CMS Price Transparency Data
Sleep study (overnight, in lab)
Facility: Hialeah Hospital
Billing Code: 95810 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 95810
- Insurance Median: $1,046
- Cash Discount Price: $13,085
- vs. Medicare Baseline: 1.19x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Hialeah Hospital is $1,046. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $13,085. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.19x the Medicare baseline. Located in 651 E 25Th St, Hialeah, FL.
Cash / Self-Pay
$13,085
Average discount available for prompt cash payment at this facility.
Insurance Median
$1,046
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: $13,085 (1491%)
Insurance Median: $1,046 (119%)
Cash: $13,085 (1491% of Medicare)
Ins. Median: $1,046 (119% 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
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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 | $393 - $9,422 | 45% |
| Humana | $492 - $4,443 | 56% |
| Medicaid / KanCare | $492 - $517 | 56% |
| UnitedHealthcare | $500 - $4,945 | 57% |
| Avmed Broad Network | $575 | 66% |
| 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% |
| Oscar Health Plan Hix | $802 | 91% |
| Medicare (plans) | $886 - $2,152 | 101% |
| Leon Health Inc | $981 | 112% |
| Devoted Health | $985 | 112% |
| Tricare | $991 | 113% |
| Bristol Hospice- Miami Dade Llc | $1,001 | 114% |
| Catholic Hospice | $1,001 | 114% |
| Comprehensive Home Health Care Dba Opuscare Of South Florida | $1,001 | 114% |
| Hcr Manor Care Services Of Fl | $1,001 | 114% |
| Hospice Other | $1,001 | 114% |
| Odyssey Healthcare Of Marion County Dba Kindred Hospice | $1,001 | 114% |
| Seasons Hospice And Pallative Care Of Southern Florida Inc | $1,001 | 114% |
| Veterans Administration Vaccn | $1,001 | 114% |
| Vitas Healthcare Hospice Corporation Of Fl | $1,001 | 114% |
| Vitas Hospice Unit Agreement | $1,001 | 114% |
| Cigna | $1,034 - $3,847 | 118% |
| Longevity Health Plan | $1,046 | 119% |
| Bc/Bs Of Fl Miami Dade Blue Select | $1,053 | 120% |
| Florida Pace Centers | $1,182 | 135% |
| Bright Health Management Commercial | $1,201 | 137% |
| Bc/Bs Myblue Hmo Hix | $1,215 | 138% |
| Bc/Bs Of Fl Simplyblue | $1,279 | 146% |
| Imagine Health | $1,309 | 149% |
| Naphcare Inc | $1,379 | 157% |
| Bc/Bs Of Fl Health Options Hmo | $1,408 | 160% |
| Bc/Bs Of Fl Network Blue | $1,442 | 164% |
| Bc/Bs Of Fl Blue Select Exchange Non Par | $1,587 | 181% |
| Avmed Exchange | $1,751 | 200% |
| Ambetter / Centene | $1,852 | 211% |
| Molina Marketplace Program Exchange | $1,907 | 217% |
| Bc/Bs Of Fl Ppo | $1,952 | 222% |
| Auto Insurance | $2,002 | 228% |
| Avmed Select Network | $2,048 | 233% |
| Amerihealth Caritas Next Exchange | $2,152 | 245% |
| Bc/Bs Of Fl Phs | $6,784 | 773% |
| Dimensions International | $8,506 | 970% |
| First Health | $8,898 | 1014% |
| Dimension Health Ppo | $9,814 | 1119% |
| Dimension Health Wc | $9,814 | 1119% |
| Workers Compensation | $9,814 | 1119% |
| Commercial Non-Contracted | $13,085 | 1491% |
| Self Pay - Mcd Pending 100 Percent | $13,085 | 1491% |
| Single Case Agreement | $13,085 | 1491% |