CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: UPMC Memorial

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $3,020
Cash Discount Price: $4,017
vs. Medicare Baseline: 3.44x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at UPMC Memorial is $3,020. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,017. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 3.44x the Medicare baseline. Located in 1701 Innovation Drive, York, PA.

Cash / Self-Pay

$4,017

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,020

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: $4,017 (458%)

Insurance Median: $3,020 (344%)

Cash: $4,017 (458% of Medicare)

Ins. Median: $3,020 (344% 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 344% of the Medicare baseline (a markup of 244%). 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
UnitedHealthcare	$354 - $3,865	40%
Blue Cross Blue Shield	$411 - $3,438	47%
Amerihealth Caritas	$440	50%
Highmark Wholecare (Prev Gateway)	$440	50%
Upmc Health Plan	$451 - $4,992	51%
Health Partners Plans (Jefferson Health Plan)	$472	54%
Geisinger	$505 - $5,151	58%
Upmc Work Partners	$1,013	115%
Aetna	$1,018 - $4,051	116%
Cigna	$1,024 - $5,563	117%
Prime Net	$1,033 - $5,313	118%
Keystone Health Plan	$1,252 - $2,148	143%
Keystone Autism Services	$1,561	178%
Wellspan Population Health	$4,381 - $4,992	499%
Multiplan	$5,320 - $6,062	606%

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 $4,017.
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 Memorial 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.