CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Cleveland Clinic Indian River Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $881
Cash Discount Price: $2,973
vs. Medicare Baseline: 1.00x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Cleveland Clinic Indian River Hospital is $881. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,973. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.00x the Medicare baseline. Located in 1000 36Th St, Vero Beach, FL.

Cash / Self-Pay

$2,973

Average discount available for prompt cash payment at this facility.

Insurance Median

$881

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: $2,973 (339%)

Insurance Median: $881 (100%)

Cash: $2,973 (339% of Medicare)

Ins. Median: $881 (100% 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.

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
UnitedHealthcare	$456	52%
Amerihealth	$480	55%
Medicaid / KanCare	$480	55%
Molina	$480	55%
Value Options	$480 - $613	55%
Wellcare	$480 - $1,021	55%
Aetna	$484 - $6,457	55%
Blue Cross Blue Shield	$600 - $1,428	68%
Avmed	$613 - $2,339	70%
Careplus	$613 - $1,021	70%
Magellan	$613 - $4,843	70%
United	$613 - $3,386	70%
Freedom Health	$644 - $1,021	73%
Independent Living Systems	$644 - $1,072	73%
Wellmed	$644 - $1,021	73%
Clear Spring Health	$662 - $906	75%
Clarity Health	$699 - $5,246	80%
The Legacy Companies	$699 - $5,246	80%
Cigna	$720 - $2,421	82%
National Provider Network	$753	86%
Three Rivers	$753	86%
Consociate Health	$807	92%
Carelon Bh Strategies	$1,021	116%
Humana	$1,021	116%
Devoted Health	$1,123	128%
Bmi	$4,439	506%
Multiplan	$6,457	736%

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 $2,973.
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 Cleveland Clinic Indian River Hospital 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.