CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Jfk University Medical Center

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $4,991
Cash Discount Price: $1,072
vs. Medicare Baseline: 5.69x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Jfk University Medical Center is $4,991. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,072. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 5.69x the Medicare baseline. Located in 65 James Street, Edison, NJ.

Cash / Self-Pay

$1,072

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,991

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: $1,072 (122%)

Insurance Median: $4,991 (569%)

Cash: $1,072 (122% of Medicare)

Ins. Median: $4,991 (569% 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 569% of the Medicare baseline (a markup of 469%). 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
Blue Cross Blue Shield	$104 - $1,127	12%
Horizon	$181 - $7,730	21%
Karna	$196 - $1,122	22%
Vaccn	$1,017 - $1,127	116%
Wellcare	$1,017 - $1,127	116%
Aetna	$1,017 - $7,336	116%
United Community/Americhoice	$1,068 - $1,183	122%
Amerigroup	$1,127 - $1,813	128%
UnitedHealthcare	$1,430 - $4,254	163%
Clover	$1,497	171%
Seoul Medical Group	$1,788	204%
Oxford	$3,690	421%
Cigna	$4,159 - $8,007	474%
Amerihealth	$4,821 - $8,226	550%
Brighton Health Plan	$4,991 - $7,486	569%
Brighton Health Plan - Jri@Oumc	$5,407	616%
Activecare First McO	$5,823	664%
Intergroup	$5,823	664%
Bergen Risk	$6,238	711%
Prime Health	$6,654	758%
Multiplan - PHCS	$7,070	806%
Qualcare	$7,702	878%

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 $1,072.
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 Jfk University 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.