CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Childrens Hospital of the Kings Daughters Inc

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $4,012
Cash Discount Price: $5,294
vs. Medicare Baseline: 4.57x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Childrens Hospital of the Kings Daughters Inc is $4,012. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,294. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 4.57x the Medicare baseline. Located in 601 Children's Lane, Norfolk, VA.

Cash / Self-Pay

$5,294

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,012

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: $5,294 (603%)

Insurance Median: $4,012 (457%)

Cash: $5,294 (603% of Medicare)

Ins. Median: $4,012 (457% 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 457% of the Medicare baseline (a markup of 357%). 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	$573 - $2,950	65%
UnitedHealthcare	$576 - $4,835	66%
Sentara Community Plan	$674 - $1,349	77%
Aetna	$707 - $4,835	81%
Humana	$707 - $1,414	81%
Amerihealth Caritas	$1,353	154%
Healthy Blue	$1,353	154%
Carolina Complete Health	$1,380	157%
Wellcare	$1,393	159%
Sentara Health Plans	$3,651	416%
Cigna	$3,906	445%
Virginia Health Network	$4,117 - $4,706	469%
Medcost	$5,000 - $5,412	570%
First Health	$5,294	603%
Multiplan	$5,412	617%
Phcs	$5,412 - $5,588	617%
Vhn	$5,412 - $5,588	617%
Johns Hopkins Healthcare	$5,588	637%

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 $5,294.
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 Childrens Hospital of the Kings Daughters Inc 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.