CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Carolinas Medical Center-Northeast

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $1,258
Cash Discount Price: $3,183
vs. Medicare Baseline: 1.43x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Carolinas Medical Center-Northeast is $1,258. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,183. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.43x the Medicare baseline. Located in 920 Church St N, Concord, NC.

Cash / Self-Pay

$3,183

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,258

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: $3,183 (363%)

Insurance Median: $1,258 (143%)

Cash: $3,183 (363% of Medicare)

Ins. Median: $1,258 (143% 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
Cigna	$109 - $5,093	12%
Humana	$111 - $987	13%
Aetna	$113 - $3,883	13%
UnitedHealthcare	$113 - $2,820	13%
Ortho Carolina	$137 - $1,210	16%
Partners	$138 - $802	16%
Trillium	$138 - $820	16%
Amerihealth Caritas	$139 - $781	16%
Carolina Complete Health	$139 - $796	16%
Healthy Blue	$139 - $796	16%
Vaya	$139 - $804	16%
Wellcare	$139 - $796	16%
Alliance	$140 - $812	16%
Medcost	$311 - $4,774	35%
Blue Cross Blue Shield	$369 - $2,285	42%
Choicecare	$389 - $5,220	44%
Ambetter / Centene	$1,849 - $2,311	211%
Employers Health Network	$2,814	321%
Physician Reach Out	$3,183	363%
Magellan	$3,819	435%
Gmmi	$4,138	472%
Quik Trip	$4,138	472%
Carolina Behavioral Health	$4,583 - $5,093	522%
Healthgram	$5,093	581%
Private Health Care Systems	$5,093	581%
Lifesynch Community Choice Care	$5,220	595%
First Health	$5,411	617%
Beechstreet	$5,729	653%
Multiplan	$6,047	689%

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 $3,183.
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 Carolinas Medical Center-Northeast 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.