CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Grandview Medical Center

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 95810
  • Insurance Median: $5,770
  • Cash Discount Price: $4,501
  • vs. Medicare Baseline: 6.58x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Grandview Medical Center is $5,770. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,501. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 6.58x the Medicare baseline. Located in 3690 Grandview Parkway, Birmingham, AL.
Cash / Self-Pay
$4,501

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,770

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: $4,501 (513%)
Insurance Median: $5,770 (658%)
Cash: $4,501 (513% of Medicare)
Ins. Median: $5,770 (658% 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 658% of the Medicare baseline (a markup of 558%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Medicaid / KanCare $369 42%
Veterans Eval Services $430 49%
Encompass Health $476 54%
Tricare $746 85%
Blue Advantage $773 88%
Humana $773 88%
Medicare (plans) $773 88%
UnitedHealthcare $773 - $10,386 88%
Victory Health $773 88%
Viva Health $773 - $12,695 88%
Select Health $781 89%
Hospice $785 89%
Node Champva $785 89%
Node Va $785 89%
Cigna $788 - $1,631 90%
Node Devoted Health Mcr Adv $788 90%
Node Clover Health Mcr Adv $793 90%
Aetna $796 - $2,500 91%
Node Wellcare Mcr Adv $801 91%
Node Us Dept Of Labor $982 112%
Ambetter / Centene $1,178 134%
Blue Cross Blue Shield $1,314 150%
Healthspring $1,375 157%
Self Pay $3,462 - $5,539 395%
First Health $3,500 - $18,049 399%
Bp Health Advocate $5,770 658%
Ag Administrators $8,078 921%
Alamed $8,078 921%
Choicecare $8,078 921%
Drummond $8,078 921%
American Employee Alliance $9,232 1052%
Healthchoice $11,540 - $13,849 1315%
Value Options $11,540 1315%
Multiplan $14,079 - $16,157 1605%
Blue Bell Creameries $16,157 1842%
Natl Comp Care $17,311 1973%
Usa Ppo $17,311 1973%
Coventry Work Comp Al $18,049 2057%
Novanet $18,638 2124%
Alabama Wc $19,619 2236%
Cal-Med $19,619 2236%
Corvel $19,619 2236%
Associated Admin $20,773 2368%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3690 Grandview Parkway, Birmingham, AL 35243
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals