Sleep study (overnight, in lab)
Facility: Saint John Hospital
Billing Code: 95810 (CPT)
- CPT Billing Code: 95810
- Insurance Median: $837
- Cash Discount Price: $809
- vs. Medicare Baseline: 0.95x 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.
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 |
|---|---|---|
| UnitedHealthcare | $383 - $1,133 | 44% |
| Medicaid / KanCare | $383 | 44% |
| Celtic | $391 - $1,294 | 45% |
| Healthy Blue | $391 - $849 | 45% |
| Blue Cross Blue Shield | $528 - $1,056 | 60% |
| Medicare (plans) | $809 | 92% |
| Tricare | $809 | 92% |
| Midland Care Connection | $809 | 92% |
| Cigna | $809 | 92% |
| Aetna | $809 - $947 | 92% |
| Kansas Superior Select | $825 | 94% |
| Oha Networks | $1,052 | 120% |
| Worker Compensation | $1,085 | 124% |
| Well Path | $1,133 | 129% |
| Corizon | $1,133 | 129% |
| Employer Direct Healthcare | $1,133 | 129% |
| Centurion | $1,214 | 138% |
| Naphcare | $1,254 | 143% |
Consumer Guidance & Cost Commentary
For the CPT code 95810, representing an overnight sleep study at Saint John Hospital in Leavenworth, KS, the facility's cash price is $809.00, which matches the cash median for this procedure in the region. While the hospital's gross chargemaster rate is $10,266.00, commercial payers negotiate rates that often exceed the cash price; for instance, UnitedHealthcare and Celtic have negotiated ranges starting at $383 but extending up to $1,294 and $1,133 respectively, while Medicaid/KanCare is set at $383. This pricing structure highlights a common billing dynamic where in-network negotiated rates can be higher than the cash-pay amount, potentially making self-payment a more cost-effective option for patients with high-deductible plans or those who have already met their out-of-pocket maximum.
To minimize unexpected costs, patients should verify their specific plan's negotiated rate before scheduling, as commercial rates vary significantly by payer and can sometimes surpass the Medicare benchmark of $877.34. Although the facility offers a median negotiated rate of $837.00, which is slightly higher than the cash price, patients should proactively ask about "self-pay" or "prompt-pay" discounts during registration to bypass administrative fees and claim processing costs. It is also important to request a detailed, itemized bill rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered. If a balance bill arises from an out-of-network ancillary service, patients should utilize the No Surprises Act to dispute the charge