CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Clarion Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 95810
  • Insurance Median: $1,028
  • Cash Discount Price: $1,266
  • vs. Medicare Baseline: 1.17x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Clarion Hospital is $1,028. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,266. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.17x the Medicare baseline. Located in One Hospital Drive, Clarion, PA.
Cash / Self-Pay
$1,266

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,028

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: $1,266 (144%)
Insurance Median: $1,028 (117%)
Cash: $1,266 (144% of Medicare)
Ins. Median: $1,028 (117% 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.

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
Upmc $169 - $1,130 19%
Medicaid / KanCare $347 40%
Amerihealth $381 - $979 43%
Jefferson Health Plan $381 43%
Geisinger $416 - $1,028 47%
Highmark $768 - $1,624 88%
Highmark - Ind.& Managed Care $768 - $2,198 88%
Martin'S Point - Usfhp $791 - $979 90%
Gateway $836 - $1,047 95%
Workers Comp $867 99%
Devoted Health Plan $904 - $1,037 103%
Highmark Community Blue $975 111%
Cigna $979 - $1,130 112%
Medicare (plans) $979 112%
Tricare $979 112%
UnitedHealthcare $979 112%
Aetna $1,008 - $2,251 115%
The Health Plan $1,037 - $2,300 118%
Pa Health & Wellness $1,047 119%
American Health Plan $1,077 123%
Peak Health $1,582 - $2,300 180%
Devon $1,695 193%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Hospital Drive, Clarion, PA 16214
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals