Sleep study (overnight, in lab)
Facility: Wesley Medical Center
Billing Code: 95810 (CPT)
- CPT Billing Code: 95810
- Insurance Median: $3,846
- Cash Discount Price: $22,103
- vs. Medicare Baseline: 4.38x 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 438% of the Medicare baseline (a markup of 338%). 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 |
|---|---|---|
| UnitedHealthcare | $383 | 44% |
| Medicaid / KanCare | $395 | 45% |
| Amerigroup | $398 | 45% |
| Aetna | $398 - $7,891 | 45% |
| United | $1,534 - $9,946 | 175% |
| Blue Cross Blue Shield | $1,749 | 199% |
| Health Partners Of Kansas | $3,824 - $11,052 | 436% |
| Wppa | $3,846 | 438% |
| Ambetter / Centene | $3,979 | 454% |
| Medical Associates Health Plan | $4,177 | 476% |
| Preferred Health Choices | $4,177 | 476% |
| Spirit Aerosystems | $7,073 | 806% |
| First Health | $10,189 | 1161% |
| Triwest Healthcare Alliance | $14,367 | 1638% |
| Multiplan | $15,472 - $19,893 | 1764% |
| Usa Managed Care | $18,788 | 2141% |
Consumer Guidance & Cost Commentary
For the sleep study procedure (CPT 95810) at Wesley Medical Center in Wichita, KS, the cash median price is $22,103.00, which aligns exactly with the facility's gross charge. This rate is significantly higher than the state average, as indicated by a 4.4x multiplier compared to Medicare's benchmark of $877.34. While commercial insurance plans like Aetna and Multiplan have negotiated rates ranging from $398 to $19,893, these figures often exceed the cash price for patients with high-deductible plans. In such cases, paying the cash median of $22,103.00 upfront can be more cost-effective than relying on insurance, which may result in higher out-of-pocket costs if the deductible is not yet met or if the negotiated rate exceeds the cash amount.
Patients should proactively inquire about "self-pay" or "prompt-pay" discounts before scheduling, as these incentives can reduce the final bill by 20% to 50% by bypassing administrative claim processing fees. It is important to avoid balance billing, which occurs when a provider bills the difference between the full charge and the insurance allowed amount; however, the No Surprises Act protects patients from such surprise bills for emergency care and non-emergency services at in-network facilities. To ensure accuracy, consumers should request a detailed, itemized billing audit rather than accepting a summary bill, as over 80% of hospital invoices contain errors such as unbundled codes or charges for services not rendered. By comparing the facility's rates directly to the Medicare benchmark and verifying prompt-pay options, patients can make informed