CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Wellspan York Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $4,134
Cash Discount Price: $3,935
vs. Medicare Baseline: 4.71x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Wellspan York Hospital is $4,134. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,935. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 4.71x the Medicare baseline. Located in 1001 South George Street, York, PA.

Cash / Self-Pay

$3,935

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,134

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: $3,935 (449%)

Insurance Median: $4,134 (471%)

Cash: $3,935 (449% of Medicare)

Ins. Median: $4,134 (471% 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 471% of the Medicare baseline (a markup of 371%). 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
Medicaid / KanCare	$433 - $1,743	49%
Johns_Hopkins_Healthcare_Plan	$996 - $4,673	114%
Medicare (plans)	$996 - $1,076	114%
Aetna	$1,026 - $4,481	117%
Highmark	$1,494 - $6,141	170%
Blue_Cross	$2,734 - $4,427	312%
First_Health_Network	$4,265 - $4,481	486%
Cigna	$4,391 - $4,464	500%
Phc	$4,427	505%
Wellspan_Capital_Blue_Cross	$4,525	516%
United_Healthcare	$4,629	528%
Geisinger	$4,673	533%
Upmc	$4,673	533%

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 $3,935.
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 Wellspan York 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.