CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Decatur County Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 95810
  • Insurance Median: $2,475
  • Cash Discount Price: $1,459
  • vs. Medicare Baseline: 2.82x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Decatur County Hospital is $2,475. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,459. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 2.82x the Medicare baseline. Located in 1405 Nw Church Street, Leon, IA.
Cash / Self-Pay
$1,459

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,475

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: $1,459 (166%)
Insurance Median: $2,475 (282%)
Cash: $1,459 (166% of Medicare)
Ins. Median: $2,475 (282% 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 282% of the Medicare baseline (a markup of 182%). 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
Aetna $114 - $2,678 13%
Tricare $114 - $1,831 13%
UnitedHealthcare $114 - $2,882 13%
Amerigroup Mcaid-All Plans $120 - $3,560 14%
Everystep Hospice-All Plans $134 - $1,763 15%
Misc Commercial-All Plans $188 - $2,475 21%
Rural Carrier Benefit Plan-All Plans $199 - $2,610 23%
Christian Healthcare -All Plans $206 - $2,712 23%
Wellmark Hmo $215 - $1,115 25%
Wellmark Ppo - All Other Plans $215 - $1,227 25%
Ntca The Rural Broadband-All Plans $219 - $2,882 25%
Farm Bureau Financial-All Other Plans $232 - $3,051 26%
Farm Bureau Property And Ca $232 - $3,051 26%
Priority Health-All Plans $258 - $3,390 29%
Iowa Total Care Mcaid-All Plans $263 - $3,458 30%
Blue Cross Blue Shield $1,085 124%
Midlands Choice-All Plans $1,242 - $3,322 142%
Champva -All Plans $1,526 174%
Benefit Admin System-All Plans $2,204 251%
Humana $2,475 282%
Meritain Health-All Plans $2,475 282%
All Savers-All Plans $2,542 290%
Allied Benefit System-All Plans $2,542 290%
American Family Ins Grp-All Plans $2,542 290%
Medica-All Other Plans $2,712 309%
Golden Rule-All Plans $2,882 328%
Cigna $2,915 332%
Medical Mutual-All Plans $2,983 340%
Medi Share-All Plans $3,085 352%
Uhss-All Plans $3,085 352%
Health Partners-All Plans $3,119 356%
Lewermark-All Plans $3,220 367%
Mail Handlers Benefit-All Plans $3,322 379%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1405 Nw Church Street, Leon, IA 50144
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals