CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Sycamore Shoals Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 95810
  • Insurance Median: $926
  • Cash Discount Price: $549
  • vs. Medicare Baseline: 1.06x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Sycamore Shoals Hospital is $926. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $549. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.06x the Medicare baseline. Located in 1501 West Elk Avenue, Elizabethton, TN.
Cash / Self-Pay
$549

Average discount available for prompt cash payment at this facility.

Insurance Median
$926

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: $549 (63%)
Insurance Median: $926 (106%)
Cash: $549 (63% of Medicare)
Ins. Median: $926 (106% 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
Blue Cross Blue Shield $181 - $2,105 21%
UnitedHealthcare $715 - $2,776 81%
Aetna $779 - $2,334 89%
Amerigroup $779 - $834 89%
Humana $779 89%
Managed Medicaire $779 89%
Medicare (plans) $779 89%
Sentara Health $779 - $1,018 89%
United Mine Workers Of America $779 89%
Molina Healthcare $810 - $1,098 92%
Cigna $818 - $1,698 93%
Devoted Health Plan $818 93%
Nhc Advantage $818 93%
Wellcare $826 - $3,659 94%
Optima Health $1,056 120%
Medcost $1,281 146%
Ambetter / Centene $1,698 194%
First Health Coventry $2,744 313%
Seven Corners, Inc. $3,659 417%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1501 West Elk Avenue, Elizabethton, TN 37643
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals