CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Hospital of Univ of Pennsylvania

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 95810
  • Insurance Median: $4,224
  • Cash Discount Price: $10,560
  • vs. Medicare Baseline: 4.81x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Hospital of Univ of Pennsylvania is $4,224. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $10,560. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 4.81x the Medicare baseline. Located in 3400 Spruce St, Philadelphia, PA.
Cash / Self-Pay
$10,560

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,224

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: $10,560 (1204%)
Insurance Median: $4,224 (481%)
Cash: $10,560 (1204% of Medicare)
Ins. Median: $4,224 (481% 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 481% of the Medicare baseline (a markup of 381%). 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 - $10,560 31%
Kaiser Permanente $284 - $10,560 32%
Keystone Mercy Health Plan $346 - $10,560 39%
Pa Medical Assistance $347 - $10,560 40%
Gspp And Wissahickon Hospice $451 51%
Upmc $459 - $10,560 52%
Health Partners $476 - $10,560 54%
UnitedHealthcare $533 - $10,560 61%
Cigna $588 - $4,752 67%
Blue Cross Blue Shield $903 - $6,442 103%
Medicare (plans) $903 - $921 103%
Philadelphia Va Medical Center $903 103%
Tricare $903 103%
Ibc $921 105%
Geisinger Health Plan $930 - $2,863 106%
Humana $930 - $8,448 106%
Devoted Health $948 108%
Pa Health And Wellness $948 - $1,489 108%
Penn Life (Living Independently For Elders) $948 108%
Aetna $957 - $10,560 109%
Clover Health Plan $975 111%
Keystone First $1,002 114%
Us Family Health Plan $1,038 118%
Gateway Health Plan $1,119 128%
Elap $1,282 146%
Paired Kidney Exchange $1,373 156%
Claims Watcher $1,444 - $1,625 165%
Oscar Health Plan $1,534 175%
Centivo $1,625 185%
Elap Services $1,679 191%
Horizon Nj Health $1,785 - $1,856 203%
Highmark $1,898 216%
Preferred Health Care Eliance $2,323 265%
Penn Global Medicine $2,392 273%
Pgm - Regie De L'Assurance Maladie Quebec $2,429 277%
Pgm - Kuwait Defense $3,696 - $4,752 421%
Qualcare $4,013 457%
Olympus $4,150 473%
Coventry $4,224 - $5,386 481%
Pgm - Chop $4,224 481%
Wissahickon Hospice $4,224 481%
Healthamerica/Coventry $4,752 - $5,174 542%
Ibc Commercial Hpn $4,977 567%
Keystone Hmo Proactive $5,102 582%
First Health Global $5,280 602%
Health Net $6,336 722%
Pgm - Royal Embassy Of Saudi Arabia $6,336 722%
Pgm - Embassy Of Qatar $6,864 782%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $6,864 782%
Interlink $7,075 806%
Pgm - Embassy Of The United Emirates/Ipc $7,392 843%
Health America/Ccn $8,448 963%
Intergroup $8,448 963%
Pgm - Kuwait Health Division $8,448 963%
Pgm - Kuwait Oil $8,448 963%
Preferred Care $8,448 963%
Blue Quality Centers For Transplant (Bqct) $10,560 1204%
City Of Philadelphia Behavioral Health $10,560 1204%
Commercial Other $10,560 1204%
International Pfs $10,560 1204%
United Behavioral Health $10,560 1204%
Workers Compensation $10,560 1204%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3400 Spruce St, Philadelphia, PA 19104
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals