CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Montefiore New Rochelle Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $1,062
Cash Discount Price: $2,241
vs. Medicare Baseline: 1.21x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Montefiore New Rochelle Hospital is $1,062. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,241. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.21x the Medicare baseline. Located in 16 Guion Place, New Rochelle, NY.

Cash / Self-Pay

$2,241

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%)

Cash / Self-Pay: $2,241 (255%)

Insurance Median: $1,062 (121%)

Cash: $2,241 (255% of Medicare)

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.

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
Aetna	$452 - $506	52%
UnitedHealthcare	$507 - $1,204	58%
Healthfirst	$564 - $1,204	64%
Molina Healthcare Of Ny Affinity	$905 - $2,041	103%
Amidacare	$924 - $1,264	105%
Emblem	$924 - $2,758	105%
Empire	$924 - $1,847	105%
Fidelis	$924 - $1,204	105%
Medicaid / KanCare	$924	105%
Metroplus	$924 - $1,663	105%
Mvp	$924 - $2,067	105%
Wellcare	$933 - $1,228	106%
Hamaspik	$970 - $1,300	111%
Vnsny Choice	$1,062 - $1,204	121%
Vnsny Select Health	$1,062	121%
Villagecaremax	$1,204	137%
Centerlight	$1,240	141%
Partners_Health_Plan	$1,264	144%
Humana	$1,324	151%
Centivo	$2,241	255%
Cigna	$5,597	638%

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 $2,241.
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 Montefiore New Rochelle 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.