CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Guadalupe Regional Medical Center

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $996
Cash Discount Price: $871
vs. Medicare Baseline: 1.14x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Guadalupe Regional Medical Center is $996. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $871. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.14x the Medicare baseline. Located in 1215 E Court St, Seguin, TX.

Cash / Self-Pay

$871

Average discount available for prompt cash payment at this facility.

Insurance Median

$996

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: $871 (99%)

Insurance Median: $996 (114%)

Cash: $871 (99% of Medicare)

Ins. Median: $996 (114% 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.

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
Superior Hlth Plan Mmcd	$179 - $1,445	20%
Healthcare Highways	$298 - $2,409	34%
UnitedHealthcare	$298 - $2,409	34%
Aetna	$337 - $2,730	38%
Humana	$337 - $2,730	38%
Cigna	$357 - $2,891	41%
Texas Mutual Insurance Co	$357 - $2,891	41%
Christus Exchange Health Plan	$564 - $996	64%
Mcr Clover Health	$564 - $996	64%
Mcr Texas Independence Health	$564 - $996	64%
Mcr Wellcare	$564 - $996	64%
Oscar Health Plan	$564 - $996	64%
Va Triwest Health Alliance	$564 - $996	64%
Blue Cross Blue Shield	$1,780 - $1,980	203%

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 $871.
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 Guadalupe Regional 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.