CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Adventist Health Portland

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 95810
  • Insurance Median: $2,854
  • Cash Discount Price: $1,492
  • vs. Medicare Baseline: 3.25x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Adventist Health Portland is $2,854. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,492. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 3.25x the Medicare baseline. Located in 10123 Se Market Street, Portland, OR.
Cash / Self-Pay
$1,492

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,854

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: $1,492 (170%)
Insurance Median: $2,854 (325%)
Cash: $1,492 (170% of Medicare)
Ins. Median: $2,854 (325% 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 325% of the Medicare baseline (a markup of 225%). 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
Ods - All Plans $764 87%
Care Oregon - All Plans $811 92%
Healthcare Resources - All Plans $925 - $1,170 105%
Kaiser Mcr Adv $955 109%
Humana $974 - $1,012 111%
Moda Mcr Adv $1,012 115%
UnitedHealthcare $1,012 - $3,125 115%
Healthnet Mcr Adv $1,098 125%
Workers Comp $1,425 - $1,802 162%
Ah Employee Health Plan - All Plans $1,718 196%
Moda Conn Oebb/Syn Pebb $1,909 218%
Bc Premera First - All Plans $2,059 - $2,604 235%
Moda Affinity - All Other Plans $2,195 250%
Regence Ohsu Plus $2,212 252%
Healthnet Hmo/Pos - All Other Plans $2,343 - $2,964 267%
Healthnet Epo/Pos/Ppo $2,364 - $2,990 269%
Regence - All Other Plans $2,458 280%
Worldventure - All Plans $2,471 - $3,125 282%
Kaiser - All Other Plans $2,489 284%
Providence Hp - All Plans $2,677 - $3,386 305%
Regence Preferred Mcr Adv $2,687 - $3,399 306%
Pacific Source Comm - All Plans $2,718 - $3,438 310%
Cigna $2,780 - $3,516 317%
First Choice - All Plans $2,854 - $3,610 325%
Moda Select $2,988 341%
Multiplan - All Plans $3,088 - $3,907 352%
Phcs - All Plans $3,088 - $3,907 352%
Regence Mcr Adv $3,130 - $3,959 357%
Aetna $3,171 - $4,011 361%
First Health-Coventry - All Plans $3,294 - $4,167 375%
Moda Connexus $3,379 385%
Moda Synergy $3,575 407%
National Provider Network - All Plans $3,624 - $4,584 413%
Health Payors Organization Ltd- All Plans $3,706 - $4,688 422%
Moda Ohsu Ppo/Epo/Hmc $7,412 - $9,376 845%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 10123 Se Market Street, Portland, OR 97216
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals