CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: St Joseph's Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 95810
  • Insurance Median: $3,911
  • Cash Discount Price: $4,028
  • vs. Medicare Baseline: 4.46x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at St Joseph's Hospital is $3,911. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,028. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 4.46x the Medicare baseline. Located in 12866 Troxler Avenue, Highland, IL.
Cash / Self-Pay
$4,028

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,911

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: $4,028 (459%)
Insurance Median: $3,911 (446%)
Cash: $4,028 (459% of Medicare)
Ins. Median: $3,911 (446% 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 446% of the Medicare baseline (a markup of 346%). 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
Molina Healthcare $797 - $1,594 91%
Meridian Health Plan $835 - $1,670 95%
UnitedHealthcare $1,119 - $5,595 128%
Aetna $1,119 - $3,911 128%
Blue Cross Blue Shield $1,119 128%
Humana $1,119 128%
Clear Spring Health of Illinois $1,119 128%
Sae Hospice $1,119 128%
Amish Community $1,567 179%
Naphcare $2,350 268%
Celtic Insurance Company $2,462 281%
Hopetrust $2,798 319%
Claim Doc $2,798 319%
Wellfirst $3,582 408%
Cigna $3,749 427%
Caterpillar, Inc. $4,125 470%
First Health $4,135 471%
Multiplan/Phcs $4,756 542%
Healthlink $4,756 542%
Provider Network of America $5,036 574%
Healthcare Finest Network (Hfn) $5,036 574%
Illinois Breast and Cervical Cancer Program $5,595 638%
Healthscope $5,595 638%
Current Health Solutions $5,595 638%
Health Alliance Medical Plans $5,595 638%
Consociate Group $5,595 638%
Qtc Medical Group of Illinois $5,595 638%
Mental Health Network $5,595 638%
Interplan $5,595 638%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12866 Troxler Avenue, Highland, IL 62249
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals