CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Prisma Health Tuomey Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 95810
  • Insurance Median: $1,498
  • Cash Discount Price: $4,259
  • vs. Medicare Baseline: 1.71x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Prisma Health Tuomey Hospital is $1,498. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,259. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.71x the Medicare baseline. Located in 129 N Washington St, Sumter, SC.
Cash / Self-Pay
$4,259

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,498

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: $4,259 (485%)
Insurance Median: $1,498 (171%)
Cash: $4,259 (485% of Medicare)
Ins. Median: $1,498 (171% 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.

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
Medicaid / KanCare $318 - $1,009 36%
Humana $480 - $4,914 55%
Blue Cross Blue Shield $803 - $4,308 92%
Cigna $803 - $5,025 92%
Covid19 Hrsa Uninsured Testing & Treatment Fund [904] $803 92%
Medicare (plans) $803 - $843 92%
Triwest Healthcare Alliance Vcp [902] $803 92%
Va Community Care Network-Vaccn [903] $803 92%
UnitedHealthcare $831 - $1,761 95%
Aetna $843 - $5,176 96%
Healthy Conn Prime-First Choice Vip Care [5300] $843 96%
Healthy Conn Prime-Molina Healthcare [5330] $843 96%
Healthy Conn Prime-Wellcare Prime By Atc [5310] $843 96%
Tricare $952 109%
Bluechoice [810] $1,009 - $4,307 115%
Workers Comp [600] $1,124 128%
Ambetter / Centene $1,477 168%
Prisma Health Seniorcare Pace - Midlands [5400] $1,520 173%
Prisma Health Seniorcare Pace-Upstate [5200] $1,520 173%
Bob Jones Univ-Pai [821] $1,624 185%
Golden Rule Insurance Company [2991] $1,761 201%
Oxford Health Plans [2992] $1,761 201%
Zzumr-Salt Lake City Ut [3169] $1,761 201%
Promise Health Plan Contracted [2401] $2,293 - $3,931 261%
Scdc-Sc Dept Of Corrections [7232] $2,430 277%
Orangeburg Senior Helping Center Pace [5401] $2,621 299%
Meritain Health Contracted [2200] $4,193 - $5,176 478%
Planned Administrators [820] $4,308 491%
Preferred Administrators Contracted [2839] $4,586 523%
Medcost [2940] $4,848 - $5,438 553%
Atlantic Packaging Contracted [4833] $4,914 560%
Aps Healthcare System [2981] $5,242 597%
Multiplan/Phcs Contracted [2950] $5,831 665%
Vsp Vision Care [2986] $5,897 672%
First Health Contracted [2952] $6,093 694%
Furman Int/Allen University Student [2951] $6,093 694%
Quiktrip-First Health [3067] $6,093 694%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 129 N Washington St, Sumter, SC 29150
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals