CMS Price Transparency Data
Sleep study (overnight, in lab)
Facility: Prisma Health Oconee Memorial Hospital
Billing Code: 95810 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 95810
- Insurance Median: $937
- Cash Discount Price: $4,259
- vs. Medicare Baseline: 1.07x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Prisma Health Oconee Memorial Hospital is $937. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,259. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.07x the Medicare baseline. Located in 298 Memorial Dr, Seneca, SC.
Cash / Self-Pay
$4,259
Average discount available for prompt cash payment at this facility.
Insurance Median
$937
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: $4,259 (485%)
Insurance Median: $937 (107%)
Cash: $4,259 (485% of Medicare)
Ins. Median: $937 (107% 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.
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 |
|---|---|---|
| Medicaid / KanCare | $366 - $1,009 | 42% |
| First Choice Benefits Mgmt [3074] | $517 | 59% |
| Medicare (plans) | $517 - $962 | 59% |
| Humana | $553 - $909 | 63% |
| Blue Cross Blue Shield | $786 - $3,020 | 90% |
| Champva [3049] | $874 | 100% |
| Cigna | $874 - $4,547 | 100% |
| Covid19 Hrsa Uninsured Testing & Treatment Fund [904] | $874 | 100% |
| Deseret Mutual Ins Co [3066] | $874 | 100% |
| Generic Skilled Nursing [3196] | $874 | 100% |
| Hospice Contracted [1500] | $874 | 100% |
| Hospice Non Contracted [3190] | $874 | 100% |
| Triwest Healthcare Alliance Vcp [902] | $874 | 100% |
| Va Community Care Network-Vaccn [903] | $874 | 100% |
| Veterans Administration [3194] | $874 | 100% |
| UnitedHealthcare | $905 - $4,165 | 103% |
| Aetna | $918 - $5,176 | 105% |
| Healthy Conn Prime-Wellcare Prime By Atc [5310] | $918 | 105% |
| Healthy Conn Prime-First Choice Vip Care [5300] | $927 | 106% |
| Bluechoice [810] | $937 - $4,078 | 107% |
| Healthy Conn Prime-Molina Healthcare [5330] | $962 | 110% |
| Tricare | $1,006 | 115% |
| Workers Comp [600] | $1,224 | 140% |
| Prisma Health Seniorcare Pace - Midlands [5400] | $1,520 | 173% |
| Prisma Health Seniorcare Pace-Upstate [5200] | $1,520 | 173% |
| Ambetter / Centene | $1,609 | 183% |
| Bob Jones Univ-Pai [821] | $1,624 | 185% |
| Promise Health Plan Contracted [2401] | $2,293 - $3,931 | 261% |
| Sc Dept Of Corrections [2998] | $2,430 | 277% |
| Scdc-Sc Dept Of Corrections [7232] | $2,430 | 277% |
| Orangeburg Senior Helping Center Pace [5401] | $2,621 | 299% |
| Planned Administrators [820] | $3,020 | 344% |
| Golden Rule Insurance Company [2991] | $4,165 | 475% |
| Oxford Health Plans [2992] | $4,165 | 475% |
| Zzumr-Salt Lake City Ut [3169] | $4,165 | 475% |
| Meritain Health Contracted [2200] | $4,193 - $5,176 | 478% |
| Evernorth Behavioral Contracted [2982] | $4,547 | 518% |
| Mvp Health Care [3037] | $4,547 | 518% |
| Preferred Administrators Contracted [2839] | $4,586 | 523% |
| Medcost [2940] | $4,848 - $5,438 | 553% |
| Atlantic Packaging Contracted [4833] | $4,914 | 560% |
| Aps Healthcare System [2981] | $5,242 | 597% |
| Multiplan/Phcs Contracted [2950] | $5,831 | 665% |
| Vsp Vision Care [2986] | $5,897 | 672% |
| First Health Contracted [2952] | $6,093 | 694% |
| Furman Int/Allen University Student [2951] | $6,093 | 694% |
| Quiktrip-First Health [3067] | $6,093 | 694% |