CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Tristar Southern Hills Medical Center

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $2,569
Cash Discount Price: $10,703
vs. Medicare Baseline: 2.93x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Tristar Southern Hills Medical Center is $2,569. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $10,703. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 2.93x the Medicare baseline. Located in 391 Wallace Rd, Nashville, TN.

Cash / Self-Pay

$10,703

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,569

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: $10,703 (1220%)

Insurance Median: $2,569 (293%)

Cash: $10,703 (1220% of Medicare)

Ins. Median: $2,569 (293% 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 293% of the Medicare baseline (a markup of 193%). 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	$269 - $2,462	31%
United	$1,268 - $4,816	145%
Bright Health	$1,819 - $2,569	207%
Oscar	$1,959	223%
Kentucky Labor Cabinet	$1,970	225%
Apex Health	$2,034	232%
Nhc Advantage, Inc.	$2,034	232%
Pruitt Health (Allyalign)	$2,034	232%
Aetna	$2,311 - $5,351	263%
Ambetter / Centene	$2,387 - $2,483	272%
Humana	$2,676	305%
Cigna	$2,697 - $3,489	307%
Centurion	$4,409	503%
Bgfh Singlesource	$5,351 - $9,097	610%
Multiplan	$6,208	708%
Employers Health Network	$7,492	854%
Odom'S Tn Pride Sausage	$8,027	915%
Beech Street	$9,418	1073%
Prime Health	$9,418	1073%

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 $10,703.
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 Southern Hills 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.