CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Pennsylvania Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 95810
  • Insurance Median: $3,714
  • Cash Discount Price: $7,463
  • vs. Medicare Baseline: 4.23x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Pennsylvania Hospital is $3,714. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,463. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 4.23x the Medicare baseline. Located in 800 Spruce Street, Philadelphia, PA.
Cash / Self-Pay
$7,463

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,714

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: $7,463 (851%)
Insurance Median: $3,714 (423%)
Cash: $7,463 (851% of Medicare)
Ins. Median: $3,714 (423% 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 423% of the Medicare baseline (a markup of 323%). 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
Gateway Health Plan $270 - $1,114 31%
Medicaid / KanCare $270 - $7,644 31%
Keystone Mercy Health Plan $346 39%
Pa Medical Assistance $347 40%
Upmc $459 - $7,644 52%
Health Partners $476 - $7,644 54%
UnitedHealthcare $533 - $7,644 61%
Cigna $588 - $2,589 67%
Blue Cross Blue Shield $898 - $7,644 102%
Medicare (plans) $898 - $916 102%
Philadelphia Va Medical Center $898 102%
Tricare $903 103%
Ibc $916 104%
Geisinger Health Plan $925 - $2,849 105%
Humana $925 - $6,115 105%
Pa Health And Wellness $943 - $1,482 107%
Penn Life (Living Independently For Elders) $943 107%
Aetna $952 - $7,644 109%
Clover Health Plan $970 111%
Keystone First $997 114%
Us Family Health Plan $1,038 118%
Horizon Nj Health $1,230 - $1,344 140%
Elap $1,275 145%
Claims Watcher $1,437 - $1,617 164%
Oscar Health Plan $1,527 174%
Centivo $1,617 184%
Elap Services $1,671 190%
Pgm - Regie De L'Assurance Maladie Quebec $1,675 - $1,758 191%
Highmark $1,889 215%
Preferred Health Care Eliance $1,893 - $1,987 216%
Penn Global Medicine $2,380 271%
Pgm - Kuwait Defense $2,548 - $3,440 290%
Devon $2,767 - $3,440 315%
Qualcare $2,767 - $2,905 315%
Coventry $2,912 - $3,898 332%
Pgm - Chop $2,912 - $3,058 332%
Wissahickon Hospice $2,912 - $3,058 332%
Healthamerica/Coventry $3,276 - $3,746 373%
Olympus $3,539 - $3,715 403%
First Health Global $3,640 - $3,822 415%
Urn-Cancer Resource Services $3,640 - $3,822 415%
Health Net $4,369 - $4,586 498%
Pgm - Royal Embassy Of Saudi Arabia $4,369 - $4,586 498%
Pgm - Embassy Of Qatar $4,733 - $4,969 539%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $4,733 - $4,969 539%
Ibc Commercial Hpn $4,977 567%
Pgm - Embassy Of The United Emirates/Ipc $5,097 - $5,351 581%
Keystone Hmo Proactive $5,102 582%
Devon Health Services Inc $5,825 - $6,115 664%
Health America/Ccn $5,825 - $6,115 664%
Intergroup $5,825 - $6,115 664%
Pgm - Kuwait Health Division $5,825 - $6,115 664%
Pgm - Kuwait Oil $5,825 - $6,115 664%
Preferred Care $5,825 - $6,115 664%
Commercial Other $7,281 - $7,644 830%
Community Behavioral Health $7,281 - $7,644 830%
International Pfs $7,281 - $7,644 830%
Quest Behavioral Health $7,281 - $7,644 830%
United Behavioral Health $7,281 - $7,644 830%
Workers Compensation $7,281 - $7,644 830%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 800 Spruce Street, Philadelphia, PA 19107
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals