CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Ira Davenport Memorial Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $2,988
Cash Discount Price: $3,106
vs. Medicare Baseline: 3.41x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Ira Davenport Memorial Hospital is $2,988. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,106. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 3.41x the Medicare baseline. Located in 7571 State Route 54, Bath, NY.

Cash / Self-Pay

$3,106

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,988

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: $3,106 (354%)

Insurance Median: $2,988 (341%)

Cash: $3,106 (354% of Medicare)

Ins. Median: $2,988 (341% 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 341% of the Medicare baseline (a markup of 241%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Empire	$93 - $610	11%
Blue Cross Blue Shield	$849 - $15,576	97%
Fidelis	$921	105%
Humana	$1,204 - $4,621	137%
Tricare	$1,204	137%
Amerihealth Caritas Mcr Adv - All Plans	$1,216	139%
Fidelis Care - Exchange - All Plans	$2,824	322%
Geisinger - All Plans	$2,988	341%
Cigna	$3,199	365%
Mvp Health Plan - All Plans	$3,199	365%
Independent Health - All Plans	$3,337	380%
Upmc - All Plans	$3,543	404%
Pomco Inc - All Plans	$3,697	421%
Aetna	$3,851 - $4,582	439%
UnitedHealthcare	$3,851 - $5,391	439%
Emblem Health - All Plans	$4,518	515%
Emblem/Ghi	$4,744	541%
Martins Point - All Plans	$5,134	585%
Healthnow - All Plans	$16,911	1928%

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 $3,106.
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 Ira Davenport 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.