Sleep study (overnight, in lab)
Facility: Trego County Lemke Memorial Hospital
Billing Code: 95810 (CPT)
- CPT Billing Code: 95810
- Insurance Median: $2,646
- Cash Discount Price: $3,298
- vs. Medicare Baseline: 3.02x 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 302% of the Medicare baseline (a markup of 202%). 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 | $1,445 | 165% |
| Humana | $1,901 | 217% |
| Tricare | $2,053 | 234% |
| UnitedHealthcare | $2,406 - $3,880 | 274% |
| Va Ccn - All Plans | $2,406 | 274% |
| Medicaid / KanCare | $2,406 - $3,880 | 274% |
| Aetna | $2,406 - $3,492 | 274% |
| Ambetter / Centene | $2,646 | 302% |
| Health Partners - All Plans | $3,686 | 420% |
| Healthy Blue Mcaid - All Plans | $3,880 | 442% |
Consumer Guidance & Cost Commentary
For the sleep study procedure (CPT 95810) at Trego County Lemke Memorial Hospital in Wakeeney, Kansas, the facility's cash median rate of $3,298.00 is significantly higher than the state average of $2,053.00. While commercial insurance plans like Blue Cross Blue Shield and Humana negotiate rates starting at $1,445 and $1,901 respectively, these negotiated amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying cash directly. It is important to note that while the facility is a Critical Access Hospital owned by the local government, patients should explicitly ask for "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50% by bypassing costly insurance claims processing.
When reviewing your final invoice, ensure you receive a detailed itemized bill rather than a summary statement, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered. Although the facility's gross charge is $3,880.00, comparing this directly to the chargemaster is misleading; instead, use the Medicare benchmark of $877.34 as the true cost baseline, which reveals that commercial rates are often marked up significantly above this federal standard. If you receive a balance bill from an out-of-network provider at this in-network facility, you may have protections under the No Surprises Act, and you should dispute any unexpected charges in writing rather than paying immediately to avoid credit damage.