CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Physicians Care Surgical Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 95810
  • Insurance Median: $502
  • Cash Discount Price: $372
  • vs. Medicare Baseline: 0.57x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Physicians Care Surgical Hospital is $502. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $372. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 0.57x the Medicare baseline. Located in 454 Enterprise Drive, Royersford, PA.
Cash / Self-Pay
$372

Average discount available for prompt cash payment at this facility.

Insurance Median
$502

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: $372 (42%)
Insurance Median: $502 (57%)
Cash: $372 (42% of Medicare)
Ins. Median: $502 (57% 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.

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
Aarp $465 53%
Aetna $465 - $1,960 53%
Blue Cross Blue Shield $465 - $1,844 53%
Cigna $465 53%
Devon Health Services $465 53%
Gpm Health And Life Insurance Mc Supplement $465 53%
Humana $465 53%
Ibc Security 65 $465 53%
Keystone 65 Hmo $465 53%
Medicare (plans) $465 53%
Pcsh Aarp $465 53%
Personal Choice 65 $465 53%
Shenandoah Life $465 53%
Tricare $465 53%
Unified Health Services $465 53%
UnitedHealthcare $465 - $986 53%
Vibra Health Plan $465 53%
Amerihealth Administrators $502 57%
Amerihealth New Jersey Hmo $502 57%
Carefirst Administrators $502 57%
Empire Plan $502 57%
Horizon Of New Jersey $502 57%
Ibc $502 57%
Ibc - Local $502 57%
Ibc 2021 $502 57%
Ibc Local $502 57%
Independence Administrators $502 57%
Independence Bc $502 57%
Independence Federal $502 57%
Keystone Direct Pos $502 57%
Keystone Healthplan East $502 57%
Keystone Hmo $502 57%
Pcsh Ibc $502 57%
Personal Choice $502 57%
Regence Blue Shield $502 57%
Allsavers $986 112%
Golden Rule Op $986 112%
Oxford Health Plan $986 112%
Oxford Life Insurance Company $986 112%
Surest $986 112%
Connecticare $1,004 114%
Highmark $1,844 210%
Ag Administrators $1,960 223%
Ag Administrators Inc $1,960 223%
Allied Benefit Systems $1,960 223%
Allied Benefits Systems $1,960 223%
Continental Benefits $1,960 223%
Coventry $1,960 223%
Geha $1,960 223%
Healthez $1,960 223%
Lucent Health $1,960 223%
Marpai Health $1,960 223%
Meritain Health $1,960 223%
Premier Care Network $1,960 223%
Trustmark $1,960 223%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 454 Enterprise Drive, Royersford, PA 19468
  • CMS Rating: No CMS Rating
  • Ownership Type: Physician
  • Hospital Type: Acute Care Hospitals