CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Montefiore St Luke's Cornwall

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $1,447
Cash Discount Price: $1,072
vs. Medicare Baseline: 1.65x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Montefiore St Luke's Cornwall is $1,447. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,072. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.65x the Medicare baseline. Located in 70 Dubois Street, Newburgh, NY.

Cash / Self-Pay

$1,072

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,447

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: $1,072 (122%)

Insurance Median: $1,447 (165%)

Cash: $1,072 (122% of Medicare)

Ins. Median: $1,447 (165% 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	$587 - $1,479	67%
Blue Cross Blue Shield	$707 - $9,540	81%
Emblem	$707 - $10,753	81%
Medicaid / KanCare	$707	81%
Hamaspik	$743 - $1,158	85%
Fidelis	$858 - $1,243	98%
Aetna	$1,022 - $9,221	116%
Mediblue	$1,040	119%
Affinity	$1,072 - $1,126	122%
Cdphp	$1,072	122%
Hudson Valley	$1,072	122%
Oscar	$1,072 - $9,073	122%
Point Comfort	$1,072	122%
UnitedHealthcare	$1,072 - $3,729	122%
Villagecaremax	$1,072	122%
Vnsny Choice	$1,072	122%
Centerlight	$1,104	126%
Wellcare	$1,104	126%
Geha	$1,143 - $9,221	130%
Meritain Health	$1,143 - $9,221	130%
Nippon Life Insurance	$1,143 - $9,221	130%
Humana	$1,179	134%
Magnacare	$1,320 - $10,081	150%
Mvp	$2,139	244%
Northwell	$2,884 - $8,737	329%
American Postal Workers	$3,728	425%
Cigna	$5,703 - $8,558	650%
Centivo	$8,468	965%

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 $1,072.
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 St Luke's Cornwall 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.