CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Independence Health System Butler Memorial Hospita

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $1,380
Cash Discount Price: $3,463
vs. Medicare Baseline: 1.57x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Independence Health System Butler Memorial Hospita is $1,380. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,463. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.57x the Medicare baseline. Located in One Hospital Way, Butler, PA.

Cash / Self-Pay

$3,463

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,380

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: $3,463 (395%)

Insurance Median: $1,380 (157%)

Cash: $3,463 (395% of Medicare)

Ins. Median: $1,380 (157% 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	$169 - $5,194	19%
Amerihealth	$297 - $1,028	34%
Medicaid / KanCare	$347	40%
UnitedHealthcare	$347 - $2,510	40%
Geisinger	$378 - $4,947	43%
Jefferson Health Plan	$381	43%
Gateway	$392 - $5,194	45%
Aetna	$399 - $3,958	45%
Ccbh - Behavioral Health	$696 - $2,474	79%
Pnoa	$867 - $3,958	99%
Highmark	$925 - $2,065	105%
Highmark - Ind.& Managed Care	$925 - $2,294	105%
Highmark Aca - Direct Blue	$925 - $1,290	105%
Highmark Community Blue	$925 - $2,024	105%
Workers Comp	$956	109%
Life Butler County	$979	112%
Martin'S Point - Usfhp	$979 - $1,731	112%
Medicare (plans)	$979	112%
Peak Health	$979 - $3,463	112%
Provider Partners	$979	112%
Tricare	$979	112%
Humana	$1,018	116%
Devoted Health Plan	$1,037 - $1,979	118%
The Health Plan	$1,037 - $2,300	118%
Pa Health & Wellness	$1,047	119%
American Health Plan	$1,077	123%
Ellwood Group	$1,484 - $2,127	169%
Cigna	$2,236 - $2,474	255%
Private Healthcare Systems	$3,463 - $4,205	395%
Devon	$3,710	423%
Intergroup	$3,958	451%
Multiplan	$4,452	507%

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 $3,463.
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 Independence Health System Butler Memorial Hospita 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.