CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Indiana Regional Medical Center

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $625
Cash Discount Price: $1,218
vs. Medicare Baseline: 0.71x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Indiana Regional Medical Center is $625. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,218. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 0.71x the Medicare baseline. Located in 835 Hospital Road, Indiana, PA.

Cash / Self-Pay

$1,218

Average discount available for prompt cash payment at this facility.

Insurance Median

$625

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: $1,218 (139%)

Insurance Median: $625 (71%)

Cash: $1,218 (139% of Medicare)

Ins. Median: $625 (71% 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
Highmark	$239 - $2,466	27%
Tricare	$285 - $3,383	32%
Highmark Wholecare	$305 - $896	35%
Humana	$308 - $882	35%
Aetna	$311 - $2,741	35%
UnitedHealthcare	$311 - $1,353	35%
Cigna	$313 - $2,656	36%
Medicare (plans)	$313 - $896	36%
United Mine Workers Of America	$313 - $896	36%
Ambetter / Centene	$323 - $926	37%
Amerihealth Caritas	$323 - $926	37%
Geisinger Health Plan	$323 - $926	37%
Upmc Health Plan	$324 - $1,556	37%
Geisinger	$438 - $2,508	50%
Pa Health And Wellness Commercial	$438 - $2,508	50%
Department Of Human Services And Torrance State Hospital	$2,131	243%
Premier Comp Solutions, Llc	$3,045	347%
Miscellaneous Commercial	$3,383	386%
Pa Workers Compensation	$3,383	386%

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 $1,218.
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 Indiana Regional Medical Center 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.