CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: HCA Florida North Florida Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $5,258
Cash Discount Price: $20,619
vs. Medicare Baseline: 5.99x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at HCA Florida North Florida Hospital is $5,258. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $20,619. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 5.99x the Medicare baseline. Located in 6500 W Newberry Rd, Gainesville, FL.

Cash / Self-Pay

$20,619

Average discount available for prompt cash payment at this facility.

Insurance Median

$5,258

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: $20,619 (2350%)

Insurance Median: $5,258 (599%)

Cash: $20,619 (2350% of Medicare)

Ins. Median: $5,258 (599% 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 599% of the Medicare baseline (a markup of 499%). 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 - $5,632	56%
Prime Health	$503 - $5,751	57%
Careworks (Rockport Community)	$519 - $5,929	59%
United	$957 - $9,279	109%
Blue Cross Blue Shield	$2,186 - $5,196	249%
Avmed	$2,474 - $10,310	282%
Oscar	$2,474	282%
Simply Healthcare	$2,619	299%
Simply	$3,175	362%
Cigna	$3,588 - $8,578	409%
Molina Healthcare	$3,918 - $6,598	447%
Humana	$4,124	470%
Evolutions	$4,742	540%
Sunshine State Health Plan	$5,258	599%
Aetna	$6,186	705%
Plotkin Health	$10,310	1175%
Prime Health Sheriff	$10,310	1175%
Corizon Phs	$12,371	1410%
Multiplan	$16,083 - $17,526	1833%
Evernorth	$16,495	1880%
Evolutions Healthcare	$17,526	1998%
Ppo Next	$17,526	1998%
Novanet	$18,557	2115%
Beacon Health Options	$20,619	2350%

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 $20,619.
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 North Florida 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.