Sleep study (overnight, in lab)
Facility: Lmh
Billing Code: 95810 (CPT)
- CPT Billing Code: 95810
- Insurance Median: $879
- Cash Discount Price: $1,409
- vs. Medicare Baseline: 1.00x 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 |
|---|---|---|
| Aetna | $300 - $7,879 | 34% |
| UnitedHealthcare | $381 - $6,304 | 43% |
| Blue Cross Blue Shield | $387 - $6,142 | 44% |
| Medicare (plans) | $432 - $865 | 49% |
| Cigna | $432 - $6,341 | 49% |
| Humana | $432 - $865 | 49% |
| Haskell Indian Health Services | $432 - $865 | 49% |
| Allwell | $441 - $882 | 50% |
| Ambetter / Centene | $670 - $1,341 | 76% |
| Non Contracted | $1,426 - $7,595 | 163% |
| First Health | $1,657 - $8,829 | 189% |
Consumer Guidance & Cost Commentary
For this overnight sleep study in Lawrence, Kansas, the facility's cash price of $1,409 is significantly lower than the gross chargemaster of $5,638, offering a substantial discount for self-pay patients. While the facility's negotiated rates with major payers like UnitedHealthcare and Blue Cross Blue Shield range from $381 to $6,304, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket and seeking prompt-pay discounts. It is important to note that Medicare, which serves as a reliable benchmark for fair pricing, covers this service at $877.34; commercial rates are frequently higher due to administrative costs and contract structures, so comparing your specific insurance allowed amount to the Medicare rate rather than the hospital's list price provides a clearer picture of true value.
Patients should be aware that while the No Surprises Act protects against balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, unexpected charges can still occur if ancillary services like laboratory tests are billed separately. To avoid these surprises, always request a full itemized bill before paying, as summary invoices can hide unbundled codes or services not rendered. If you receive a bill, dispute any errors in writing to the billing supervisor rather than accepting a verbal settlement, and remember that signing consent waivers for out-of-network costs without reading them can inadvertently waive your legal protections.