CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Seton Medical Center Harker Heights

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $3,242
Cash Discount Price: $647
vs. Medicare Baseline: 3.70x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Seton Medical Center Harker Heights is $3,242. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $647. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 3.70x the Medicare baseline. Located in 850 W Central Texas Expressway, Harker Heights, TX.

Cash / Self-Pay

$647

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,242

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: $647 (74%)

Insurance Median: $3,242 (370%)

Cash: $647 (74% of Medicare)

Ins. Median: $3,242 (370% 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 370% of the Medicare baseline (a markup of 270%). 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
Blue Cross Blue Shield	$1,124 - $4,784	128%
Healthscope Benefits [2290]	$1,164	133%
UnitedHealthcare	$1,164 - $2,521	133%
Healthcare Highways [2210]	$2,521	287%
Medicaid / KanCare	$2,521 - $6,930	287%
Oncology Patient Assistance Programs [2295]	$2,521	287%
Selecthealth [3740]	$2,521	287%
Web Tpa [2115]	$2,521	287%
Cigna	$2,942 - $5,599	335%
American Postal Workers Union [1070]	$3,058	349%
Aetna	$3,426 - $3,711	390%
First Health [1375]	$3,711	423%
Mailhandlers [1595]	$3,711	423%
First Care Commercial [1371]	$4,849	553%

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 $647.
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 Seton Medical Center Harker Heights 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.