CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: St Luke's Hospital - Upper Bucks Campus

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $1,721
Cash Discount Price: $14,117
vs. Medicare Baseline: 1.96x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at St Luke's Hospital - Upper Bucks Campus is $1,721. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $14,117. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.96x the Medicare baseline. Located in 3000 St. Luke's Drive, Quakertown, PA.

Cash / Self-Pay

$14,117

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,721

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: $14,117 (1609%)

Insurance Median: $1,721 (196%)

Cash: $14,117 (1609% of Medicare)

Ins. Median: $1,721 (196% 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
Keystone First	$347	40%
Geisinger	$409 - $4,411	47%
Amerihealth Caritas	$416	47%
Highmark Wholecare	$416	47%
Upmc Health Plan	$416 - $4,300	47%
Jefferson Health Plan	$499	57%
Blue Cross Blue Shield	$1,042 - $12,991	119%
Highmark	$1,042 - $3,599	119%
Aetna	$1,062 - $5,474	121%
Humana	$1,083	123%
UnitedHealthcare	$1,125 - $4,533	128%
Oscar	$4,071	464%
Cigna	$4,293	489%

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 $14,117.
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 St Luke's Hospital - Upper Bucks Campus 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.