CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Texas Health Harris Methodist Hospital Cleburne

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $3,784
Cash Discount Price: $4,830
vs. Medicare Baseline: 4.31x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Texas Health Harris Methodist Hospital Cleburne is $3,784. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,830. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 4.31x the Medicare baseline. Located in 201 Walls Drive, Cleburne, TX.

Cash / Self-Pay

$4,830

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,784

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: $4,830 (551%)

Insurance Median: $3,784 (431%)

Cash: $4,830 (551% of Medicare)

Ins. Median: $3,784 (431% 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 431% of the Medicare baseline (a markup of 331%). 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
Amerigroup	$811 - $1,019	92%
Blue Cross Blue Shield	$811 - $3,702	92%
Cook Childrens	$811	92%
UnitedHealthcare	$811 - $5,556	92%
Superior Wellcare	$852 - $1,067	97%
Molina	$877 - $1,019	100%
Aetna	$893 - $5,643	102%
American Health	$970	111%
Healthspring	$990	113%
Humana	$1,009	115%
Fort Worth Firefighters	$3,537 - $4,915	403%
City Of Fort Worth	$3,784	431%
Cigna	$4,929 - $7,576	562%
Quick Trip	$5,716	652%
Phcs	$6,730	767%
Healthsmart	$7,004 - $7,728	798%
Multiplan	$7,004	798%
Galaxy	$7,084	807%
Usa	$7,084	807%

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 $4,830.
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 Texas Health Harris Methodist Hospital Cleburne 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.