CMS Price Transparency Data
Sleep study (overnight, in lab)
Facility: Palmetto General Hospital
Billing Code: 95810 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 95810
- Insurance Median: $1,034
- Cash Discount Price: $2,947
- vs. Medicare Baseline: 1.18x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Palmetto General Hospital is $1,034. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,947. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.18x the Medicare baseline. Located in 2001 W 68Th St, Hialeah, FL.
Cash / Self-Pay
$2,947
Average discount available for prompt cash payment at this facility.
Insurance Median
$1,034
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: $2,947 (336%)
Insurance Median: $1,034 (118%)
Cash: $2,947 (336% of Medicare)
Ins. Median: $1,034 (118% 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 | $88 - $2,100 | 10% |
| Oscar Health Plan Hix | $181 | 21% |
| Imagine Health | $295 | 34% |
| Bc/Bs Of Fl Network Blue | $450 - $1,467 | 51% |
| Bc/Bs Of Fl Blue Select Exchange Non Par | $478 - $1,612 | 54% |
| Humana | $492 - $4,443 | 56% |
| Medicaid / KanCare | $492 - $2,947 | 56% |
| UnitedHealthcare | $500 - $5,043 | 57% |
| Cigna | $513 - $1,473 | 58% |
| Bc/Bs Of Fl Health Options Hmo | $563 - $1,530 | 64% |
| Bc/Bs Myblue Hmo Hix | $594 - $1,317 | 68% |
| Bc/Bs Of Fl Miami Dade Blue Select | $594 - $1,152 | 68% |
| Avmed Broad Network | $620 | 71% |
| Bc/Bs Of Fl Simplyblue | $624 - $1,386 | 71% |
| Healthsun Health Plans | $655 - $1,034 | 75% |
| Veterans Administration Mill Bill | $689 | 79% |
| Bc/Bs Of Fl Ppo | $735 - $1,943 | 84% |
| Self Pay/Uninsured | $780 - $1,231 | 89% |
| Employer Direct Healthcare | $793 - $1,001 | 90% |
| Medicare (plans) | $886 - $2,947 | 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% |
| Compassionate Care Hospice Of Miami Dade And The Fl Keys Inc | $1,001 | 114% |
| Hospice Other | $1,001 | 114% |
| Ima Evalutations Inc | $1,001 | 114% |
| Odyssey Healthcare Of Marion County Dba Kindred Hospice | $1,001 | 114% |
| Opuscare Of South Fl | $1,001 | 114% |
| Seasons Hospice And Pallative Care Of Southern Florida Inc | $1,001 | 114% |
| Select Specialty Hospital | $1,001 | 114% |
| Veterans Administration Vaccn | $1,001 | 114% |
| Vitas Healthcare Hospice | $1,001 | 114% |
| Westchester General Hospital | $1,001 | 114% |
| Longevity Health Plan | $1,051 | 120% |
| Florida Pace Centers | $1,182 | 135% |
| Bright Health Management Commercial | $1,201 | 137% |
| Naphcare Inc | $1,379 | 157% |
| Liga Contra El Cancer | $1,473 | 168% |
| Bc/Bs Of Fl Phs | $1,478 | 168% |
| Avmed Exchange | $1,751 | 200% |
| Magellan Behavioral Health | $1,768 | 202% |
| Ambetter / Centene | $1,852 | 211% |
| Molina Marketplace Program Exchange | $1,907 | 217% |
| Dimensions International | $1,915 | 218% |
| First Health | $1,974 | 225% |
| Auto Insurance | $2,002 | 228% |
| Avmed Select Network | $2,048 | 233% |
| Amerihealth Caritas Next Exchange | $2,152 | 245% |
| Dimension Health Ppo | $2,210 | 252% |
| Dimension Health Wc | $2,210 | 252% |
| Workers Compensation | $2,210 | 252% |
| Beacon Health Strategies Commercial | $2,947 | 336% |
| Commercial Non-Contracted | $2,947 | 336% |
| Self Pay - Mcd Pending 100 Percent | $2,947 | 336% |
| Single Case Agreement | $2,947 | 336% |
| United Behavioral Health Psych | $2,947 | 336% |