Sleep study (overnight, in lab)
Facility: University Of Kansas Health System - St Francis Campus
Billing Code: 95810 (CPT)
- CPT Billing Code: 95810
- Insurance Median: $3,741
- Cash Discount Price: $2,245
- vs. Medicare Baseline: 4.26x 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 426% of the Medicare baseline (a markup of 326%). 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 |
|---|---|---|
| Aetna | $3,068 | 350% |
| Web Tpa [2115] | $3,068 | 350% |
| Black Lung [6055] | $3,068 | 350% |
| Lucent Health [6000] | $3,068 | 350% |
| Blue Cross Blue Shield | $3,068 | 350% |
| Healthcare Highways [2210] | $3,068 | 350% |
| Oncology Patient Assistance Programs [2295] | $3,068 | 350% |
| Hooray Health [8000] | $3,068 | 350% |
| Department Of Corrections [1340] | $3,741 | 426% |
| American Postal Workers Union [1070] | $4,325 | 493% |
| National Association Of Letter Carriers [1695] | $4,325 | 493% |
| Cigna | $4,325 | 493% |
| Healthpartners [1500] | $4,325 | 493% |
| Humana | $4,414 | 503% |
| 1199 Seiu Benefit Fund [3505] | $5,037 | 574% |
| Enablecomp [1350] | $5,237 | 597% |
| Worker'S Comp [2125] | $5,237 | 597% |
| First Health [1375] | $5,814 | 663% |
| American Healthcare [1055] | $5,814 | 663% |
| Administrative Concepts [1005] | $5,814 | 663% |
| Multiplan [1680] | $5,814 | 663% |
| Coventry Healthcare [1320] | $6,135 | 699% |
| Ks Disability Determination [6090] | $7,482 | 853% |
Consumer Guidance & Cost Commentary
For the sleep study procedure (CPT 95810) at the University of Kansas Health System - St Francis Campus in Topeka, KS, the facility's cash price of $2,245 is significantly lower than the gross charge of $7,482. While the facility's negotiated rates with insurance payers range from $3,068 to $7,482, the cash price remains the lowest option available. It is important to note that for patients with high-deductible plans, paying the cash price directly can sometimes be more cost-effective than using insurance, as the negotiated rates often exceed the cash amount. Additionally, patients should verify if the hospital offers "self-pay" or "prompt-pay" discounts, which can further reduce the final bill by bypassing administrative processing fees and claims delays.
When evaluating the cost relative to the national baseline, the facility's cash price is 2.6 times the Medicare benchmark rate of $877.34, which aligns with the typical commercial markup range of 200% to 300% of Medicare. This comparison highlights that while the facility's negotiated rates are higher than the cash price, they still represent a substantial markup over the federal government's cost-based reimbursement. Patients are advised to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as double-billing or unbundled codes. Furthermore, if you have insurance, ensure you understand your deductible status before scheduling, as paying the full negotiated rate without meeting your deductible can result in higher out-of-pocket costs than paying cash outright.