CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Kings County Hospital Center

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $962
Cash Discount Price: $1,197
vs. Medicare Baseline: 1.10x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Kings County Hospital Center is $962. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,197. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.10x the Medicare baseline. Located in 451 Clarkson Avenue, Brooklyn, NY.

Cash / Self-Pay

$1,197

Average discount available for prompt cash payment at this facility.

Insurance Median

$962

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: $1,197 (136%)

Insurance Median: $962 (110%)

Cash: $1,197 (136% of Medicare)

Ins. Median: $962 (110% 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
Healthfirst	$100 - $2,363	11%
Aetna	$104 - $1,384	12%
Amidacare	$126 - $1,050	14%
Emblem	$126 - $1,806	14%
Wellcare	$136 - $783	16%
Metroplus	$159 - $2,363	18%
Fidelis	$181 - $2,363	21%
Oscar	$188 - $906	21%
Magnacare	$320	36%
Oxford	$362 - $410	41%
United	$434 - $1,313	49%
Affinity	$638 - $2,363	73%
Blue Cross Blue Shield	$725 - $4,315	83%
Centerlight	$725 - $2,697	83%
Elderplan	$725 - $1,204	83%
Centers Plan For Healthy Living	$754 - $1,252	86%
Hamaspik	$761	87%
Local 1199	$969 - $4,584	110%
Carelon	$1,050 - $3,506	120%
Senior Whole Health	$1,050	120%
United Behavioral Health	$1,050 - $1,155	120%
Carelon (Amida Care)	$1,071	122%
Vnsny	$1,071 - $1,204	122%
Vaccn	$1,204	137%
Multiplan	$4,315	492%
Villagecare Max	$4,584	522%

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 $1,197.
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 Kings County Hospital 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.