Sleep study (overnight, in lab)
Facility: Ellsworth County Medical Center
Billing Code: 95810 (CPT)
- CPT Billing Code: 95810
- Insurance Median: $476
- Cash Discount Price: $574
- vs. Medicare Baseline: 0.54x 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 |
|---|---|---|
| Healthy Blue Mcr Adv | $114 - $376 | 13% |
| Triwest -All Plans | $114 - $376 | 13% |
| UnitedHealthcare | $114 - $800 | 13% |
| Humana | $114 - $760 | 13% |
| Va Ccn-All Plans | $114 - $376 | 13% |
| Providers Care-Wppa-All Plans | $139 - $1,200 | 16% |
| Aetna | $252 - $720 | 29% |
| Cigna | $340 - $760 | 39% |
| Medicaid / KanCare | $476 - $800 | 54% |
| Healthy Blue Mcaid- All Other Plans | $476 - $800 | 54% |
| Coventry Mcaid-All Plans | $476 - $800 | 54% |
| First Health - All Plans | $720 | 82% |
| Blue Cross Blue Shield | $846 - $1,046 | 96% |
Consumer Guidance & Cost Commentary
For the CPT code 95810, representing an overnight sleep study at Ellsworth County Medical Center in Ellsworth, Kansas, the cash price is $574.00, which matches the facility's median paid amount. This cash rate is significantly lower than the Medicare benchmark of $877.34, suggesting that paying out-of-pocket could result in substantial savings compared to standard government reimbursement. While the facility is a Critical Access Hospital with a proprietary ownership structure, patients should be aware that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract dynamics. For instance, the median negotiated rate across payers is $476.00, yet individual payer ranges extend up to $1,200, meaning some insured patients may pay more than the cash price depending on their specific plan.
To minimize costs, patients with high-deductible plans should consider paying the cash price of $574.00 directly, as this avoids potential balance billing if their insurance allows a higher negotiated rate. It is crucial to request a prompt-pay discount from the billing department before scheduling, as these upfront discounts can further reduce the final amount owed. Additionally, patients should insist on receiving an itemized bill rather than a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered. By comparing the facility's rates against the Medicare baseline and actively disputing any discrepancies through written audits, consumers can ensure they are not overcharged for this essential diagnostic service.