CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Tristar Summit Medical Center

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $2,902
Cash Discount Price: $11,847
vs. Medicare Baseline: 3.31x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Tristar Summit Medical Center is $2,902. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $11,847. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 3.31x the Medicare baseline. Located in 5655 Frist Blvd, Hermitage, TN.

Cash / Self-Pay

$11,847

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,902

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: $11,847 (1350%)

Insurance Median: $2,902 (331%)

Cash: $11,847 (1350% of Medicare)

Ins. Median: $2,902 (331% 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 331% of the Medicare baseline (a markup of 231%). 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
Blue Cross Blue Shield	$242 - $2,725	28%
United	$1,319 - $5,331	150%
Bright Health	$2,014 - $2,843	230%
Oscar	$2,168	247%
Kentucky Labor Cabinet	$2,181	249%
Apex Health	$2,251	257%
Nhc Advantage, Inc.	$2,251	257%
Pruitt Health (Allyalign)	$2,251	257%
Aetna	$2,311 - $5,923	263%
Ambetter / Centene	$2,642 - $2,748	301%
Humana	$2,962 - $7,700	338%
Cigna	$2,985 - $9,477	340%
Centurion	$4,881	556%
Bgfh Singlesource	$5,923 - $10,070	675%
Multiplan	$7,700	878%
Employers Health Network	$8,293	945%
Odom'S Tn Pride Sausage	$8,885	1013%
Compsych	$9,477	1080%
Beech Street	$10,425	1188%
Prime Health	$10,425	1188%

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 $11,847.
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 Tristar Summit 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.