CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: UT Health East Texas Tyler Regional Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $4,150
Cash Discount Price: $1,660
vs. Medicare Baseline: 4.73x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at UT Health East Texas Tyler Regional Hospital is $4,150. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,660. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 4.73x the Medicare baseline. Located in 1000 South Beckham Ave, Tyler, TX.

Cash / Self-Pay

$1,660

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,150

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: $1,660 (189%)

Insurance Median: $4,150 (473%)

Cash: $1,660 (189% of Medicare)

Ins. Median: $4,150 (473% 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 473% of the Medicare baseline (a markup of 373%). 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
Medicaid / KanCare	$1,076 - $4,150	123%
Blue Cross Blue Shield	$3,787	432%
Cigna	$3,787 - $6,640	432%
Amerigroup Commercial [5055]	$4,150	473%
Black Lung [6055]	$4,150	473%
Healthcare Highways [2210]	$4,150	473%
Healthscope Benefits [2290]	$4,150	473%
Lucent Health [6000]	$4,150	473%
Parkland Community Health Plan [6015]	$4,150	473%
UnitedHealthcare	$4,150	473%
Web Tpa [2115]	$4,150	473%
Group Pension Admin [1450]	$10,957	1249%
Phcs [1780]	$10,957	1249%

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 $1,660.
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 UT Health East Texas Tyler Regional Hospital 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.