CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Medstar Health Physical Therapy

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $1,240
Cash Discount Price: $1,212
vs. Medicare Baseline: 1.41x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Medstar Health Physical Therapy is $1,240. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,212. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.41x the Medicare baseline. Located in 102 Irving St Nw, Washington, DC.

Cash / Self-Pay

$1,212

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,240

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: $1,212 (138%)

Insurance Median: $1,240 (141%)

Cash: $1,212 (138% of Medicare)

Ins. Median: $1,240 (141% 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
Carefirst Advantage Inc	$900	103%
Carefirst Blue Choice Inc	$914 - $1,788	104%
Tricare	$914	104%
UnitedHealthcare	$914 - $1,492	104%
Aetna	$927 - $1,305	106%
Health Care Service Corporation	$945	108%
Humana	$945	108%
Kaiser Permanente	$945 - $1,453	108%
Jhhc	$1,212	138%
Pfc	$1,212	138%
Medstar Family Choice Inc	$1,324	151%
Kaiser	$1,458	166%
Cigna	$1,585	181%
First Health	$1,585	181%
Private Healthcare Systems (Phcs)	$1,585	181%

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 $1,212.
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 Medstar Health Physical Therapy 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.