CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Holyoke Medical Center

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $1,218
Cash Discount Price: $1,835
vs. Medicare Baseline: 1.39x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Holyoke Medical Center is $1,218. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,835. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.39x the Medicare baseline. Located in 575 Beech Street, Holyoke, MA.

Cash / Self-Pay

$1,835

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,218

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: $1,835 (209%)

Insurance Median: $1,218 (139%)

Cash: $1,835 (209% of Medicare)

Ins. Median: $1,218 (139% 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
Health New England	$617 - $1,237	70%
Aetna	$906 - $1,123	103%
Blue Cross Blue Shield	$1,123 - $1,472	128%
Tufts Health Plan	$1,123 - $1,282	128%
UnitedHealthcare	$1,123 - $1,387	128%
Commonwealth Care Alliance	$1,179	134%
Wellsense Sco	$1,190	136%
Fallon	$1,201 - $1,237	137%
Wellcare	$1,201	137%
Bmchp	$1,237	141%
Cigna	$1,261	144%
Senior Whole Health	$1,291	147%
Tufts Health Public Plans	$1,347	154%
Harvard Pilgrim	$1,387	158%
Gic Unicare	$1,440	164%
Wellsense Direct Metals Silver	$1,546	176%

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 $1,835.
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 Holyoke Medical Center 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.