CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Montefiore Mount Vernon Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 95810
  • Insurance Median: $1,062
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.21x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Montefiore Mount Vernon Hospital is $1,062. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.21x the Medicare baseline. Located in 12 North 7Th Avenue, Mount Vernon, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,062

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%)
Insurance Median: $1,062 (121%)
Ins. Median: $1,062 (121% 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.

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
American Postal Workers $507 58%
UnitedHealthcare $507 - $1,072 58%
Healthfirst $703 - $1,506 80%
Metroplus $710 - $1,663 81%
Amidacare $924 105%
Blue Cross Blue Shield $924 - $2,078 105%
Emblem $924 - $1,286 105%
Fidelis $924 - $1,616 105%
Medicaid / KanCare $924 105%
Molina Healthcare Of Ny Affinity $924 - $2,078 105%
Mvp $924 - $1,894 105%
Wellcare $933 - $1,093 106%
Hamaspik $970 - $998 111%
Vnsny Choice $1,062 - $1,072 121%
Vnsny Select Health $1,062 121%
Point Comfort $1,072 122%
Villagecaremax $1,072 122%
Centerlight $1,104 - $1,179 126%
Elderplan $1,104 126%
Partners Health Plan $1,126 128%
Longevity $1,168 133%
Humana $1,179 134%
Aetna $1,248 - $1,396 142%
Cigna $5,703 - $6,337 650%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12 North 7Th Avenue, Mount Vernon, NY 10550
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals