CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: University of Iowa Health Care Medical Center Down

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $3,392
Cash Discount Price: $3,653
vs. Medicare Baseline: 3.87x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at University of Iowa Health Care Medical Center Down is $3,392. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,653. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 3.87x the Medicare baseline. Located in 500 E Market Street, Iowa City, IA.

Cash / Self-Pay

$3,653

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,392

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: $3,653 (416%)

Insurance Median: $3,392 (387%)

Cash: $3,653 (416% of Medicare)

Ins. Median: $3,392 (387% 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 387% of the Medicare baseline (a markup of 287%). 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
Immergrun	$253 - $1,741	29%
Aetna	$559 - $1,658	64%
Iowa Total Care	$559 - $2,786	64%
Medical Associates	$559 - $4,667	64%
Molina Healthcare	$559 - $2,786	64%
UnitedHealthcare	$559 - $5,293	64%
Blue Cross Blue Shield	$565 - $3,343	64%
Healthpartners	$570 - $5,920	65%
Wellpoint (Amerigroup)	$587 - $1,005	67%
Oscar Health	$637 - $4,388	73%
Great River Health Systems	$708 - $4,876	81%
Quad City Community Healthcare	$758 - $5,224	86%
Sedgwick	$809 - $5,572	92%
Global Excel	$859 - $5,920	98%
Sanford Health Plan	$859 - $5,920	98%
Employee Benefit Systems	$890 - $6,268	101%
Sisco	$890 - $6,129	101%
Healthsmart	$910 - $6,268	104%
Hfn	$930 - $6,408	106%
Multiplan	$930 - $6,408	106%
Aplos Health Plan	$1,288 - $5,572	147%
Midlands Choice	$2,361 - $4,527	269%

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 $3,653.
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 University of Iowa Health Care Medical Center Down 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.