CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Fayette County Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $1,557
Cash Discount Price: $3,735
vs. Medicare Baseline: 1.77x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Fayette County Hospital is $1,557. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,735. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 1.77x the Medicare baseline. Located in 650 W Taylor St, Vandalia, IL.

Cash / Self-Pay

$3,735

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,557

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: $3,735 (426%)

Insurance Median: $1,557 (177%)

Cash: $3,735 (426% of Medicare)

Ins. Median: $1,557 (177% 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
Aetna	$90 - $4,296	10%
Blue Cross Blue Shield	$90 - $5,230	10%
Illinicare - All Plans	$90 - $1,557	10%
Medicaid / KanCare	$90 - $1,557	10%
Meridian-All Plans	$90 - $1,557	10%
Health Alliance Mcare	$119 - $1,992	14%
Healthlink Mcr Adv	$119 - $1,992	14%
Cigna	$131 - $4,670	15%
Coventry/Ghp-All Plans	$160 - $4,047	18%
Multiplan - All Plans	$220 - $5,292	25%
Health Alliance - All Other Plans	$237 - $5,143	27%
UnitedHealthcare	$1,032 - $5,168	118%
Healthlink Hmo	$1,069 - $4,358	122%
Healthlink Ppo - All Other Plans	$1,069 - $4,981	122%
Humana	$1,992	227%

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 $3,735.
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 Fayette 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.