CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: The East Alabama Healthcare Authority

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $1,232
Cash Discount Price: $2,247
vs. Medicare Baseline: 1.40x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at The East Alabama Healthcare Authority is $1,232. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,247. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.40x the Medicare baseline. Located in 2000 Pepperell Parkway, Opelika, AL.

Cash / Self-Pay

$2,247

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,232

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: $2,247 (256%)

Insurance Median: $1,232 (140%)

Cash: $2,247 (256% of Medicare)

Ins. Median: $1,232 (140% 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
Aetna	$107 - $4,085	12%
Blue Cross Blue Shield	$107 - $1,232	12%
Cigna	$107 - $1,814	12%
Humana	$107 - $2,860	12%
Simpra	$107 - $922	12%
Viva	$107 - $2,291	12%
Novanet	$613	70%
Beechstreet	$878 - $3,472	100%
Alabama Crime Victims	$2,042	233%
Mcm Maxcare	$3,268	372%
Mega Life	$3,268	372%
UnitedHealthcare	$3,268	372%
Coventry First Health	$3,472	396%
Geha	$3,472	396%
Multiplan	$3,472	396%
Workers Comp	$3,472	396%
Trpn	$3,676	419%

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 $2,247.
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 The East Alabama Healthcare Authority 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.