CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Children's Healthcare of Atlanta at Scottish Rite

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $3,647
Cash Discount Price: $5,321
vs. Medicare Baseline: 4.16x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Children's Healthcare of Atlanta at Scottish Rite is $3,647. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,321. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 4.16x the Medicare baseline. Located in 1001 Johnson Ferry Road, Atlanta, GA.

Cash / Self-Pay

$5,321

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,647

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: $5,321 (606%)

Insurance Median: $3,647 (416%)

Cash: $5,321 (606% of Medicare)

Ins. Median: $3,647 (416% 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 416% of the Medicare baseline (a markup of 316%). 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
Peachstate [43]	$2,224	253%
Caresource [61]	$2,285	260%
Amerigroup [102]	$2,308	263%
Cigna	$3,517	401%
Blue Cross Blue Shield	$3,530 - $5,194	402%
United [5]	$3,530	402%
Ambetter / Centene	$3,562	406%
Oscar [228]	$3,565	406%
Aetna	$3,581	408%
Caresource Marketplace Bronze/Silver/Gold [60]	$3,616	412%
Kaiser [6]	$3,623	413%
Sidecar Health [236]	$3,671	418%
Direct Employer Agreements [72]	$3,725 - $4,523	425%
Coventry [9]	$3,734	426%
Northeast Georgia Heatlh System [808]	$3,991	455%
Veracity Benefits [809]	$3,991	455%
First Health [74]	$3,994	455%
Phcs [93]	$4,523	516%
Secure Health [340]	$4,523	516%
Beech Street [71]	$4,789	546%
Multiplan [92]	$5,215	594%
Novanet [41]	$5,321	606%

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 $5,321.
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 Children's Healthcare of Atlanta at Scottish Rite 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.