CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: St Francis Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 95810
  • Insurance Median: $3,103
  • Cash Discount Price: $3,999
  • vs. Medicare Baseline: 3.54x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at St Francis Hospital is $3,103. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,999. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 3.54x the Medicare baseline. Located in 7Th and Clayton Sts, Wilmington, DE.
Cash / Self-Pay
$3,999

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,103

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: $3,999 (456%)
Insurance Median: $3,103 (354%)
Cash: $3,999 (456% of Medicare)
Ins. Median: $3,103 (354% 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 354% of the Medicare baseline (a markup of 254%). 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
Pace-Trinity Health $827 94%
Saint Francis Life $827 94%
Blue Cross Blue Shield $914 - $5,972 104%
Cigna $923 - $3,809 105%
Medicare (plans) $937 - $958 107%
Blue Shield - De (Highmark) Medciare Advantage $941 107%
Highmark Health Options Dual Plan $941 107%
Aetna $967 - $4,098 110%
Coventry $1,097 125%
Delaware First Health $1,283 146%
Medicaid / KanCare $2,154 246%
Blue Benefit Administrators Of Massachusetts $3,103 354%
Blue Care Network $3,103 354%
Blue Distinction Transplant $3,103 354%
Blue Shield - Ca $3,103 354%
Blue Shield - Id (Regence) $3,103 354%
Blue Shield - Ny Highmark Northeastern $3,103 354%
Blue Shield - Ny Highmark Western $3,103 354%
Blue Shield - Pa (Highmark) $3,103 354%
Blue Shield - Wa (Regence) $3,103 354%
Meritain $4,098 467%
Trustmark Small Business Benefits $4,098 467%
Devon Health Services $5,845 666%
Galaxy Health Network $5,845 666%
Multiplan $5,845 666%
Prime Health Services $5,845 666%
Three Rivers Provider Network $5,845 666%
Wc Corvel $5,845 666%
Geha $5,907 673%
UnitedHealthcare $5,907 673%
Amerihealth $5,972 681%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7Th and Clayton Sts, Wilmington, DE 19805
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals