CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Piedmont Augusta Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $2,279
Cash Discount Price: $1,468
vs. Medicare Baseline: 2.60x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Piedmont Augusta Hospital is $2,279. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,468. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 2.60x the Medicare baseline. Located in 1350 Walton Way, Augusta, GA.

Cash / Self-Pay

$1,468

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,279

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: $1,468 (167%)

Insurance Median: $2,279 (260%)

Cash: $1,468 (167% of Medicare)

Ins. Median: $2,279 (260% 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 260% of the Medicare baseline (a markup of 160%). 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
Absolute Total Care [20109]	$176	20%
Blue Cross Blue Shield	$532 - $2,430	61%
Medicaid / KanCare	$772 - $1,529	88%
Alliant Health Plans Of Georgia [10952]	$1,215 - $2,407	138%
Alliant Solocare [11101]	$1,215 - $2,407	138%
Medcost [10966]	$1,308 - $2,592	149%
Multiplan [10600]	$1,445 - $2,862	165%
Phcs [10601]	$1,445 - $2,862	165%
UnitedHealthcare	$1,725 - $2,654	197%
Cigna	$1,733	198%
Industry Buying Group [10840]	$2,135 - $4,553	243%
Aetna	$2,397 - $4,749	273%
Kaiser [10500]	$2,430 - $4,814	277%
First Health [10303]	$2,791 - $5,529	318%
Novanet [10819]	$2,956 - $5,854	337%

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 $1,468.
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 Piedmont Augusta 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.