Sleep study (overnight, in lab)
Facility: Hospital District #6 Patterson Health Center
Billing Code: 95810 (CPT)
- CPT Billing Code: 95810
- Insurance Median: $1,260
- Cash Discount Price: $1,120
- vs. Medicare Baseline: 1.44x 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 |
|---|---|---|
| Blue Cross Blue Shield | $994 - $1,046 | 113% |
| UnitedHealthcare | $1,260 - $1,400 | 144% |
| Providers Care (Wppa)-All Plans | $2,450 | 279% |
Consumer Guidance & Cost Commentary
For CPT code 95810, a sleep study performed overnight in a lab, the facility in Anthony, KS, has a cash median price of $1,120 and a negotiated rate of $1,260. This negotiated amount aligns with the median paid by UnitedHealthcare plans, which range from $1,260 to $1,400. While the facility is a Critical Access Hospital owned by the Government, patients should note that cash payments may sometimes be more cost-effective than using insurance if their plan's negotiated rate exceeds the cash price, particularly for those with high-deductible plans. It is always advisable to confirm with the hospital whether "self-pay" or "prompt-pay" discounts are available before scheduling, as these can further reduce out-of-pocket costs.
The Medicare benchmark for this service is $877.34, which serves as a baseline for evaluating the facility's pricing structure. The facility's cash rate of $1,120 represents a markup of 1.4 times the Medicare amount, while the negotiated rate of $1,260 reflects the typical commercial pricing dynamic where rates often exceed the true cost of delivery. Given that over 80% of hospital bills contain errors, patients should request a detailed, itemized bill rather than accepting a summary invoice to identify any unbundled charges or services not rendered. If a balance bill arises from out-of-network ancillary services, the No Surprises Act may provide protection, but patients should verify their coverage status and deductible requirements before proceeding to avoid unexpected financial liability.