CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Saint Vincent Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $624
Cash Discount Price: $59
vs. Medicare Baseline: 0.71x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Saint Vincent Hospital is $624. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $59. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 0.71x the Medicare baseline. Located in 232 West 25Th Street, Erie, PA.

Cash / Self-Pay

$59

Average discount available for prompt cash payment at this facility.

Insurance Median

$624

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: $59 (7%)

Insurance Median: $624 (71%)

Cash: $59 (7% of Medicare)

Ins. Median: $624 (71% 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
Amerihealth	$80 - $1,162	9%
Univera	$96 - $722	11%
Pennsylvania Health And Wellness	$101 - $520	12%
Geisinger	$111 - $554	13%
UnitedHealthcare	$111 - $29,898	13%
Highmark	$134 - $1,615	15%
Cigna	$187 - $2,362	21%
Aetna	$297 - $2,254	34%
University Of Pittsburgh Medical Center	$311 - $1,107	35%
Highmark Wholecare	$373 - $1,173	43%
Jefferson Health Plans	$414 - $530	47%
American Health Plans	$1,107	126%
Life Pittsburgh	$1,107	126%
Martin'S Point	$1,107	126%
Medicare (plans)	$1,140	130%
Blue Cross Blue Shield	$1,162 - $1,745	132%
Humana	$1,173	134%
Molina	$1,206	137%
Medical Mutual	$2,362	269%

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 $59.
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 Saint Vincent 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.