CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Galion Community Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $4,008
Cash Discount Price: $4,436
vs. Medicare Baseline: 4.57x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Galion Community Hospital is $4,008. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,436. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 4.57x the Medicare baseline. Located in 269 Portland Way South, Galion, OH.

Cash / Self-Pay

$4,436

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,008

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: $4,436 (506%)

Insurance Median: $4,008 (457%)

Cash: $4,436 (506% of Medicare)

Ins. Median: $4,008 (457% 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 457% of the Medicare baseline (a markup of 357%). 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
Caresource	$1,189	136%
Medicaid / KanCare	$1,189	136%
Ohiorise	$1,189	136%
Molina	$1,213 - $5,629	138%
Blue Cross Blue Shield	$1,225 - $4,332	140%
Amerihealth	$1,248	142%
United_Healthcare	$1,248 - $4,801	142%
Buckeye	$1,286 - $4,142	147%
Humana	$1,286 - $4,142	147%
Medicare (plans)	$1,774 - $4,142	202%
Mount_Carmel	$1,774 - $4,142	202%
Aetna	$1,810 - $4,436	206%
Medical_Mutual	$4,175 - $4,224	476%
Cigna	$4,593	524%

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 $4,436.
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 Galion 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.