Sleep study (overnight, in lab)
Facility: Lincoln County Hospital
Billing Code: 95810 (CPT)
- CPT Billing Code: 95810
- Insurance Median: $1,056
- Cash Discount Price: $2,719
- vs. Medicare Baseline: 1.20x 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 | $1,056 | 120% |
Consumer Guidance & Cost Commentary
For this sleep study procedure at Lincoln County Hospital in Lincoln, KS, the cash price of $2,719 is notably lower than the negotiated rate of $1,056 paid by Blue Cross Blue Shield, which is the only payer in this dataset. While the facility is a Critical Access Hospital with government-local ownership, patients with high-deductible plans or those without insurance may find paying the cash price directly more cost-effective than relying on insurance, as the negotiated rate exceeds the cash amount. It is important to note that while the facility offers a cash rate, patients should explicitly ask about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can further reduce the final bill by bypassing administrative processing costs and collection fees.
The Medicare benchmark for this service is $877.34, which serves as a baseline for evaluating the facility's pricing markup. Although the data does not provide specific state or county average comparisons for this exact code, the significant difference between the Medicare rate and the cash price highlights the potential for substantial savings when paying out-of-pocket. Patients should be aware of balance billing risks if they receive care from out-of-network providers, even at an in-network hospital, where the provider might bill the difference between their full chargemaster rate and the insurance allowed amount. To avoid unexpected costs, consumers should request a full itemized bill to verify that all charges are accurate and that no unbundled codes or services not rendered have been included.