Sleep study (overnight, in lab)
Facility: Providence Medical Center
Billing Code: 95810 (CPT)
- CPT Billing Code: 95810
- Insurance Median: $849
- Cash Discount Price: $809
- vs. Medicare Baseline: 0.97x 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 | $273 - $947 | 31% |
| UnitedHealthcare | $383 - $1,306 | 44% |
| Medicaid / KanCare | $383 | 44% |
| Celtic | $391 - $1,294 | 45% |
| Healthy Blue | $391 - $849 | 45% |
| Midland Care Connection | $809 | 92% |
| Medicare (plans) | $809 | 92% |
| Tricare | $809 | 92% |
| Cigna | $809 | 92% |
| Kansas Superior Select | $849 | 97% |
| Corizon | $1,052 | 120% |
| Oha Networks | $1,052 | 120% |
| Worker Compensation | $1,085 | 124% |
| Well Path Prison | $1,133 | 129% |
| Employer Direct Healthcare | $1,133 | 129% |
| Centurion | $1,214 | 138% |
| Naphcare | $1,254 | 143% |
| Blue Cross Blue Shield | $1,294 - $1,497 | 147% |
Consumer Guidance & Cost Commentary
For the sleep study procedure (CPT 95810) at Providence Medical Center in Kansas City, KS, the facility's cash price of $809.00 is significantly lower than the negotiated rates charged to most major insurance payers, which range from $383 to $1,497. While the facility's cash rate aligns with the lowest end of the negotiated spectrum for some plans like Medicaid/KanCare and Midland Care Connection, it is notably lower than the average negotiated rates for large carriers such as UnitedHealthcare and Blue Cross Blue Shield. This pricing structure suggests that for patients with high-deductible plans or those without insurance, paying the cash price directly may result in lower out-of-pocket costs compared to the insurance negotiated rates, provided the patient's plan does not cover the service or has not yet met its deductible.
To maximize potential savings, patients should proactively request a "self-pay" or "prompt-pay" discount before scheduling their visit, as these upfront payment incentives can reduce the final bill by 20% to 50%. It is important to avoid automatic claims submission, which can void cash discounts if the billing system defaults to insurance processing; signing a waiver of insurance submission at registration ensures the facility applies the cash rate. Additionally, while the facility's cash rate is competitive, patients should remain aware of balance billing protections under the No Surprises Act, which prevent unexpected charges for out-of-network services at in-network facilities, and should always request a detailed, itemized bill to verify that no unbundled codes or services not rendered have been included in the final charge.