CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Jones Memorial Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $519
Cash Discount Price: $1,934
vs. Medicare Baseline: 0.59x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Jones Memorial Hospital is $519. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,934. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 0.59x the Medicare baseline. Located in 191 North Main Street, Wellsville, NY.

Cash / Self-Pay

$1,934

Average discount available for prompt cash payment at this facility.

Insurance Median

$519

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: $1,934 (220%)

Insurance Median: $519 (59%)

Cash: $1,934 (220% of Medicare)

Ins. Median: $519 (59% 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
Medicaid / KanCare	$85 - $687	10%
Aetna	$96 - $1,217	11%
Excellus 2201	$96 - $705	11%
Medicare (plans)	$104 - $2,134	12%
UnitedHealthcare	$106 - $1,148	12%
Independent Health 5156	$109 - $1,650	12%
Blue Cross Blue Shield	$115 - $2,240	13%
Cigna	$146 - $2,694	17%
Fidelis 5155	$192 - $981	22%
Capital District Physicians Health Plan (Cdphp) 5149	$291 - $1,481	33%
UPMC Health Plan 5138	$861	98%
Humana	$1,148	131%
Total Senior Care 1319	$1,148	131%
Empire Plan 5179	$2,032	232%
Mvp 2900	$2,548	290%

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 $1,934.
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 Jones Memorial 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.