Sleep study (overnight, in lab)
Facility: Stanton County Hospital
Billing Code: 95810 (CPT)
- CPT Billing Code: 95810
- Insurance Median: $3,793
- Cash Discount Price: $3,990
- vs. Medicare Baseline: 4.32x 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 432% of the Medicare baseline (a markup of 332%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $1,004 - $3,793 | 114% |
| Healthy Blue Mcr Adv - All Other Plans | $3,910 | 446% |
| Healthy Blue Mcaid | $3,990 | 455% |
Consumer Guidance & Cost Commentary
For a sleep study (overnight, in lab) at Stanton County Hospital in Johnson, KS, the cash price is $3,990, which matches the facility's negotiated rate with Healthy Blue Mcaid and the gross charge. This cash price is significantly higher than the state average for this service, as indicated by the 4.3x markup compared to the Medicare benchmark of $877.34. While the facility is a Critical Access Hospital owned by the local government, patients should note that commercial negotiated rates often exceed cash prices due to administrative overhead and contract structures. If you have a high-deductible plan where your deductible has not yet been met, paying the cash price of $3,990 upfront might be more cost-effective than relying on insurance, especially since the median negotiated rate for in-network payers like Blue Cross Blue Shield is $3,793, which still exceeds the cash amount.
To ensure you are receiving the best possible rate, it is crucial to request an itemized billing audit before finalizing payment, as summary bills often obscure individual charges or unbundled codes that could be disputed. Additionally, you should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full within a short window, bypassing costly insurance claims processing. Since the Medicare benchmark represents the true cost baseline for this procedure, any commercial rate should ideally be compared against this figure rather than the inflated chargemaster list. If you encounter a balance bill or unexpected charges, you have the right to dispute the amount with the insurer and request a review under federal protections, ensuring you are not