CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Geisinger St. Luke's Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $3,458
Cash Discount Price: $12,452
vs. Medicare Baseline: 3.94x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Geisinger St. Luke's Hospital is $3,458. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $12,452. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 3.94x the Medicare baseline. Located in 100 Paramount Boulevard, Orwigsburg, PA.

Cash / Self-Pay

$12,452

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,458

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: $12,452 (1419%)

Insurance Median: $3,458 (394%)

Cash: $12,452 (1419% of Medicare)

Ins. Median: $3,458 (394% 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 394% of the Medicare baseline (a markup of 294%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Amerihealth Caritas	$402	46%
Geisinger	$409 - $3,568	47%
Highmark Wholecare	$416	47%
Upmc Health Plan	$416 - $3,809	47%
Blue Cross Blue Shield	$1,013 - $5,252	115%
Highmark	$1,023 - $2,930	117%
Aetna	$1,033 - $4,787	118%
Humana	$1,053	120%
UnitedHealthcare	$1,094 - $3,777	125%
Cigna	$3,909	446%

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 $12,452.
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 Geisinger St. Luke's 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.