Sleep study (overnight, in lab)
Facility: Goodland Regional Medical Center
Billing Code: 95810 (CPT)
- CPT Billing Code: 95810
- Insurance Median: $2,772
- Cash Discount Price: $2,772
- vs. Medicare Baseline: 3.16x 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 316% of the Medicare baseline (a markup of 216%). 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 | $1,056 | 120% |
| Wppa | $2,618 - $2,772 | 298% |
| UnitedHealthcare | $2,772 | 316% |
Consumer Guidance & Cost Commentary
For this sleep study procedure at Goodland Regional Medical Center, the cash median price is $2,772, which matches the median negotiated rate for in-network payers like Wppa and UnitedHealthcare. While the facility's gross chargemaster lists the service at $3,080, patients with high-deductible plans may find paying the cash price directly more affordable than using insurance, as the negotiated rates often exceed the cash amount. It is important to note that the facility is a Critical Access Hospital in Goodland, Kansas, and while specific state or county average data was not provided in this report, patients should always verify if their specific insurance plan offers a lower allowed amount than the cash price before scheduling.
The Medicare benchmark for this service is $877.34, which serves as a baseline for evaluating the facility's pricing markup. The cash price of $2,772 represents a significant increase over the Medicare rate, reflecting the administrative costs and profit margins inherent in commercial billing. To minimize potential costs, patients should inquire directly with the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full upfront. Additionally, if you have received a bill after using insurance, you should request a detailed, itemized CPT-coded statement rather than accepting a summary bill, as this allows you to identify any errors, unbundled codes, or services not rendered before finalizing payment.