CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: The University of Vermont Health Network-Alice Hy

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $850
Cash Discount Price: $3,451
vs. Medicare Baseline: 0.97x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at The University of Vermont Health Network-Alice Hy is $850. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,451. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 0.97x the Medicare baseline. Located in 133 Park Street, Po Box 729, Malone, NY.

Cash / Self-Pay

$3,451

Average discount available for prompt cash payment at this facility.

Insurance Median

$850

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: $3,451 (393%)

Insurance Median: $850 (97%)

Cash: $3,451 (393% of Medicare)

Ins. Median: $850 (97% 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
Capital District Physicians' Health Plan	$394 - $3,833	45%
UnitedHealthcare	$406 - $4,020	46%
Fidelis Care	$493 - $1,306	56%
Humana	$493 - $1,306	56%
Mvp	$493 - $1,306	56%
Blue Cross Blue Shield	$539 - $3,292	61%
Aetna	$580 - $3,510	66%
Martins Point	$580 - $1,306	66%
Veterans Affairs Community Care Network	$580 - $1,306	66%
Choicecare	$588 - $3,061	67%
St. Regis	$1,306 - $2,306	149%
Magnacare	$2,257 - $3,265	257%
Highmark Blueshield	$2,765 - $3,657	315%

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 $3,451.
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 The University of Vermont Health Network-Alice Hy 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.