CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Licking Memorial Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 95810
  • Insurance Median: $2,440
  • Cash Discount Price: $4,297
  • vs. Medicare Baseline: 2.78x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Licking Memorial Hospital is $2,440. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,297. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 2.78x the Medicare baseline. Located in 1320 West Main Street, Newark, OH.
Cash / Self-Pay
$4,297

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,440

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: $4,297 (490%)
Insurance Median: $2,440 (278%)
Cash: $4,297 (490% of Medicare)
Ins. Median: $2,440 (278% 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 278% of the Medicare baseline (a markup of 178%). 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
Tricare $811 92%
Aetna $828 - $4,858 94%
Blue Cross Blue Shield $828 - $5,052 94%
Champva [500001] $828 94%
Cigna $828 - $5,294 94%
Humana $828 - $5,705 94%
Medicare (plans) $828 94%
UnitedHealthcare $828 - $4,999 94%
Veterans Administration [100068] $828 94%
Wellcare By Allwell [450104] $828 94%
Molina Marketplace [100106] $1,325 151%
Medical Mutual [100114] $1,491 - $4,882 170%
Medben [700068] $1,898 - $5,764 216%
Benicomp [70090] $2,034 - $4,411 232%
Consociate Health 6 Degrees [100059] $2,169 - $4,705 247%
Consociate Health [100029] $2,169 - $4,705 247%
Allied Benefit Systems [100015] $2,218 - $4,811 253%
Geha [100039] $2,218 - $4,811 253%
Gravie Administrative Services [100165] $2,218 - $4,811 253%
Meritain [100063] $2,218 - $4,811 253%
Optima [700069] $2,218 - $4,811 253%
Trustmark Small Business Benefits [100263] $2,218 - $4,811 253%
Webtpa [100127] $2,218 - $4,811 253%
Healthscope [100157] $2,305 - $4,999 263%
Surest [100016] $2,305 - $4,999 263%
United Medical Resources [700071] $2,305 - $4,999 263%
American Postal Workers [100089] $2,440 - $5,294 278%
Antidote Health Plan Of Ohio [70006803] $2,440 - $5,294 278%
Coresource [100002] $2,440 - $5,882 278%
Great West Life [700064] $2,440 - $5,294 278%
National Association Of Letter Carriers [100067] $2,440 - $5,294 278%
Ohio Healthy Luminare Health [100264] $2,440 - $5,294 278%
Ohio Healthy [100255] $2,440 - $5,294 278%
Ohio Ppo Connect [70006801] $2,440 - $5,294 278%
Osu Prime Care [100254] $2,440 - $5,294 278%
Quality Care Partners [70006802] $2,440 - $5,294 278%
The Health Plan [100261] $2,440 - $5,294 278%
Wellfleet Group, Llc [100164] $2,440 - $5,294 278%
Coventry [100010] $2,503 - $5,429 285%
Pan American Life [700070] $2,503 - $5,429 285%
Ohio Health Choice [100109] $2,603 - $5,646 297%
Administrative Concepts [100006] $2,630 - $5,705 300%
Carefactor [100087] $2,630 - $5,705 300%
Philadelphia American Life [100260] $2,630 - $5,882 300%
Reliance Standard-Asrm [100258] $2,630 - $5,705 300%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1320 West Main Street, Newark, OH 43055
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals