CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: North Shore Medical Center

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 95810
  • Insurance Median: $1,266
  • Cash Discount Price: $16,581
  • vs. Medicare Baseline: 1.44x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at North Shore Medical Center is $1,266. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16,581. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.44x the Medicare baseline. Located in 1100 Nw 95Th St, Miami, FL.
Cash / Self-Pay
$16,581

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,266

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: $16,581 (1890%)
Insurance Median: $1,266 (144%)
Cash: $16,581 (1890% of Medicare)
Ins. Median: $1,266 (144% 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.

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
Humana $492 - $4,443 56%
Medicaid / KanCare $492 - $16,581 56%
Aetna $497 - $11,938 57%
UnitedHealthcare $500 - $5,099 57%
Avmed Broad Network $599 68%
Healthsun Health Plans $655 - $1,034 75%
Veterans Administration Mill Bill $689 79%
Self Pay/Uninsured $780 - $1,231 89%
Employer Direct Healthcare $793 - $1,001 90%
Medicare (plans) $886 - $16,581 101%
Leon Health Inc $981 112%
Devoted Health $985 112%
Tricare $991 113%
Hospice Other $1,001 114%
Veterans Administration Vaccn $1,001 114%
Oscar Health Plan Hix $1,016 116%
Cigna $1,034 - $8,291 118%
Longevity Health Plan $1,051 120%
Florida Pace Centers $1,182 135%
Bright Health Management Commercial $1,201 137%
Centurion Prison $1,231 140%
Bc/Bs Myblue Hmo Hix $1,363 155%
Bc/Bs Of Fl Simplyblue $1,434 163%
Bc/Bs Of Fl Network Blue $1,491 170%
Bc/Bs Of Fl Health Options Hmo $1,583 180%
Bc/Bs Of Fl Blue Select Exchange Non Par $1,639 187%
Imagine Health $1,658 189%
Avmed Exchange $1,751 200%
Ambetter / Centene $1,852 211%
Molina Marketplace Program Exchange $1,907 217%
Bc/Bs Of Fl Ppo $1,934 220%
Auto Insurance $2,002 228%
Avmed Select Network $2,048 233%
Amerihealth Caritas Next Exchange $2,152 245%
Bc/Bs Of Fl Phs $8,596 980%
Magellan Behavioral Health $9,949 1134%
Dimensions International $10,778 1228%
First Health $11,275 1285%
Dimension Health Ppo $12,436 1417%
Dimension Health Wc $12,436 1417%
Workers Compensation $12,436 1417%
Beacon Health Strategies Commercial $16,581 1890%
Commercial Non-Contracted $16,581 1890%
Self Pay - Mcd Pending 100 Percent $16,581 1890%
Single Case Agreement $16,581 1890%
United Behavioral Health Psych $16,581 1890%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1100 Nw 95Th St, Miami, FL 33150
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals