare baseline (a markup of 218%). 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	$470 - $10,217	54%
Buckeye Community Health Plan	$470 - $10,217	54%
Medical Mutual Of Ohio	$470 - $5,394	54%
Meridian Health Plan Of Mi	$470 - $6,641	54%
UnitedHealthcare	$508 - $10,217	58%
Summacare	$534 - $7,898	61%
Paramount Healthcare Inc	$598 - $10,217	68%
Blue Cross Blue Shield	$607 - $10,217	69%
Frontpath	$613 - $4,934	70%
Health Alliance Plan	$613 - $10,217	70%
Humana	$613 - $6,641	70%
Molina Healthcare Of Ohio	$613 - $10,217	70%
Caresource	$623 - $10,217	71%
Cigna	$698 - $5,628	80%
Amerihealth	$832 - $8,398	95%
Health Ohio Network	$847 - $10,217	97%
Multiplan	$1,987 - $7,268	226%

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 $5,249.
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 Memorial 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.