CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Central Florida Lake Monroe Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $3,686
Cash Discount Price: $15,686
vs. Medicare Baseline: 4.20x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Central Florida Lake Monroe Hospital is $3,686. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $15,686. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 4.20x the Medicare baseline. Located in 1401 W Seminole Blvd, Sanford, FL.

Cash / Self-Pay

$15,686

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,686

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: $15,686 (1788%)

Insurance Median: $3,686 (420%)

Cash: $15,686 (1788% of Medicare)

Ins. Median: $3,686 (420% 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 420% of the Medicare baseline (a markup of 320%). 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	$493 - $5,340	56%
Prime Health	$503 - $5,453	57%
Careworks (Rockport Community)	$519 - $5,621	59%
Freedom Health	$1,129	129%
Optimum	$1,129	129%
Truli For Health	$1,333	152%
Blue Cross Blue Shield	$1,365 - $3,325	156%
United	$2,021 - $7,059	230%
Simply	$2,416	275%
Oscar	$2,510	286%
Simply Healthcare	$2,620	299%
Cigna	$2,729	311%
Molina Healthcare	$2,980 - $5,020	340%
Humana	$3,137	358%
Evolutions	$3,608	411%
Avmed	$3,765 - $7,843	429%
Sunshine State Health Plan	$4,000	456%
Aetna	$4,706	536%
Florida Health Care Plan	$5,914	674%
Plotkin Health	$7,843	894%
Prime Health Sheriff	$7,843	894%
Multiplan	$11,764 - $13,333	1341%
Three Rivers Provider Network	$11,764	1341%
Ppo Next	$13,333	1520%
Novanet	$14,117	1609%

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 $15,686.
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 Central Florida Lake Monroe 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.