Sleep study (overnight, in lab)
Facility: St Luke Hospital & Living Center
Billing Code: 95810 (CPT)
- CPT Billing Code: 95810
- Insurance Median: $1,244
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.42x 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 |
|---|---|---|
| Bluestem Pace | $1,244 | 142% |
| Blue Cross Blue Shield | $1,244 | 142% |
| Kansas Department Of Health And Environment | $1,244 | 142% |
| UnitedHealthcare | $1,244 | 142% |
| Va Ccn | $1,244 | 142% |
| Humana | $1,244 | 142% |
| Ambetter / Centene | $1,257 | 143% |
Consumer Guidance & Cost Commentary
For CPT code 95810, representing an overnight sleep study at St Luke Hospital & Living Center in Marion, Kansas, the facility's negotiated rates are consistent across all seven payers, ranging from $1,244 to $1,257. This negotiated amount is significantly higher than the Medicare benchmark of $877.34, reflecting a markup of 1.4 times the federal baseline. While commercial insurance contracts often include administrative overhead that inflates these rates, patients with high-deductible plans may find it financially advantageous to pay the cash price directly, as the cash rate is not listed but could potentially be lower than the insurer's allowed amount. It is important to note that the facility is a Critical Access Hospital owned by a Government Hospital District, which may influence its pricing structure compared to private entities.
Before scheduling this service, patients should verify their specific plan details and ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the total cost by 20% to 50% if paid upfront. Although the data does not provide specific cash or median paid figures, understanding that commercial negotiated rates often exceed cash prices is crucial for budgeting. If you are concerned about potential balance billing or billing errors, request a full itemized bill before payment, as over 80% of hospital charges contain mistakes such as unbundled codes or services not rendered. Always confirm your deductible status and ensure you sign a waiver to prevent automatic claims submission if you choose to pay out-of-pocket.