CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: UPMC Williamsport

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $4,346
Cash Discount Price: $5,467
vs. Medicare Baseline: 4.95x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at UPMC Williamsport is $4,346. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,467. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 4.95x the Medicare baseline. Located in 700 High Street, Williamsport, PA.

Cash / Self-Pay

$5,467

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,346

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: $5,467 (623%)

Insurance Median: $4,346 (495%)

Cash: $5,467 (623% of Medicare)

Ins. Median: $4,346 (495% 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 495% of the Medicare baseline (a markup of 395%). 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
UnitedHealthcare	$346 - $6,232	39%
Geisinger	$381 - $6,104	43%
Upmc Health Plan	$381 - $3,972	43%
Amerihealth Caritas	$391 - $999	45%
Highmark Wholecare (Prev Gateway)	$487 - $1,047	56%
Pa Health & Wellness	$591 - $1,048	67%
Blue Cross Blue Shield	$979 - $4,269	112%
Aetna	$999 - $6,013	114%
Upmc Work Partners	$1,069	122%
Three Rivers Provider Network	$1,144 - $8,200	130%
Multiplan	$1,181 - $7,107	135%
Coventry/First Health	$4,565 - $6,132	520%
Wirerope Works	$5,066	577%
Cigna	$6,241	711%
America'S Choice	$7,289	831%
Intergroup	$7,289	831%

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 $5,467.
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 UPMC Williamsport 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.