CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Ascension Seton Hays

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $1,542
Cash Discount Price: $4,477
vs. Medicare Baseline: 1.76x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Ascension Seton Hays is $1,542. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,477. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.76x the Medicare baseline. Located in 6001 Kyle Pkwy, Kyle, TX.

Cash / Self-Pay

$4,477

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,542

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: $4,477 (510%)

Insurance Median: $1,542 (176%)

Cash: $4,477 (510% of Medicare)

Ins. Median: $1,542 (176% 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
Champva	$524 - $603	60%
Tricare	$827 - $986	94%
Blue Cross Blue Shield	$857 - $2,079	98%
Whole Foods	$877	100%
Aarp Mc Wellmed	$966	110%
Sendero Chap	$976	111%
Addr Cancer Together	$986	112%
Aetna	$986 - $9,691	112%
Covid Hrsa	$986	112%
Cshcn Cidc	$986	112%
Devoted Health Mcr Replacement	$986	112%
Humana	$986	112%
Medicare (plans)	$986	112%
Research Study	$986	112%
Smarthealth	$986	112%
Superior Allwell	$986	112%
Utmb	$986	112%
Wellcare Med Advantage	$986	112%
UnitedHealthcare	$1,006 - $10,210	115%
Connected Senior Care	$1,016	116%
Pphp Mcr Advantage	$1,035	118%
Tx Independence Hp	$1,035	118%
Oscar Health Exchange	$1,063	121%
Occunet	$1,380	157%
Sendero Idealcare	$1,725	197%
Ambetter / Centene	$1,775	202%
Covenant Health	$2,377 - $9,691	271%

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 $4,477.
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 Ascension Seton Hays 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.