CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Community Memorial Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 95810
  • Insurance Median: $4,463
  • Cash Discount Price: $3,557
  • vs. Medicare Baseline: 5.09x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Community Memorial Hospital is $4,463. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,557. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 5.09x the Medicare baseline. Located in W180 N8085 Town Hall Rd, Menomonee Falls, WI.
Cash / Self-Pay
$3,557

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,463

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: $3,557 (405%)
Insurance Median: $4,463 (509%)
Cash: $3,557 (405% of Medicare)
Ins. Median: $4,463 (509% 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 509% of the Medicare baseline (a markup of 409%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Allwell $988 113%
Blue Cross Blue Shield $988 - $5,498 113%
Community Care $988 113%
Health Partners $988 - $4,204 113%
Humana $988 113%
Icare $988 113%
Network Health Plan $988 - $2,947 113%
Security Health Plan $988 113%
UnitedHealthcare $988 - $4,090 113%
Aetna $1,008 - $4,528 115%
Care Wisconsin/Mychoice $1,018 116%
Centivo $1,940 - $2,134 221%
Froedtert South $2,717 310%
Chorus Community Health Plan $2,781 317%
Sheboygan Employers Health Network $3,294 375%
Common Ground $3,881 442%
Trilogy $4,463 509%
Health Payment Systems $4,499 513%
Wisconsin Physician Services $4,528 516%
Aspirus $5,174 590%
Ibsi Passport $5,239 597%
Americas Choice $5,627 641%
Federated Mutual $5,627 641%
Healtheos $5,627 641%
Multiplan/Private Healthcare Systems $5,627 641%
Savility $5,627 641%
Cigna $5,692 649%
First Health Network $5,692 649%
Healthsmart $5,821 663%
Physicians Plus $5,821 663%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: W180 N8085 Town Hall Rd, Menomonee Falls, WI 53051
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals