CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Kootenai Health

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $740
Cash Discount Price: $4,059
vs. Medicare Baseline: 0.84x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Kootenai Health is $740. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,059. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 0.84x the Medicare baseline. Located in 2003 Kootenai Health Way, Coeur D'Alene, ID.

Cash / Self-Pay

$4,059

Average discount available for prompt cash payment at this facility.

Insurance Median

$740

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: $4,059 (463%)

Insurance Median: $740 (84%)

Cash: $4,059 (463% of Medicare)

Ins. Median: $740 (84% 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
Coordinated Care Of Washington	$70 - $361	8%
Molina Healthcare Of Idaho	$70 - $2,002	8%
Molina Healthcare Of Washington	$70 - $361	8%
Magellan	$108 - $524	12%
Wellpoint	$108 - $524	12%
Blue Cross Blue Shield	$115 - $4,871	13%
Humana	$115 - $888	13%
Premera	$115 - $3,345	13%
Regence Blue Shield Of Idaho	$115 - $996	13%
UnitedHealthcare	$115 - $4,871	13%
Pacificsource	$116 - $4,433	13%
Aetna	$121 - $4,492	14%
Group Health/Kaiser	$158 - $3,195	18%
Mountain Health Co-Op	$4,194	478%
Cigna	$4,432 - $4,497	505%
Interwest Health	$4,600	524%
First Choice Health (Ameriben)	$4,616 - $4,687	526%

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 $4,059.
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 Kootenai Health 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.