Sleep study (overnight, in lab)
Facility: Saint Luke'S South Hospital
Billing Code: 95810 (CPT)
- CPT Billing Code: 95810
- Insurance Median: $5,348
- Cash Discount Price: $7,130
- vs. Medicare Baseline: 6.10x 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 610% of the Medicare baseline (a markup of 510%). 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 |
|---|---|---|
| Medicaid / KanCare | $339 - $1,301 | 39% |
| Commercial-Contracted [8000] | $641 - $9,614 | 73% |
| UnitedHealthcare | $1,557 - $3,034 | 177% |
| Humana | $3,803 | 433% |
| Cigna | $3,827 - $9,020 | 436% |
| Transplants-Case Rates [5750] | $4,159 - $11,884 | 474% |
| Blue Cross Blue Shield | $5,348 - $8,925 | 610% |
| First Health [5512] | $7,045 | 803% |
| Aetna | $10,101 - $11,290 | 1151% |
Consumer Guidance & Cost Commentary
For the CPT code 95810, representing an overnight sleep study at Saint Luke's South Hospital in Overland Park, KS, the facility's cash median price is $7,130. This cash rate is significantly higher than the national average for this service, which is approximately $1,000. While the facility's negotiated rates for commercial payers range from $339 to $11,884, these amounts are often inflated by administrative costs and contract structures. It is important to note that commercial negotiated rates frequently exceed cash prices; therefore, patients with high-deductible plans may find paying the cash median of $7,130 directly to the hospital more cost-effective than relying on insurance, which could result in a higher allowed amount after deductibles are met.
When evaluating the cost relative to federal standards, the Medicare benchmark for this procedure is $877.34. The facility's cash price represents a markup of 6.1 times the Medicare amount, which is notably higher than the typical fair pricing range of 120% to 150% of Medicare. To maximize savings, patients should proactively request self-pay or prompt-pay discounts before scheduling, as these programs can offer fee reductions of 20% to 50% by bypassing insurance billing cycles. Additionally, since over 80% of hospital bills contain errors, consumers are advised to demand a full itemized CPT-coded bill rather than accepting summary invoices, ensuring that all charges are accurate and that no services were unbundled or rendered incorrectly.