CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: HCA Healthone Presbyterian St Luke's

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $3,338
Cash Discount Price: $8,040
vs. Medicare Baseline: 3.80x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at HCA Healthone Presbyterian St Luke's is $3,338. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,040. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 3.80x the Medicare baseline. Located in 1719 E 19Th Ave, Denver, CO.

Cash / Self-Pay

$8,040

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,338

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: $8,040 (916%)

Insurance Median: $3,338 (380%)

Cash: $8,040 (916% of Medicare)

Ins. Median: $3,338 (380% 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 380% of the Medicare baseline (a markup of 280%). 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
Vail Health	$1,222	139%
United	$1,510 - $3,618	172%
Kaiser	$1,608 - $2,090	183%
Pinnacol Workers Comp	$1,609	183%
Multiplan	$1,677 - $7,236	191%
Cigna	$2,042 - $5,145	233%
Aetna	$2,412 - $4,245	275%
Bright Health	$2,412	275%
Rocky Mountain Health Plan	$2,456	280%
Blue Cross Blue Shield	$2,560 - $5,949	292%
Emerging Therapy Solutions	$3,859 - $5,145	440%
Kaiser National Transplant	$3,859	440%
Colorado Program For Children With Special Needs	$4,100	467%
Western Plains Community Health	$5,226	596%
Northcare	$5,628	641%
Physician Health Partners	$5,628	641%
Medical Development International	$6,432	733%
Prime Health	$7,236	825%

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 $8,040.
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 HCA Healthone Presbyterian St Luke's 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.