CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: UPMC Hamot

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $1,349
Cash Discount Price: $2,099
vs. Medicare Baseline: 1.54x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at UPMC Hamot is $1,349. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,099. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.54x the Medicare baseline. Located in 201 State Street, Erie, PA.

Cash / Self-Pay

$2,099

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,349

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: $2,099 (239%)

Insurance Median: $1,349 (154%)

Cash: $2,099 (239% of Medicare)

Ins. Median: $1,349 (154% 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
Blue Cross Blue Shield	$281 - $2,439	32%
Upmc Health Plan	$381 - $472	43%
UnitedHealthcare	$399	45%
Aetna	$416 - $2,449	47%
Geisinger	$482	55%
Highmark Wholecare (Prev Gateway)	$514 - $1,749	59%
Health Partners Plans (Jefferson Health Plan)	$523	60%
Univera	$525 - $1,539	60%
Amerihealth Caritas	$541	62%
Pa Health & Wellness	$591	67%
Cigna	$1,049 - $1,399	120%
Upmc Work Partners	$1,069	122%
Independent Health	$1,349 - $1,797	154%
Intergroup	$2,274 - $2,798	259%
Multiplan	$2,449 - $2,798	279%

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 $2,099.
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 Hamot 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.