CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Lafollette Medical Center

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 95810
  • Insurance Median: $862
  • Cash Discount Price: $4,251
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Lafollette Medical Center is $862. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,251. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 0.98x the Medicare baseline. Located in 923 East Central Avenue, La Follette, TN.
Cash / Self-Pay
$4,251

Average discount available for prompt cash payment at this facility.

Insurance Median
$862

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: $4,251 (485%)
Insurance Median: $862 (98%)
Cash: $4,251 (485% of Medicare)
Ins. Median: $862 (98% 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 $166 - $2,465 19%
Bluecare $170 - $191 19%
Medicaid / KanCare $346 - $3,542 39%
UnitedHealthcare $346 - $14,169 39%
Veterans Eval Services $443 50%
Amerigroup $702 80%
Tricare $761 87%
Node Champva $801 91%
Triwest $818 93%
Humana $821 - $3,117 94%
Medicare (plans) $821 94%
Node Bluecare Plus Tn Mcr Adv $821 94%
Node Hospice Non Par Agree $834 95%
Node Va $834 95%
Node Wellcare Mcr Adv $834 95%
Node Devoted Health Mcr Adv $838 96%
Node Farm Bureau Mcr Adv $838 96%
Aetna $846 - $8,813 96%
Node Blueadvantage Mcr Adv $846 96%
Node Healthspring Mcr Adv $846 96%
Node Amerigroup Mcr Adv $862 98%
Windsor Health Plan $862 98%
Node Nhc Mcr Adv $903 103%
Node Us Dept Of Labor $1,043 119%
Novanet Work Comp Tn $1,511 172%
Tn Work Comp $1,526 174%
Ambetter / Centene $1,544 176%
Node Point Comfort Underwriters $1,836 209%
Wellcare $3,542 404%
Cigna $3,572 407%
Self Pay $4,068 464%
Multiplan Complementary $10,769 1227%
Beech Street Work Comp Tn $130,285 14850%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 923 East Central Avenue, La Follette, TN 37766
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals