CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Carlsbad Medical Center

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $3,542
Cash Discount Price: $1,003
vs. Medicare Baseline: 4.04x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Carlsbad Medical Center is $3,542. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,003. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 4.04x the Medicare baseline. Located in 2430 West Pierce Street, Carlsbad, NM.

Cash / Self-Pay

$1,003

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,542

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: $1,003 (114%)

Insurance Median: $3,542 (404%)

Cash: $1,003 (114% of Medicare)

Ins. Median: $3,542 (404% 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 404% of the Medicare baseline (a markup of 304%). 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
Veterans Eval Services	$452	52%
Self Pay	$668 - $1,337	76%
Department Of Veterans Affairs	$850	97%
Tricare	$850	97%
Blue Cross Blue Shield	$896 - $6,034	102%
Medicare (plans)	$896	102%
Node Molina Mcr Adv	$896	102%
Presbyterian	$896 - $4,831	102%
Node Va	$910	104%
Triwest	$910	104%
UnitedHealthcare	$932 - $4,425	106%
Medicaid / KanCare	$934 - $981	106%
Node Choice Care Mcr Adv	$941	107%
Node Devoted Health Mcr Adv	$941	107%
Us Department Of Labor	$1,138	130%
Wexford Health	$1,138	130%
Work Comp Nm	$2,406	274%
Node Molina Health Exchange	$2,486	283%
Eddy County Detention	$3,342	381%
Nm Health Connection	$3,642	415%
Zelis	$4,211 - $5,615	480%
Omni Network	$4,345	495%
Capstar	$4,411	503%
Cigna	$4,636 - $5,601	528%
Choice Care	$4,679	533%
Ccn First Health	$5,347	609%
Healthsmart	$5,414 - $5,748	617%
Aetna	$5,615	640%
Multiplan	$5,615	640%
Medical Control Inc	$6,216	709%

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 $1,003.
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 Carlsbad Medical Center 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.