CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Santa Rosa Medical Center

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $1,468
Cash Discount Price: $1,388
vs. Medicare Baseline: 1.67x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Santa Rosa Medical Center is $1,468. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,388. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.67x the Medicare baseline. Located in 6002 Berryhill Rd, Milton, FL.

Cash / Self-Pay

$1,388

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,468

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: $1,388 (158%)

Insurance Median: $1,468 (167%)

Cash: $1,388 (158% of Medicare)

Ins. Median: $1,468 (167% 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
Veterans Eval Services	$469	53%
Medicaid / KanCare	$478 - $554	54%
Humana	$492 - $882	56%
Wellcare	$502	57%
Molina	$540	62%
Fl Community Care	$549	63%
Tricare	$852	97%
Aetna	$882 - $13,658	101%
Blue Cross Blue Shield	$882 - $5,934	101%
Cigna	$882 - $2,092	101%
Medicare (plans)	$882	101%
UnitedHealthcare	$882 - $1,795	101%
Hospice Of Nw Fl	$897 - $4,286	102%
Node Champva	$897	102%
Node Va	$897	102%
Node Wellcare Mcr Adv	$927	106%
Geo Group	$1,121	128%
Node Us Dept Of Labor	$1,121	128%
Florida State Auto Insurance	$1,794	204%
Self Pay	$1,972 - $2,129	225%
Ambetter / Centene	$2,143	244%
Oscar	$2,703	308%
Prime Health Work Comp Fl	$5,233	596%
Florida Workers Compensation	$5,395	615%
Prime Health Services	$6,857 - $7,404	782%

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 $1,388.
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 Santa Rosa 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.