Sleep study (overnight, in lab)
Facility: Republic County Hospital
Billing Code: 95810 (CPT)
- CPT Billing Code: 95810
- Insurance Median: $2,116
- Cash Discount Price: $1,725
- vs. Medicare Baseline: 2.41x 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 241% of the Medicare baseline (a markup of 141%). 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 |
|---|---|---|
| Rural Carriers-All Plans | $1,955 | 223% |
| Meritain-All Plans | $2,070 | 236% |
| Aetna | $2,070 | 236% |
| UnitedHealthcare | $2,116 | 241% |
| Cigna | $2,185 | 249% |
| Midlands Choice-All Plans | $2,185 | 249% |
| First Health-All Plans | $2,185 | 249% |
Consumer Guidance & Cost Commentary
For CPT code 95810, a sleep study performed at Republic County Hospital in Belleville, Kansas, the facility's cash median rate is $1,725, while the negotiated rate paid by insurance carriers averages $2,116. This negotiated amount is notably higher than the cash price, which can be advantageous for patients with high-deductible plans who have not yet met their out-of-pocket maximum, as paying the lower cash rate of $1,725 may result in immediate savings compared to the insurance allowed amount. The facility, a Critical Access Hospital, lists a facility rating of 3 and is owned by a voluntary non-profit private entity.
To ensure you receive the most accurate pricing, it is essential to request an itemized billing audit before finalizing payment, as summary bills often obscure individual charges and may include unbundled codes or services not rendered. Additionally, because the facility offers a cash median rate lower than its negotiated rates, you should explicitly ask about "self-pay" or "prompt-pay" discounts, which can further reduce your bill by bypassing administrative costs associated with insurance claims processing. Always verify your deductible status and confirm that the facility has classified your visit as self-pay prior to scheduling to avoid automatic claims submission that would void any potential cash discounts.