CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Albany Medical Center Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $572
Cash Discount Price: $1,327
vs. Medicare Baseline: 0.65x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Albany Medical Center Hospital is $572. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,327. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 0.65x the Medicare baseline. Located in 43 New Scotland Avenue, Mail Code 34, Albany, NY.

Cash / Self-Pay

$1,327

Average discount available for prompt cash payment at this facility.

Insurance Median

$572

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: $1,327 (151%)

Insurance Median: $572 (65%)

Cash: $1,327 (151% of Medicare)

Ins. Median: $572 (65% 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
Cdphp	$75 - $2,310	9%
Medicare (plans)	$83 - $669	9%
Fidelis	$87 - $2,310	10%
Blue Cross Blue Shield	$91 - $2,310	10%
Tricare	$94 - $580	11%
Hamaspik	$103 - $2,413	12%
Blue Shield Highmark	$105 - $1,670	12%
Mvp	$110 - $1,144	13%
UnitedHealthcare	$110 - $2,442	13%
Aetna	$114 - $3,657	13%
Nascentia	$121 - $638	14%
Emblem Health Ghi	$122 - $1,258	14%
Medicaid / KanCare	$128 - $654	15%
Cigna	$171 - $1,009	19%
Nys Department Of Corrections	$269 - $1,324	31%
Blue Shield	$472 - $1,202	54%
Nascentia Health Options	$906	103%
Emblem	$932 - $2,442	106%
Empire Plan Nyship	$1,592 - $1,831	181%
Mvp Commercial	$1,990 - $2,289	227%
Emblem_Ghi	$2,123 - $2,442	242%
Magnacare	$2,123 - $2,442	242%
Mvp Essential Plan	$2,207	252%
Multiplan	$2,256 - $2,594	257%

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 $1,327.
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 Albany Medical Center 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.