CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Texas Childrens Hospital North Austin Campus

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $3,728
Cash Discount Price: $4,114
vs. Medicare Baseline: 4.25x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Texas Childrens Hospital North Austin Campus is $3,728. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,114. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 4.25x the Medicare baseline. Located in 9835 North Lake Creek Parkway Bldg A, Austin, TX.

Cash / Self-Pay

$4,114

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,728

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: $4,114 (469%)

Insurance Median: $3,728 (425%)

Cash: $4,114 (469% of Medicare)

Ins. Median: $3,728 (425% 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 425% of the Medicare baseline (a markup of 325%). 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
First Care Health Plan	$1,539 - $4,213	175%
UnitedHealthcare	$1,539 - $4,213	175%
Driscoll Children'S Health Plan Mcd	$1,710 - $1,975	195%
Molina Mcd	$1,710 - $1,975	195%
Blue Cross Blue Shield	$1,995 - $4,147	227%
Community Health Choice	$2,012 - $4,213	229%
Community First Health Plan Mcd	$2,280 - $2,633	260%
Cook Children'S Health Plan	$2,280 - $2,633	260%
Cigna	$3,248 - $4,213	370%
Aetna	$3,647 - $4,213	416%
Kelseycare	$3,704 - $4,279	422%
Healthsmart	$3,989 - $4,608	455%
Evolutions Healthcare	$4,274 - $4,937	487%
First Health	$5,015 - $6,254	572%
Multiplan	$5,129 - $5,925	585%
Galaxy Health Network	$5,414 - $6,254	617%

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 $4,114.
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 Childrens Hospital North Austin Campus 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.