CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Southeast Iowa Regional Medical Center

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $1,092
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.24x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Southeast Iowa Regional Medical Center is $1,092. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.24x the Medicare baseline. Located in 1221 South Gear Avenue, West Burlington, IA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,092

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%)

Insurance Median: $1,092 (124%)

Ins. Median: $1,092 (124% 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.

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
American Healthplan Of Iowa - Midlevel	$91	10%
Humana	$113	13%
Aetna	$124	14%
American Healthplan Of Iowa - Md	$126	14%
Medicaid / KanCare	$159 - $163	18%
Plain Church	$190 - $2,200	22%
Blue Cross Blue Shield	$232 - $3,016	26%
Absolute Solutions	$263	30%
First Agency	$263	30%
Multiplan	$263	30%
Midlands Choice	$272 - $3,046	31%
Henderson County	$277	32%
UnitedHealthcare	$283	32%
Wellpoint (Amerigroup)	$741 - $1,895	84%
Immugrun	$834 - $2,132	95%
Brighton Amish Church	$861 - $2,200	98%
6 Degree	$1,059 - $2,707	121%
Geha	$1,231 - $3,147	140%

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 $X.
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 Southeast Iowa Regional Medical Center 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.