CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Penn State Health St. Joseph

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $996
Cash Discount Price: $1,720
vs. Medicare Baseline: 1.14x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Penn State Health St. Joseph is $996. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,720. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.14x the Medicare baseline. Located in 2500 Bernville Road, Reading, PA.

Cash / Self-Pay

$1,720

Average discount available for prompt cash payment at this facility.

Insurance Median

$996

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: $1,720 (196%)

Insurance Median: $996 (114%)

Cash: $1,720 (196% of Medicare)

Ins. Median: $996 (114% 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
[Amerihealth Caritas]	$742 - $873	85%
[Highmark Wholecare]	$742 - $873	85%
[Geisinger]	$786 - $4,771	90%
[Health Partners Plans]	$812 - $891	93%
[Pa Health & Wellness]	$817 - $900	93%
[Highmark]	$865 - $4,747	99%
UnitedHealthcare	$873 - $4,477	100%
[Cbc]	$873 - $3,496	100%
[Ibc]	$873 - $3,287	100%
Aetna	$882 - $3,378	101%
Humana	$882	101%
[Healthspring]	$882	101%
[Upmc]	$891 - $4,886	102%
[Point Comfort Underwriters]	$1,092	124%
[Highmark Choice Blue]	$3,798	433%
[Highmark Aca]	$3,987	454%
Cigna	$4,057	462%
[Preferred Healthcare Systems]	$4,960	565%
[First Health]	$5,290	603%
[Multiplan]	$5,290	603%

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 $1,720.
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 Penn State Health St. Joseph 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.