CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Childrens Hospital of Wisconsin

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 95810
  • Insurance Median: $4,653
  • Cash Discount Price: $3,086
  • vs. Medicare Baseline: 5.30x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Childrens Hospital of Wisconsin is $4,653. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,086. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 5.30x the Medicare baseline. Located in 9000 W Wisconsin Ave, Milwaukee, WI.
Cash / Self-Pay
$3,086

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,653

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: $3,086 (352%)
Insurance Median: $4,653 (530%)
Cash: $3,086 (352% of Medicare)
Ins. Median: $4,653 (530% 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 530% of the Medicare baseline (a markup of 430%). 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
Froedtert Health $3,619 - $5,142 412%
Medical College Of Wisconsin $3,619 - $4,235 412%
Network Health Plan $3,681 - $4,307 420%
UnitedHealthcare $3,800 - $4,604 433%
Aspirus Health Plan $3,878 - $4,537 442%
Common Ground Healthcare Cooperative $3,878 - $5,142 442%
Trilogy Health Solutions $3,878 - $5,142 442%
Wps Health Plan $3,930 - $5,445 448%
Advocate Aurora Healthcare $3,981 - $4,658 454%
Blue Cross Blue Shield $4,033 - $5,747 460%
Centivo $4,033 - $4,719 460%
Health Partners $4,033 - $5,324 460%
Employer Health Care Alliance Cooperative $4,059 - $4,749 463%
Dean Health Plan $4,136 - $4,840 471%
Group Health Cooperative Of Eau Claire $4,136 - $4,840 471%
Oan Llc $4,136 - $4,840 471%
Security Health Plan $4,292 - $5,021 489%
Health Payment Systems $4,374 - $5,118 499%
Praire States $4,395 - $5,142 501%
Quartz Health Insurance $4,395 - $5,142 501%
Sheboygan Employer'S Health Network $4,395 - $5,142 501%
Mayo Clinic Health Solutions $4,498 - $5,263 513%
Aetna $4,550 - $5,384 519%
Bellin Thedacare $4,653 - $5,445 530%
Cigna $4,653 - $5,445 530%
Group Health Cooperative Of South Central Wisconsin $4,653 - $5,445 530%
Prevea Health Network $4,653 - $5,445 530%
Multiplan $4,705 - $5,747 536%
Coventry Health Care $4,912 - $5,747 560%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9000 W Wisconsin Ave, Milwaukee, WI 53226
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Childrens