CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Cass County Memorial Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $1,337
Cash Discount Price: $2,185
vs. Medicare Baseline: 1.52x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Cass County Memorial Hospital is $1,337. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,185. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.52x the Medicare baseline. Located in 1501 East Tenth Street, Atlantic, IA.

Cash / Self-Pay

$2,185

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,337

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: $2,185 (249%)

Insurance Median: $1,337 (152%)

Cash: $2,185 (249% of Medicare)

Ins. Median: $1,337 (152% 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
Midlands Choice Medica Mcr	$624	71%
Triwest - All Plans	$1,272	145%
Aetna	$1,311 - $2,965	149%
Amerigroup Mcr Adv - All Other Plans	$1,311	149%
Medica Mcr Adv	$1,311	149%
Tricare	$1,311	149%
UnitedHealthcare	$1,311 - $2,834	149%
Va Ccn - All Plans	$1,311	149%
Wellmark Mcr Adv	$1,324	151%
Iowa Total Care Mcaid	$1,337	152%
Iowa Total Care Mcr	$1,337	152%
Molina Mcaid - All Plans	$1,337	152%
American Hlth Mcr Adv - All Plans	$1,350	154%
Medicaid / KanCare	$1,350	154%
Iowa Total Care Comm - All Other Plans	$1,442	164%
Midlands Choice New Bus	$2,029	231%
Medica Comm - All Other Plans	$2,746	313%
Wellmark Hmo	$2,774	316%
Midlands Choice Pho (Ppo) - All Other Plans	$2,809	320%
Multiplan - All Plans	$2,965	338%
Wellmark Ppo - All Other Plans	$3,049	348%

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 $2,185.
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 Cass County Memorial 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.