CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Boston Children's Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 95810
  • Insurance Median: $4,350
  • Cash Discount Price: $6,126
  • vs. Medicare Baseline: 4.96x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Boston Children's Hospital is $4,350. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,126. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 4.96x the Medicare baseline. Located in 300 Longwood Avenue, Boston, MA.
Cash / Self-Pay
$6,126

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,350

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: $6,126 (698%)
Insurance Median: $4,350 (496%)
Cash: $6,126 (698% of Medicare)
Ins. Median: $4,350 (496% 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 496% of the Medicare baseline (a markup of 396%). 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
Blue Cross Blue Shield $2,202 - $4,044 251%
Unicare $2,817 321%
Cdphp $3,002 - $5,207 342%
Harvard Pilgrim $3,113 - $4,139 355%
United $3,664 - $5,118 418%
Aetna $3,676 - $5,135 419%
Mgb/Allways $3,725 - $4,529 425%
Tufts Public Plan $3,763 - $3,772 429%
United Ri Nj Ny $3,859 440%
Ambetter / Centene $3,872 441%
Carelon Strategies/Bhs $3,982 454%
UnitedHealthcare $3,982 - $5,207 454%
Carelon/Beacon $4,594 524%
Fallon $4,674 - $4,723 533%
Health New England $4,950 564%
Cigna $5,207 - $5,528 593%
Ets/Lifetrac $5,207 593%
Interlink Transplant $5,207 593%
Community Health Options $5,513 628%
Humana $5,513 628%
Coventry/Hcvm/First Health $5,636 642%
Multiplan/Phcs $5,636 - $5,820 642%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 Longwood Avenue, Boston, MA 02115
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens