CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: St Vincent's Birmingham

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $2,697
Cash Discount Price: Unavailable
vs. Medicare Baseline: 3.07x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at St Vincent's Birmingham is $2,697. 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 3.07x the Medicare baseline. Located in 810 St Vincent's Drive, Birmingham, AL.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,697

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: $2,697 (307%)

Ins. Median: $2,697 (307% 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 307% of the Medicare baseline (a markup of 207%). 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
Ambetter / Centene	$597 - $1,080	68%
Blue Cross Blue Shield	$754	86%
Cooper Green	$785	89%
UnitedHealthcare	$785 - $1,886	89%
Humana	$793 - $3,726	90%
Aetna	$809 - $3,017	92%
Cigna	$809 - $2,378	92%
Prime Health Services	$825 - $4,977	94%
Seven Corners	$1,060	121%
Viva	$3,549	405%
Construction Claims Management	$4,274	487%
Corvel	$4,274	487%
Alamed	$4,525	516%
Comp One	$4,525	516%
Multiplan	$4,732	539%
Pnoa	$4,732	539%
Novanet	$5,028	573%

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 $X.
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 St Vincent's Birmingham 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.