CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Marshfield Medical Center - Beaver Dam (Mmc-Bd)

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $7,770
Cash Discount Price: $8,921
vs. Medicare Baseline: 8.86x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Marshfield Medical Center - Beaver Dam (Mmc-Bd) is $7,770. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,921. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 8.86x the Medicare baseline. Located in 707 S University Ave, Beaver Dam, WI.

Cash / Self-Pay

$8,921

Average discount available for prompt cash payment at this facility.

Insurance Median

$7,770

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: $8,921 (1017%)

Insurance Median: $7,770 (886%)

Cash: $8,921 (1017% of Medicare)

Ins. Median: $7,770 (886% 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 886% of the Medicare baseline (a markup of 786%). 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
Blue Cross Blue Shield	$3,183 - $4,776	363%
The Alliance	$4,768	543%
Security Health Plan (Shp)	$4,881 - $5,424	556%
Amish/Mennonite	$5,164	589%
Quartz	$5,352	610%
Wps Health Insurance	$6,319	720%
Cigna	$6,385 - $6,949	728%
Health Payment Systems	$6,535	745%
UnitedHealthcare	$7,033	802%
Humana	$7,418 - $8,357	846%
Group Health Cooperative Of Eau Claire	$7,700 - $8,920	878%
Network Health Plan	$7,841	894%
First Health	$7,982	910%
Molina Healthcare Of Wi	$7,982	910%
Trilogy	$8,451	963%
Healtheos By Multiplan Inc.	$8,733 - $8,920	995%
Health Partners	$8,920	1017%
Coventry	$9,014	1027%

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 $8,921.
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 Marshfield Medical Center - Beaver Dam (Mmc-Bd) 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.