CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Capital Health Regional Medical Center

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $4,041
Cash Discount Price: $45,047
vs. Medicare Baseline: 4.61x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Capital Health Regional Medical Center is $4,041. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $45,047. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 4.61x the Medicare baseline. Located in 750 Brunswick Ave, Trenton, NJ.

Cash / Self-Pay

$45,047

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,041

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: $45,047 (5134%)

Insurance Median: $4,041 (461%)

Cash: $45,047 (5134% of Medicare)

Ins. Median: $4,041 (461% 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 461% of the Medicare baseline (a markup of 361%). 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
Clover	$966	110%
Wellpoint	$966 - $2,432	110%
Humana	$985	112%
Fidelis	$1,112	127%
Medicare (plans)	$1,145	131%
UnitedHealthcare	$1,352 - $2,252	154%
Medicaid / KanCare	$1,443 - $2,404	164%
Horizon Nj Health	$1,500	171%
Aetna	$1,825 - $5,984	208%
Cigna	$2,919 - $42,229	333%
Blue Cross Blue Shield	$3,369 - $6,734	384%
Oxford Benefit Plan	$12,299 - $20,495	1402%
Multiplan	$28,720 - $47,859	3274%

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 $45,047.
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 Capital Health Regional 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.