CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Primary Children's Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 95810
  • Insurance Median: $3,155
  • Cash Discount Price: $3,333
  • vs. Medicare Baseline: 3.60x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Primary Children's Hospital is $3,155. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,333. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 3.60x the Medicare baseline. Located in 100 North Mario Capecchi Drive, Salt Lake City, UT.
Cash / Self-Pay
$3,333

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,155

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: $3,333 (380%)
Insurance Median: $3,155 (360%)
Cash: $3,333 (380% of Medicare)
Ins. Median: $3,155 (360% 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 360% of the Medicare baseline (a markup of 260%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
American Health $115 - $2,533 13%
Health Plan Of Nevada $115 - $496 13%
Healthy U $115 - $503 13%
Molina $115 - $3,733 13%
Selecthealth $115 - $3,733 13%
Southwest Behavioral Health $115 - $952 13%
UnitedHealthcare $115 - $3,733 13%
Tricare $975 111%
Triwest $975 111%
Donor Connect $1,600 - $1,769 182%
Aetna $3,155 - $3,778 360%
Awh Connected $3,155 - $3,778 360%
Byu Athletics $3,155 - $3,733 360%
Campbell Scientific $3,155 - $3,733 360%
Cigna $3,155 - $3,733 360%
Deseret Mutual $3,155 - $3,733 360%
Emi $3,155 - $3,733 360%
Emi Health $3,155 - $3,733 360%
First Choice $3,155 - $3,733 360%
First Choice Of The Midwest $3,155 - $3,733 360%
Franklin County $3,155 - $3,733 360%
Global Excel $3,155 - $3,733 360%
Health Utah $3,155 - $3,733 360%
Humana $3,155 - $3,733 360%
Hygeia Corporation $3,155 - $3,733 360%
Ifit $3,155 - $3,733 360%
Juniper Systems $3,155 - $3,733 360%
Lw Miller $3,155 - $3,733 360%
Managed Care Admin $3,155 - $3,733 360%
Medcare International $3,155 - $3,733 360%
Motivhealth $3,155 - $3,733 360%
Pehp $3,155 - $3,733 360%
Prodegi Corp Benefit $3,155 - $3,733 360%
Tanner Llc $3,155 - $3,733 360%
Uofu $3,155 - $3,733 360%
Utah Tech $3,155 - $3,733 360%
Wise Network $3,155 - $3,733 360%
First Health $3,200 - $3,778 365%
Blue Cross Blue Shield $3,244 - $3,822 370%
Springtide $3,244 - $3,822 370%
Utah Behavioral Health Network $3,600 410%
Altius Mhnet Behavioral Health $3,911 446%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 North Mario Capecchi Drive, Salt Lake City, UT 84113
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens