CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: North Austin Medical Center

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 95810
  • Insurance Median: $2,627
  • Cash Discount Price: $7,680
  • vs. Medicare Baseline: 2.99x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at North Austin Medical Center is $2,627. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,680. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 2.99x the Medicare baseline. Located in 12221 Mopac Expressway North, Austin, TX.
Cash / Self-Pay
$7,680

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,627

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: $7,680 (875%)
Insurance Median: $2,627 (299%)
Cash: $7,680 (875% of Medicare)
Ins. Median: $2,627 (299% 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 299% of the Medicare baseline (a markup of 199%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 $353 40%
Superior Health Plan $384 - $1,306 44%
United $1,142 - $3,456 130%
Blue Cross Blue Shield $1,162 - $2,880 132%
Oscar $1,475 - $1,644 168%
Moda $1,805 206%
Covenant Management Systems $2,212 252%
Healthcare Highways $2,235 - $2,304 255%
Imo Med - Select Network $2,304 263%
Aetna $2,445 - $4,473 279%
Nomi Health $2,458 - $2,842 280%
Cigna $2,465 - $3,149 281%
Moda Health $2,765 - $2,842 315%
Evry Health $2,826 322%
Texas Healthcare Foundation Heb $2,842 324%
Texas Workforce Commission $2,995 341%
Curative Administrators $3,072 350%
Harbor Health Team $3,072 350%
Averde Health $3,456 394%
UnitedHealthcare $3,456 394%
Comanche County $3,840 438%
National Choicecare $3,840 438%
Healthsmart Preferred Care $4,224 - $6,144 481%
Independent Medical Systems $4,224 481%
Physicians Cooperative Of Texas $4,224 481%
Prime Health $4,608 525%
First Health $4,800 - $5,453 547%
Coastal Comp Health Networks $4,992 569%
National Health Care $4,992 569%
Texas Municipal League $5,376 613%
Medcorp Southwest $5,760 657%
Rockport Healthcare Group $6,144 - $6,912 700%
Bce Emergis Corporation $6,912 788%
Beech Street $6,912 788%
Medical Control Network Solutions $6,912 788%
Multiplan $6,912 788%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12221 Mopac Expressway North, Austin, TX 78758
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals