CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Mainehealth Pen Bay Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $1,129
Cash Discount Price: $3,313
vs. Medicare Baseline: 1.29x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Mainehealth Pen Bay Hospital is $1,129. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,313. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.29x the Medicare baseline. Located in 6 Glen Cove Drive, Rockport, ME.

Cash / Self-Pay

$3,313

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,129

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: $3,313 (378%)

Insurance Median: $1,129 (129%)

Cash: $3,313 (378% of Medicare)

Ins. Median: $1,129 (129% 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
Blue Cross Blue Shield	$113 - $4,782	13%
Aetna	$114 - $4,904	13%
Wellcare	$115 - $1,014	13%
Humana	$128 - $985	15%
UnitedHealthcare	$128 - $5,207	15%
Multiplan	$218 - $5,256	25%
Harvard Pilgrim Healthcare	$223 - $4,760	25%
Community Health Options	$235 - $4,431	27%
Cigna	$2,614 - $4,412	298%

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 $3,313.
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 Mainehealth Pen Bay Hospital 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.