CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: UPMC Passavant

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $1,414
Cash Discount Price: $8,374
vs. Medicare Baseline: 1.61x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at UPMC Passavant is $1,414. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,374. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.61x the Medicare baseline. Located in 9100 Babcock Boulevard, Pittsburgh, PA.

Cash / Self-Pay

$8,374

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,414

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: $8,374 (954%)

Insurance Median: $1,414 (161%)

Cash: $8,374 (954% of Medicare)

Ins. Median: $1,414 (161% 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
Upmc Health Plan	$381 - $1,370	43%
UnitedHealthcare	$399 - $1,067	45%
Blue Cross Blue Shield	$509 - $3,564	58%
Highmark Wholecare (Prev Gateway)	$514 - $6,978	59%
Amerihealth Caritas	$541 - $1,048	62%
Pa Health & Wellness	$591 - $1,048	67%
Health Plan Of Upper Ohio Valley	$970 - $6,448	111%
Aetna	$1,018 - $3,489	116%
Upmc Work Partners	$1,069	122%
Private Health Care Systems	$1,243 - $12,979	142%
Cigna	$4,745 - $5,582	541%
Coventry/First Health	$9,769	1113%
Intergroup	$11,583 - $12,560	1320%
Humana	$11,863 - $12,979	1352%
Multiplan	$11,863 - $12,979	1352%

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 $8,374.
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 Passavant 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.