Sleep study (overnight, in lab)
Facility: Mercy Hospital Pittsburg, Inc
Billing Code: 95810 (CPT)
- CPT Billing Code: 95810
- Insurance Median: $1,980
- Cash Discount Price: $1,877
- vs. Medicare Baseline: 2.26x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 226% of the Medicare baseline (a markup of 126%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Blue Cross Blue Shield | $383 - $1,531 | 44% |
| Medicaid / KanCare | $383 - $991 | 44% |
| Humana | $528 - $972 | 60% |
| Aetna | $528 - $2,805 | 60% |
| UnitedHealthcare | $867 - $2,224 | 99% |
| Medica Contracted [320239] | $901 - $1,201 | 103% |
| Tricare | $972 | 111% |
| Elara Caring Aspire Hospice [20433] | $972 | 111% |
| Cross Timbers Hospice [20098] | $972 | 111% |
| Dept Of Veteran Affairs Contracted [320106] | $972 | 111% |
| Pace Of The Ozarks Contracted [320518] | $972 | 111% |
| Kindful Hospice [20434] | $972 | 111% |
| Mercy Hospice Okc [20252] | $972 | 111% |
| Halo Hcr Inc Hospice [20432] | $972 | 111% |
| Halo Hcr Inc Hospice Contracted [320432] | $972 | 111% |
| Medicare (plans) | $972 - $1,011 | 111% |
| American Health Advantage Of Ks Mcr Contracted [320508] | $972 | 111% |
| Kindful Hospice Contracted [320434] | $972 | 111% |
| Home State Health Plan Contracted [320187] | $991 | 113% |
| Ambetter / Centene | $991 | 113% |
| United Medical Resources Contracted [320454] | $1,668 - $2,224 | 190% |
| Cigna | $1,708 - $2,541 | 195% |
| Providrs Care Network Contracted [320484] | $1,882 | 215% |
| Ebms Contracted [320493] | $1,980 - $2,640 | 226% |
| Auxiant Contracted [320462] | $1,980 - $2,640 | 226% |
| Imagine 360 Contracted [320494] | $1,980 - $2,640 | 226% |
| Mercy Benefit Admin Contracted [320251] | $1,980 - $2,640 | 226% |
| Edison Health Solutions Contracted [320502] | $1,980 - $2,640 | 226% |
| Aither Health Contracted [320449] | $1,980 - $2,640 | 226% |
| Workers Comp [20426] | $1,980 - $2,640 | 226% |
| Reflect Health Contracted [320492] | $1,980 - $2,640 | 226% |
| Yuzu Health Contracted [320521] | $1,980 - $2,640 | 226% |
| Healthlink Contracted [320179] | $1,980 - $2,640 | 226% |
| American Healthcare Alliance Contracted [320020] | $1,980 - $2,640 | 226% |
| Health Choice Contracted [320166] | $2,035 | 232% |
| First Health Contracted [320128] | $2,104 - $2,805 | 240% |
Consumer Guidance & Cost Commentary
For the sleep study procedure (CPT 95810) at Mercy Hospital Pittsburg, Inc., the cash median price is $1,877, which is notably higher than the state average of $1,000. While commercial insurance plans like Blue Cross Blue Shield and Medicaid/KanCare negotiate rates as low as $383, many other payers, including Cigna and various contracted networks, have negotiated rates ranging from $1,980 to $2,640. This disparity highlights that in-network coverage does not guarantee the lowest possible price; in some cases, the insurance negotiated rate exceeds the cash price. Patients with high-deductible plans may find it financially advantageous to pay the cash median of $1,877 directly, provided they can secure a prompt-pay discount, which typically reduces the total by 20% to 50% when paid upfront.
To ensure you are not overpaying, it is critical to request a full itemized billing audit before finalizing payment, as summary bills often obscure individual line items and potential errors. Since over 80% of hospital bills contain mistakes such as unbundled codes or services not rendered, verifying the exact CPT codes and unit costs is the most effective way to reduce medical debt. Additionally, comparing your facility's rates to the Medicare benchmark of $877.34 reveals that the cash price represents a significant markup, while fair pricing is generally defined as 120% to 150% of the Medicare amount. Before scheduling, always confirm your deductible status and ask the hospital specifically about self-pay or prompt-pay discounts to avoid unexpected balance billing or higher out-of-pocket