CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Anderson Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $3,776
Cash Discount Price: $3,524
vs. Medicare Baseline: 4.30x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Anderson Hospital is $3,776. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,524. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 4.30x the Medicare baseline. Located in 6800 State Route 162, Maryville, IL.

Cash / Self-Pay

$3,524

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,776

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: $3,524 (402%)

Insurance Median: $3,776 (430%)

Cash: $3,524 (402% of Medicare)

Ins. Median: $3,776 (430% 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 430% of the Medicare baseline (a markup of 330%). 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
Medicaid / KanCare	$176 - $992	20%
Health Care Service Corporation	$560 - $3,828	64%
Tricare	$566 - $5,786	65%
Humana	$626 - $4,869	71%
Medicare (plans)	$626 - $4,869	71%
UnitedHealthcare	$626 - $4,869	71%
Aetna	$906 - $4,869	103%
Essence	$920 - $5,114	105%
Devoted Health Ppo	$924 - $4,967	105%
Clear Springs Health	$933 - $5,015	106%
Ambetter / Centene	$1,334 - $7,199	152%
Blue Choice	$1,334 - $7,199	152%
Work Comp	$1,376 - $26,600	157%
Hopetrust	$2,301 - $12,413	262%
Self Pay	$2,865 - $25,000	327%
Blue Cross Blue Shield	$3,073 - $4,648	350%
Healthlink	$3,553 - $5,857	405%
Cigna	$3,725 - $5,438	425%
Mercy Aco	$3,725 - $5,438	425%
Mercy Benefit Admin	$3,725 - $5,438	425%
Multiplan/Phcs	$4,298 - $6,275	490%
Beech Street Corporation	$5,158 - $7,530	588%

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 $3,524.
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 Anderson 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.