CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Cook Childrens Medical Center

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $4,111
Cash Discount Price: $7,496
vs. Medicare Baseline: 4.69x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Cook Childrens Medical Center is $4,111. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,496. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 4.69x the Medicare baseline. Located in 801 Seventh Avenue, Fort Worth, TX.

Cash / Self-Pay

$7,496

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,111

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: $7,496 (854%)

Insurance Median: $4,111 (469%)

Cash: $7,496 (854% of Medicare)

Ins. Median: $4,111 (469% 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 469% of the Medicare baseline (a markup of 369%). 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
Beacon	$2,154 - $4,847	246%
Firstcare	$2,154 - $8,812	246%
Health Plan W/O Uhrip	$2,154 - $3,685	246%
Health Plan W. Uhrip	$3,002 - $4,188	342%
Rightcare	$3,002 - $4,847	342%
United Community	$3,153 - $3,870	359%
Wellpoint	$3,153 - $3,870	359%
Blue Cross Blue Shield	$3,243 - $9,914	370%
Molina	$3,321 - $4,076	379%
El Paso Health First	$3,949 - $4,847	450%
Superior Health	$3,949 - $4,847	450%
Tx Children Health	$3,949 - $4,847	450%
UnitedHealthcare	$3,949 - $9,363	450%
Aetna	$4,344 - $9,363	495%
S&W Health	$7,539 - $9,253	859%
Cigna	$7,628 - $9,363	869%
Healthscope	$7,628 - $9,363	869%
Imagine Health	$7,628 - $9,363	869%
Humana	$7,808 - $9,694	890%
Multiplan	$7,808 - $9,583	890%
First Health	$7,898 - $9,694	900%
Galaxy Health	$8,077 - $9,914	921%
Healthsmart	$8,077 - $9,914	921%
Usamco	$8,257 - $10,134	941%

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 $7,496.
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 Cook Childrens 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.