CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Nemours Childrens Hospital, Florida

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $3,245
Cash Discount Price: $7,974
vs. Medicare Baseline: 3.70x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Nemours Childrens Hospital, Florida is $3,245. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,974. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 3.70x the Medicare baseline. Located in 6535 Nemours Pkwy, Orlando, FL.

Cash / Self-Pay

$7,974

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,245

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: $7,974 (909%)

Insurance Median: $3,245 (370%)

Cash: $7,974 (909% of Medicare)

Ins. Median: $3,245 (370% 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 370% of the Medicare baseline (a markup of 270%). 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
Truli	$830 - $3,190	95%
Florida Blue	$922 - $4,864	105%
Tricare	$1,021	116%
Aetna	$1,084 - $3,509	124%
Avmed	$2,472	282%
UnitedHealthcare	$2,964	338%
Employers Health Network Fl	$3,190	364%
Cigna	$3,222	367%
Evolutions Healthcare	$3,588	409%
Integra Administrative Group	$4,784	545%
Global Medical Management	$5,183	591%
Prime Health Services	$5,183	591%
Star Healthcare Network	$5,183	591%
Velocity	$5,980	682%
First Health Network	$6,220	709%
Pnoa	$6,379	727%
Seminole Tribe Of Fl	$6,379	727%
Private Healthcare Systems	$7,336	836%

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 $7,974.
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 Nemours Childrens Hospital, Florida 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.