CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: HCA Florida Aventura Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $3,747
Cash Discount Price: $16,047
vs. Medicare Baseline: 4.27x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at HCA Florida Aventura Hospital is $3,747. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16,047. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 4.27x the Medicare baseline. Located in 20900 Biscayne Blvd, Aventura, FL.

Cash / Self-Pay

$16,047

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,747

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: $16,047 (1829%)

Insurance Median: $3,747 (427%)

Cash: $16,047 (1829% of Medicare)

Ins. Median: $3,747 (427% 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 427% of the Medicare baseline (a markup of 327%). 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
Corvel Corporation	$539 - $5,813	61%
Careworks (Rockport)	$550 - $5,936	63%
Prime Health	$550 - $5,936	63%
Freedom Health	$1,380 - $2,568	157%
Optimum	$1,380	157%
Blue Cross Blue Shield	$1,653 - $3,691	188%
Avmed	$1,926 - $8,024	220%
Simply Healthcare Plans	$2,086	238%
Simply Healthcare	$2,166	247%
Oscar	$2,568	293%
Amerihealth Caritas	$2,728	311%
Molina	$2,728 - $4,333	311%
Cigna	$3,370	384%
Humana	$3,370 - $5,456	384%
Health Sun Health Plan	$3,418	390%
Aids Healthcare	$3,530 - $19,256	402%
Mmm Of Fl (Health Advantage Plan)	$3,691	421%
United Ppo	$3,803	433%
United	$4,000 - $7,221	456%
Sunshine State Health Plan	$4,172	476%
Aetna	$4,814	549%
Plotkin Health	$8,024	915%
Prime Health Sherriff	$8,024	915%
Medica Healthcare	$9,307	1061%
Multiplan	$12,035 - $13,640	1372%
Evernorth Bh	$12,838	1463%

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 $16,047.
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 HCA Florida Aventura 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.