CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Lehigh Valley Hospital - Macungie

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 95810
  • Insurance Median: $1,108
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.26x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Lehigh Valley Hospital - Macungie is $1,108. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.26x the Medicare baseline. Located in 3369 State Route 100, Macungie, PA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,108

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%)
Insurance Median: $1,108 (126%)
Ins. Median: $1,108 (126% 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
Geisinger $433 - $4,553 49%
Highmark Wholecare/Gateway $440 50%
Jefferson Health Partners $468 - $2,072 53%
Pa Health & Wellness $468 53%
Aetna $502 - $5,171 57%
Amerihealth Caritas $503 57%
Upmc $570 - $5,044 65%
Blue Cross Blue Shield $1,036 118%
Highmark Blue Shield $1,046 - $2,785 119%
Humana $1,046 119%
Amerihealth $1,067 122%
Cigna $1,067 122%
Gateway $1,108 126%
Emblem $1,119 - $4,620 128%
Pa Health & Wellness (Allwell) $1,139 130%
Ambetter / Centene $3,142 358%
Valley Preferred $6,040 688%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3369 State Route 100, Macungie, PA 18062
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals