CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Monroe County Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $2,176
Cash Discount Price: $3,109
vs. Medicare Baseline: 2.48x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Monroe County Hospital is $2,176. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,109. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 2.48x the Medicare baseline. Located in 6580 165Th Street, Albia, IA.

Cash / Self-Pay

$3,109

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,176

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: $3,109 (354%)

Insurance Median: $2,176 (248%)

Cash: $3,109 (354% of Medicare)

Ins. Median: $2,176 (248% 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 248% of the Medicare baseline (a markup of 148%). 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
Aetna	$114 - $5,182	13%
Geha - All Plans	$114 - $4,146	13%
Humana	$114 - $2,198	13%
Mahp Mcare - All Plans	$114 - $2,176	13%
Tricare	$114 - $2,176	13%
UnitedHealthcare	$114 - $4,923	13%
Va Ccn - All Plans	$114 - $2,176	13%
Amerigroup Mcare	$116 - $2,198	13%
Wellmark Mcare	$116 - $2,198	13%
Preferred Hlth - All Plans	$137 - $3,886	16%
Centivo - All Plans	$149 - $3,265	17%
Integrated Hp - All Plans	$166 - $5,027	19%
Multiplan - All Plans	$166 - $4,664	19%
Wellmark Hmo	$211 - $991	24%
Wellmark Ppo - All Other Plans	$211 - $1,067	24%
Midlands Choice - All Plans	$272 - $3,627	31%
Iowa Total Care Mcaid - All Plans	$2,590 - $5,286	295%
Molina Mcaid - All Plans	$2,628 - $5,312	300%
Amerigroup Mcaid - All Other Plans	$2,666 - $5,441	304%

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 $3,109.
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 Monroe County Hospital 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.