CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: HCA Florida Raulerson Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $4,566
Cash Discount Price: $17,561
vs. Medicare Baseline: 5.20x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at HCA Florida Raulerson Hospital is $4,566. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $17,561. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 5.20x the Medicare baseline. Located in 1796 Hwy 441 North, Okeechobee, FL.

Cash / Self-Pay

$17,561

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,566

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: $17,561 (2002%)

Insurance Median: $4,566 (520%)

Cash: $17,561 (2002% of Medicare)

Ins. Median: $4,566 (520% 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 520% of the Medicare baseline (a markup of 420%). 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 - $5,017	56%
Careworks (Rockport)	$503 - $5,123	57%
Prime Health	$503 - $5,123	57%
Freedom Health	$1,510 - $2,810	172%
Optimum	$1,510	172%
Avmed	$2,283 - $8,780	260%
Simply Healthcare Plans	$2,283	260%
Blue Cross Blue Shield	$2,845 - $4,232	324%
Molina	$3,337 - $4,741	380%
Oscar	$3,337	380%
Health Sun Health Plan	$3,740	426%
Simply Healthcare	$4,127	470%
Sunshine State Health Plan	$4,478	510%
Cigna	$4,619 - $6,164	526%
Aetna	$5,268	600%
Humana	$6,498 - $7,024	741%
United Ppo	$7,727	881%
United	$7,902 - $8,300	901%
Plotkin Health	$8,780	1001%
Prime Health Sherriff	$8,780	1001%
Multiplan	$13,171 - $14,927	1501%

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 $17,561.
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 Raulerson 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.