CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Lancaster General Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 95810
  • Insurance Median: $4,706
  • Cash Discount Price: $5,536
  • vs. Medicare Baseline: 5.36x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Lancaster General Hospital is $4,706. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,536. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 5.36x the Medicare baseline. Located in 555 North Duke Street, Lancaster, PA.
Cash / Self-Pay
$5,536

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,706

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: $5,536 (631%)
Insurance Median: $4,706 (536%)
Cash: $5,536 (631% of Medicare)
Ins. Median: $4,706 (536% 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 536% of the Medicare baseline (a markup of 436%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Medicaid / KanCare $270 - $1,701 31%
UnitedHealthcare $297 - $5,437 34%
Gateway $316 36%
Upmc For You $589 67%
Tricare $785 89%
Highmark $864 - $6,396 98%
Albright Life $872 99%
Coatesville Va $872 99%
Hospice Generic $872 99%
Lebanon Veterans Hospital $872 99%
Medicare (plans) $872 - $965 99%
Aetna $881 - $4,330 100%
Blue Cross Blue Shield $885 - $5,437 101%
Amerihealth Caritas $890 101%
Cigna $899 - $5,352 102%
Health Partners Mcr Advantage $899 102%
Devoted Health $916 104%
Pa Health And Wellness Mcr $916 104%
Hospice And Community Care $954 - $1,215 109%
Elap Employees $1,239 141%
Old Order Group $1,355 - $2,047 154%
Lg Coresource/Lg Eliance $1,430 - $1,823 163%
Lancashire Hall $1,506 - $6,396 172%
Nursing Home Op Services $1,506 - $1,919 172%
Oscar Health Plan $1,701 194%
Affilia Home Health $2,008 - $6,396 229%
Masonic Homes $2,108 - $6,396 240%
Claim Watcher Plus $2,617 298%
Claim Watcher $2,879 328%
Elap Other Groups $3,176 362%
Eliance Health Solutions $3,212 - $4,093 366%
Highmark Commercial Preferred $3,358 - $6,396 383%
Ehp $4,116 - $5,245 469%
Upmc Commercial $4,116 - $5,437 469%
Devon $4,266 - $5,437 486%
Geisinger Commercial $4,266 - $5,437 486%
Intergroup Services $4,266 - $5,437 486%
Preferred Healthcare $4,266 - $5,437 486%
Medi-Share Christian Care $4,768 - $6,076 543%
Commercial Generic $5,019 - $6,396 572%
Highmark Commercial Non-Preferred $5,019 - $6,448 572%
Magellan $5,019 - $6,396 572%
United Behavioral Health $5,019 - $6,396 572%
Value Options $5,019 - $6,396 572%
Workers Compensation $5,019 - $6,396 572%
Gift Of Life Donor Program $13,500 1539%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 555 North Duke Street, Lancaster, PA 17602
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals