CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Charleston Area Medical Center

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $327
Cash Discount Price: $5,331
vs. Medicare Baseline: 0.37x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Charleston Area Medical Center is $327. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,331. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 0.37x the Medicare baseline. Located in 501 Morris Street, Charleston, WV.

Cash / Self-Pay

$5,331

Average discount available for prompt cash payment at this facility.

Insurance Median

$327

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: $5,331 (608%)

Insurance Median: $327 (37%)

Cash: $5,331 (608% of Medicare)

Ins. Median: $327 (37% 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
Tricare	$184 - $6,214	21%
Integrated Medical Solutions	$275 - $1,711	31%
Three Rivers Providers Network	$297 - $10,045	34%
Triwest Va	$297 - $851	34%
Healthsmart	$300 - $10,149	34%
Multiplan	$300 - $10,149	34%
Cigna	$303 - $9,631	35%
Aetna	$306 - $10,149	35%
Blue Cross Blue Shield	$306 - $9,444	35%
Caresource	$306 - $2,193	35%
Choicecare Network	$306 - $10,149	35%
City Of Charleston	$306 - $7,767	35%
Naphcare	$306 - $1,755	35%
Optimum Choice Inc.	$306 - $877	35%
The Health Plan Of West Virginia Inc.	$306 - $10,045	35%
Unicare Health Plan Of West Virginia Inc.	$306 - $332	35%
UnitedHealthcare	$306 - $10,149	35%
West Virginia Senior Advantage Inc.	$321 - $921	37%

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 $5,331.
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 Charleston Area Medical Center 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.