CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Jamaica Hospital Medical Center

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $1,013
Cash Discount Price: $1,814
vs. Medicare Baseline: 1.15x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Jamaica Hospital Medical Center is $1,013. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,814. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.15x the Medicare baseline. Located in 89Th Avenue and Van Wyck Expressway, Jamaica, NY.

Cash / Self-Pay

$1,814

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,013

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: $1,814 (207%)

Insurance Median: $1,013 (115%)

Cash: $1,814 (207% of Medicare)

Ins. Median: $1,013 (115% 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
Ghi	$245 - $1,067	28%
UnitedHealthcare	$272 - $1,067	31%
Healthfirst	$453 - $907	52%
Fidelis	$507 - $1,067	58%
Aetna	$533 - $2,552	61%
Beacon Health Strategies	$533 - $1,067	61%
Centerlight Healthcare	$533 - $1,067	61%
Empire	$533 - $2,606	61%
Hip	$533 - $2,272	61%
Metroplus	$533 - $1,173	61%
Elderplan	$544 - $1,088	62%
Vns	$544 - $1,088	62%
Wellcare Of Ny	$555 - $1,109	63%
Humana	$565 - $1,131	64%
Senior Whole Health	$565 - $1,131	64%
Hamaspik Choice	$613 - $2,500	70%
Magnacare	$613 - $1,227	70%
Centers Plan For Healthy Living	$667 - $1,333	76%
1999 National Benefit Fund	$772	88%
World Trade Center Program	$875 - $1,068	100%
Emblemhealth	$880 - $1,760	100%
Hotel Trades Council	$1,912	218%
Empire Blue Priority	$2,215	252%
Villagecaremax	$2,776	316%

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 $1,814.
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 Jamaica Hospital 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.