CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Clara Maass Medical Center

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $4,016
Cash Discount Price: $1,548
vs. Medicare Baseline: 4.58x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Clara Maass Medical Center is $4,016. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,548. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 4.58x the Medicare baseline. Located in One Clara Maass Drive, Belleville, NJ.

Cash / Self-Pay

$1,548

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,016

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: $1,548 (176%)

Insurance Median: $4,016 (458%)

Cash: $1,548 (176% of Medicare)

Ins. Median: $4,016 (458% 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 458% of the Medicare baseline (a markup of 358%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
UnitedHealthcare	$992 - $4,663	113%
Fidelis Care	$1,010 - $1,141	115%
Aetna	$1,086 - $4,592	124%
Wellpoint	$1,141 - $4,436	130%
Clover Health	$1,141	130%
Blue Cross Blue Shield	$1,141 - $7,430	130%
Humana	$1,141	130%
Emblem Health	$1,998	228%
Wellcare	$2,271	259%
Amerihealth	$3,838 - $4,313	437%
Cigna	$4,096 - $5,482	467%
First Health	$4,670	532%
Qualcare Inc	$5,977 - $6,374	681%

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 $1,548.
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 Clara Maass 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.