CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Lecom Medical Center and Behavioral Health Pav

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $1,469
Cash Discount Price: $1,469
vs. Medicare Baseline: 1.67x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Lecom Medical Center and Behavioral Health Pav is $1,469. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,469. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.67x the Medicare baseline. Located in 5515 Peach Street, Erie, PA.

Cash / Self-Pay

$1,469

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,469

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: $1,469 (167%)

Insurance Median: $1,469 (167%)

Cash: $1,469 (167% of Medicare)

Ins. Median: $1,469 (167% 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
UnitedHealthcare	$471	54%
Blue Cross Blue Shield	$890 - $1,254	101%
Healthchoice_Berks	$1,468	167%
Healthchoice_Blair	$1,468	167%
Healthchoice_Carbon_Monroe_Pike	$1,468	167%
Healthchoice_Chester	$1,468	167%
Healthchoice_Erie	$1,468	167%
Healthchoice_Lycoming_Clinton	$1,468	167%
Healthchoice_Northcentral	$1,468	167%
Healthchoice_Northeast	$1,468	167%
Healthchoice_Somerset_Bedford	$1,468	167%
Healthchoice_York_Adams	$1,468	167%
Medicare (plans)	$1,468	167%
Upmc_Commercial	$1,468	167%
Upmc_For_Life	$1,468	167%
Upmc_For_Life_Hmo_Premier_Rx	$1,468	167%
Upmc_Partner	$1,468	167%
Upmc_Value	$1,468	167%
Upmc_Value_Select	$1,468	167%
Aetna	$1,615	184%
Cigna	$2,027	231%

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 $1,469.
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 Lecom Medical Center and Behavioral Health Pav 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.