CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Johnston Memorial Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $976
Cash Discount Price: $549
vs. Medicare Baseline: 1.11x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Johnston Memorial Hospital is $976. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $549. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.11x the Medicare baseline. Located in 16000 Johnston Memorial Drive, Abingdon, VA.

Cash / Self-Pay

$549

Average discount available for prompt cash payment at this facility.

Insurance Median

$976

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: $549 (63%)

Insurance Median: $976 (111%)

Cash: $549 (63% of Medicare)

Ins. Median: $976 (111% 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.

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
Blue Cross Blue Shield	$181 - $3,430	21%
UnitedHealthcare	$715 - $2,776	81%
Aetna	$838 - $2,334	96%
Humana	$838	96%
Managed Medicaire	$838	96%
Medicare (plans)	$838	96%
Mountain Empire Pace	$838	96%
Sentara Health	$838 - $1,228	96%
United Mine Workers Of America	$838	96%
Amerigroup	$871 - $897	99%
Molina Healthcare	$871 - $1,015	99%
Cigna	$880 - $1,698	100%
Devoted Health Plan	$880	100%
Nhc Advantage	$880	100%
Wellcare	$888	101%
Optima Health	$976	111%
Medcost	$1,281	146%
Ambetter / Centene	$1,827	208%
First Health Coventry	$3,659	417%
Seven Corners, Inc.	$3,659	417%

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 $549.
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 Johnston Memorial 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.