CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: St Anthony Community Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 95810
  • Insurance Median: $1,996
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 2.28x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at St Anthony Community Hospital is $1,996. 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 2.28x the Medicare baseline. Located in 15 Maple Avenue -19, Warwick, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,996

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: $1,996 (228%)
Ins. Median: $1,996 (228% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 228% of the Medicare baseline (a markup of 128%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Medicare (plans) $1,067 - $1,141 122%
Mvp Gold (McR) $1,067 122%
Hamaspik (McR) $1,067 122%
Affinity By Molina McR $1,120 128%
Emblem Select Care (Exchange) $1,844 210%
Mvp Exchange $2,148 245%
Emblem Ghi/Hip PPO $2,167 247%
Geisinger Health Commercial/Exchange $3,520 401%
Blue Cross Blue Shield $3,948 - $4,872 450%
Self-Pay $4,368 498%
Tricare $6,209 708%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 15 Maple Avenue -19, Warwick, NY 10990
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals