CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: North Carolina Baptist Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $1,288
Cash Discount Price: $1,999
vs. Medicare Baseline: 1.47x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at North Carolina Baptist Hospital is $1,288. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,999. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.47x the Medicare baseline. Located in Medical Center Boulevard, Winston-Salem, NC.

Cash / Self-Pay

$1,999

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,288

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: $1,999 (228%)

Insurance Median: $1,288 (147%)

Cash: $1,999 (228% of Medicare)

Ins. Median: $1,288 (147% 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
Medcost	$770 - $2,729	88%
Blue Cross Blue Shield	$805 - $1,302	92%
Amerihealth	$879 - $1,106	100%
Carolina Complete	$879 - $928	100%
Health Blue	$879 - $928	100%
Partners	$879 - $928	100%
Vaya	$888 - $937	101%
UnitedHealthcare	$890 - $1,416	101%
Wellcare	$890 - $985	101%
Alliance	$897 - $946	102%
Trillium	$906 - $955	103%
Aetna	$922 - $3,488	105%
Apex	$985	112%
Cigna	$985 - $2,462	112%
Devoted	$985	112%
Healthteam	$985	112%
Humana	$995 - $2,245	113%
Medicare (plans)	$995	113%
Ambetter / Centene	$1,050 - $1,108	120%
Liberty	$1,133	129%
Oscar	$1,167 - $1,477	133%
Directnet	$2,299 - $2,425	262%
Cone Health	$2,723 - $2,873	310%
Healthgram	$2,723 - $2,873	310%
First Carolina Care	$3,112 - $3,283	355%
Private Healthcare Systems	$3,190 - $3,365	364%
Multiplan	$3,501 - $3,694	399%

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 $1,999.
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 North Carolina Baptist 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.