CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Falls Community Hospital and Clinic

Billing Code: 95810 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$959

about 1.1× the $877 Medicare rate · typically $534–$1,169

modeled estimate · not a bill or quote

What this hospital charges insurers

$934

About the fair price

about $25 under the fair price · 1.1× Medicare

Medicare pays $877 Fair price $959 This hospital $934 Cash price $4,573 Hospital's list price $5,717

How we calculate the fair BaseRate →

How this hospital compares to other TX hospitals

Highest price of the 9 TX hospitals we have prices for — worth calling around.

Cheapest $218 Priciest $934

Black dot = this hospital, among the 9 TX hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Sleep study (overnight, in lab) is about $959 (about 1.1× the $877 Medicare rate). Falls Community Hospital and Clinic charges insurers about $934, or about $4,573 in cash — about the fair price. Located in Marlin, TX.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$934 - $4,002	106%
Blue Cross Blue Shieldmajor	$2,254	257%
Aetnamajor	$4,573	521%
Cignamajor	$1,143	130%
Humanamajor	$934	106%
Baylor Scott & White	$934	106%

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 4,573), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 95810.

Insurance Before you use insurance

Call your insurance company to confirm Falls Community Hospital and Clinic is in-network.
Ask your insurer whether prior approval is required for CPT code 95810.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Falls Community Hospital and Clinic

Compare: Sleep study (overnight, in lab) at other TX hospitals

Insurance negotiated median for the same procedure, sorted lowest first.