Sleep study (overnight, in lab)
Facility: Susan B Allen Memorial Hospital
Billing Code: 95810 (CPT)
- CPT Billing Code: 95810
- Insurance Median: $554
- Cash Discount Price: $2,018
- vs. Medicare Baseline: 0.63x 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 | $350 | 40% |
| Providrs Care | $757 | 86% |
Consumer Guidance & Cost Commentary
For the CPT code 95810, representing an overnight sleep study at Susan B Allen Memorial Hospital in El Dorado, KS, the facility's cash median price is $2,018.00, which is significantly lower than the negotiated rates paid by UnitedHealthcare ($350) and Providrs Care ($757). This discrepancy highlights that for patients with high-deductible plans, paying cash directly can sometimes be more cost-effective than relying on insurance, especially when the insurer's negotiated rate exceeds the cash price. While the facility's cash rate is notably lower than its gross charge of $3,105.00, it is important to note that commercial negotiated rates often include administrative overhead and do not represent the lowest possible price available.
To ensure you are receiving the best possible rate, we recommend contacting the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the final bill. Additionally, if you have insurance, be aware that the No Surprises Act protects you from balance billing for out-of-network services at in-network facilities, and you should always request a full itemized CPT-coded bill before agreeing to any payment plan to avoid errors or unbundled charges. Comparing this specific service to broader state or county averages is not possible with the current data, as the report only provides specific payer and cash rates for this facility.