CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Lodi Community Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $3,470
Cash Discount Price: $4,196
vs. Medicare Baseline: 3.96x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Lodi Community Hospital is $3,470. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,196. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 3.96x the Medicare baseline. Located in 225 Elyria Street, Lodi, OH.

Cash / Self-Pay

$4,196

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,470

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: $4,196 (478%)

Insurance Median: $3,470 (396%)

Cash: $4,196 (478% of Medicare)

Ins. Median: $3,470 (396% 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 396% of the Medicare baseline (a markup of 296%). 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
UnitedHealthcare	$822 - $4,003	94%
Buckeye	$866	99%
Caresource	$866	99%
Blue Cross Blue Shield	$909 - $5,282	104%
Molina	$909	104%
United	$909 - $4,610	104%
Amerihealth	$952	109%
Humana	$1,937	221%
Mmo	$1,937 - $3,454	221%
Summacare	$1,937 - $3,958	221%
Oscar	$1,945 - $2,482	222%
Aetna	$2,195 - $6,456	250%
The Health Plan	$2,582 - $5,165	294%
Amish Community Aid Plan	$2,905 - $3,228	331%
Ohcp	$3,138	358%
Aultcare	$3,228	368%
Omas	$3,228	368%
Ohio Healthy	$3,486	397%
Php	$3,874	442%
Phphi	$3,874	442%
Upmc	$3,874	442%
Cigna	$4,164	475%
Cc Ehp	$4,338	494%
Gms	$4,519	515%
Medical Benefit Corp	$4,519	515%
Consociate Health	$4,842	552%
Frontpath	$5,810	662%
Managed Care Services	$5,810	662%
Multiplan	$5,810	662%
Tertiary Care Network	$5,810	662%

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 $4,196.
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 Lodi Community 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.