CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Roxborough Memorial Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $922
Cash Discount Price: $877
vs. Medicare Baseline: 1.05x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Roxborough Memorial Hospital is $922. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $877. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.05x the Medicare baseline. Located in 5800 Ridge Ave, Philadelphia, PA.

Cash / Self-Pay

$877

Average discount available for prompt cash payment at this facility.

Insurance Median

$922

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: $877 (100%)

Insurance Median: $922 (105%)

Cash: $877 (100% of Medicare)

Ins. Median: $922 (105% 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
Health Partners Plan	$270 - $1,317	31%
Medicaid / KanCare	$270	31%
Keystone	$287 - $913	33%
UnitedHealthcare	$305 - $1,835	35%
Humana	$702	80%
Blue Cross Blue Shield	$878 - $1,573	100%
Medicare (plans)	$878 - $922	100%
Pa Health & Wellness	$878 - $1,053	100%
Tricare	$878	100%
Providers Partner Health Plan	$904	103%
Spartan	$922	105%
Auto Insurance	$966	110%
Worker Compensation	$992	113%
Employer Direct Healthcare	$1,229	140%
Naphcare	$1,361	155%
Highmark	$1,913	218%
Cigna	$2,076	237%

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 $877.
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 Roxborough Memorial Hospital 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.