CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Vandalia Health Broaddus Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $1,702
Cash Discount Price: $1,626
vs. Medicare Baseline: 1.94x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Vandalia Health Broaddus Hospital is $1,702. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,626. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.94x the Medicare baseline. Located in 1 Healthcare Drive Mansfield Hill, Philippi, WV.

Cash / Self-Pay

$1,626

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,702

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: $1,626 (185%)

Insurance Median: $1,702 (194%)

Cash: $1,626 (185% of Medicare)

Ins. Median: $1,702 (194% 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
Correctional Medical Systems	$83 - $408	9%
Aetna	$87 - $2,077	10%
The Health Plan	$87 - $2,091	10%
Unicare	$87 - $429	10%
Blue Cross Blue Shield	$164 - $1,648	19%
Peak Health	$401 - $740	46%
Highmark	$1,702	194%
UnitedHealthcare	$1,719 - $2,256	196%
Humana	$1,788	204%
West Virginia Senior Advantage	$1,805	206%
Cigna	$2,033	232%
First Health	$2,077	237%
Geisenger Health Plan	$2,160	246%
Health Network America	$2,160 - $2,207	246%
Multiplan/Phcs	$2,184	249%
Geha	$2,207	252%
Selectnet	$2,277	260%

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 $1,626.
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 Vandalia Health Broaddus 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.