CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Harlingen Medical Center

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $871
Cash Discount Price: $858
vs. Medicare Baseline: 0.99x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Harlingen Medical Center is $871. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $858. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 0.99x the Medicare baseline. Located in 5501 South Expressway 77, Harlingen, TX.

Cash / Self-Pay

$858

Average discount available for prompt cash payment at this facility.

Insurance Median

$871

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: $858 (98%)

Insurance Median: $871 (99%)

Cash: $858 (98% of Medicare)

Ins. Median: $871 (99% 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
Aetna	$858 - $931	98%
Blue Cross Blue Shield	$858 - $1,593	98%
Careworks Worker Compensation Fka Rockport Community Network	$858	98%
Cigna	$858 - $884	98%
Humana	$858	98%
Medicare (plans)	$858	98%
San Benito Medical Associates	$858	98%
Superior Health Plan	$858	98%
Texas Bluebonnett Health Plan	$858 - $1,416	98%
Tricare	$858	98%
UnitedHealthcare	$858	98%
Veterans Evaluation Services	$858	98%
Wellmed	$858	98%
Workers Compensation	$858	98%
Molina	$901 - $1,331	103%
Provider Partners Health Plan	$901	103%
Imperial Insurance Company	$910	104%
Asserta Health	$1,116	127%
Friday Health Plan	$1,116	127%
Magic Valley Electric Cooperative	$1,116	127%
Superior Health Commercial Exchange	$1,116	127%
Employer Direct Healthcare	$1,202	137%
Corporate Remedies Worker Compensation	$1,288	147%
Naphcare	$1,331	152%
Baker Benefits Administrators	$1,717	196%

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 $858.
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 Harlingen 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.