CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Ascension Ne Wisconsin - St Elizabeth Campus

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $1,045
Cash Discount Price: $3,551
vs. Medicare Baseline: 1.19x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Ascension Ne Wisconsin - St Elizabeth Campus is $1,045. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,551. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.19x the Medicare baseline. Located in 1506 S Oneida St, Appleton, WI.

Cash / Self-Pay

$3,551

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,045

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: $3,551 (405%)

Insurance Median: $1,045 (119%)

Cash: $3,551 (405% of Medicare)

Ins. Median: $1,045 (119% 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	$126	14%
Cchp	$247 - $1,310	28%
Centivo Nw1	$408 - $1,993	47%
Centivo Nw3	$408 - $1,993	47%
Medicare (plans)	$978	111%
Veterans Administration	$978	111%
Wellcare	$1,027	117%
Smarthealth	$1,369	156%
Molina Marketplace	$2,054	234%
Aca	$2,887	329%
Alliance	$3,125	356%
UnitedHealthcare	$3,687	420%

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 $3,551.
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 Ascension Ne Wisconsin - St Elizabeth Campus 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.