Sleep study (overnight, in lab)
Facility: Kansas City Orthopaedic Institute
Billing Code: 95810 (CPT)
- CPT Billing Code: 95810
- Insurance Median: $2,413
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 2.75x 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 275% of the Medicare baseline (a markup of 175%). 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 |
|---|---|---|
| Aetna | $928 | 106% |
| UnitedHealthcare | $928 | 106% |
| Cigna | $957 | 109% |
| Blue Cross Blue Shield | $2,413 | 275% |
Consumer Guidance & Cost Commentary
For the sleep study procedure (CPT 95810) at Kansas City Orthopaedic Institute in Leawood, KS, the negotiated rates vary significantly by insurer, ranging from $928 for Aetna and UnitedHealthcare to $2,413 for Blue Cross Blue Shield. While the facility's median negotiated rate of $2,413 is notably higher than the state of Kansas average, patients with high-deductible plans may find the cash price more advantageous if it falls below the insurance allowed amount. It is important to note that cash-pay rates are not explicitly listed in this report; however, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can often reduce the final cost by 20% to 50% by bypassing administrative billing cycles.
When reviewing your final bill, be aware that commercial insurance rates often include administrative overhead and contract markups that can exceed the true cost of care, which is best represented by the Medicare benchmark of $877.34 for this service. If you receive a bill that includes charges for services not rendered, unbundled components, or items that were cancelled, you should request a formal itemized audit rather than accepting a summary invoice. Under federal protections like the No Surprises Act, you are also shielded from balance billing for out-of-network services at in-network facilities, so any unexpected charges should be disputed in writing with the billing supervisor rather than paid immediately to avoid credit damage.