CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Holy Family Memorial

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $3,324
Cash Discount Price: $2,890
vs. Medicare Baseline: 3.79x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Holy Family Memorial is $3,324. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,890. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 3.79x the Medicare baseline. Located in 2300 Western Ave, Manitowoc, WI.

Cash / Self-Pay

$2,890

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,324

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: $2,890 (329%)

Insurance Median: $3,324 (379%)

Cash: $2,890 (329% of Medicare)

Ins. Median: $3,324 (379% 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 379% of the Medicare baseline (a markup of 279%). 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
Network Health Plan	$478 - $968	54%
Blue Cross Blue Shield	$968 - $3,311	110%
Community Care Incorporated	$968	110%
Health Partners	$968 - $3,415	110%
Humana	$968	110%
Icare	$968	110%
Molina	$968 - $1,045	110%
Security Health Plan	$968 - $4,203	110%
UnitedHealthcare	$968 - $4,090	110%
Allwell	$987	112%
Medical College Of Wisconsin	$1,734	198%
Centivo	$2,102 - $2,417	240%
Dean Health Plan	$2,627	299%
Health Payment Systems	$2,963	338%
Sheboygan Employers Health Network	$3,152	359%
Chorus Community Health Plan	$3,378	385%
Trilogy	$3,468	395%
Cigna	$3,783	431%
Wps Health Plan	$3,888	443%
Aspirus	$4,203	479%
Healtheos	$4,203	479%
Multiplan/Private Healthcare Systems	$4,203	479%
Preferred One	$4,203	479%
Healthsmart	$4,361	497%
First Health Network	$4,624	527%

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 $2,890.
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 Holy Family Memorial 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.