CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Strong Memorial Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $1,135
Cash Discount Price: $2,374
vs. Medicare Baseline: 1.29x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Strong Memorial Hospital is $1,135. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,374. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.29x the Medicare baseline. Located in 601 Elmwood Ave, Rochester, NY.

Cash / Self-Pay

$2,374

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,135

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: $2,374 (271%)

Insurance Median: $1,135 (129%)

Cash: $2,374 (271% of Medicare)

Ins. Median: $1,135 (129% 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
Medicaid / KanCare	$441 - $3,890	50%
Aetna	$493 - $1,558	56%
Excellus Bc/Bs [2201]	$493 - $1,077	56%
Medicare (plans)	$493 - $1,667	56%
Blue Cross Blue Shield	$517 - $3,890	59%
Excellus [2201]	$517	59%
Highmark Bc/Bs Of Western Ny [5143]	$575 - $723	66%
Elderplan [1316]	$580	66%
Icircle [1728]	$580	66%
Martins Point [1205]	$580 - $1,204	66%
Nascentia [1729]	$580	66%
UnitedHealthcare	$580 - $3,890	66%
Humana	$586 - $1,541	67%
Excellus Bc/Bs [2201], Bc/Bs Out Of Area [2401]	$660 - $2,003	75%
Fidelis [5155]	$687 - $3,890	78%
Independent Health [5156]	$901 - $1,090	103%
Mvp [2900]	$1,059 - $4,231	121%
Molina Healthcare [5189]	$1,128	129%
Cigna	$1,385 - $4,589	158%
Capital District Physicians Health Plan (Cdphp) [5149]	$1,481 - $1,981	169%
Molina Healthcare [1723], Molina Healthcare [5189]	$3,890	443%

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 $2,374.
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 Strong Memorial 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.