CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Hackensack Meridian Health Pascack Valley Medical

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $3,760
Cash Discount Price: $1,395
vs. Medicare Baseline: 4.29x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Hackensack Meridian Health Pascack Valley Medical is $3,760. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,395. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 4.29x the Medicare baseline. Located in 250 Old Hook Road, Westwood, NJ.

Cash / Self-Pay

$1,395

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,760

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: $1,395 (159%)

Insurance Median: $3,760 (429%)

Cash: $1,395 (159% of Medicare)

Ins. Median: $3,760 (429% 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 429% of the Medicare baseline (a markup of 329%). 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
Healthscope Benefits [2290]	$403	46%
UnitedHealthcare	$403 - $4,648	46%
Medicaid / KanCare	$722 - $760	82%
Medicare (plans)	$895	102%
Aetna	$1,094	125%
Black Lung [6055]	$2,039	232%
Commercial Generic [1285]	$2,039	232%
Create Flex / Select [3580]	$2,039	232%
Healthcare Highways [2210]	$2,039	232%
Horizon [3625]	$2,039 - $4,648	232%
Lucent Health [6000]	$2,039	232%
Oncology Patient Assistance Programs [2295]	$2,039	232%
Selecthealth [3740]	$2,039	232%
Web Tpa [2115]	$2,039	232%
Worker's Comp [2125]	$2,039 - $4,476	232%
Wtc Healthcare Sme Karna [8005]	$2,039	232%
Qualcare [3725]	$4,173 - $4,825	476%
Magnacare Commercial [3650]	$4,476	510%
Blue Cross Blue Shield	$4,648	530%
Cigna	$4,725	539%
Mvp Health Plan [2180]	$4,725	539%
National Association of Letter Carriers [1695]	$4,725	539%
Emblem Health [2430]	$4,825	550%
Humana	$4,825	550%
Amerihealth [3520]	$4,974	567%

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 $1,395.
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 Hackensack Meridian Health Pascack Valley Medical 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.