CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Sarasota Memorial Hospital - Venice

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $1,037
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.18x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Sarasota Memorial Hospital - Venice is $1,037. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.18x the Medicare baseline. Located in 2600 Laurel Road East, North Venice, FL.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,037

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%)

Insurance Median: $1,037 (118%)

Ins. Median: $1,037 (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

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
Simply Healthcare	$478 - $502	54%
Sunshine State	$502	57%
Molina	$516	59%
Amerihealth Caritas	$526	60%
Community Care Plan	$526	60%
Florida Community Care	$526 - $1,123	60%
Blue Cross Blue Shield	$1,021	116%
Aetna	$1,052 - $5,785	120%
UnitedHealthcare	$1,052	120%
Simply Freedom Optimum	$1,072	122%
Wellcare	$1,072	122%
Ambetter / Centene	$2,757	314%
Careworks	$5,785	659%
Enlyte	$5,785	659%

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 $X.
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 Sarasota Memorial Hospital - Venice 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.