CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: UPMC Chautauqua at Wca

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $1,287
Cash Discount Price: $1,188
vs. Medicare Baseline: 1.47x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at UPMC Chautauqua at Wca is $1,287. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,188. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.47x the Medicare baseline. Located in 207 Foote Avenue, Jamestown, NY.

Cash / Self-Pay

$1,188

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,287

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: $1,188 (135%)

Insurance Median: $1,287 (147%)

Cash: $1,188 (135% of Medicare)

Ins. Median: $1,287 (147% 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
Magnacare	$282 - $1,485	32%
Upmc Health Plan	$433 - $1,268	49%
Geisinger	$482	55%
Health Partners Plans (Jefferson Health Plan)	$523	60%
Univera	$626	71%
Beacon	$1,243 - $1,554	142%
Fidelis	$1,243	142%
Humana	$1,243 - $1,584	142%
United Behavioral Health	$1,243	142%
UnitedHealthcare	$1,243 - $1,287	142%
Wellcare	$1,280	146%
Aetna	$1,287 - $1,293	147%
Independent Health	$1,348 - $1,712	154%
Multiplan	$1,485	169%
Ghi/Emblem Health	$1,584	181%
Statewide Independent Ppo	$1,742	199%
Affordable First Health	$1,782	203%
Blue Cross Blue Shield	$3,118	355%

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 $1,188.
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 UPMC Chautauqua at Wca 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.