CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Blue Ridge Regional Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 95810
  • Insurance Median: $2,009
  • Cash Discount Price: $4,888
  • vs. Medicare Baseline: 2.29x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Blue Ridge Regional Hospital is $2,009. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,888. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 2.29x the Medicare baseline. Located in 125 Hospital Drive, Spruce Pine, NC.
Cash / Self-Pay
$4,888

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,009

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: $4,888 (557%)
Insurance Median: $2,009 (229%)
Cash: $4,888 (557% of Medicare)
Ins. Median: $2,009 (229% 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 229% of the Medicare baseline (a markup of 129%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Blue Cross Blue Shield $782 - $2,024 89%
United $832 - $2,312 95%
Wellcare $845 96%
Amerihealth $853 97%
Partners Health Management $861 98%
Vaya Health $861 98%
Aetna $978 - $3,534 111%
Apex Health $978 111%
Cigna $1,662 - $1,999 189%
Amerihealth Caritas $1,808 206%
Caresource $2,151 245%
Oscar $2,224 253%
Medcost $2,278 - $2,530 260%
Magellan $2,933 334%
Magellan Behavioral Health $2,933 334%
Multiplan $3,910 446%
Avalon Administrative Services $4,154 473%
Prime Health $4,301 - $4,399 490%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 125 Hospital Drive, Spruce Pine, NC 28777
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals