CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: St Anthony Summit Medical Center

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $3,945
Cash Discount Price: $2,630
vs. Medicare Baseline: 4.50x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at St Anthony Summit Medical Center is $3,945. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,630. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 4.50x the Medicare baseline. Located in 340 Peak One Drive, Frisco, CO.

Cash / Self-Pay

$2,630

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,945

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: $2,630 (300%)

Insurance Median: $3,945 (450%)

Cash: $2,630 (300% of Medicare)

Ins. Median: $3,945 (450% 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 450% of the Medicare baseline (a markup of 350%). 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
Aetna	$511 - $5,917	58%
Blue Cross Blue Shield	$511 - $10,485	58%
Cigna	$511 - $5,654	58%
Devoted Health	$511	58%
Humana	$511	58%
Kaiser	$511	58%
Medicare (plans)	$511	58%
UnitedHealthcare	$511 - $6,022	58%
Centura Employee Plan	$785	89%
Peak Health	$1,429	163%
Direct To Employer	$1,502 - $3,945	171%
Denver Health	$1,953 - $3,945	223%
United Colorado Doctor'S Plan	$4,674	533%
Multiplan	$6,048	689%

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 $2,630.
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 Anthony Summit Medical Center 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.