CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Unitypoint Health - Meriter

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $595
Cash Discount Price: $1,202
vs. Medicare Baseline: 0.68x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Unitypoint Health - Meriter is $595. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,202. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 0.68x the Medicare baseline. Located in 202 S Park St, Madison, WI.

Cash / Self-Pay

$1,202

Average discount available for prompt cash payment at this facility.

Insurance Median

$595

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: $1,202 (137%)

Insurance Median: $595 (68%)

Cash: $1,202 (137% of Medicare)

Ins. Median: $595 (68% 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
Aspirus	$109 - $983	12%
Blue Cross Blue Shield	$109 - $5,111	12%
Illinicare	$109 - $983	12%
Prevea 360	$109 - $2,127	12%
UnitedHealthcare	$109 - $1,353	12%
Humana	$115 - $983	13%
Meridiancare	$115 - $983	13%
Health Partners Open Network	$246 - $1,215	28%
Cigna	$280 - $701	32%
Security Health Plan	$300 - $751	34%
Wellmark Uph Self-Funded	$326 - $5,111	37%
Mercy Care	$350 - $876	40%
Medical Associates Health Plan	$469 - $2,492	53%

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 $1,202.
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 Unitypoint Health - Meriter 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.